Clinical and echocardiographic factors associated with the postoperative low cardiac output in patients with cardiovascular surgical treatment
Keywords:
low cardiac output, ventricular dysfunction, heart surgical intervention, extracorporeal circulation.Abstract
Introduction: Among the different complications that arise in the immediate postoperative period, the low cardiac output presents higher associated morbidity and mortality, with an incidence of up to 45.0 %.
Objective: To determine the factors related to the postoperative emergence of the low cardiac output in patients with cardiovascular surgical treatment and extracorporeal circulation, according to demographic, clinical and echocardiographic variables.
Methods: An analytic, cases and controls investigation was carried out, which included patients that received heart surgical treatment in the Cardiology and Cardiovascular Surgery Service of Saturnino Lora Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba, from January to December, 2019. Each study group was conformed by 43 members, for which was considered the presence (cases) or not (controls) of the low cardiac output syndrome.
Results: In the series there was a prevalence of the patients under 65 years in both study groups (51.2 and 73.5 % for cases and controls, respectively), as well as the male sex (60.9 %); in a same way, the emergency surgical intervention was the most frequent (80.2 %). The atrial fibrillation and the systolic function of the right ventricle presented high statistical significance (p <0.05).
Conclusions: Some clinical and echocardiographic elements (age, atrial fibrillation, systolic function of the left and right ventricles, as well as emergency surgical intervention) were associated in an independent way with the emergence of the low cardiac output.
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2. Ahn HJ, Lee JW, Joo KH, You YH, Ryu S, Lee JW, et al. Point of care ultrasound guided percutaneous cannulation of extracorporeal membrane oxygenation: Make it simple. J Emerg Med. 2018;54(4):507-13.
3. Perez Vela JL, Martín Benitez JC, Carrasco Gonzalez M, de la Cal López MA, Hinojosa Pérez R, Sagredo Meneses V, et al. Summary of the consensus document: "Clinical practice guide for the management of low cardiac output syndrome in the postoperative period of heart surgery". Med Intensiva. 2012 [citado 06/10/2022];36(4):277-87. Disponible en: https://www.medintensiva.org/es-pdf-S2173572712000781
4. Wood KL, Ayers B, Gosev I, Kumar N, Melvin AL, Barrus B, et al. Venoarterial extracorporeal membrane oxygenation without routine systemic anticoagulation decreases adverse events. Ann Thorac. Sur. 2020; 109(5): 1458-66.
5. Ad N, Luc JGY, Nguyen TC. Cardiac surgery in North America and coronavirus disease 2019 (COVID-19): Regional variability in burden and impact. J Thorac Cardiovasc Surg. 2021; 162(3):893-903.
6. Cuerpo Caballero G, Carnero Alcázar M, López Menéndez J, Centella Hernández T, Polo López L, García Fuster R, et al. Cirugía cardiovascular en España en el año 2020. Registro de intervenciones de la Sociedad Española de Cirugía Cardiovascular y Endovascular. Cirugia Cardiovasc. 2022 [citado 06/10/2022];29(4):207-20. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9157242/
7. Bertini P, Guarracino F. Anticoagulation in extracorporeal membrane oxygenation: still a challenge. Minerva Anestesiol. 2020; 86:7-8.
8. Vera Rivero DA, Chirino Sánchez L, Yanes García R. Orígenes y desarrollo histórico de la cirugía cardiovascular en Cuba durante el siglo XX. Acta Médica del Centro. 2020;14(1):133-41.
9. Kacila M, Tiwari KK, Granov N, Edin Omerbašić, Slavenka Štraus. Assessment of the initial and modified Parsonnet score in mortality prediction of the patients operated in the Sarajevo heart center. Bosn J Basic Med Sci. 2010;10(2): 165-68.
10. Fernández Mesa JE, Padrón García KM, Paredes Cordero ÁM, Díaz Vázquez E, González Greck O, González Trujillo A. Predictores de bajo gasto cardíaco perioperatorio en pacientes operados de cirugía cardíaca valvular. CorSalud. 2018 [citado 06/10/2022];10(4):286-93. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/389/808
11. Lorenzo S. Síndrome de bajo gasto cardíaco en el posoperatorio de cirugía cardíaca. Rev Urug Cardiol. 2020 [citado 06/10/2022];35(3):292-321. Disponible en: http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S1688-04202020000300292&lng=es
12. Pérez Vela JL, Jiménez Rivera JJ, Alcalá Llorente MA, González de Marcos B, Torrado H, García Laborda C, et al. Síndrome de bajo gasto cardiaco en el postoperatorio de cirugía cardiaca. Perfil, diferencias en evolución clínica y pronóstico. Estudio ESBAGA. Med Intensiva. 2018 [citado 06/10/2022];42(3):159-67. Disponible en: https://www.medintensiva.org/es-pdf-S0210569117301997
13. Martínez Clavel LL, Dávila Cabrera SF, Nodal Leyva PE, Hernández Román MA, de Arazoza Hernández A, Alonso Valdéz J. Caracterización de la mortalidad en cirugía cardiaca. Rev Cubana Cardiol Cir Cardiovasc. 2020;26(1):2-9.
14. Zarragoikoetxea Jauregui I. Evaluación de nuevas estrategias diagnósticas en el síndrome de bajo gasto cardíaco postoperatorio [tesis doctoral]. Valencia: Universidad de Valencia; 2019.
15. Cubides Núñez RA. Complicaciones en pacientes intervenidos por reemplazo valvular aórtico en el Hospital Universitario Mayor Mederi 2015 - 2018 [tesis de especialidad]. Bogotá: Universidad del Rosario; 2020 [citado 06/10/2022]. Disponible en: https://repository.urosario.edu.co/bitstream/handle/10336/25571/COMPLICACIONES-EN-PACIENTES-INTERVENIDOS-POR-REEMPLAZO-VALVULAR-AoRTICO-EN-EL-HOSPITAL-UNIVERSITARIO-MAYORMEDERI-2015-%E2%80%93-2018-.pdf?sequence=1
16. Gómez Núñez K, Hechavarría Pouymiró Sh, Pérez López H, Arazoza Hernández A, Nápoles Sierra I. Fibrilación auricular post operatoria en cirugía valvular en los años. Rev Cuba Cardiol Cir Cardiovasc. 2020;26(3):1561-2937.
17. Sepúlveda FA, Jiménez LM, Castro HD, Castro JA, Canas EM, Hidalgo JE, et al. Predictores de requerimiento intraoperatorio de soporte inotrópico y/o vasopresor en cirugía de revascularización miocárdica. Rev Chil Anest. 2021 [citado 06/10/2022];50(6). Disponible en: https://revistachilenadeanestesia.cl/revchilanestv5005101106/
18. Li Z, Zhang GB, Li TW, Zhang Y, Li MD, Wu Y. Risk factors of low cardiac output syndrome after cardiac valvular surgery in elderly patients with valvular disease complicated with giant left ventricle. Zhonghua Xin Xue Guan Bing Za Zhi. 2021;49(4):368-73.
19. Burstein B, Anand V, Ternus B, Tabi M, Anavekar NS, Borlaug BA, et al. Noninvasive echocardiographic cardiac power output predicts mortality in cardiac intensive care unit patients. Am Heart J. 2022;245:149-59.
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