Cardiac Output Syndrome Research Articles

Development and Validation of a Prediction Score for Low-Cardiac-Output Syndrome After Adult Cardiac Surgery

The authors aimed to develop a simple prediction score to help identify patients at high risk of low-cardiac-output syndrome after adult cardiac surgery. A single-center, retrospective, observational study. At a tertiary hospital. Adult patients who underwent on-pump cardiac surgery between April 2016 and March 2021. None. Among the 2,806 patients retained for final analyses, 355 (12.7%) developed low-cardiac-output syndrome. Using a stepwise backward variable selection procedure applied to a multivariate logistic regression, a prediction model, including 8 risk factors, could be identified-preoperative left ventricular ejection fraction, glomerular filtration rate <60 mL/min according to the Cockcroft formula or preoperative dialysis, combined surgery, nonelective surgery, mitral valve surgery for mitral valve regurgitation, history of extracardiac arteriopathy, preoperative hemoglobin <13 g/dL, and New York Heart Association functional class III or IV. A clinical prediction score was derived from the regression coefficients. The model had a good discriminative ability, with an area under the receiver operating characteristics curve of 0.8 (95% CI: 077-0.84). Using a threshold value of 5, the score had a 68% sensitivity, 79% specificity, a positive-predictive value of 33%, and a negative-predictive value of 94%. These results were validated on a validation sample using the bootstrap resampling technique. The authors developed a clinical score to facilitate the prediction of low- cardiac-output syndrome after adult cardiac surgery. This could help tailor patient management by contributing to the early identification of those at high risk of postoperative low cardiac output.

Post-Operative Cerebral Oximetry for Detection of Low - Cardiac Output Syndrome after Coronary Artery Bypass Surgery in Patients with Low Pre-Operative Left Ventricular Ejection Fraction - A Protocol for an Observational Study on Simultaneous Monitoring of Cerebral Oximetry and Cardiac Index

Post-Operative Cerebral Oximetry for Detection of Low - Cardiac Output Syndrome after Coronary Artery Bypass Surgery in Patients with Low Pre-Operative Left Ventricular Ejection Fraction - A Protocol for an Observational Study on Simultaneous Monitoring of Cerebral Oximetry and Cardiac Index

The use of amrinone in noncardiac surgery

T HE MANAGEMENT of patients with ventricular dysfunction remains a distinct challenge to the anesthesiologist. Cardiovascular disease represents a major health care problem, and perioperative cardiac morbidity is the leading cause of death following surgery and anesthesia.’ Anesthesiologists often anesthetize patients with severe coronary artery disease (CAD), valvular heart disease, and congestive heart failure (CHF). Implementation of inotropic support often becomes necessary to improve myocardial performance and prevent severe ventricular dysfunction. There is a lack of literature on the use of phosphodiesterase-III (PDE-III) inhibitors such as am&one in patients with cardiac disease and low cardiac output (CO) syndrome (LCOS) undergoing noncardiac surgery. Amrinone exhibits both inotropic and vasodilating properties (inodilator) and offers a new option in the management of ventricular dysfunction in such patients. Amrinone can be used alone or in combination with catecholamines to support the failing heart.*” This discussion will highlight potential uses of amrinone in noncardiac surgery and review clinical situations in which PDE-III inhibitors have shown promising activity.