Longer term hemodialysis-dependent chronic renal failure increases the risk of post-cardiac surgery vasoplegic syndrome View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-01-03

AUTHORS

Masafumi Suga, Daisuke Kawakami, Hiroshi Ueta, Takahiro Shimozono, Jiro Ito, Ryutaro Seo, Yuki Nakamori, Akira Korenaga, Takeshi Morimoto, Hiroyuki Mima

ABSTRACT

PurposeWe evaluated whether longer term hemodialysis (HD) is associated with a higher incidence of vasoplegic syndrome (VS) after cardiac surgery.MethodsThis retrospective, single-center cohort study included 562 consecutive patients who underwent cardiac surgery in a tertiary hospital from January 2015 to December 2016. We assessed VS occurrence and its relationship with HD duration and other risk factors. To assess the effect of the HD duration on VS occurrence, we constructed ordinal variables: HD = 0 (non-HD), 0 < HD ≤ 5 (HD ≤ 5 years), 5 < HD ≤ 10, and 10 < HD.ResultsThe overall mean (± standard deviation) age of patients was (73 ± 11) years, and there were 60.9% men. Forty-one patients (7.3%) were HD dependent. Cardiac surgeries included all coronary artery bypass graft procedures, all valvular procedures, and aortic surgery involving cardiopulmonary bypass (CPB). Sixty-six patients (10%) developed VS. Most preoperative patient characteristics were comparable between the VS and no-VS groups; a chronic HD status and a total CPB time of > 180 min were significantly more common in the VS group (P < 0.0001 and P = 0.02, respectively). Longer term HD significantly correlated with VS incidence (P < 0.0001). Ordinal variables for the HD duration and age and known risk factors for VS (preoperative use of angiotensin-converting enzyme inhibitors and beta-blockers, low left-ventricular ejection fraction, and CPB time > 180 min) were subjected to multivariate regression analysis. Long-term HD was identified as an independent predictor of VS (odds ratio, 2.29, 95% confidence interval, 1.66–3.18).ConclusionsLonger term HD may be associated with a higher VS incidence after cardiac surgery. VS should be given attention after cardiac surgery in chronic HD-dependent patients. More... »

PAGES

243-249

References to SciGraph publications

  • 2017-06-13. Risk assessment and outcomes of vasoplegia after cardiac surgery in GENERAL THORACIC AND CARDIOVASCULAR SURGERY
  • 2018-07-06. Definitions and pathophysiology of vasoplegic shock in CRITICAL CARE
  • 2018-02-27. Vasoplegia treatments: the past, the present, and the future in CRITICAL CARE
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00540-019-02727-0

    DOI

    http://dx.doi.org/10.1007/s00540-019-02727-0

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1123813504

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/31900585


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    60 independent predictors
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    64 occurrence
    65 ordinal variables
    66 patient characteristics
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    68 predictors
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    74 risk
    75 risk factors
    76 single-center cohort study
    77 status
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    79 surgery
    80 syndrome
    81 tertiary hospital
    82 time
    83 total CPB time
    84 valvular procedures
    85 variables
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