Shao-Wei Chen1, Chih-Hsiang Chang2, Pao-Hsien Chu3, Tien-Hsing Chen3, Victor Chien-Chia Wu3, Yao-Kuang Huang4, Chien-Hung Liao5, Shang-Yu Wang6, Pyng-Jing Lin4, Feng-Chun Tsai7. 1. Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan; Graduate Institute of Clinical Medical Sciences, College of medicine, Chang Gung University, Taoyuan City, Taiwan. 2. Graduate Institute of Clinical Medical Sciences, College of medicine, Chang Gung University, Taoyuan City, Taiwan; Kidney research center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan. 3. Department of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan. 4. Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan. 5. Department of Traumatology and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan. 6. Graduate Institute of Clinical Medical Sciences, College of medicine, Chang Gung University, Taoyuan City, Taiwan; Department of Traumatology and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan. 7. Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan City, Taiwan. Electronic address: josephchen0939@yahoo.com.tw.
Abstract
PURPOSE: The aim of this study is to investigate the incidence, severity, and outcome of postoperative acute respiratory distress syndrome (ARDS), according to the Berlin definition, in isolated valvular heart surgery. The preoperative and perioperative predisposing factors of this complication were also identified. METHODS: A retrospective chart review was conducted on 457 patients who underwent isolated valvular heart surgery between January 2010 and December 2012. Clinical characteristics and outcomes were collected. The primary outcome was postoperative ARDS, according to the 2012 Berlin definition for ARDS. RESULTS: A total of 37 patients (8.1%) developed postoperative ARDS, with a mortality rate of 29.7%. The multivariate analysis identified that age (odds ratios [ORs], 1.067, P ≤ .001), liver cirrhosis (OR, 7.159; P = .001), massive blood transfusion (OR, 2.980; P = .005), and tricuspid valve replacement (OR, 5.197; P = .012) were independent risk factors of postoperative ARDS. Furthermore, we have determined that the increased severity stages of ARDS were associated with decreased postoperative survival. CONCLUSIONS: In conclusion, postoperative ARDS, according to Berlin definition, in valvular surgery, was associated with high in-hospital mortality. The severity of ARDS was associated with patient midterm mortality. In multivariate analysis, age, liver cirrhosis, massive blood transfusion, and tricuspid valve replacement were identified as independent risk factors of ARDS.
PURPOSE: The aim of this study is to investigate the incidence, severity, and outcome of postoperative acute respiratory distress syndrome (ARDS), according to the Berlin definition, in isolated valvular heart surgery. The preoperative and perioperative predisposing factors of this complication were also identified. METHODS: A retrospective chart review was conducted on 457 patients who underwent isolated valvular heart surgery between January 2010 and December 2012. Clinical characteristics and outcomes were collected. The primary outcome was postoperative ARDS, according to the 2012 Berlin definition for ARDS. RESULTS: A total of 37 patients (8.1%) developed postoperative ARDS, with a mortality rate of 29.7%. The multivariate analysis identified that age (odds ratios [ORs], 1.067, P ≤ .001), liver cirrhosis (OR, 7.159; P = .001), massive blood transfusion (OR, 2.980; P = .005), and tricuspid valve replacement (OR, 5.197; P = .012) were independent risk factors of postoperative ARDS. Furthermore, we have determined that the increased severity stages of ARDS were associated with decreased postoperative survival. CONCLUSIONS: In conclusion, postoperative ARDS, according to Berlin definition, in valvular surgery, was associated with high in-hospital mortality. The severity of ARDS was associated with patient midterm mortality. In multivariate analysis, age, liver cirrhosis, massive blood transfusion, and tricuspid valve replacement were identified as independent risk factors of ARDS.
Authors: Joo Han Song; Won Ki Woo; Seung Hwan Song; Hyo Hyun Kim; Bong Joon Kim; Ha Eun Kim; Do Jung Kim; Jee Won Suh; Yu Rim Shin; Han Ki Park; Seung Hyun Lee; Hyun Chel Joo; Sak Lee; Byung Chul Chang; Kyung Jong Yoo; Young Sam Kim; Young Nam Youn Journal: J Thorac Dis Date: 2016-07 Impact factor: 2.895
Authors: Christina M Möller; Peter-Paul Ellmauer; Florian Zeman; Diane Bitzinger; Bernhard Flörchinger; Bernhard M Graf; York A Zausig Journal: PLoS One Date: 2021-02-11 Impact factor: 3.240