| Emergency cardiac mechanical assistance: place of mucosal gastric tonometry as prognostic indicator. | |
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MedLine Citation:
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PMID: 17582249 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVES: The death of patients treated by ventricular assist device is usually related to multiorgan failure for which a disorder of splanchnic circulation is blamed. Gastric tonometry (measurement of gastric intra-mucosal pressure of CO(2)) has already been studied in many fields and especially in cardiac surgery. The aim of this study was to investigate the prognostic value of gastric tonometry monitoring after implantation of a ventricular assist device. METHODS: In this prospective study, all consecutive patients scheduled for a ventricular assist device were included. Gastric tonometry was added to standard monitoring. Data were collected (lactate, gastric CO(2) (PgCO(2)) during cardiopulmonary bypass, at admission to ICU, 24 and 48 h later and when norepinephrine was stopped. Preoperative biologic and haemodynamic data were also collected. The primary endpoint was death. RESULTS: Fifty-six patients (50 men and 6 women) were included. In 91% of the cases, the mechanical assistance was biventricular. The objective of the assistance was a bridge to transplant in 93% (n = 27). Twenty-seven deaths (48%) occurred during the study, 59% (n = 16) of them took place before the cardiac transplantation (mean time = 18 +/- 16 days after assist device insertion). Many factors were found to be associated with death: weight (P = 0.018), red cells administration (P = 0.025), length of surgery (P = 0.016), PgCO(2) on admission to ICU (P = 0.040) and norepinephrine dose at 24 h. CONCLUSIONS: Gastric tonometry has a prognostic value in the early postoperative hours after the implantation of a ventricular assist device. |
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Authors:
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P Rosamel; C Flamens; S Paulus; M Cannesson; O Bastien |
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Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2007-06-21 |
Journal Detail:
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Title: European journal of anaesthesiology Volume: 24 ISSN: 0265-0215 ISO Abbreviation: Eur J Anaesthesiol Publication Date: 2007 Oct |
Date Detail:
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Created Date: 2007-09-07 Completed Date: 2008-01-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8411711 Medline TA: Eur J Anaesthesiol Country: England |
Other Details:
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Languages: eng Pagination: 840-6 Citation Subset: IM |
Affiliation:
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Service d'Anesthésie et Réanimation, Hôpital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic alpha-Agonists
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therapeutic use Adult Cardiopulmonary Bypass Emergency Treatment Female Gastric Mucosa / metabolism* Heart-Assist Devices / adverse effects* Humans Intensive Care Male Manometry / methods* Middle Aged Monitoring, Physiologic / methods* Multiple Organ Failure / etiology Norepinephrine / therapeutic use Postoperative Complications / mortality, physiopathology* Prognosis Prospective Studies Prosthesis Implantation / adverse effects, mortality Splanchnic Circulation / physiology Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic alpha-Agonists; 51-41-2/Norepinephrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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