Risk factors for post-cardiopulmonary bypass vasoplegia in patients with preserved left ventricular function.

Details

Serval ID
serval:BIB_97AE6CFAE07B
Type
Article: article from journal or magazin.
Collection
Publications
Title
Risk factors for post-cardiopulmonary bypass vasoplegia in patients with preserved left ventricular function.
Journal
The Annals of thoracic surgery
Author(s)
Mekontso-Dessap A., Houël R., Soustelle C., Kirsch M., Thébert D., Loisance D.Y.
ISSN
0003-4975 (Print)
ISSN-L
0003-4975
Publication state
Published
Issued date
05/2001
Peer-reviewed
Oui
Volume
71
Number
5
Pages
1428-1432
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Although vasodilatory shock (VS) is one of the main complications of cardiopulmonary bypass (CPB), its pathophysiologic basis remains unclear. The aim of this study was to identify predisposing factors for the development of VS after CPB independent of ventricular function.
Thirty-six patients undergoing coronary artery bypass grafting who developed VS were compared with 72 control patients without post-CPB cardiogenic or vasoplegic shock, in a 2:1 case control study. Patients and controls underwent the same anesthetic protocol and were matched by age, sex, operation date, and left ventricle ejection fraction.
Preoperative and intraoperative patient characteristics were not significantly different between the two groups. Preoperative use of angiotensin-converting enzyme inhibitors and intravenous heparin were independent predictors for post-CPB VS by multivariate analysis (relative risk of 2.26 and 2.78, respectively). Intensive care unit stay and hospital stay were significantly longer in VS cases than controls, without any difference in early postoperative mortality.
The only independent risk factors for postoperative VS identified were preoperative use of angiotensin-converting enzyme inhibitors and intravenous heparin. These risk factors were independent of age, gender, anesthetic protocol, and left ventricle ejection fraction.
Keywords
Aged, Angiotensin-Converting Enzyme Inhibitors/administration & dosage, Angiotensin-Converting Enzyme Inhibitors/adverse effects, Cardiopulmonary Bypass, Coronary Artery Bypass, Female, Hemodynamics/physiology, Heparin/administration & dosage, Heparin/adverse effects, Humans, Male, Middle Aged, Postoperative Complications/physiopathology, Premedication, Risk Factors, Shock/physiopathology, Stroke Volume/physiology, Vasodilation/physiology, Ventricular Function, Left/physiology
Pubmed
Web of science
Create date
30/03/2019 17:05
Last modification date
20/08/2019 14:59
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