Association between vasopressor dependence and early outcome in patients after cardiac surgery

Summary Arterial hypotension with vasopressor dependence is a major problem after cardiac surgery. We evaluated the early postoperative course of 1558 consecutive patients scheduled for cardiac surgery, and compared the outcome of patients with and without vasopressor dependence (defined as the need...

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Published inAnaesthesia Vol. 61; no. 10; pp. 938 - 942
Main Authors Weis, F., Kilger, E., Beiras‐Fernandez, A., Nassau, K., Reuter, D., Goetz, A., Lamm, P., Reindl, L., Briegel, J.
Format Journal Article
LanguageEnglish
Published Oxford, UK Blackwell Publishing Ltd 01.10.2006
Blackwell
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Summary:Summary Arterial hypotension with vasopressor dependence is a major problem after cardiac surgery. We evaluated the early postoperative course of 1558 consecutive patients scheduled for cardiac surgery, and compared the outcome of patients with and without vasopressor dependence (defined as the need for > 0.1 μg.kg−1.h−1 noradrenaline for > 3 h in the face of normovolaemia). Vasopressor dependence was diagnosed in 424 patients (27%) and was associated with a higher incidence of postoperative renal failure (67 (15.7%) vs 7 (0.6%), respectively; p < 0.0001), a longer duration of ventilation (median IQR [range]) 14 (8–26 [6–39]) h vs 8 (5–11 [4–32]) h; p < 0.0001), a greater need for red cell transfusion (3 (1–5 [0–10]) units vs 1 (0–2 [0–4]) units; p < 0.001) and a longer length of stay in the ICU (4 (2–6 [2–9] days) vs 2 (1–3 [1–6] days; p < 0.001). Vasopressor dependence could be predicted from a combination of factors, including pre‐operative ejection fraction < 37%, cardiopulmonary bypass lasting > 94 min, and postoperative interleukin‐6 > 837 pg.ml−1.
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ISSN:0003-2409
1365-2044
DOI:10.1111/j.1365-2044.2006.04779.x