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Right ventricular ejection fraction in postoperative cardiac surgery patients is independently associated with ICU morbidity and mortality
Intensive Care Medicine Experimental volume 3, Article number: A112 (2015)
Left ventricular heart failure is a well-known risk factor in cardiac surgery. However, data on the clinical relevance of right ventricular (RV) failure are limited.1
To establish the prognostic implications of RV failure in a large series of post cardiac surgery patients.
We performed a single-centre retrospective analysis of all high risk cardiac surgery patients in a four year period. By protocol these patients were equipped with a pulmonary artery catheter (Vigilance®, Baxter), enabling continuous RV ejection fraction (RVEF) measurements. RVEF was categorized into three subgroups: RVEF < 20%, 20-30% and >30%. Demographic data and hemodynamic variables were recorded. Primary outcome was predefined as the correlation between the average RVEF over the first 24 hours in the ICU and markers of morbidity.
A total of 1115 patients were included. Patient characteristics are summarized in table 1. Patients with an RVEF < 20% had a significant longer duration of mechanical ventilation and lengths of stay in the ICU, higher ICU mortality, and increased use of inotropes and fluids. In a multivariate logistic regression model, RVEF appeared to be an independent risk factor for duration of mechanical ventilation, length of stay ICU, and ICU mortality.
A RVEF < 20% is independently associated with increased ICU mortality and morbidity in high risk postoperative cardiac surgery patients.
Haddad F, et al: The Right Ventricle in Cardiac Surgery, a Perioperative Perspective: II. Pathophysiology, Clinical Importance, and Management. Anesthesia & Analgesia. 2009, 108: 422-33. 10.1213/ane.0b013e31818d8b92.
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Bootsma, I., de Lange, F., Koopmans, M. et al. Right ventricular ejection fraction in postoperative cardiac surgery patients is independently associated with ICU morbidity and mortality. ICMx 3, A112 (2015). https://doi.org/10.1186/2197-425X-3-S1-A112
- Right Ventricular
- Pulmonary Artery Catheter
- Right Ventricular Ejection Fraction
- Right Ventricular Failure
- Ventricular Heart