Association between vasopressor dependence and early outcome in patients after cardiac surgery
Summary Arterial hypotension with vasopressor dependence is a major problem after cardiac surgery. We evaluated the early postoperative course of 1558 consecutive patients scheduled for cardiac surgery, and compared the outcome of patients with and without vasopressor dependence (defined as the need...
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| Veröffentlicht in: | Anaesthesia 2006-10, Vol.61 (10), p.938-942 |
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| creator | Weis, F. Kilger, E. Beiras‐Fernandez, A. Nassau, K. Reuter, D. Goetz, A. Lamm, P. Reindl, L. Briegel, J. |
| description | Summary
Arterial hypotension with vasopressor dependence is a major problem after cardiac surgery. We evaluated the early postoperative course of 1558 consecutive patients scheduled for cardiac surgery, and compared the outcome of patients with and without vasopressor dependence (defined as the need for > 0.1 μg.kg−1.h−1 noradrenaline for > 3 h in the face of normovolaemia). Vasopressor dependence was diagnosed in 424 patients (27%) and was associated with a higher incidence of postoperative renal failure (67 (15.7%) vs 7 (0.6%), respectively; p |
| doi_str_mv | 10.1111/j.1365-2044.2006.04779.x |
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Arterial hypotension with vasopressor dependence is a major problem after cardiac surgery. We evaluated the early postoperative course of 1558 consecutive patients scheduled for cardiac surgery, and compared the outcome of patients with and without vasopressor dependence (defined as the need for > 0.1 μg.kg−1.h−1 noradrenaline for > 3 h in the face of normovolaemia). Vasopressor dependence was diagnosed in 424 patients (27%) and was associated with a higher incidence of postoperative renal failure (67 (15.7%) vs 7 (0.6%), respectively; p < 0.0001), a longer duration of ventilation (median IQR [range]) 14 (8–26 [6–39]) h vs 8 (5–11 [4–32]) h; p < 0.0001), a greater need for red cell transfusion (3 (1–5 [0–10]) units vs 1 (0–2 [0–4]) units; p < 0.001) and a longer length of stay in the ICU (4 (2–6 [2–9] days) vs 2 (1–3 [1–6] days; p < 0.001). Vasopressor dependence could be predicted from a combination of factors, including pre‐operative ejection fraction < 37%, cardiopulmonary bypass lasting > 94 min, and postoperative interleukin‐6 > 837 pg.ml−1.</description><identifier>ISSN: 0003-2409</identifier><identifier>EISSN: 1365-2044</identifier><identifier>DOI: 10.1111/j.1365-2044.2006.04779.x</identifier><identifier>PMID: 16978306</identifier><identifier>CODEN: ANASAB</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Aged ; Aged, 80 and over ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiac Surgical Procedures - adverse effects ; Cardiopulmonary Bypass ; Clinical outcomes ; Drug Administration Schedule ; Female ; Heart surgery ; Humans ; Hypotension - drug therapy ; Hypotension - etiology ; Male ; Medical sciences ; Middle Aged ; Norepinephrine - administration & dosage ; Postoperative Care - methods ; Postoperative period ; Prognosis ; Prospective Studies ; Risk Factors ; Stroke Volume ; Time Factors ; Treatment Outcome ; Vasoconstrictor Agents - administration & dosage</subject><ispartof>Anaesthesia, 2006-10, Vol.61 (10), p.938-942</ispartof><rights>2006 INIST-CNRS</rights><rights>2006 The Authors Journal compilation 2006 The Association of Anaesthetists of Great Britain and Ireland</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4759-1c8bb4057c2b1cded71353aee1c68d48890fc30b46ff4749937f99f2292bb153</citedby><cites>FETCH-LOGICAL-c4759-1c8bb4057c2b1cded71353aee1c68d48890fc30b46ff4749937f99f2292bb153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2044.2006.04779.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2044.2006.04779.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18103131$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16978306$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weis, F.</creatorcontrib><creatorcontrib>Kilger, E.</creatorcontrib><creatorcontrib>Beiras‐Fernandez, A.</creatorcontrib><creatorcontrib>Nassau, K.</creatorcontrib><creatorcontrib>Reuter, D.</creatorcontrib><creatorcontrib>Goetz, A.</creatorcontrib><creatorcontrib>Lamm, P.</creatorcontrib><creatorcontrib>Reindl, L.</creatorcontrib><creatorcontrib>Briegel, J.</creatorcontrib><title>Association between vasopressor dependence and early outcome in patients after cardiac surgery</title><title>Anaesthesia</title><addtitle>Anaesthesia</addtitle><description>Summary
Arterial hypotension with vasopressor dependence is a major problem after cardiac surgery. We evaluated the early postoperative course of 1558 consecutive patients scheduled for cardiac surgery, and compared the outcome of patients with and without vasopressor dependence (defined as the need for > 0.1 μg.kg−1.h−1 noradrenaline for > 3 h in the face of normovolaemia). Vasopressor dependence was diagnosed in 424 patients (27%) and was associated with a higher incidence of postoperative renal failure (67 (15.7%) vs 7 (0.6%), respectively; p < 0.0001), a longer duration of ventilation (median IQR [range]) 14 (8–26 [6–39]) h vs 8 (5–11 [4–32]) h; p < 0.0001), a greater need for red cell transfusion (3 (1–5 [0–10]) units vs 1 (0–2 [0–4]) units; p < 0.001) and a longer length of stay in the ICU (4 (2–6 [2–9] days) vs 2 (1–3 [1–6] days; p < 0.001). Vasopressor dependence could be predicted from a combination of factors, including pre‐operative ejection fraction < 37%, cardiopulmonary bypass lasting > 94 min, and postoperative interleukin‐6 > 837 pg.ml−1.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiopulmonary Bypass</subject><subject>Clinical outcomes</subject><subject>Drug Administration Schedule</subject><subject>Female</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>Hypotension - drug therapy</subject><subject>Hypotension - etiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Norepinephrine - administration & dosage</subject><subject>Postoperative Care - methods</subject><subject>Postoperative period</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Stroke Volume</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Vasoconstrictor Agents - administration & dosage</subject><issn>0003-2409</issn><issn>1365-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1r3DAQhkVpabab_oUiCu3NjmTJ-rgUlpB-QEgvOUfI8qh48UquZDfZf1-5uzTQUzUHDczzDsODEKakpuVd7WvKRFs1hPO6IUTUhEup66cXaPN38BJtCCGsajjRF-hNzntCaKOoeo0uqNBSMSI26GGXc3SDnYcYcAfzI0DAv2yOU4IySbiHCUIPwQG2ocdg03jEcZldPAAeAp5KFMKcsfUzJOxs6gfrcF7SD0jHS_TK2zHD2_O_Rfefb-6vv1a33798u97dVo7LVlfUqa7jpJWu6ajroZeUtcwCUCdUz5XSxDtGOi6855JrzaTX2jeNbrqOtmyLPp7WTin-XCDP5jBkB-NoA8QlG6GUIFqJAr7_B9zHJYVymqFaMq6Z4gVSJ8ilmHMCb6Y0HGw6GkrM6t_szarZrJrN6t_88W-eSvTdef_SHaB_Dp6FF-DDGbDZ2dEnG9yQnzlFCaOltujTiXscRjj-9wFmd7e7WVv2G1D7oY4</recordid><startdate>200610</startdate><enddate>200610</enddate><creator>Weis, F.</creator><creator>Kilger, E.</creator><creator>Beiras‐Fernandez, A.</creator><creator>Nassau, K.</creator><creator>Reuter, D.</creator><creator>Goetz, A.</creator><creator>Lamm, P.</creator><creator>Reindl, L.</creator><creator>Briegel, J.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>200610</creationdate><title>Association between vasopressor dependence and early outcome in patients after cardiac surgery</title><author>Weis, F. ; Kilger, E. ; Beiras‐Fernandez, A. ; Nassau, K. ; Reuter, D. ; Goetz, A. ; Lamm, P. ; Reindl, L. ; Briegel, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4759-1c8bb4057c2b1cded71353aee1c68d48890fc30b46ff4749937f99f2292bb153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anesthesia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiopulmonary Bypass</topic><topic>Clinical outcomes</topic><topic>Drug Administration Schedule</topic><topic>Female</topic><topic>Heart surgery</topic><topic>Humans</topic><topic>Hypotension - drug therapy</topic><topic>Hypotension - etiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Norepinephrine - administration & dosage</topic><topic>Postoperative Care - methods</topic><topic>Postoperative period</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Stroke Volume</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Vasoconstrictor Agents - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Weis, F.</creatorcontrib><creatorcontrib>Kilger, E.</creatorcontrib><creatorcontrib>Beiras‐Fernandez, A.</creatorcontrib><creatorcontrib>Nassau, K.</creatorcontrib><creatorcontrib>Reuter, D.</creatorcontrib><creatorcontrib>Goetz, A.</creatorcontrib><creatorcontrib>Lamm, P.</creatorcontrib><creatorcontrib>Reindl, L.</creatorcontrib><creatorcontrib>Briegel, J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Anaesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weis, F.</au><au>Kilger, E.</au><au>Beiras‐Fernandez, A.</au><au>Nassau, K.</au><au>Reuter, D.</au><au>Goetz, A.</au><au>Lamm, P.</au><au>Reindl, L.</au><au>Briegel, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between vasopressor dependence and early outcome in patients after cardiac surgery</atitle><jtitle>Anaesthesia</jtitle><addtitle>Anaesthesia</addtitle><date>2006-10</date><risdate>2006</risdate><volume>61</volume><issue>10</issue><spage>938</spage><epage>942</epage><pages>938-942</pages><issn>0003-2409</issn><eissn>1365-2044</eissn><coden>ANASAB</coden><abstract>Summary
Arterial hypotension with vasopressor dependence is a major problem after cardiac surgery. We evaluated the early postoperative course of 1558 consecutive patients scheduled for cardiac surgery, and compared the outcome of patients with and without vasopressor dependence (defined as the need for > 0.1 μg.kg−1.h−1 noradrenaline for > 3 h in the face of normovolaemia). Vasopressor dependence was diagnosed in 424 patients (27%) and was associated with a higher incidence of postoperative renal failure (67 (15.7%) vs 7 (0.6%), respectively; p < 0.0001), a longer duration of ventilation (median IQR [range]) 14 (8–26 [6–39]) h vs 8 (5–11 [4–32]) h; p < 0.0001), a greater need for red cell transfusion (3 (1–5 [0–10]) units vs 1 (0–2 [0–4]) units; p < 0.001) and a longer length of stay in the ICU (4 (2–6 [2–9] days) vs 2 (1–3 [1–6] days; p < 0.001). Vasopressor dependence could be predicted from a combination of factors, including pre‐operative ejection fraction < 37%, cardiopulmonary bypass lasting > 94 min, and postoperative interleukin‐6 > 837 pg.ml−1.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>16978306</pmid><doi>10.1111/j.1365-2044.2006.04779.x</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiac Surgical Procedures - adverse effects Cardiopulmonary Bypass Clinical outcomes Drug Administration Schedule Female Heart surgery Humans Hypotension - drug therapy Hypotension - etiology Male Medical sciences Middle Aged Norepinephrine - administration & dosage Postoperative Care - methods Postoperative period Prognosis Prospective Studies Risk Factors Stroke Volume Time Factors Treatment Outcome Vasoconstrictor Agents - administration & dosage |
| title | Association between vasopressor dependence and early outcome in patients after cardiac surgery |
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