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Is incidence of postoperative vasoplegic syndrome different between off-pump and on-pump coronary artery bypass grafting surgery?
- Source :
- European Journal of Cardio-Thoracic Surgery. 34:820-825
- Publication Year :
- 2008
- Publisher :
- Oxford University Press (OUP), 2008.
-
Abstract
- Objective: Postoperative vasoplegic syndrome (PVS) is a potentially lethal condition with increased mortality and other postoperative morbidities.Many previous studies have examined the outcomes associatedwith on-pump coronaryartery bypass grafting (CABG) surgery, little is known about the incidence of PVS after off-pump CABG. Methods: From November 21, 2005 to June 9, 2006, 334 patients underwent isolated onpump CABG and 362 had off-pump CABG surgery. Perioperative variables were retrospectively compared between on-pump and off-pump CABG surgery using univariate analysis. Significant variables were included into a stepwise regression model to ascertain their independent impact on the incidence of PVS. Results: The incidence of PVS in isolated on-pump CABG was 6.9%; in off-pump CABG was 2.8% (p = 0.01). However, in multivariable models adjusted for confounders, on-pump CABG did not reach statistical significance as a risk factor of PVS (OR = 2.3, 95% CI 0.94— 5.78; p = 0.07). In on-pump CABG, preoperative left ventricular EF less than 35% (OR = 3.6; p = 0.02) and increased body mass index (OR = 1.1; p = 0.04) were identified as risk predictors of PVS; whereas elective surgery (OR = 0.2; p = 0.02) and preoperative use of b-blockers (OR = 0.21; p = 0.02) were associated with a decreased rate of PVS. PVS was associated with longer ICU stay (OR = 6.0; p < 0.01), postoperative ventilation (OR = 4.6; p < 0.01), and hospital stay (OR = 2.62; p = 0.03). There was a stronger association between preoperative ACE inhibitors therapy and increased risk of PVS in off-pump CABG surgery (OR = 4.52, 95% CI 0.95—21.67; p = 0.06) than in on-pump CABG surgery (OR = 1.06, 95% CI 0.35— 3.19; p = 0.91), but neither of them reaches statistical significance. Conclusions: The incidence of PVS after off-pump CABG surgery was significantly lower than after on-pump CABG surgery. # 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
medicine.medical_treatment
Coronary Artery Bypass, Off-Pump
Coronary artery bypass surgery
Risk Factors
Internal medicine
medicine
Humans
Coronary Artery Bypass
Vasoplegic syndrome
Elective surgery
Risk factor
Shock, Surgical
Aged
Retrospective Studies
Off-pump coronary artery bypass
Univariate analysis
Cardiopulmonary Bypass
business.industry
Incidence (epidemiology)
Stroke Volume
Syndrome
General Medicine
Perioperative
Middle Aged
medicine.disease
Surgery
cardiovascular system
Cardiology
Female
Vascular Resistance
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 10107940
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- European Journal of Cardio-Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....916a8606e8770104f8c8a97b10bc6a7e