The Ability of Carbon Dioxide–Derived Indices to Predict Adverse Outcome After Cardiac Surgery
| Autor: | Mohamed Fki, Koutheir Walha, Hichem Kolsi, Wael Jawadi, Ali Chaabouni, Abdelhamid Karoui |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Adverse outcomes 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology law Internal medicine Cardiopulmonary bypass Clinical endpoint Humans Medicine Prospective Studies Cardiac Surgical Procedures Cardiopulmonary Bypass Receiver operating characteristic business.industry Mortality rate Area under the curve Carbon Dioxide Cardiac surgery Oxygen Anesthesiology and Pain Medicine Cardiology Hyperlactatemia Blood Gas Analysis Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia. 35:3604-3611 |
| ISSN: | 1053-0770 |
| DOI: | 10.1053/j.jvca.2021.04.039 |
| Popis: | Objective The objective of this study was to assess whether the central venous-to-arterial carbon dioxide partial-pressure difference (ΔPCO2) and the ratio of the ΔPCO2 to the arterial-venous difference in oxygen content (ΔPCO2/Ca-vO2) predict postoperative complications (PC) after cardiac surgery. Design Prospective, observational, noninterventional study. Participants The study comprised 60 patients undergoing cardiac surgery with cardiopulmonary bypass. Interventions The primary endpoint was the occurrence of PC. Data were first analyzed in two groups based on the occurrence of PC. Then, receiver operating characteristic curves of the ΔPCO2 and the ΔPCO2/Ca-vO2 ratio were analyzed for the prediction of PC. Measurements and Main Results Among the study participants, 22 (36.7%) experienced PC. The death rate was 18.3%. The present study found that the ΔPCO2 and the ΔPCO2/Ca-vO2 ratio predicted the occurrence of PC with areas under the curve of 0.702 and 0.666, respectively. The best thresholds of these markers were 8.3 mmHg for the ΔPCO2 and 2.16 mmHg/mL for the ΔPCO2/Ca-vO2 ratio. A significant difference was found for these indicators between the groups with and without PC. The ΔPCO2 and the ΔPCO2/Ca-vO2 ratio were significantly correlated to EuroSCORE II, duration of aortic clamping, majority of prognostic scores the first two days postoperatively, and the lactate level. The ΔPCO2/Ca-vO2 ratio is predictive of hyperlactatemia >2 mmol/L, with an area under the curve of 0.787. Conclusion The ΔPCO2 and the ΔPCO2/Ca-vO2 ratio predict the occurrence of complications in cardiac surgery. |
| Databáze: | OpenAIRE |
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