Determinants and Outcomes of Vasoplegia Following Left Ventricular Assist Device Implantation

Journal of the American Heart Association
Kristen M TecsonSusan M Joseph

Abstract

Vasoplegia is associated with adverse outcomes following cardiac surgery; however, its impact following left ventricular assist device implantation is largely unexplored. In 252 consecutive patients receiving a left ventricular assist device, vasoplegia was defined as the occurrence of normal cardiac function and index but with the need for intravenous vasopressors within 48 hours following surgery for >24 hours to maintain a mean arterial pressure >70 mm Hg. We further categorized vasoplegia as none; mild, requiring 1 vasopressor (vasopressin, norepinephrine, or high-dose epinephrine [>5 μg/min]); or moderate to severe, requiring ≥2 vasopressors. Predictors of vasoplegia severity were determined using a cumulative logit (ordinal logistic regression) model, and 1-year mortality was evaluated using competing-risks survival analysis. In total, 67 (26.6%) patients developed mild vasoplegia and 57 (22.6%) developed moderate to severe vasoplegia. The multivariable model for vasoplegia severity utilized preoperative Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile, central venous pressure, systolic blood pressure, and intraoperative cardiopulmonary bypass time, which yielded an area under the cur...Continue Reading

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Citations

Oct 22, 2020·Cardiovascular Drugs and Therapy·Olga PapazisiA H Jan Danser
Jan 24, 2021·Perfusion·Sam EmmanuelChristopher Simon Hayward
Jun 16, 2019·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Jiho HanMelana Yuzefpolskaya
Aug 5, 2021·European Journal of Clinical Investigation·Alessia GambaroFlavio Luciano Ribichini
Jul 7, 2021·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Joshua T SwanFaisal N Masud

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

SAS

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