دورية أكاديمية
أعرض في EDS

Prolonged cardiovascular pharmacological support and fluid management after cardiac surgery.

التفاصيل البيبلوغرافية
العنوان: Prolonged cardiovascular pharmacological support and fluid management after cardiac surgery.
المؤلفون: Kontar L; Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.; Division of Intensive Care Unit, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.; Medical Intensive Care Unit, Centre Hospitalier Universitaire d'Amiens, Amiens, France., Beaubien-Souligny W; Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.; Division of Nephrology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada., Couture EJ; Department of Anesthesiology and Intensive Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec, Quebec, Canada., Jacquet-Lagrèze M; Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada., Lamarche Y; Department of Surgery, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada., Levesque S; Montreal Health Innovations Coordinating Centre, Montreal Heart Institute, Montreal, Quebec, Canada., Babin D; Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada., Denault AY; Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.; Division of Intensive Care Unit, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
المصدر: PloS one [PLoS One] 2023 May 11; Vol. 18 (5), pp. e0285526. Date of Electronic Publication: 2023 May 11 (Print Publication: 2023).
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Cardiac Surgical Procedures*/adverse effects , Cardiovascular Agents*, Adult ; Humans ; Prospective Studies ; Stroke Volume ; Ventricular Function, Left ; Cardiopulmonary Bypass/adverse effects
مستخلص: Objective: To identify potentially modifiable risk factors related to prolonged cardiovascular pharmacological support after weaning from cardiopulmonary bypass (CPB).
Methods: This is a secondary analysis of two prospective cohort study in a specialized cardiac surgery institution in adult patients undergoing cardiac surgery with the use of CPB between August 2016 and July 2017. Prolonged cardiovascular pharmacological support was defined by the need for at least one vasopressor or one inotropic agent 24 hours after separation from CPB. Risk factors were identified among baseline characteristics and peri-operative events through multivariable logistic regression.
Results: A total of 247 patients were included and 98 (39.7%) developed prolonged pharmacological support. In multivariable analysis, left ventricular ejection fraction ≤ 30% (OR 9.52, 95% confidence interval (CI) 1.14; 79.25), elevated systolic pulmonary artery pressure (sPAP) > 30 and ≤ 55 mmHg (moderate) (OR 2.52, CI 1.15; 5.52) and sPAP > 55 mmHg (severe) (OR 8.12, CI 2.54; 26.03), as well as cumulative fluid balance in the first 24 hours after surgery (OR 1.76, CI 1.32; 2.33) were independently associated with the development of prolonged pharmacological support.
Conclusions: Prolonged cardiovascular pharmacological support is frequent after cardiac surgery on CPB. Severe LV systolic dysfunction, preoperative pulmonary hypertension and postoperative fluid overload are risk factors. Further studies are required to explore if those risk factors could be modified or not.
Competing Interests: Dr. Denault is on the Speakers Bureau for CAE Healthcare (2010), Masimo (2017) and Edwards (2019). No other conflict of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
(Copyright: © 2023 Kontar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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المشرفين على المادة: 0 (Cardiovascular Agents)
تواريخ الأحداث: Date Created: 20230511 Date Completed: 20230515 Latest Revision: 20230613
رمز التحديث: 20230614
مُعرف محوري في PubMed: PMC10174538
DOI: 10.1371/journal.pone.0285526
PMID: 37167244
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0285526