Alexander Kogan1, Michael J Segel2, Eilon Ram3, Ehud Raanani3, Yael Peled-Potashnik4, Shany Levin3, Leonid Sternik3. 1. Department of Cardiac Surgery, Sheba Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel, alexanderkogan140@hotmail.com. 2. Pulmonology Institute, Sheba Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel. 3. Department of Cardiac Surgery, Sheba Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel. 4. Heart Institute, Sheba Medical Center (affiliated to the Sackler School of Medicine, Tel Aviv University), Tel Hashomer, Israel.
Abstract
BACKGROUND: Lung injury with development of the acute respiratory distress syndrome (ARDS) is a serious complication which can occur after major surgery, including cardiac surgery. OBJECTIVE: The aim of our study was to compare the prevalence, risk factors, and mortality of ARDS following cardiac surgery according to the American-European Consensus Conference (AECC) definition and the new Berlin definition of ARDS. METHODS: We performed a retrospective, observational study that included prospectively collected data from consecutive adult patients, aged from 18 to 92 years, who had undergone cardiac surgery (both on and off pump) at a large tertiary university hospital over 5 years (from September 2012 to September 2017). RESULTS: During the study period, 3,972 patients underwent cardiac surgery, and 3,946 patients were included in the study. Fifty-five patients developed ARDS (1.14%) according to the AECC definition and 59 patients (1.15%) according to the Berlin definition, with a mortality of 32.7 and 30.5%, respectively (18 patients). Multivariate regression analysis identified prior cardiac surgery, complex cardiac surgery, emergency procedures, and transfusion of > 3 packed red blood cell units as predictors for ARDS. CONCLUSION: The development of ARDS in patients after cardiac surgery is a rare but serious complication associated with significant mortality. Moreover, our findings showed that prevalence, mortality, and risk factors for developing ARDS were similar according to both the AECC and the new Berlin definition.
BACKGROUND:Lung injury with development of the acute respiratory distress syndrome (ARDS) is a serious complication which can occur after major surgery, including cardiac surgery. OBJECTIVE: The aim of our study was to compare the prevalence, risk factors, and mortality of ARDS following cardiac surgery according to the American-European Consensus Conference (AECC) definition and the new Berlin definition of ARDS. METHODS: We performed a retrospective, observational study that included prospectively collected data from consecutive adult patients, aged from 18 to 92 years, who had undergone cardiac surgery (both on and off pump) at a large tertiary university hospital over 5 years (from September 2012 to September 2017). RESULTS: During the study period, 3,972 patients underwent cardiac surgery, and 3,946 patients were included in the study. Fifty-five patients developed ARDS (1.14%) according to the AECC definition and 59 patients (1.15%) according to the Berlin definition, with a mortality of 32.7 and 30.5%, respectively (18 patients). Multivariate regression analysis identified prior cardiac surgery, complex cardiac surgery, emergency procedures, and transfusion of > 3 packed red blood cell units as predictors for ARDS. CONCLUSION: The development of ARDS in patients after cardiac surgery is a rare but serious complication associated with significant mortality. Moreover, our findings showed that prevalence, mortality, and risk factors for developing ARDS were similar according to both the AECC and the new Berlin definition.
Authors: Reda M Albadawy; Bismeen A Jadoon; Mysara M Mogahed; Mohamed E Ibrahim; Tarek S Essawy; Ahmed M A Amin; Marwa S Abd-Elraouf; Mona A Elawady Journal: J Environ Public Health Date: 2021-06-17