The long-term effects of prolonged intensive care stay post-cardiac surgery

Pathology of Hyperlactatemia and lactic acidosis is convoluted, including tissue hypoxia, pulmonary abnormalities, Ischemic shock, hypohemoglobinemia and generalized an-aerobic conditions. All or any one of these conditions may have occurred due to surgical intervention, long-term cardiogeneic syndromes or after long Intensive care stay. Present study described the assessment and correlation of post-operative Hyperlactatemia in cardiac surgery patients to the longer length of stay in Intensive care units (ICUs). Pre-operative and Post operative blood samples were analyzed in seventy five (Males = 59, females = 16) cardiac surgery patients for Lactate and other biochemical parameters were according to the prescribed methods. Post-operative blood sample analyses were also performed 4-6 hrs after surgery and after 24 hrs post-operatively. Six hours postoperative assessment of lactate, showed alerted levels, manifesting post-operative complications and development of co-morbid. It was also noted that patients (n = 21) with higher lactate >20mg/dl had to stay longer in ICUs (12-18 days stay, average 16.15 ± 2.50 days) as compared to those (n = 54) with normal range of lactate level (5-9 days stay, average 7.20 ± 2.10 days). It is thus concluded that post-operative Hyperlactatemia and lactic acidosis in cardiac surgery patients is a significant condition to detect poor outcome. Additionally post-operative lactate level can predict length of stay in ICUs and any prospect of developing adverse outcome and co-morbid.

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Survival after cardiac surgery and long-term intensive care unit stay

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0032-1332330 ◽

2013 ◽

Vol 61 (S 01) ◽

Author(s):

C Schimmer ◽

K Hamouda ◽

M Özkur ◽

SP Sommer ◽

I Aleksic ◽

...

Keyword(s):

Intensive Care Unit ◽

Cardiac Surgery ◽

Intensive Care ◽

Intensive Care Unit Stay

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Long Term Renal Outcomes in Children with Acute Kidney Injury Post-Cardiac Surgery

Kidney International Reports ◽

10.1016/j.ekir.2021.04.018 ◽

2021 ◽

Author(s):

Sidharth Kumar Sethi ◽

Rajesh Sharma ◽

Aditi Gupta ◽

Abhishek Tibrewal ◽

Romel Akole ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Kidney Injury ◽

Renal Outcomes ◽

Post Cardiac Surgery

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The influence of prolonged intensive care stay on quality of life, recovery, and clinical outcomes following cardiac surgery: A prospective cohort study

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2018.05.076 ◽

2018 ◽

Vol 156 (5) ◽

pp. 1906-1915.e3 ◽

Cited By ~ 9

Author(s):

Mohammad S. Diab ◽

Rajdeep Bilkhu ◽

Gopal Soppa ◽

Mark Edsell ◽

Nick Fletcher ◽

...

Keyword(s):

Quality Of Life ◽

Cardiac Surgery ◽

Cohort Study ◽

Intensive Care ◽

Clinical Outcomes ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Intensive Care Stay

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Prognostic Value of GDF-15 in Predicting Prolonged Intensive Care Stay following Cardiac Surgery: A Retrospective Case-Control Study

10.21203/rs.3.rs-194462/v1 ◽

2021 ◽

Author(s):

Henry Barton ◽

Elisabeth Zechendorf ◽

Dirk Ostareck ◽

Antje Ostareck-Lederer ◽

Christian Stoppe ◽

...

Keyword(s):

Cardiac Surgery ◽

Intensive Care ◽

Confidence Interval ◽

Prediction Models ◽

Unit Length ◽

Icu Stay ◽

Intensive Care Stay ◽

Cardio Pulmonary Bypass ◽

Prolonged Icu Stay ◽

Pulmonary Bypass

Abstract Background: Predicting intensive care unit length of stay and outcome following cardiac surgery is currently based on clinical parameters. Novel biomarkers could be employed to improve the prediction models. Methods: We performed a qualitative cytokine screening array to identify highly expressed biomarkers in preoperative blood samples of cardiac surgery patients. After identification of one highly expressed biomarker, growth differentiation factor 15 (GDF-15), a quantitative ELISA was undertaken. Preoperative levels of GDF-15 were compared in regard to duration of intensive care stay, cardio-pulmonary bypass time and indicators of organ dysfunction.Results: Preoperatively, GDF-15 was highly expressed in addition to several less highly expressed other biomarkers. After qualitative analysis we could show that preoperatively raised levels of GDF-15 was positively associated with prolonged ICU stay exceeding 48 h (median 713 versus 1041 pg/ml, p = 0.003). It was also associated with prolonged mechanical ventilation and rates of severe sepsis but not with dialysis rates or cardio-pulmonary bypass time. In univariate regression, raised GDF-15 levels were predictive of a prolonged ICU stay (OR 1.01, 95% Confidence Interval 1 – 1.02, p= 0.029). On ROC curves, GDF-15 was found to predict prolonged ICU stay (AUC= 0.86, 95% Confidence Interval 0.71 – 0.99, p= 0.003).Conclusion: GDF-15 showed potential as predictor of prolonged intensive care stay following cardiac surgery, which might be valuable for risk stratification models.

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Effect of Sleep Disorder on Delirium in Post-Cardiac Surgery Patients

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2020.62 ◽

2020 ◽

Vol 47 (5) ◽

pp. 627-633 ◽

Cited By ~ 2

Author(s):

Hongbai Wang ◽

Liang Zhang ◽

Qipeng Luo ◽

Yinan Li ◽

Fuxia Yan

Keyword(s):

Intensive Care Unit ◽

Logistic Regression ◽

Regression Analysis ◽

Cardiac Surgery ◽

Intensive Care ◽

Sleep Quality ◽

Sleep Disorder ◽

Logistic Regression Analysis ◽

Univariate Analysis ◽

Post Cardiac Surgery

ABSTRACT:Background:Post-cardiac surgery patients exhibit a higher incidence of postoperative delirium (PD) compared to non-cardiac surgery patients. Patients with various cardiac diseases suffer from preoperative sleep disorder (SPD) induced by anxiety, depression, breathing disorder, or other factors.Objective:To examine the effect of sleep disorder on delirium in post-cardiac surgery patients.Methods:We prospectively selected 186 patients undergoing selective cardiac valve surgery. Preoperative sleep quality and cognitive function of all eligible participants were assessed through the Pittsburgh Sleep Quality Index (PSQI) and the Montreal Cognitive Assessment, respectively. The Confusion Assessment Method for Intensive Care Unit was used to assess PD from the first to seventh day postoperatively. Patients were divided into two groups according to the PD diagnosis: (1) No PD group and (2) the PD group.Results:Of 186 eligible patients, 29 (15.6%) were diagnosed with PD. A univariate analysis showed that gender (p = 0.040), age (p = 0.009), SPD (p = 0.008), intraoperative infusion volume (p = 0.034), postoperative intubation time (p = 0.001), and intensive care unit stay time (p = 0.009) were associated with PD. A multivariate logistic regression analysis demonstrated that age (odds ratio (OR): 1.106; p = 0.001) and SPD (OR: 3.223; p = 0.047) were independently associated with PD. A receiver operating characteristic curve demonstrated that preoperative PSQI was predictive of PD (area under curve: 0.706; 95% confidence interval: 0.595–0.816). A binomial logistic regression analysis showed that there was a significant association between preoperative 6 and 21 PSQI scores and PD incidence (p = 0.009).Conclusions:Preoperative SPD was significantly associated with PD and a main predictor of PD.

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