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 in | Anaesthesia Vol. 61; no. 10; pp. 938 - 942 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Publishing Ltd
01.10.2006
Blackwell |
Subjects | |
Online Access | Get full text |
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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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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0003-2409 1365-2044 |
DOI: | 10.1111/j.1365-2044.2006.04779.x |