Low cardiac output predicts serious gastrointestinal complications after cardiopulmonary bypass operations

2011 ◽  
Vol 59 (S 01) ◽  
Author(s):  
B Schmack ◽  
P Soos ◽  
A Weymann ◽  
G Veres ◽  
B Merkely ◽  
...  
1999 ◽  
Vol 46 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Kevin C. Dennehy ◽  
Jean-Yves Dupuis ◽  
Howard J. Nathan ◽  
J. Earl Wynands

2020 ◽  
pp. 1-7
Author(s):  
Eva M. Marwali ◽  
Putri Caesa ◽  
Muhammad Rayhan ◽  
Poppy S. Roebiono ◽  
Dicky Fakhri ◽  
...  

Abstract Objective: To determine if triiodothyronine alters lactate, glucose, and pyruvate metabolism, and if serum pyruvate concentration could serve as a predictor of low cardiac output syndrome in children after cardiopulmonary bypass procedures. Methods: This study was ancillary to the Oral Triiodothyronine for Infants and Children undergoing Cardiopulmonary bypass (OTICC) trial. Serum pyruvate was measured in the first 48 patients and lactate and glucose were measured in all 208 patients enrolled in the OTICC study on the induction of anaesthesia, 1 and 24 hours post-aortic cross-clamp removal. Patients were also defined as having low cardiac output syndrome according to the OTICC trial protocol. Result: Amongst the designated patient population for pyruvate analysis, 22 received placebo, and 26 received triiodothyronine (T3). Lactate concentrations were nearly 20 times greater than pyruvate. Lactate and pyruvate levels were not significantly different between T3 and placebo group. Glucose levels were significantly higher in the placebo group mainly at 24-hour post-cross-clamp removal. Additionally, lactate and glucose levels peaked at 1-hour post-cross-clamp removal in low cardiac output syndrome and non-low cardiac output syndrome patients, but subsequently decreased at a slower rate in low cardiac output syndrome. Lactate and pyruvate concentrations correlated with glucose only prior to surgery. Conclusion: Thyroid supplementation does not alter systemic lactate/pyruvate metabolism after cardiopulmonary bypass and reperfusion. Pyruvate levels are not useful for predicting low cardiac output syndrome. Increased blood glucose may be regarded as a response to hypermetabolic stress, seen mostly in patients with low cardiac output syndrome.


2012 ◽  
Vol 25 (12) ◽  
pp. 2756-2761 ◽  
Author(s):  
Raul Abella ◽  
Angela Satriano ◽  
Alessandro Frigiola ◽  
Alessandro Varrica ◽  
Antonio DW Gavilanes ◽  
...  

1990 ◽  
Vol 4 (6) ◽  
pp. 83 ◽  
Author(s):  
J.P. Lançon ◽  
H. Rosay ◽  
P. Fontaine ◽  
J.F. Obadia ◽  
J.P. Merle ◽  
...  

Heart ◽  
1980 ◽  
Vol 43 (4) ◽  
pp. 388-392 ◽  
Author(s):  
M Kawamura ◽  
O Minamikawa ◽  
H Yokochi ◽  
S Maki ◽  
T Yasuda ◽  
...  

2021 ◽  
Vol 10 (4) ◽  
pp. 712
Author(s):  
Sarah E. Drennan ◽  
Kathryn Y. Burge ◽  
Edgardo G. Szyld ◽  
Jeffrey V. Eckert ◽  
Arshid M. Mir ◽  
...  

Cardiac surgery employing cardiopulmonary bypass exposes infants to a high risk of morbidity and mortality. The objective of this study was to assess the utility of clinical and laboratory variables to predict the development of low cardiac output syndrome, a frequent complication following cardiac surgery in infants. We performed a prospective observational study in the pediatric cardiovascular ICU in an academic children’s hospital. Thirty-one patients with congenital heart disease were included. Serum levels of nucleosomes and a panel of 20 cytokines were measured at six time points in the perioperative period. Cardiopulmonary bypass patients were characterized by increased levels of interleukin-10, -6, and -1α upon admission to the ICU compared to non-bypass cardiac patients. Patients developing low cardiac output syndrome endured longer aortic cross-clamp time and required greater inotropic support at 12 h postoperatively compared to bypass patients not developing the condition. Higher preoperative interleukin-10 levels and 24 h postoperative interleukin-8 levels were associated with low cardiac output syndrome. Receiver operating characteristic curve analysis demonstrated a moderate capability of aortic cross-clamp duration to predict low cardiac output syndrome but not IL-8. In conclusion, low cardiac output syndrome was best predicted in our patient population by the surgical metric of aortic cross-clamp duration.


2019 ◽  
Vol 18 (3) ◽  
pp. 35-43
Author(s):  
A. O. Marichev ◽  
S. V. Datsenko ◽  
O. V. Deinega ◽  
E. A. Kabakova ◽  
E. S. Kurskova ◽  
...  

Aim – determine a forms of metabolic acidosis (MetAc) after cardiac surgery with cardiopulmonary bypass (CPB). Estimate significance of MetAc in an early postoperative period.Material and methods. We included the 129 adult cardiac surgery patients. We studied the indicators of acid-base blood status, markers of systemic inflammation, an oxygen delivery and consumption, the hemodynamic parameters, the clinical course of the postoperative period.Results. The acid-base disorders were found in 73.6 % of cases. The metabolic acidosis was in 51.2 % of cases: the lactate acidosis was in 92.4 % and the hyperchloremic acidosis was in 7.6 %. The metabolic lactate acidosis was represented by two forms: 1. the acid-base disorders due to a low cardiac output syndrome with a decrease in oxygen delivery and contractility (14.7 %); 2. the lactate acidosis due to a systemic inflammatory response syndrome (49.2 % of cases). It is associated with a high delivery and a low oxygen extraction, increased cardiac output and a vasoplegia. Patients with these disorders had a higher level of leukocytosis after 24 hours of the end the operation, had a longer duration of respiratory support and a long ICU stay and hospital stay.Conclusion. The lactate acidosis is represented by two forms: the lactate acidosis associated with the low cardiac output syndrome and lactate acidosis associated with the systemic inflammatory response. The lactate acidosis is a predictor of adverse outcome after cardiac surgery with CPB and associated with a postoperative complications and a mortality. 


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