Dataset Information

Impaired right ventricular ejection fraction after cardiac surgery is associated with a complicated ICU stay.

ABSTRACT:

Background

Right ventricular (RV) dysfunction is a known risk factor for increased mortality in cardiac surgery. However, the association between RV performance and ICU morbidity is largely unknown.

Methods

We performed a single-centre, retrospective study including cardiac surgery patients equipped with a pulmonary artery catheter, enabling continuous right ventricular ejection fraction (RVEF) measurements. Primary endpoint of our study was ICU morbidity (as determined by ICU length of stay, duration of mechanical ventilation, usage of inotropic drugs and fluids, and kidney dysfunction) in relation to RVEF. Patients were divided into three groups according to their RVEF; ?30%.

Results

We included 1109 patients. Patients with a RVEF p?p?=?0.033), usage of inotropic drugs (OR 0.944, CI 0.917-0.971, p?p?=?0.011).

Conclusions

A decreased RVEF is independently associated with a complicated ICU stay.

SUBMITTER: Bootsma IT

PROVIDER: S-EPMC6307315 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Impaired right ventricular ejection fraction after cardiac surgery is associated with a complicated ICU stay.

Bootsma Inge T IT Scheeren Thomas W L TWL de Lange Fellery F Haenen Johannes J Boonstra Piet W PW Boerma E Christaan EC

Journal of intensive care 20181227

<h4>Background</h4>Right ventricular (RV) dysfunction is a known risk factor for increased mortality in cardiac surgery. However, the association between RV performance and ICU morbidity is largely unknown.<h4>Methods</h4>We performed a single-centre, retrospective study including cardiac surgery patients equipped with a pulmonary artery catheter, enabling continuous right ventricular ejection fraction (RVEF) measurements. Primary endpoint of our study was ICU morbidity (as determined by ICU len ...[more]

PMID: 30607248

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Project description:BackgroundThe prevalence and clinical significance of right ventricular (RV) systolic dysfunction (RVD) in patients with heart failure and preserved ejection fraction (HFpEF) are not well characterized.Methods and resultsConsecutive, prospectively identified HFpEF (Framingham HF criteria, ejection fraction ≥50%) patients (n=562) from Olmsted County, Minnesota, underwent echocardiography at HF diagnosis and follow-up for cause-specific mortality and HF hospitalization. RV function was categorized by tertiles of tricuspid annular plane systolic excursion and by semiquantitative (normal, mild RVD, or moderate to severe RVD) 2-dimensional assessment. Whether RVD was defined by semiquantitative assessment or tricuspid annular plane systolic excursion ≤15 mm, HFpEF patients with RVD were more likely to have atrial fibrillation, pacemakers, and chronic diuretic therapy. At echocardiography, patients with RVD had slightly lower left ventricular ejection fraction, worse diastolic dysfunction, lower blood pressure and cardiac output, higher pulmonary artery systolic pressure, and more severe RV enlargement and tricuspid valve regurgitation. After adjustment for age, sex, pulmonary artery systolic pressure, and comorbidities, the presence of any RVD by semiquantitative assessment was associated with higher all-cause (hazard ratio=1.35; 95% confidence interval, 1.03-1.77; P=0.03) and cardiovascular (hazard ratio=1.85; 95% confidence interval, 1.20-2.80; P=0.006) mortality and higher first (hazard ratio=1.99; 95% confidence interval, 1.35-2.90; P=0.0006) and multiple (hazard ratio=1.81; 95% confidence interval, 1.18-2.78; P=0.007) HF hospitalization rates. RVD defined by tricuspid annular plane systolic excursion values showed similar but weaker associations with mortality and HF hospitalizations.ConclusionsIn the community, RVD is common in HFpEF patients, is associated with clinical and echocardiographic evidence of more advanced HF, and is predictive of poorer outcomes.

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Dataset Information

Impaired right ventricular ejection fraction after cardiac surgery is associated with a complicated ICU stay.

Background

Methods

Results

Conclusions

Publications

Impaired right ventricular ejection fraction after cardiac surgery is associated with a complicated ICU stay.

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