The predictive value of gastric reactance for postoperative morbidity and mortality in cardiac surgery patients

• Published in: Physiological measurement Vol. 31; no. 11; pp. 1423 - 1436
• Main Authors: Beltran, N E, Sanchez-Miranda, G, Godinez, M M, Diaz, U, Sacristan, E
• Format: Journal Article
• Language: English
• Published: England IOP Publishing 01.11.2010
• Subjects: Cardiac Surgical Procedures - mortality; Electric Impedance; Female; Hemodynamics; Humans; Lactic Acid - blood; Male; Middle Aged; Morbidity; Postoperative Complications - etiology; Postoperative Period; Predictive Value of Tests; ROC Curve; Stomach - physiopathology
• ISSN: 0967-3334; 1361-6579
• DOI: 10.1088/0967-3334/31/11/002

No useful method to directly monitor the level of end organ tissue injury is currently available clinically. Gastric reactance has been proposed to measure changes in a tissue structure caused by ischemia. The purpose of this study was to assess whether gastric reactance is a reliable, clinically relevant predictor of complications and a potentially useful tool to assess hypoperfusion in cardiovascular surgery patients. The value of gastric reactance measurements, standard hemodynamic and regional perfusion variables, and scores to predict postoperative complications were compared in 55 higher risk cardiovascular surgery patients with cardiopulmonary bypass. Low frequency gastric reactance, X(L), had a significant predictive value of postoperative persistent shock requiring more than 48 h of vasopressors and associated complications, before, during and after surgery (p < 0.05). Results suggest that reactance is an earlier predictor of patients at risk than all other variables tested. Patients with a high reactance (X(L) > 26) before surgery had a significantly higher incidence of complications, higher mortality and more days in the ICU than patients with a low reactance (X(L) < 13). X(L) was found to be a reliable and clinically relevant measurement. These results justify further clinical research to explore how this information may be used to improve patient management.