Impaired Right Ventricular Ejection Fraction After Cardiac Surgery is Associated with a Complicated ICU Stay

Overview

Journal J Intensive Care

Publisher Biomed Central

Specialty Critical Care

Date 2019 Jan 5

PMID 30607248

Citations 6

Authors

Inge T Bootsma

Thomas W L Scheeren

Fellery De Lange

Johannes Haenen

Piet W Boonstra

E Christaan Boerma

Affiliations

Soon will be listed here.

Abstract

Background: Right ventricular (RV) dysfunction is a known risk factor for increased mortality in cardiac surgery. However, the association between RV performance and ICU morbidity is largely unknown.

Methods: We performed a single-centre, retrospective study including cardiac surgery patients equipped with a pulmonary artery catheter, enabling continuous right ventricular ejection fraction (RVEF) measurements. Primary endpoint of our study was ICU morbidity (as determined by ICU length of stay, duration of mechanical ventilation, usage of inotropic drugs and fluids, and kidney dysfunction) in relation to RVEF. Patients were divided into three groups according to their RVEF; < 20%, 20-30%, and > 30%.

Results: We included 1109 patients. Patients with a RVEF < 20% had a significantly longer stay in ICU, a longer duration of mechanical ventilation, higher fluid balance, a higher incidence of inotropic drug usage, and more increase in postoperative creatinine levels in comparison to the other subgroups. In a multivariate analysis, RVEF was independently associated with increased ICU length of stay (OR 0.934 CI 0.908-0.961, < 0.001), prolonged duration of mechanical ventilation (OR 0.969, CI 0.942-0.998, = 0.033), usage of inotropic drugs (OR 0.944, CI 0.917-0.971, < 0.001), and increase in creatinine (OR 0.962, CI 0.934-0.991, = 0.011).

Conclusions: A decreased RVEF is independently associated with a complicated ICU stay.

Citing Articles

Impact of the right ventricular mechanical pattern assessed by three-dimensional echocardiography on adverse outcomes following cardiac surgery.

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Effect of Preoperative Pulmonary Hypertension on the Course of Right Ventricular Function: A Three-dimensional Echocardiographic Study in Valvular Surgery Patients.

Ito S, Yoshitani K, Fukushima S, Matsuda H J Cardiovasc Echogr. 2025; 34(4):170-178.

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Right ventricular ejection fraction derived from intraoperative three-dimensional transesophageal echocardiography versus cardiac magnetic resonance imaging.

Defoe M, Lam W, Becher H, Lydell C, Hong Y, Sidhu S Can J Anaesth. 2023; 70(10):1576-1586.

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Predictors of Outcome in Patients with Pulmonary Hypertension Undergoing Mitral and Tricuspid Valve Surgery.

Kew E, Caruso V, Grapsa J, Bosco P, Lucchese G Medicina (Kaunas). 2023; 59(6).

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