Risk Stratification Scores for Predicting Mortality in Coronary Artery Bypass Surgery

Baretti, Rufus; N, Pannek; Jp, Knecht; Krabatsch, Thomas; Hübler, Sabine; Hetzer, R.

doi:10.1055/s-2002-33097

Cited by 11 publications

(2 citation statements)

References 10 publications

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“…There were no significant differences between groups in EuroSCORE or Parsonnet indices 34 , bypass times, clamp times or volumes of administered cardioplegia (Table 3). Additional Plasma-Lyte 148 boluses did not exceed 500 ml in any patient.…”

Section: Resultsmentioning

confidence: 95%

Acid-Base Effects of a Bicarbonate-Balanced Priming Fluid during Cardiopulmonary Bypass: Comparison with Plasma-Lyte 148. A Randomised Single-Blinded Study

Morgan

Power

Venkatesh

et al. 2008

Anaesth Intensive Care

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Fluid-induced metabolic acidosis can be harmful and can complicate cardiopulmonary bypass. In an attempt to prevent this disturbance, we designed a bicarbonate-based crystalloid circuit prime balanced on physico-chemical principles with a strong ion difference of 24 mEq/l and compared its acid-base effects with those of Plasma-Lyte 148, a multiple electrolyte replacement solution containing acetate plus gluconate totalling 50 mEq/l. Twenty patients with normal acid-base status undergoing elective cardiac surgery were randomised 1:1 to a 2 litre prime of either bicarbonate-balanced fluid or Plasma-Lyte 148. With the trial fluid, metabolic acid-base status was normal following bypass initiation (standard base excess 0.1 (1.3) mEq/l, mean, SD), whereas Plasma-Lyte 148 produced a slight metabolic acidosis (standard base excess-2.2 (2.1) mEq/l). Estimated group difference after baseline adjustment was 3.6 mEq/l (95% confidence interval 2.1 to 5.1 mEq/l, P=0.0001). By late bypass, mean standard base excess in both groups was normal (0.8 (2.2) mEq/l vs.-0.8 (1.3) mEq/l, P=0.5). Strong ion gap values were unaltered with the trial fluid, but with Plasma-Lyte 148 increased significantly on bypass initiation (15.2 (2.5) mEq/l vs. 2.5 (1.5) mEq/l, P <0.0001), remaining elevated in late bypass (8.4 (3.4) mEq/l vs. 5.8 (2.4) mEq/l, P <0.05). We conclude that a bicarbonate-based crystalloid with a strong ion difference of 24 mEq/l is balanced for cardiopulmonary bypass in patients with normal acid-base status, whereas Plasma-Lyte 148 triggers a surge of unmeasured anions, persisting throughout bypass. These are likely to be gluconate and/or acetate. Whether surges of exogenous anions during bypass can be harmful requires further study.

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Section: Resultsmentioning

confidence: 95%

Acid-Base Effects of a Bicarbonate-Balanced Priming Fluid during Cardiopulmonary Bypass: Comparison with Plasma-Lyte 148. A Randomised Single-Blinded Study

Morgan

Power

Venkatesh

et al. 2008

Anaesth Intensive Care

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“…Studies applying external risk scores to centre-specific populations reported a wide range of areas under the ROC curve (0.67 [19] and 0.831 [20]). …”

Section: Discussionmentioning

confidence: 99%

On-line variable live-adjusted displays with internal and external risk-adjusted mortalities. A valuable method for benchmarking and early detection of unfavourable trends in cardiac surgery

Albert¹,

Walter

Arnrich

et al. 2004

European Journal of Cardio-Thoracic Surgery

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F�rderung von Transparenz und Qualit�tskontrolle in der Herzchirurgie

Albert

Walter

Arnrich

et al. 2004

Zeitschrift f�r Herz-, Thorax- und Gef��chirurgie

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Risk Stratification Scores for Predicting Mortality in Coronary Artery Bypass Surgery

Abstract: All RSSs satisfactorily estimated the group risk for mortality. No RSS expressed sufficient validity to predict individuals with lethal outcome. In clinical use, CCS/Higgins proved the most practicable.

Cited by 11 publications

References 10 publications

Acid-Base Effects of a Bicarbonate-Balanced Priming Fluid during Cardiopulmonary Bypass: Comparison with Plasma-Lyte 148. A Randomised Single-Blinded Study

Acid-Base Effects of a Bicarbonate-Balanced Priming Fluid during Cardiopulmonary Bypass: Comparison with Plasma-Lyte 148. A Randomised Single-Blinded Study

On-line variable live-adjusted displays with internal and external risk-adjusted mortalities. A valuable method for benchmarking and early detection of unfavourable trends in cardiac surgery

F�rderung von Transparenz und Qualit�tskontrolle in der Herzchirurgie

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