Health Outcomes with and without Use of Inotropic Therapy in Cardiac Surgery

Nielsen, Dorthe Viemose; Hansen, Malene; Johnsen, Søren Paaske; Hansen, Mads Koch; Hindsholm, K. B.; Jakobsen, Carl-Johan

doi:10.1097/aln.0000000000000224

Cited by 104 publications

(60 citation statements)

References 26 publications

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“…Most of the randomized controlled trials suggesting increased mortality in patients using inotropic drugs have been performed in patients with heart failure. Use of inotropic drugs in cardiac surgery can be seen at rates up to 90%, depending on the conditions of the patient and the surgical procedure [6] . A retrospective cohort study of 1326 cardiac surgery patients has shown inotropic and vazopressor (norepinephrine, vasopressin, epinephrine, dobutamine and milrinone) exposure is independently associated with mortality either in multivariate logistic regression analysis and propensity score matching [5] .…”

Section: Discussionmentioning

confidence: 99%

The Use Of Catecholaminergic Inotropic Agents is Not An Independent Risk Factor For 30-Day Mortality

Sabuncu¹,

Aykut²,

Demir³

et al. 2018

GKDA Derg

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Objective: Low cardiac output syndrome can develop in patients who have undergone open heart surgery. Inotropic drug therapy is being initiated to improve cardiac performance, but these drugs also have significant side effects. The primary aim of this study is to determine the relationship between the use of inotropic drugs and 30-day mortality, however its secondary aim is to determine the independent factors predicting mortality. Material and Method: Our retrospective observational study included 1002 patients undergoing cardiac surgery with cardiopulmonary bypass. Demographic and intraoperative characteristics of patients, use of inotropic agents, postoperative 30-day mortality data were obtained from anesthesia records, postoperative intensive care records and epicrises. Results: Dopamine (n=274: 27.3%), dobutamine (n= 110: 11%) and adrenaline (n=63: 6.3%) were used in indicated number of patients. In the univariate analysis, inotropic drug use was associated with mortality, but multiple regression analysis showed that inotropic drug use was not an independent risk factor for mortality alone. Independent risk factors for mortality were found to be advanced age, hypertension, heart failure, low ejection fraction and preoperative anemia. Conclusion: Our findings showed that inotropic use in perioperative period was not an independent predictor of 30day-mortality. Although this result is not compatible with studies performed with small number of samples, it is correlated with large-scale patient studies. Independent risk factors for 30-day-mortality were advanced age, hypertension, heart failure, low ejection fraction, and peroperative hemoglobin drop. Our findings are compatible with frequently seen risk factors in research. More progress is needed in this regard.

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Section: Discussionmentioning

confidence: 99%

The Use Of Catecholaminergic Inotropic Agents is Not An Independent Risk Factor For 30-Day Mortality

Sabuncu¹,

Aykut²,

Demir³

et al. 2018

GKDA Derg

View full text Add to dashboard Cite

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“…So erhöhen Inotropika den myokardialen Sauerstoffbedarf und können proarrhythmogen wirksam werden [67]. Sie erhöhen das postoperative Risiko für einen Myokardinfarkt, einen Schlaganfall oder Nierenfunktionsstörungen und können mit einer erhöhten Mortalität vergesellschaftet sein [68,69].…”

Section: Caveunclassified

Behandlungsprinzipien in der herzchirurgischen Intensivmedizin

Breuer¹,

Marx²

2020

Intensivmedizin up2date

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“…Терапией СНСВ первой линии, которая должна быть инициирована сразу после коррекции волемического статуса, является назначение инотропных препаратов и вазодилататоров для повышения сократимости миокарда и достижения адекватной пред-и постнагрузки. Однако повышение СВ, инициируемое инотропными препаратами, достигается ценой увеличения потребности миокарда в кислороде и повышения летальности [94]. Поддержание кислотно-основного состояния и нормотермии, коррекция электролитного состава плазмы крови, адекватная респираторная поддержка -все это повышает чувствительность к катехоламинам и улучшает дальнейший прогноз.…”

Section: терапия синдрома низкого сердечного выбросаunclassified

Low cardiac output syndrome in cardiac surgery

et al. 2019

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Ефремов Сергей Михайловичд-р мед. наук, врач анестезиологреаниматолог отделения реанимации и интенсивной терапии 1 ; ORCID: http:// orcid.org/0000-0001-5581-9169 Киров Михаил Юрьевич-д-р мед. наук, профессор, заведующий кафедрой анестезиологии и реаниматологии 2 ; ORCID: http://orcid.org/0000-0002-4375-3374 Ломиворотов Владимир Николаевич-д-р мед. наук, профессор учебного центра 1

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Health Outcomes with and without Use of Inotropic Therapy in Cardiac Surgery

Abstract: Use of intra- and postoperative inotropes was associated with increased mortality and major postoperative morbidity.

Cited by 104 publications

References 26 publications

The Use Of Catecholaminergic Inotropic Agents is Not An Independent Risk Factor For 30-Day Mortality

The Use Of Catecholaminergic Inotropic Agents is Not An Independent Risk Factor For 30-Day Mortality

Behandlungsprinzipien in der herzchirurgischen Intensivmedizin

Low cardiac output syndrome in cardiac surgery

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