Association Between Arterial Carbon Dioxide Tension and Outcome in Patients Admitted to the Intensive Care Unit After Coronary Artery Bypass Surgery

2017 ◽  
Vol 61 (3) ◽  
pp. 59
Author(s):  
J. H. Choi ◽  
E. H. Lee ◽  
M. S. Jang ◽  
D. H. Jeong ◽  
M. K. Kim
Keyword(s):  
Carbon Dioxide ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Carbon Dioxide Tension ◽  
Arterial Carbon Dioxide Tension

Impact of postoperative hypothermia on outcomes after off-pump coronary artery bypass grafting

2021 ◽  
pp. 021849232110195
Author(s):  
Vasileios Ntinopoulos ◽  
Nestoras Papadopoulos ◽  
Achim Haeussler ◽  
Dragan Odavic ◽  
Patricia Fodor ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Coronary Artery ◽  
Propensity Score ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

Background Even though the physiological derangements caused by hypothermia are well described, there is no consensus about its impact on postoperative outcomes. The aim of this study is to assess the effect of postoperative hypothermia on outcomes after off-pump coronary artery bypass surgery. Methods A total of 1979 patients undergoing isolated off-pump coronary artery bypass surgery in a single center in the period 2007–2018 were classified according to their axillary temperature measurement at intensive care unit admission postoperatively to either hypothermic (<36°C) or normothermic (≥36°C). Between-group differences on baseline characteristics and postoperative outcomes were assessed before and after propensity score matching. Results Data analysis showed that 582 patients (29.4%) were hypothermic (median temperature 35.5°C) and 1397 patients (70.6%) were normothermic (median temperature 36.4°C). Using propensity score matching, 567 patient pairs were created. Patients with hypothermia exhibited a higher rate of postoperative transfusion of at least three red cell concentrate units (14.3% vs 9%, p = 0.005), a longer intubation duration (median duration, 6 vs 5 h, p < 0.0001), and a longer intensive care unit stay (median stay, 1.6 vs 1.3 days, p = 0.008). There was no difference in reoperation for bleeding, renal replacement therapy, infections, and mortality between the two groups. Conclusions Even though associated with a higher blood transfusion requirement and a slightly longer intensive care unit stay, mild postoperative hypothermia was not associated with a higher morbidity and mortality.

Is Off-Pump Coronary Artery Bypass Surgery Superior to On-Pump Coronary Artery Bypass Surgery on Postoperative Paradoxical Ventricular Septal Motion?

2014 ◽  
Vol 17 (4) ◽  
pp. 191 ◽  
Author(s):  
Murat Günday ◽  
Mete Alpaslan ◽  
Özgür Çiftçi ◽  
Mehmet Özülkü ◽  
Gülay Çopur ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Off Pump ◽  
Pump Coronary Artery Bypass ◽  
Septal Motion

<p><strong>Background</strong>: The aims of this study were to investigate the appearance of paradoxical ventricular septal motion (PSM) after coronary artery bypass graft (CABG) surgery and to identify factors that might be related to this abnormality.</p><p><strong>Methods</strong>: This prospective study included 119 consecutive patients (38 women, 81 men) who underwent CABG. Patients who underwent on-pump surgery (22 women, 45 men) and patients who underwent off-pump surgery (16 women, 36 men) were studied separately. All subjects underwent preoperative angiographic septal perfusion evaluation, pre- and postoperative echocardiography, and standard electrocardiographic and laboratory investigations, including troponin I and CK-MB levels. Multivariate logistic regression analysis was also performed for a variety of related parameters.</p><p><strong>Results</strong>: Significant differences in EuroSCORE, length of intensive care unit stay, length of hospital stay, PSM (assessed using echocardiography), septal perfusion (observed using preoperative angiography), postoperative pleural effusion, and intensive care unit recidivism were observed between the two groups (<em>P</em> &lt; .05). Moreover, postoperative PSM was correlated with septal perfusion (<em>r</em> = -0.687<sup>**</sup>, <em>P</em> &lt; .001), type of operation (<em>r</em> = -0.194<sup>*</sup>, <em>P</em> = .035), diabetes mellitus (<em>r</em> = 0.273<sup>**</sup>, <em>P</em> = .003), carotid stenosis (<em>r</em> = 0.235<sup>*</sup>, <em>P</em> = .011), the number of distal anastomoses (<em>r</em> = 0.245<sup>**</sup>, <em>P</em> = .008), pleural effusion (<em>r</em> = 0.193<sup>*</sup>, <em>P</em> = .037), and intensive care unit recidivism (<em>r</em> = 0.249<sup>**</sup>, <em>P</em> = .007). However, multivariate analysis demonstrated that only preoperative septal perfusion (odds ratio: 0.037; 95% confidence interval: 0.011-0.128; <em>P</em> &lt; .05) constitutes an independent risk factor for PSM (<em>P</em> &lt; .05).</p><p><strong>Conclusions</strong>: This study demonstrated that preoperative septal perfusion deficiency represents an independent risk factor for postoperative PSM in patients undergoing CABG. Further investigations addressing the timing of the appearance of PSM and the correlation of this finding with perfusion imaging studies may provide new details concerning the mechanisms that underlie this abnormality.</p>

Outcome after coronary artery bypass surgery with miniaturized versus conventional cardiopulmonary bypass

Perfusion ◽  
2008 ◽  
Vol 23 (6) ◽  
pp. 361-367 ◽  
Author(s):  
R Rimpiläinen ◽  
F Biancari ◽  
JO Wistbacka ◽  
P Loponen ◽  
SP Koivisto ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Potential Efficacy ◽  
Risk Patients

We have reviewed the results of our experience with the use of miniaturized (Mini-CPB) versus conventional (C-CPB) cardiopulmonary bypass in coronary artery bypass surgery (CABG). This study included 365 patients who underwent CABG with C-CPB and 101 patients with Mini-CPB. In-hospital mortality was lower in the C-CPB group (1.4% vs. 3.0%, P = 0.38). A better, but not statistically significant, immediate outcome was observed in the C-CPB group as indicated by a shorter length of stay in the intensive care unit as well as a lower incidence of combined adverse end-point. However, this was probably due to significantly higher operative risk in the Mini-CPB group (logistic EuroSCORE: 8.5 ± 10.0 vs. 4.6 ± 7.1, P < 0.0001). Seventy-seven propensity score-matched pairs had similar immediate postoperative results after Mini-CPB and C-CPB (30-day mortality: 1.3% vs. 1.3%; stroke: 0% vs. 0%; intensive care unit stay ≥5 days: 6.5% vs. 9.1%; combined adverse events: 14.3% vs. 11.7%). Mini-CPB achieves similar results to C-CPB in patients undergoing isolated CABG. The potential efficacy of Mini-CPB is expected to be more evident in high-risk patients or in complex cardiac surgery requiring much longer cardiopulmonary perfusion.

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