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The Association of the Pulmonary Artery Pulsatility Index and Right Ventricular Function after Cardiac Surgery.
Wei, Johnny; Kee, Abigail; Dukes, Rachel; Franke, Jack; Leonardo, Vincent; Flynn, Brigid C.
Afiliación
  • Wei J; Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA.
  • Kee A; Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA.
  • Dukes R; Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA.
  • Franke J; Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA.
  • Leonardo V; Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA.
  • Flynn BC; Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA.
Crit Care Res Pract ; 2024: 5408008, 2024.
Article en En | MEDLINE | ID: mdl-38379715
ABSTRACT

Background:

The pulmonary artery pulsatility index (PAPi) has been shown to correlate with right ventricular (RV) failure in patients with cardiac disease. However, the association of PAPi with right ventricular function following cardiac surgery is not yet established.

Methods:

PAPi and other hemodynamic variables were obtained postoperatively for 959 adult patients undergoing cardiac surgery. The association of post-bypass right ventricular function and other clinical factors to PAPi was evaluated using linear regression. A propensity-score matched cohort for PAPi ≥ 2.00 was used to assess the association of PAPi with postoperative outcomes.

Results:

156 patients (16.3%) had post-bypass right ventricular dysfunction defined by visualization on transesophageal echocardiography. There was no difference in postoperative PAPi based on right ventricular function (2.12 vs. 2.00, p=0.21). In our matched cohort (n = 636), PAPi < 2.00 was associated with increased incidence of acute kidney injury (23.0% vs 13.2%, p < 0.01) and ventilator time (6.0 hours vs 5.6 hours, p=0.04) but not with 30-day mortality or intensive care unit length of stay.

Conclusion:

In a general cohort of patients undergoing cardiac surgery, postoperative PAPi was not associated with postcardiopulmonary bypass right ventricular dysfunction. A postoperative PAPi < 2 may be associated with acute kidney injury.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Crit Care Res Pract Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Egipto

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Crit Care Res Pract Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Egipto