Intraoperative regional myocardial acidosis predicts the need for inotropic support in cardiac surgery

American Journal of Surgery

Volumn 188, Issue 5, 2004, Pages 474-480

  Kumbhani, Dharam J ^a   Healey, Nancy A ^a   Birjiniuk, Vladimir ^a,b   Crittenden, Michael D ^a,b   Treanor, Patrick R ^a   Al Tabbaa, Amer K ^a,b   Khuri, Shukri F ^a,b  

^a VETERANS AFFAIRS MEDICAL CENTER   (United States)

^b BRIGHAM AND WOMEN S HOSPITAL   (United States)

Author keywords

Cardiovascular agents; Cardiovascular surgery; Intraoperative monitoring; Ischemia; Myocardial revascularization; Reperfusion injury

Indexed keywords

ADRENALIN; AMRINONE; DOBUTAMINE; NORADRENALIN;

ACIDOSIS; ADULT; AGED; AORTA BALLOON; ARTICLE; CARDIOPULMONARY BYPASS; CONTROLLED STUDY; FEMALE; HEART MUSCLE; HEART SURGERY; HUMAN; INTRAOPERATIVE PERIOD; MAJOR CLINICAL STUDY; MALE; MULTIVARIATE LOGISTIC REGRESSION ANALYSIS; MYOCARDIAL DISEASE; PH; POSTOPERATIVE PERIOD; PREDICTION; PREOPERATIVE PERIOD; PRIORITY JOURNAL; REPERFUSION; TEMPERATURE; TIME;

ACIDOSIS; AGED; CARDIOPULMONARY BYPASS; CARDIOTONIC AGENTS; CHI-SQUARE DISTRIBUTION; COHORT STUDIES; CORONARY DISEASE; FEMALE; FOLLOW-UP STUDIES; HEALTH SERVICES NEEDS AND DEMAND; HUMANS; HYDROGEN-ION CONCENTRATION; MALE; MIDDLE AGED; MONITORING, INTRAOPERATIVE; MYOCARDIAL REPERFUSION INJURY; MYOCARDIUM; PREDICTIVE VALUE OF TESTS; PROBABILITY; RETROSPECTIVE STUDIES; RISK ASSESSMENT; ROC CURVE; SENSITIVITY AND SPECIFICITY; SURVIVAL ANALYSIS; TREATMENT OUTCOME;

EID: 8544232749     PISSN: 00029610     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.amjsurg.2004.07.015     Document Type: Article

References (25)

1. Breisblatt WM, Stein KL, Wolfe CJ, et al. Acute myocardial dysfunction and recovery: A common occurrence after coronary bypass surgery. J Am Coll Cardiol 1990;15:1261-9.
2. M. Muller, M. Brau, M.M. Kwapisz Incidence and risk calculation of inotropic support in patients undergoing cardiac surgery with cardiopulmonary bypass using an automated anaesthesia record-keeping system Br J Anaesth 89 2002 398 404
3. Lewis KP. Early intervention of inotropic support in facilitating weaning from cardiopulmonary bypass: The New England Deaconess Hospital experience. J Cardiothorac Vasc Anesth 1993;7(suppl 2):40-5.
4. S.F. Khuri, M. Josa, W. Marston First report of intramyocardial pH in man: II Assessment of adequacy of myocardial preservation J Thorac Cardiovasc Surg 86 1983 667 678
5. R. Lange, R.A. Kloner, M. Zeiler Time course of ischemic alteration during normothermic and hypothermic arrest and its reflection by on-line monitoring of tissue pH J Thorac Cardiovasc Surg 86 1983 418 434
6. S.F. Khuri, R.A. Kloner, S.A. Karaffa The significance of the late fall in myocardial pCO2 and its relationship to myocardial pH after regional occlusion in the dog Circ Res 56 1985 537 547
7. Biswas KS, Hossain M, Healey N, et al. Intraoperative myocardial acidosis predicts adverse outcomes following cardiac surgery (abstr). Circulation 1999;100(suppl):I-596.
8. Khuri SF, Healey NA, Hossain M, et al. Intraoperative regional myocardial acidosis reduces long-term survival after cardiac surgery. J Thorac Cardiovasc Surg 2004; in press.
9. Khabbaz KR, Zankoul F, Warner KG. Intraoperative metabolic monitoring of the heart: II. Online measurement of myocardial tissue pH. Ann Thorac Surg 2001;72(suppl):S2227-34.
10. Hosmer DW. Model Building. In: Hosmer DW, Lemeshow S, editors. Applied Logistic Regression. 2nd ed. New York: Wiley; 2000:91-114.
11. J.A. Hanley, B.J. McNeil The meaning and use of the area under a receiver operating characteristic (ROC) curve Radiology 143 1982 29 36
12. S. Lemeshow, D.W. Hosmer Jr A review of goodness of fit statistics for use in the development of logistic regression models Am J Epidemiol 115 1982 92 9106
13. R.L. Royster, J.F. Butterworth IV, D.S. Prough Preoperative and intraoperative predictors of inotropic support and long-term outcome in patients having coronary artery bypass grafting Anesth Analg 72 1991 729 736
14. V. Rao, J. Ivanov, R.D. Weisel Predictors of low cardiac output syndrome after coronary artery bypass J Thorac Cardiovasc Surg 112 1996 38 51
15. J.F. Butterworth IV, C. Legault, R.L. Royster, J.W. Hammon Jr Factors that predict the use of positive inotropic drug support after cardiac valve surgery Anesth Analg 86 1998 461 467
16. E. Maseda, L. Suarez, R. Peinado Predictive factors of inotropic support in myocardial revascularization surgery Rev Esp Anestesiol Reanim 43 1996 123 125
17. S.F. Khuri, J.T. Flaherty, J.B. O'Riordan Changes in intramyocardial ST segment voltage and gas tensions with regional myocardial ischemia in the dog Circ Res 37 1975 455 463
18. S.F. Khuri, R.A. Kloner, L.D. Hillis Intramural pCO2: A reliable index of the severity of myocardial ischemic injury Am J Physiol 237 1979 H253 9
19. 31P NMR spectroscopy during ischemia J Thorac Cardiovasc Surg 103 1992 902 907
20. G.T. O'Connor, J.D. Birkmeyer, L.J. Dacey for the Northern New England Cardiovascular Disease Study Group Results of a regional study with modes of death associated with coronary artery bypass grafting Ann Thorac Surg 66 1998 1323 1328
21. T. Reffelman, R.A. Kloner The 'no-reflow' phenomenon; basic science and clinical correlates Heart 87 2002 162 168
22. Wolfe JA. The coronary artery bypass conduit: II. Assessment of the quality of the distal anastomosis. Ann Thorac Surg 2001;72(suppl):S2253-9.
23. V. Rao, J. Ivanov, R.D. Weisel Lactate release during reperfusion predicts low cardiac output syndrome after coronary bypass surgery Ann Thorac Surg 71 2001 1925 1930
24. S.E. Fremes, M.G. Tamariz, D. Abramov Late results of the Warm Heart Trial: The influence of nonfatal cardiac events on late survival Circulation 102 suppl 3 2000 III339 45
25. Khuri SF. pH-Guided Myocardial Management: Evolution and Clinical Application. 1st ed. Ann Arbor, MI: Terumo Cardiovascular Systems Corp; 2003.