Risk factors for low cardiac output syndrome after coronary artery bypass grafting surgery

Sá, Michel Pompeu Barros de Oliveira; Nogueira, Joana Rosa Costa; Ferraz, Paulo Ernando; Figueiredo, Omar Jacobina; Cavalcante, Wagner Cid Palmeira; Cavalcante, Thiago Cid Palmeira; Silva, Hugo Thiago Torres da; Santos, Cecília Andrade; Lima, Renato Oliveira de Albuquerque; Vasconcelos, Frederico Pires; Lima, Ricardo de Carvalho

doi:10.5935/1678-9741.20120037

Cited by 42 publications

(46 citation statements)

References 13 publications

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“…The rate of incomplete revascularization in this study was 6.4%, which was lower than that in previous reports. 11,22) Our result was consistent with a previous study which stated that incomplete revascularization was an independent risk factor for LCOS following CABG.…”

Section: Predictors Of Lcos After Cabgsupporting

confidence: 93%

“…10,11) It was observed that 25.4% of patients who developed LCOS following CABG surgery in our series died. The surgical mortality in those patients suffering from LCOS following CABG in our series was far below other series mentioned above.…”

Section: Discussionmentioning

confidence: 60%

“…[7][8][9] However, few reports have focused on the independent risk factors for LCOS following CABG surgery. 10,11) This study sought to evaluate the predictors of LCOS following CABG surgery by reviewing 1524 consecutive well-documented patients who underwent isolated CABG in our center from January 2010 to December 2013, in order to optimize perioperative risk factors involved in strategies to reduce the incidence of LCOS following CABG surgery.…”

mentioning

confidence: 99%

“…Vol 56 No 2 PREDICTORS OF LCOS AFTER CABG the first hospitalization in the intensive care unit immediately after isolated CABG surgery 11,12) : 1) Need for inotropic support with vasoactive drugs (dopamine 4 μg/kg/minute at least for a minimum of 12 hours and/or dobutamine and/or milrinone and/or epinephrine and/or noradrenaline) or mechanical circulatory support with an intra-aortic balloon pump to maintain systolic blood pressure greater than 90 mmHg after correction of all electrolytes and blood gas abnormalities while adjusting preload volume to its optimal values; 2) Signs of impairment of body perfusion (cold extremities, hypotension, oliguria or anuria, lowered level of consciousness, or a combination of these signs) after correction of all electrolytes and blood gas abnormalities while adjusting preload volume to its optimal values. Subjects: After approval by the ethics committee, in accordance with the "Declaration of Helsinki", we reviewed the records of consecutive well-documented patients undergoing isolated CABG in our center from January 2010 to December 2013.…”

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confidence: 99%

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Predictors of Low Cardiac Output Syndrome After Isolated Coronary Artery Bypass Grafting

Ding

Shi

et al. 2015

Int. Heart J.

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SummaryLow cardiac output syndrome (LCOS) is one of the most important complications following coronary artery bypass grafting (CABG) and results in higher morbidity and mortality. However, few reports have focused on the predictors of LCOS following CABG. This study aimed to evaluate the predictors of LCOS following isolated CABG through the review of 1524 consecutive well-documented patients in a single center, retrospective trial.The relevant preoperative and intraoperative data of patients with complete information from medical records undergoing isolated CABG from January 2010 to December 2013 in our center were investigated and retrospectively analyzed. LCOS was considered when the following criteria were met: signs of impairment of body perfusion and need for inotropic support with vasoactive drugs or mechanical circulatory support with an intra-aortic balloon pump to maintain systolic blood pressure greater than 90 mmHg.LCOS developed in 205 patients following CABG, accounting for 13.5% of the total population. The in-hospital mortality in the LCOS group was significantly higher than that in the non-LCOS group (25.4% versus 1.8%, P < 0.0001). In addition to the length of ICU stay and postoperative hospital stay, LCOS was correlated with negative cerebral, respiratory and renal outcomes. Through univariate analysis and then logistic regression analysis, the predictors of LCOS following CABG included older age (age > 65 years) (OR = 1.85, 95%CI 1.27-3.76), impaired left ventricular function (OR = 2.05, 95%CI 1.53-4.54), on-pump CABG (OR = 2.16, 95%CI 1.53-4.86), emergent CPB (OR = 9.15, 95%CI 3.84-16.49), and incomplete revascularization (OR = 2.62, 95%CI 1.79-5.15).LCOS following isolated CABG caused higher mortality, higher rates of morbidity, and longer ICU and postoperative hospital stays. Older age, impaired left ventricular function, on-pump CABG, emergent CPB, and incomplete revascularization were identified as 5 predictors of LCOS following isolated CABG surgery. (Int Heart J 2015; 56: 144-149)

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Section: Predictors Of Lcos After Cabgsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 60%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Predictors of Low Cardiac Output Syndrome After Isolated Coronary Artery Bypass Grafting

Ding

Shi

et al. 2015

Int. Heart J.

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“…Presence of any CVD was used as a binary variable in the analysis regardless of the haemodynamic significance. Chronic obstructive pulmonary disease (COPD) was considered present for patients with dyspnea or chronic cough and prolonged use of bronchodilators or corticosteroids and/or compatible radiological changes (hypertransparency by hyperinflation and/or retraction of ribs and/or retraction diaphragm) (4). Diabetes was present when the patient was diagnosed before and/or on hypoglycemic medication.…”

Section: Methodsmentioning

confidence: 99%

Readmission To Intensive Care Unit After Coronary Bypass Operations in the Short Term

Gümüş¹,

Polat²,

Yektaş³

et al. 2014

Turk J Anesth Reanim

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Objective: Intensive care unit (ICU) readmissions after coronary bypass (CABG) operations occur in a significant number of patients, and the prognosis is poor. We analyzed the risk factors for ICU readmissions after CABG operations. Methods:We retrospectively analyzed the prospectively collected data of 679 coronary bypass patients operated in a single institution in order to evaluate the risk factors for readmittance to the ICU with logistic regression analysis. The outcome results of patients readmitted to the ICU (Group R) and others (Group N) were compared.Results: Thirty-six (5.3%) patients were readmitted to the ICU. Postoperative in-hospital mortality and pulmonary and neurologic morbidity occurred in 43 (6.3%), 135 (19.9%), and 46 (6.8%) patients, respectively. The comparison of groups showed that mortality and morbidity were significantly higher in Group R compared to Group N (mortality 16.7% vs. 5.9, p=0.029; pulmonary morbidity 66.7% vs. 17.3%, p=0.0001; neurologic morbidity 38.9% vs. 5.0%, p=0.0001). Features associated with readmission included presence of left ventricular dysfunction preoperatively[odds ratio (OR)=4.1; 95% confidence interval (CI)=1.4-12.5; p=0.013], advanced NYHA Class (OR=5.3; 95% CI=1.3-21.7; p=0.022), pulmonary complications (OR=7.3; 95% CI=2.1-25.5; p=0.002), and neurologic complications (OR=4.6; 95% CI=1.3-16.7; p=0.021). Conclusion:Patients readmitted to the ICU postoperatively have higher rates of mortality and pulmonary and neurologic morbidity after coronary bypass operations. Left ventricular dysfunction, advanced NYHA class, and postoperative pulmonary and neurologic complications are significant risk factors for readmission to the ICU.Key Words: Coronary artery bypass, readmission, intensive care, risk factors Abstract Introduction I n the postoperative recovery period, intensive care unit (ICU) stay is necessary after coronary bypass (CABG) operations in the majority of centers. Particularly, the first few hours are critical for the risk of myocardial ischemia (1). Numerous postoperative problems have to be addressed correctly in this early postoperative period, such as hypertension, arrhythmias, bleeding, and so forth. Patients are transferred to the ICU on mechanical ventilation, and the sedated and intubated patient requires extreme caution during ICU care and extubation.During the recovery period, however, some problems may be encountered, so that patients may have to be readmitted to the ICU. Readmission to the ICU is associated with worse outcome (2). There are studies analyzing ICU readmissions in cardiac surgery patients (1-3); however, they are mostly focused on the fast track protocols. In our clinic, fast track protocols are not employed. Again, ICU readmissions occur in a significant number of patients, and the prognosis is also poor. We analyzed the risk factors for ICU readmissions after a heterogeneous group of CABG operations in a single institution. MethodsAfter approval by the institutional ethics board (Bağcılar Training and Research Hospital, Nonin...

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Complications of Coronary Artery Bypass Grafting Surgery

Khorsandi¹,

Shaikhrezai²,

Zamvar³

2015

PanVascular Medicine

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Risk factors for low cardiac output syndrome after coronary artery bypass grafting surgery

Cited by 42 publications

References 13 publications

Predictors of Low Cardiac Output Syndrome After Isolated Coronary Artery Bypass Grafting

Predictors of Low Cardiac Output Syndrome After Isolated Coronary Artery Bypass Grafting

Readmission To Intensive Care Unit After Coronary Bypass Operations in the Short Term

Complications of Coronary Artery Bypass Grafting Surgery

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