Difficult and complex separation from cardiopulmonary bypass in high-risk cardiac surgical patients: a multicenter study
Abstract
To determine the impact of the pharmacologic and mechanical support required during separation from cardiopulmonary bypass (CPB) on survival after cardiac surgery. The authors hypothesized that difficulty with separation from CPB was associated independently with life-threatening complications and survival after cardiac surgery. Prospective study. Nineteen tertiary care hospitals involved in the Blood Conservation Using Antifibrinolytics in a Randomized Controlled Trial (BART). High-risk cardiac surgical patients. Separation from CPB was stratified as easy when no support or only one vasoactive agent or inotrope was required, difficult or pharmacologically assisted when the 2 drug types were used, and complex when the first weaning process failed or the patient required mechanical devices to be weaned from CPB. These definitions were based on a retrospective analysis of 6,120 consecutive cardiac surgical patients who underwent cardiac surgery in a single center. Backward logistic regression was performed to determine predictors of life-threatening complications and mortality. There were 2,331 patients with a mean age of 66 ± 11 years, and 71.8% were men. There were 1,158 (49.7%), 835 (35.8%) and 338 (14.5%) patients in the easy...Continue Reading
References
Perioperative determinants of morbidity and mortality in elderly patients undergoing cardiac surgery
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