Risk factors for poor outcome after ECMO treatment of low cardiac output after cardiac surgery

2007 ◽  
Vol 55 (S 1) ◽  
Author(s):  
S Deiters ◽  
H Welp ◽  
J Graf ◽  
A Löher ◽  
S Schneider ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Output ◽  
Cardiac Surgery ◽  
Low Cardiac Output ◽  
Poor Outcome ◽  
Ecmo Treatment

Low cardiac output state in a postoperative cardiac patient

2020 ◽  
pp. 153-166
Author(s):  
Arun Ghose ◽  
Adrian Plunkett
Keyword(s):  
Risk Factors ◽  
Cardiac Output ◽  
Cardiac Surgery ◽  
Measurement Techniques ◽  
Surgical Patients ◽  
Low Cardiac Output ◽  
Output State ◽  
Cardiac Lesions ◽  
Systolic And Diastolic Function

Chapter 13 covers the low cardiac output state (LCOS) in children following cardiac surgery. It begins by explaining how LCOS is defined, risk factors for its development, and how to assess and investigate a child with LCOS. The role of echocardiography is discussed, and the limitations of other measurement techniques are examined. Modifiable causes of LCOS in postoperative cardiac surgical patients are examined, including residual cardiac lesions and arrhythmias—and their management discussed. Important physiological concepts in the understanding of LCOS are addressed, including preload, afterload, systolic and diastolic function, and fluid responsiveness. Finally, options for managing patients with LCOS are covered, including the role of drugs, surgery, and extracorporeal membrane oxygenation.

Blood gas analysis in newborns with low cardiac output syndrome after cardiac surgery.

2018 ◽  
Vol 19 (5) ◽  
pp. 676-687
Author(s):  
G.G. Khubulava ◽  
A.B. Naumov ◽  
S.P. Marchenko ◽  
O.Yu. Chupaeva ◽  
A.A. Seliverstova ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Cardiac Surgery ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Low Cardiac Output Syndrome ◽  
Low Cardiac Output

scholarly journals Dobutamine-sparing versus dobutamine-to-all strategy in cardiac surgery: a randomized noninferiority trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rafael Alves Franco ◽  
Juliano Pinheiro de Almeida ◽  
Giovanni Landoni ◽  
Thomas W. L. Scheeren ◽  
Filomena Regina Barbosa Gomes Galas ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Cardiac Surgery ◽  
Prolonged Mechanical Ventilation ◽  
Kidney Injury ◽  
Composite Endpoint ◽  
Tissue Perfusion ◽  
Hospital Length Of Stay ◽  
Low Cardiac Output Syndrome ◽  
Low Cardiac Output ◽  
Noninferiority Trial

Abstract Background The detrimental effects of inotropes are well-known, and in many fields they are only used within a goal-directed therapy approach. Nevertheless, standard management in many centers includes administering inotropes to all patients undergoing cardiac surgery to prevent low cardiac output syndrome and its implications. Randomized evidence in favor of a patient-tailored, inotrope-sparing approach is still lacking. We designed a randomized controlled noninferiority trial in patients undergoing cardiac surgery with normal ejection fraction to assess whether an dobutamine-sparing strategy (in which the use of dobutamine was guided by hemodynamic evidence of low cardiac output associated with signs of inadequate tissue perfusion) was noninferior to an inotrope-to-all strategy (in which all patients received dobutamine). Results A total of 160 patients were randomized to the dobutamine-sparing strategy (80 patients) or to the dobutamine-to-all approach (80 patients). The primary composite endpoint of 30-day mortality or occurrence of major cardiovascular complications (arrhythmias, acute myocardial infarction, low cardiac output syndrome and stroke or transient ischemic attack) occurred in 25/80 (31%) patients of the dobutamine-sparing group (p = 0.74) and 27/80 (34%) of the dobutamine-to-all group. There were no significant differences between groups regarding the incidence of acute kidney injury, prolonged mechanical ventilation, intensive care unit or hospital length of stay. Discussion Although it is common practice in many centers to administer inotropes to all patients undergoing cardiac surgery, a dobutamine-sparing strategy did not result in an increase of mortality or occurrence of major cardiovascular events when compared to a dobutamine-to-all strategy. Further research is needed to assess if reducing the administration of inotropes can improve outcomes in cardiac surgery. Trial registration ClinicalTrials.gov, NCT02361801. Registered Feb 2nd, 2015. https://clinicaltrials.gov/ct2/show/NCT02361801

HEMODYNAMIC EFFECTS OF HYDROCORTISONE IN NEONATES WITH LOW CARDIAC OUTPUT SYNDROME AFTER CARDIAC SURGERY

2004 ◽  
Vol 32 (Supplement) ◽  
pp. A49
Author(s):  
Heather Dickerson ◽  
Antonio R Mott ◽  
Jack F Price ◽  
Anthony C Chang ◽  
Pertti K Suominen ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Cardiac Surgery ◽  
Hemodynamic Effects ◽  
Low Cardiac Output Syndrome ◽  
Low Cardiac Output

Cardiovascular System

2015 ◽  
pp. 423-450
Author(s):  
Wolf Benjamin Kratzert ◽  
Eva Katherine Boyd
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Output ◽  
Cardiac Surgery ◽  
Pericardial Tamponade ◽  
Right Ventricular Failure ◽  
Orthotopic Heart Transplantation ◽  
Low Cardiac Output Syndrome ◽  
Future Directions ◽  
Low Cardiac Output ◽  
Hemodynamic State

This chapter addresses underlying physiology, diagnostics, and management of common cardiovascular abnormalities in the patient after cardiac surgery. The goal is to provide insights into daily management, areas of controversy, and future directions in the field. After reviewing basic physiologic principles of cardiac output and circulation; problems affecting the postoperative hemodynamic state will be addressed individually. Specific topics include the low cardiac output syndrome, right ventricular failure, myocardial ischemia, diastolic dysfunction, vasodilatory syndrome, rhythm disturbances, pericardial tamponade, and cardiac arrest. Patients with postoperative open chests, or after orthotopic heart transplantation are also discussed.

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