Acute respiratory distress syndrome after cardiac surgery

Rong, Lisa Q.; Franco, Antonino Di; Gaudino, Mario

doi:10.21037/jtd.2016.10.74

Cited by 64 publications

(42 citation statements)

References 84 publications

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“…The incidence of moderate-to-severe ARDS was 2.7%, which was also close to previous studies (that defined ARDS as a PaO 2/ FiO 2 ratio < 200) [1,2,26]. Nevertheless, provided high mortality of ARDS, it is still good to have a tool to warn the possibility of developing ARDS, especially in those with risk factors such as massive transfusion, previous cardiac surgery, long-time CPB [2,4], etc.…”

Section: Discussionsupporting

confidence: 85%

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Higher incidence of acute respiratory distress syndrome in cardiac surgical patients with elevated serum procalcitonin concentration: a prospective cohort study

Cheng

Chen

2020

Eur J Med Res

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Background: Inflammatory response is activated during cardiopulmonary bypass (CPB), which may lead to acute respiratory distress syndrome (ARDS) and procalcitonin (PCT) increases during this inflammatory response. The objective of the study was to validate whether patients with higher serum PCT concentrations have a higher incidence of ARDS. Methods:The study was a prospective, single-center, observational cohort study. All patients who received cardiac surgery with CPB were screened for study eligibility. Patients were assigned to the PCT-elevated cohort or the control cohort according to serum PCT concentration on the first postoperative day with a cut-off value of 7.0 ng/mL. Patients were followed up until the 7th postoperative day. The primary endpoint was the incidence of ARDS, which was diagnosed according to the Berlin definition.Results: A total of 296 patients were enrolled, 64 patients were assigned to the PCT-elevated cohort and 232 patients were assigned to the control cohort. PCT concentration was 16.23 ± 5.9 ng/mL in the PCT-elevated cohort, and 2.70 ± 1.43 ng/mL in the control cohort (p < 0.001). The incidence of ARDS was significantly higher in the PCT-elevated cohort than in the control cohort (21.9% versus 5.6%, p < 0.001). The incidence of moderate-to-severe ARDS was also significantly higher in the PCT-elevated cohort than in the control cohort (10.9% versus 0.4%, p < 0.001). The hazard ratio of ARDS at 7 days in the PCT-elevated cohort, as compared with the control cohort, was 6.8 (95% confidence interval 2.7 to 17.4). The hazard ratio of moderate-to-severe ARDS in the PCT-elevated cohort was 57.3 (95% confidence interval 10.4 to 316.3). The positive predictive value of PCT for ARDS and moderate-to-severe ARDS were 0.242 and 0.121, respectively; the negative predictive value of PCT for ARDS and moderate-to-severe ARDS were 0.952 and 1.0, respectively.

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Section: Discussionsupporting

confidence: 85%

“…It has been shown that PCT liberation predominantly depended on the use of CPB in cardiac surgery [18]. It is also known that the development of ARDS is associated with the use of CPB [4]. However, it is still unknown whether high PCT indicates a higher incidence of ARDS.…”

Section: Discussionmentioning

confidence: 99%

Higher incidence of acute respiratory distress syndrome in cardiac surgical patients with elevated serum procalcitonin concentration: a prospective cohort study

Cheng

Chen

2020

Eur J Med Res

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“…Inflammatory response may be the cause of ARDS and blood transfusion during cardiac may cause transfusion-related acute lung injury (TRALI). [29] Both ARDS and TRALI are hazardous complications which complicate the postoperative period in COVID-19 patients.…”

Section: And Further Potential Effects Of Cardiac Surgerymentioning

confidence: 99%

Perioperative planning for cardiovascular operations in the COVID-19 pandemic

Mavioğlu¹

2020

Turk Gogus Kalp Dama

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ÖZKoronavirüs hastalığı-2019 (COVID-19) tüm dünyada sağlık çalışanlarını alarm durumuna geçiren ciddi bir sağlık sorunudur. Pandeminin beraberinde getirmiş olduğu ve sağlık sistemini ilgilendiren ele alınması gereken iki önemli konu mevcuttur. Birincisi; pandeminin yayılma hızına yetişme sıkıntısı çekebilecek olan sağlık sisteminin yükünü azaltabilmek açısından elektif birçok işlemin/cerrahinin ertelenmesi gerekliliğidir. Bu nedenle, cerrahi gereken kardiyovasküler hastalıkların önceliğinin ve ertelenebilirliğinin belirlenmesi için "Öncelik Düzeyi" olarak adlandırdığımız bir algoritma geliştirilmesini amaçladık. İkinci olarak ise; kardiyovasküler cerrahi yapılması gereken acil ve öncelikli hastalarda cerrahinin ve sonrasında yoğun bakım ünitesinde takibinin, enfeksiyon koruma tedbirlerinin sağlandığı bir ortamda yapılması gerekliliğidir. Bu yazıda, hasta güvenliğinin sağlanabilmesi ve cerrahi ekibin maksimum seviyede korunabilmesi için uygulanabilecek olan gerekli tedbirler sunuldu. ABSTRACTCoronavirus disease-2019 (COVID-19) is a serious health concern which alert all healthcare professionals worldwide. There are two main issues caused by this pandemic regarding for the healthcare system. First, it is a necessity to postpone many elective procedures/surgeries to reduce the burden of the healthcare system which may be confronted with strain by the increased speed of transmission. Therefore, we aimed to develop an algorithm called as Level of Priority to identify the priority and deferrability of cardiovascular diseases requiring surgery. Second, it is essential to perform surgery and intensive care unit follow-up in a setting where the infection prevention measures are followed for primary patients requiring emergency cardiovascular surgery. In this article, we present necessary precautions to be exercised to provide the patient safety and the highest level of protection for the surgical team.

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“…Despite advances in CPB techniques and in preventive measures aimed at decreasing respiratory complications after cardiac surgery, postoperative acute respiratory distress syndrome (ARDS) occurs in 1−20% of patients, depending on inclusion criteria. [56][57][58][59] The use of V-A ECMO for refractory cardiovascular dysfunction after pediatric cardiac surgery has been described, but there is paucity of data on the use of postcardiotomy V-V ECMO. Respiratory distress and hypoxia are reported as indications for ECMO support in 2-30% of pediatric patients.…”

Section: Post-cardiotomy Veno-venous Ecmo For Respiratory Dysfunctionmentioning

confidence: 99%

“…57 ECMO use post Htx has been reported as high as 10%-15%. [58][59][60] The use of more marginal donor hearts may predispose to the need for PC-ECMO. Notably, Listijono and colleagues showed that its use apparently does not influence primary graft recovery or patient survival to discharge.…”

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confidence: 99%

Extracorporeal membrane oxygenation support in post-cardiotomy shock

Raffa¹

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Acute respiratory distress syndrome after cardiac surgery

Cited by 64 publications

References 84 publications

Higher incidence of acute respiratory distress syndrome in cardiac surgical patients with elevated serum procalcitonin concentration: a prospective cohort study

Higher incidence of acute respiratory distress syndrome in cardiac surgical patients with elevated serum procalcitonin concentration: a prospective cohort study

Perioperative planning for cardiovascular operations in the COVID-19 pandemic

Extracorporeal membrane oxygenation support in post-cardiotomy shock

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