Peri-operative fever and LVAD: SIRS or impaired right ventricular strain?

Autor: Marek-Iannucci S; Advanced Heart Failure and Transplant Cardiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA., Wildemann R; Department of Pharmacy, Thomas Jefferson University, Philadelphia, Pennsylvania, USA., Brailovsky Y; Advanced Heart Failure and Transplant Cardiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA., Dyer S; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA., Gamero MT; Advanced Heart Failure and Transplant Cardiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA., Alvarez RJ; Advanced Heart Failure and Transplant Cardiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA., Rame E; Advanced Heart Failure and Transplant Cardiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA., Massey HT; Department of Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA., Tchantchaleishvili V; Department of Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA., Thoma B; Department of Pharmacy, Thomas Jefferson University, Philadelphia, Pennsylvania, USA., Rajapreyar IN; Advanced Heart Failure and Transplant Cardiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: Artificial organs [Artif Organs] 2024 Oct; Vol. 48 (10), pp. 1162-1167. Date of Electronic Publication: 2024 Jun 18.
DOI: 10.1111/aor.14803
Abstrakt: Background: An inflammatory milieu after left ventricular assist device (LVAD) implantation is associated with multi-organ dysfunction and pre-operative heightened inflammatory state is associated with right ventricular failure after LVAD implantation.
Methods: We performed a retrospective analysis of 30 LVAD patients in our institution within the last 2 years for the development of fever and compared them to 30 non-LVAD open-heart surgery patients.
Results: Our results suggest that patients undergoing LVAD implantation are more likely to develop fever in the immediate post-operative period compared to other open-heart surgeries. This is independent of pharmacological treatment, age, or ethnical background. Females and obese patients were more likely to develop fever.
Conclusion: Patients with right ventricular dysfunction, as demonstrated by elevated central venous pressure (CVP), had the strongest correlation with fever development. These results pose the question if there is a systemic inflammatory response-like phenomenon driven by increased right ventricular dysfunction.
(© 2024 International Center for Artificial Organs and Transplantation and Wiley Periodicals LLC.)
Databáze: MEDLINE
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