Objective: The aim of this study was to investigate the efficacy of vasoactive inotrope score at the 24th postoperative hour for mortality and morbidity in elective adult cardiac surgery.
Methods: Consecutive patients who underwent elective adult coronary artery bypass and valve surgery in a single tertiary center for cardiac surgery between December 2021 and March 2022 were prospectively included. The vasoactive inotrope score was calculated with the dosage of inotropes that were continuing at the 24th postoperative hour. Poor outcome was defined as any event of perioperative mortality or morbidity.
Results: The study included 287 patients, of whom 69 (24.0%) were on inotropes at the 24th postoperative hour. The vasoactive inotrope score was higher (21.6±22.5 vs. 0.94±2.7, p=0.001) in patients with poor outcome. One unit increase in the vasoactive inotrope score had an odds ratio of 1.24 (95% confidence interval: 1.14-1.35) for poor outcome. The receiver operating characteristic curve of vasoactive inotrope score for poor outcome had an area under the curve of 0.857.
Conclusion: Vasoactive inotrope score at the 24th hour can be a very valuable parameter for risk calculation in the early postoperative period.
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http://dx.doi.org/10.1590/1806-9282.20221433 | DOI Listing |
Pediatr Nephrol
January 2025
Department of Anesthesiology, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu, 610000, Sichuan, China.
Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a notably common complication in pediatrics, with an incidence rate ranging from 15 to 64%. This rate is significantly higher than that observed in adults. Currently, there is a lack of substantial evidence regarding the association between intraoperative blood pressure variability (BPV) during cardiac surgery with cardiopulmonary bypass (CPB) and the development of AKI in pediatric patients.
View Article and Find Full Text PDFCirc Cardiovasc Qual Outcomes
January 2025
Tokyo Cardiovascular Care Unit Network Scientific Committee, Japan (Y.S., N.N., S. Kohsaka, K.H., T.K., M. Takei, T.J., H.N., J.M., A.S., D.K., S.T., S. Koba, T.Y., M. Takayama).
Background: The absence of practice standards in vasoactive agent usage for acute decompensated heart failure has resulted in significant treatment variability across hospitals, potentially affecting patient outcomes. This study aimed to assess temporal trends and institutional differences in vasodilator and inotrope/vasopressor utilization among patients with acute decompensated heart failure, considering their clinical phenotypes.
Methods: Data were extracted from a government-funded multicenter registry covering the Tokyo metropolitan area, comprising consecutive patients hospitalized in intensive/cardiovascular care units with a primary diagnosis of acute decompensated heart failure between January 2013 and December 2021.
Anaesth Intensive Care
January 2025
Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
Polymyxin B haemoperfusion is commonly used to adsorb endotoxins in septic shock caused by Gram-negative bacterial infections. Polymyxin B haemoperfusion has been reported to improve hypotension in Gram-positive bacterial infections; however, its efficacy and mechanism in treating such cases are unclear. We hypothesised that polymyxin B haemoperfusion would be equally effective in improving haemodynamics during Gram-positive bacterial infections as in Gram-negative bacterial infections.
View Article and Find Full Text PDFRev Esp Cardiol (Engl Ed)
January 2025
Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address:
Introduction And Objectives: Despite advances in mechanical circulatory support, mortality rates in cardiogenic shock (CS) remain high. A reliable risk stratification system could serve as a valuable guide in the clinical management of patients with CS. This study aimed to develop and externally validate a risk prediction model for in-hospital mortality in CS patients using machine learning (ML) algorithms.
View Article and Find Full Text PDFAnesth Analg
September 2024
From the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona.
Background: During orthotopic liver transplantation, allograft reperfusion is a dynamic point in the operation and often requires vasoactive medications and blood transfusions. Normothermic machine perfusion (NMP) of liver allografts has emerged to increase the number of transplantable organs and may have utility during donation after circulatory death (DCD) liver transplantation in reducing transfusion burden and vasoactive medication requirements.
Methods: This is a single-center retrospective study involving 226 DCD liver transplant recipients who received an allograft transported with NMP (DCD-NMP group) or with static cold storage (DCD-SCS group).
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