A S Rubino1, S Torrisi2, I Milazzo2, K Fattouch3, R Busà2, C Mariani4, S D'Aleo4, D Giammona2, C Sferrazzo2, C Mignosa4. 1. Cardiac Surgery Unit, A.O.U. "Policlinico-Vittorio Emanuele", Ferrarotto Hospital, University of Catania, Catania, Italy antonio.rubino@hotmail.com. 2. Perfusion Service, Cardiac Surgery Unit, Ferrarotto Hospital, University of Catania, Catania, Italy. 3. Cardiac Surgery Unit, GVM Care and Research, Maria Eleonora Hospital, Palermo, Italy. 4. Cardiac Surgery Unit, A.O.U. "Policlinico-Vittorio Emanuele", Ferrarotto Hospital, University of Catania, Catania, Italy.
Abstract
AIM: The aim of this study was to ascertain if a score, directly derived from CPB records, could correlate to major postoperative outcomes. METHODS: An additive score (QualyP Score) was created from 10 parameters: peak lactate value during CPB, peak VCO(2)i, lowest DO(2)i/VCO(2)i, peak respiratory quotient, CPB time, cross-clamp time, lowest CPB temperature, circulatory arrest, ultrafiltration during CPB, number of packed red cells transfused intraoperatively. The PerfSCORE was calculated, as well. Multivariable logistic regression models were built to detect the independent predictors of: peak lactate >3 mmol/L during the first three postoperative days; the incidence of acute kidney injury network (AKIN) 1-2-3; respiratory insufficiency; mortality. RESULTS: The mean score was 4.8±2.6 (0-10). A QualyP Score ≥1 was predictive of postoperative acidosis (OR=1.595). A score ≥2 was predictive of AKIN 2 (OR=1.268) and respiratory insufficiency (OR=1.526). A score ≥5 was predictive of AKIN 3 (OR=1.848) and mortality (OR=1.497). CONCLUSIONS: QualyP Score may help to provide a quality marker of perfusion, emphasizing the need for goal-directed perfusion strategies.
AIM: The aim of this study was to ascertain if a score, directly derived from CPB records, could correlate to major postoperative outcomes. METHODS: An additive score (QualyP Score) was created from 10 parameters: peak lactate value during CPB, peak VCO(2)i, lowest DO(2)i/VCO(2)i, peak respiratory quotient, CPB time, cross-clamp time, lowest CPB temperature, circulatory arrest, ultrafiltration during CPB, number of packed red cells transfused intraoperatively. The PerfSCORE was calculated, as well. Multivariable logistic regression models were built to detect the independent predictors of: peak lactate >3 mmol/L during the first three postoperative days; the incidence of acute kidney injury network (AKIN) 1-2-3; respiratory insufficiency; mortality. RESULTS: The mean score was 4.8±2.6 (0-10). A QualyP Score ≥1 was predictive of postoperative acidosis (OR=1.595). A score ≥2 was predictive of AKIN 2 (OR=1.268) and respiratory insufficiency (OR=1.526). A score ≥5 was predictive of AKIN 3 (OR=1.848) and mortality (OR=1.497). CONCLUSIONS: QualyP Score may help to provide a quality marker of perfusion, emphasizing the need for goal-directed perfusion strategies.
Authors: Kevin W Lobdell; Devin M Parker; Donald S Likosky; Michael Rezaee; Moritz Wyler von Ballmoos; Shama S Alam; Sherry Owens; Heather Thiessen-Philbrook; Todd MacKenzie; Jeremiah R Brown Journal: J Thorac Cardiovasc Surg Date: 2018-04-11 Impact factor: 5.209
Authors: Andrew D Shaw; Nicole R Guinn; Jessica K Brown; Rakesh C Arora; Kevin W Lobdell; Michael C Grant; Tong J Gan; Daniel T Engelman Journal: Perioper Med (Lond) Date: 2022-04-28