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Association of low mixed venous oxygen saturations during early ICU stay with increased 30-day and 1-year mortality after cardiac surgery: a single-center retrospective study.
Kaakinen, Timo I; Ikäläinen, Tomi; Erkinaro, Tiina M; Karhu, Jaana M; Liisanantti, Janne H; Ohtonen, Pasi P; Ala-Kokko, Tero I.
Afiliação
  • Kaakinen TI; Medical Research Center Oulu, Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Oulu University Hospital and University of Oulu, Oulu, Finland. timo.kaakinen@oulu.fi.
  • Ikäläinen T; Medical Research Center Oulu, Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Oulu University Hospital and University of Oulu, Oulu, Finland.
  • Erkinaro TM; Medical Research Center Oulu, Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Oulu University Hospital and University of Oulu, Oulu, Finland.
  • Karhu JM; Medical Research Center Oulu, Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Oulu University Hospital and University of Oulu, Oulu, Finland.
  • Liisanantti JH; Medical Research Center Oulu, Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Oulu University Hospital and University of Oulu, Oulu, Finland.
  • Ohtonen PP; Research Service Unit, Oulu University Hospital, Oulu, Finland.
  • Ala-Kokko TI; Medical Research Center Oulu, Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Oulu University Hospital and University of Oulu, Oulu, Finland.
BMC Anesthesiol ; 22(1): 322, 2022 10 19.
Article em En | MEDLINE | ID: mdl-36261783
BACKGROUND: Low postoperative mixed venous oxygen saturation (SvO2) values have been linked to poor outcomes after cardiac surgery. The present study was designed to assess whether SvO2 values of < 60% at intensive care unit (ICU) admission and 4 h after admission are associated with increased mortality after cardiac surgery. METHODS: During the years 2007-2020, 7046 patients (74.4% male; median age, 68 years [interquartile range, 60-74]) underwent cardiac surgery at an academic medical center in Finland. All patients were monitored with a pulmonary artery catheter. SvO2 values were obtained at ICU admission and 4 h later. Patients were divided into four groups for analyses: SvO2 ≥ 60% at ICU admission and 4 h later; SvO2 ≥ 60% at admission but < 60% at 4 h; SvO2 < 60% at admission but ≥ 60% at 4 h; and SvO2 < 60% at both ICU admission and 4 h later. Kaplan-Meier survival curves, Cox regression models, and receiver operating characteristic curve analysis were used to assess differences among groups in 30-day and 1-year mortality. RESULTS: In the overall cohort, 52.9% underwent coronary artery bypass grafting (CABG), 29.1% valvular surgery, 12.1% combined CABG and valvular procedures, 3.5% surgery of the ascending aorta or aortic dissection, and 2.4% other cardiac surgery. The 1-year crude mortality was 4.3%. The best outcomes were associated with SvO2 ≥ 60% at both ICU admission and 4 h later. Hazard ratios for 1-year mortality were highest among patients with SvO2 < 60% at both ICU admission and 4 h later, regardless of surgical subgroup. CONCLUSION: SvO2 values < 60% at ICU admission and 4 h after admission are associated with increased 30-day and 1-year mortality after cardiac surgery. Goal-directed therapy protocols targeting SvO2 ≥ 60% may be beneficial. Prospective studies are needed to confirm these observational findings.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Saturação de Oxigênio / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male Idioma: En Revista: BMC Anesthesiol Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Finlândia

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Saturação de Oxigênio / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male Idioma: En Revista: BMC Anesthesiol Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Finlândia