The influence of postoperative albumin levels on the outcome of cardiac surgery.

Background: The prognostic role of low postoperative serum albumin levels (SAL) after cardiac surgery (CS) remains unclear in patients with normal preoperative SAL. Our aim was to evaluate the influence of SAL on the outcome of CS.

Methods: Prospective observational study.

Five-year mortality in cardiac surgery patients with low cardiac output syndrome treated with levosimendan: prognostic evaluation of NT-proBNP and C-reactive protein.

Background: To determine the clinical risk factors predictive of the 5-year mortality in patients with low cardiac output syndrome (LCOS) after cardiac surgery. In addition, to assess the influence of inflammation and myocardial dysfunction severity, as measured by C-reactive protein (CRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations, on outcome.

Methods: We studied 30 patients who underwent cardiac surgery and developed postoperative LCOS requiring inotropic support for longer than 48 hours after intensive care unit (ICU) admission.

Evaluation of Serial Arterial Lactate Levels as a Predictor of Hospital and Long-Term Mortality in Patients After Cardiac Surgery.

Objectives: Although hyperlactatemia is common after cardiac surgery, its value as a prognostic marker is unclear. The aim of the present study was to determine whether postoperative serial arterial lactate (AL) measurements after cardiac surgery could predict outcome.

Design: Prospective, observational study.

Influence of cirrhosis in cardiac surgery outcomes.

Liver cirrhosis has evolved an important risk factor for cardiac surgery due to the higher morbidity and mortality that these patients may suffer compared with general cardiac surgery population. The presence of contributing factors for a poor outcome, such as coagulopathy, a poor nutritional status, an adaptive immune dysfunction, a degree of cirrhotic cardiomyopathy, and a degree of renal and pulmonary dysfunction, have to be taken into account for surgical evaluation when cardiac surgery is needed, together with the degree of liver disease and its primary complications. The associated pathophysiological characteristics that liver cirrhosis represents have a great influence in the development of complications during cardiac surgery and the postoperative course.

The influence of body mass index on outcomes in patients undergoing cardiac surgery: does the obesity paradox really exist?

Purpose: Obesity influences risk stratification in cardiac surgery in everyday practice. However, some studies have reported better outcomes in patients with a high body mass index (BMI): this is known as the obesity paradox. The aim of this study was to quantify the effect of diverse degrees of high BMI on clinical outcomes after cardiac surgery, and to assess the existence of an obesity paradox in our patients.

Evaluation of the PaO2/FiO2 ratio after cardiac surgery as a predictor of outcome during hospital stay.

Background: The arterial partial pressure of O2 and the fraction of inspired oxygen (PaO2/FiO2) ratio is widely used in ICUs as an indicator of oxygenation status. Although cardiac surgery and ICU scores can predict mortality, during the first hours after cardiac surgery few instruments are available to assess outcome. The aim of this study was to evaluate the usefulness of PaO2/FIO2 ratio to predict mortality in patients immediately after cardiac surgery.

Influence of acute kidney injury on short- and long-term outcomes in patients undergoing cardiac surgery: risk factors and prognostic value of a modified RIFLE classification.

Introduction: The development of acute kidney injury (AKI) is associated with poor outcome. The modified RIFLE (risk, injury, failure, loss of kidney function, and end-stage renal failure) classification for AKI, which classifies patients with renal replacement therapy needs according to RIFLE failure class, improves the predictive value of AKI in patients undergoing cardiac surgery. Our aim was to assess risk factors for post-operative AKI and the impact of renal function on short- and long-term survival among all AKI subgroups using the modified RIFLE classification.

Does post-cardiac surgery magnesium supplementation improve outcome?

Hypomagnesemia has been linked with increased morbidity and mortality in critically ill patients. Since the condition is common after cardiopulmonary bypass surgery, the objective of this study was to determine whether magnesium supplementation in the immediate postoperative period may improve outcomes of patients undergoing cardiac surgery with cardiopulmonary bypass. This prospective, randomized, double-blind, placebo-controlled study was conducted in a third-level, cardiac surgery intensive care unit (ICU) at a university hospital.

Short-term independent mortality risk factors in patients with cirrhosis undergoing cardiac surgery.

Objectives: Cirrhosis represents a serious risk in patients undergoing cardiac surgery. Several preoperative factors identify cirrhotic patients as high risk for cardiac surgery; however, a patient's preoperative status may be modified by surgical intervention and, as yet, no independent postoperative mortality risk factors have been identified in this setting. The objective of this study was to identify preoperative and postoperative mortality risk factors and the scores that are the best predictors of short-term risk.

Age and sex differences in perioperative myocardial infarction after cardiac surgery.

We investigate age and sex differences in acute myocardial infarction (AMI) after cardiac surgery in a prospective study of 2038 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass. An age of ≥ 70 years implied changes in the type of AMI from the ST-segment elevation myocardial infarction (STEMI) to non-ST-segment elevation myocardial infarction (non-STEMI). Men were more likely than women to suffer from AMI after cardiac surgery (11.

Relationships among haemoglobin level, packed red cell transfusion and clinical outcomes in patients after cardiac surgery.

Objective: To identify associations among haemoglobin (Hb) concentrations, blood transfusions, and clinical outcomes in patients after cardiac surgery, especially in those who undergo valve replacement or bypass surgery.

Design: Prospective observational trial.

Setting: Surgical intensive care unit in a tertiary-level university hospital.

Are there sex-based differences in serum troponin I after cardiac surgery?

Objective: To determine whether there are sex-based differences in serum troponin I (TnI) after cardiac surgery with cardiopulmonary bypass.

Design: Prospective, observational, cohort study.

Setting: Tertiary cardiac surgery intensive care unit (ICU) at a university hospital.

Is C-reactive protein a biomarker for immediate clinical outcome after cardiac surgery?

Objective: The purpose of this study was to determine the possible correlation between inflammatory activation after cardiac surgery with cardiopulmonary bypass, measured by postoperative C-reactive protein concentrations, and immediate intensive care unit outcome.

Design: A prospective, clinical cohort study.

Setting: A 10-bed surgical intensive care unit at a tertiary university hospital.

Troponin repercussion of defibrillation at the end of cardiopulmonary bypass.

Background And Aim Of The Study: Cardiopulmonary bypass (CPB) is a relatively common procedure in cardiac surgery. At the end, the heart is electrically defibrillated if not already beating. External and internal cardioversion by specific catheters do not raise plasma troponin concentration, but the possible repercussion on troponin of the direct cardioversion of the heart has not been documented.