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Hypotension after intensive care unit drop-off in adult cardiac surgery patients

BACKGROUND: Hypotension is a frequent complication in the intensive care unit (ICU) after adult cardiac surgery. AIM: To describe frequency of hypotension in the ICU following adult cardiac surgery and its relation to the hospital outcomes. METHODS: A retrospective study of post-cardiac adult surgic...

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Autores principales: Cengic, Sabina, Zuberi, Muhammad, Bansal, Vikas, Ratzlaff, Robert, Rodrigues, Eduardo, Festic, Emir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298587/
https://www.ncbi.nlm.nih.gov/pubmed/32577413
http://dx.doi.org/10.5492/wjccm.v9.i2.20
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author Cengic, Sabina
Zuberi, Muhammad
Bansal, Vikas
Ratzlaff, Robert
Rodrigues, Eduardo
Festic, Emir
author_facet Cengic, Sabina
Zuberi, Muhammad
Bansal, Vikas
Ratzlaff, Robert
Rodrigues, Eduardo
Festic, Emir
author_sort Cengic, Sabina
collection PubMed
description BACKGROUND: Hypotension is a frequent complication in the intensive care unit (ICU) after adult cardiac surgery. AIM: To describe frequency of hypotension in the ICU following adult cardiac surgery and its relation to the hospital outcomes. METHODS: A retrospective study of post-cardiac adult surgical patients at a tertiary academic medical center in a two-year period. We abstracted baseline demographics, comorbidities, and all pertinent clinical variables. The primary predictor variable was the development of hypotension within the first 30 min upon arrival to the ICU from the operating room (OR). The primary outcome was hospital mortality, and other outcomes included duration of mechanical ventilation (MV) in hours, and ICU and hospital length of stay in days. RESULTS: Of 417 patients, more than half (54%) experienced hypotension within 30 min upon arrival to the ICU. Presence of OR hypotension immediately prior to ICU transfer was significantly associated with ICU hypotension (odds ratio = 1.9; 95% confidence interval: 1.21-2.98; P < 0.006). ICU hypotensive patients had longer MV, 5 (interquartile ranges 3, 15) vs 4 h (interquartile ranges 3, 6), P = 0.012. The patients who received vasopressor boluses (n = 212) were more likely to experience ICU drop-off hypotension (odds ratio = 1.45, 95% confidence interval: 0.98-2.13; P = 0.062), and they experienced longer MV, ICU and hospital length of stay (P < 0.001, for all). CONCLUSION: Hypotension upon anesthesia-to-ICU drop-off is more frequent than previously reported and may be associated with adverse clinical outcomes.
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spelling pubmed-72985872020-06-22 Hypotension after intensive care unit drop-off in adult cardiac surgery patients Cengic, Sabina Zuberi, Muhammad Bansal, Vikas Ratzlaff, Robert Rodrigues, Eduardo Festic, Emir World J Crit Care Med Retrospective Study BACKGROUND: Hypotension is a frequent complication in the intensive care unit (ICU) after adult cardiac surgery. AIM: To describe frequency of hypotension in the ICU following adult cardiac surgery and its relation to the hospital outcomes. METHODS: A retrospective study of post-cardiac adult surgical patients at a tertiary academic medical center in a two-year period. We abstracted baseline demographics, comorbidities, and all pertinent clinical variables. The primary predictor variable was the development of hypotension within the first 30 min upon arrival to the ICU from the operating room (OR). The primary outcome was hospital mortality, and other outcomes included duration of mechanical ventilation (MV) in hours, and ICU and hospital length of stay in days. RESULTS: Of 417 patients, more than half (54%) experienced hypotension within 30 min upon arrival to the ICU. Presence of OR hypotension immediately prior to ICU transfer was significantly associated with ICU hypotension (odds ratio = 1.9; 95% confidence interval: 1.21-2.98; P < 0.006). ICU hypotensive patients had longer MV, 5 (interquartile ranges 3, 15) vs 4 h (interquartile ranges 3, 6), P = 0.012. The patients who received vasopressor boluses (n = 212) were more likely to experience ICU drop-off hypotension (odds ratio = 1.45, 95% confidence interval: 0.98-2.13; P = 0.062), and they experienced longer MV, ICU and hospital length of stay (P < 0.001, for all). CONCLUSION: Hypotension upon anesthesia-to-ICU drop-off is more frequent than previously reported and may be associated with adverse clinical outcomes. Baishideng Publishing Group Inc 2020-06-05 /pmc/articles/PMC7298587/ /pubmed/32577413 http://dx.doi.org/10.5492/wjccm.v9.i2.20 Text en ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Study
Cengic, Sabina
Zuberi, Muhammad
Bansal, Vikas
Ratzlaff, Robert
Rodrigues, Eduardo
Festic, Emir
Hypotension after intensive care unit drop-off in adult cardiac surgery patients
title Hypotension after intensive care unit drop-off in adult cardiac surgery patients
title_full Hypotension after intensive care unit drop-off in adult cardiac surgery patients
title_fullStr Hypotension after intensive care unit drop-off in adult cardiac surgery patients
title_full_unstemmed Hypotension after intensive care unit drop-off in adult cardiac surgery patients
title_short Hypotension after intensive care unit drop-off in adult cardiac surgery patients
title_sort hypotension after intensive care unit drop-off in adult cardiac surgery patients
topic Retrospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298587/
https://www.ncbi.nlm.nih.gov/pubmed/32577413
http://dx.doi.org/10.5492/wjccm.v9.i2.20
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