التفاصيل البيبلوغرافية
| العنوان: |
Six-month prognostic impact of hemodynamic profiling by short minimally invasive monitoring after cardiac surgery. |
| المؤلفون: |
Giglioli, Cristina, Cecchi, Emanuele, Stefàno, Pier Luigi, Spini, Valentina, Fortini, Giacomo, Chiostri, Marco, Marchionni, Niccolò, Romano, Salvatore Mario |
| المصدر: |
Journal of Cardiovascular & Thoracic Research; 2020, Vol. 12 Issue 4, p313-320, 8p |
| مصطلحات موضوعية: |
CONFIDENCE intervals, CARDIAC surgery, HEMODYNAMICS, PATIENT monitoring, POSTOPERATIVE period, PROGNOSIS, DATA analysis software, DESCRIPTIVE statistics, ODDS ratio |
| مستخلص: |
Introduction: Studies have shown that a hemodynamic-guided therapy improves the postoperative outcomes of high-risk patients. This study, evaluated if a short period through minimally invasive hemodynamic monitoring, pressure recording analytical method (PRAM), on admission to a post-cardiac surgery step-down unit (SDU), may identify patients at higher risk of 6-month adverse events after cardiac surgery. Methods: From December 2016-May 2017,173 patients were admitted in SDU within 24-48 hours of major cardiac surgery procedure, and submitted to clinical, laboratoristic and echocardiographic evaluation and a 1-hour PRAM recording to obtain a "biohumoral snapshot" of individual patient's. 156 173 patients (17 patients were lost at follow-up) were phone interviewed six months after surgery, to evaluate, as a composite end-point, the adverse events during follow-up. A multivariable logistic regression analysis was used to identify a model clinical-biohumoral (CBM) and clinical-biohumoralhemodynamics (CBHM). Results: No data from past clinical history and no conventional risk score (EuroScore II, STS score) independently predicted the risk of 6-month major events in our study. The risk of adverse events at six-month follow-up was directly related, in the CBM, to sustained post-operative cardiac arrhythmias, higher values of NT-proBNP and of arterial pH; inversely related to values of hs-C-reactive protein (hs- CRP) and, in the CBHM, to low values of cardiac cycle efficiency (CCE) and dP/dtmax. Conclusion: Our study although limited by its observational nature and by the limited number of patients enrolled, showed that a short period of minimally invasive hemodynamic monitoring increased the accuracy to identify patients at major risk of mid-term events after cardiac surgery. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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