PMID- 1827965
OWN - NLM
STAT- MEDLINE
DCOM- 19910627
LR  - 20190703
IS  - 0003-2999 (Print)
IS  - 0003-2999 (Linking)
VI  - 72
IP  - 6
DP  - 1991 Jun
TI  - Preoperative and intraoperative predictors of inotropic support and long-term 
      outcome in patients having coronary artery bypass grafting.
PG  - 729-36
AB  - The prognostic value of preoperative symptoms, preoperative left ventricular 
      function, and intraoperative factors as related to postoperative outcome in 
      coronary artery bypass grafting is unclear. This study was performed to identify 
      risk factors that could be used as markers to predict immediate and long-term 
      outcome, knowledge of which might allow physicians to modify these factors to 
      decrease the likelihood of an adverse outcome. We retrospectively evaluated 
      preoperative factors (including age, sex, New York Heart Association [NYHA] 
      classification of symptoms, ejection fraction [EF], wall motion abnormalities, 
      baseline left ventricular end-diastolic pressure [LVEDP], postradiographic 
      contrast injection LVEDP, change in LVEDP with contrast injection, cardiac 
      enlargement, and collateral vessels) and intraoperative factors (duration of 
      bypass and aortic cross-clamp time) in 128 patients. The need for inotropic drug 
      support was used as a marker of immediate outcome. A 36-mo follow-up used death 
      and the postoperative NYHA classification of symptoms as markers of long-term 
      outcome. The various factors associated with the use of inotropes and immediate 
      outcome were analyzed by logistic regression. The factors related to inotrope use 
      (and presumed adverse short-term outcome) in order of decreasing significance 
      were lower EF, older age, cardiac enlargement, female sex, and higher baseline 
      and postcontrast LVEDP. Patients with EF greater than or equal to 55%, but also 
      having wall motion abnormalities and LVEDP change greater than or equal to 10 mm 
      Hg, and all patients with EF less than 55% were more likely to require inotropic 
      drug stimulation after cardiopulmonary bypass. Neither the change in LVEDP nor 
      the presence of wall motion abnormalities independently predicted the need for 
      postoperative inotropic support.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Royster, R L
AU  - Royster RL
AD  - Department of Anesthesia, Wake Forest University Medical Center, Bowman Gray 
      School of Medicine, Winston-Salem, North Carolina 27103.
FAU - Butterworth, J F 4th
AU  - Butterworth JF 4th
FAU - Prough, D S
AU  - Prough DS
FAU - Johnston, W E
AU  - Johnston WE
FAU - Thomas, J L
AU  - Thomas JL
FAU - Hogan, P E
AU  - Hogan PE
FAU - Case, L D
AU  - Case LD
FAU - Gravlee, G P
AU  - Gravlee GP
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Anesth Analg
JT  - Anesthesia and analgesia
JID - 1310650
RN  - 0 (Cardiotonic Agents)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Cardiomegaly/classification
MH  - Cardiotonic Agents/*administration & dosage
MH  - *Coronary Artery Bypass
MH  - Female
MH  - *Hemodynamics
MH  - Humans
MH  - Intraoperative Period
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Sex Factors
EDAT- 1991/06/11 19:15
MHDA- 2001/03/28 10:01
CRDT- 1991/06/11 19:15
PHST- 1991/06/11 19:15 [pubmed]
PHST- 2001/03/28 10:01 [medline]
PHST- 1991/06/11 19:15 [entrez]
AID - 10.1213/00000539-199106000-00002 [doi]
PST - ppublish
SO  - Anesth Analg. 1991 Jun;72(6):729-36. doi: 10.1213/00000539-199106000-00002.