HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Rémi Houël Daniel Y. Loisance Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mekontso-Dessap, A. Articles by Loisance, D. Y. Search for Related Content PubMed PubMed Citation Articles by Mekontso-Dessap, A. Articles by Loisance, D. Y. Related Collections Cardiac - physiology Extracorporeal circulation

Ann Thorac Surg 2001;71:1428-1432
© 2001 The Society of Thoracic Surgeons

---

Original article: cardiovascular

Risk factors for post-cardiopulmonary bypass vasoplegia in patients with preserved left ventricular function

^a Service de Chirurgie Thoracique et Cardiovasculaire, CNRS UPRES-A 7053, Association Claude Bernard, Centre Hospitalo-Universitaire Henri Mondor, Créteil, France

Accepted for publication January 24, 2001.

Address reprint requests to Dr Houël, Centre Hospitalo-Universitaire Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil Cédex, France
e-mail: maurette{at}univ-paris12.fr

Background. Although vasodilatory shock (VS) is one of the main complications of cardiopulmonary bypass (CPB), its pathophysiologic basis remains unclear. The aim of this study was to identify predisposing factors for the development of VS after CPB independent of ventricular function.

Methods. Thirty-six patients undergoing coronary artery bypass grafting who developed VS were compared with 72 control patients without post-CPB cardiogenic or vasoplegic shock, in a 2:1 case control study. Patients and controls underwent the same anesthetic protocol and were matched by age, sex, operation date, and left ventricle ejection fraction.

Results. Preoperative and intraoperative patient characteristics were not significantly different between the two groups. Preoperative use of angiotensin-converting enzyme inhibitors and intravenous heparin were independent predictors for post-CPB VS by multivariate analysis (relative risk of 2.26 and 2.78, respectively). Intensive care unit stay and hospital stay were significantly longer in VS cases than controls, without any difference in early postoperative mortality.

Conclusions. The only independent risk factors for postoperative VS identified were preoperative use of angiotensin-converting enzyme inhibitors and intravenous heparin. These risk factors were independent of age, gender, anesthetic protocol, and left ventricle ejection fraction.

This article has been cited by other articles:

				X. Sun, L. Zhang, P. C. Hill, R. Lowery, A. T. Lee, R. E. Molyneaux, P. J. Corso, and S. W. Boyce Is incidence of postoperative vasoplegic syndrome different between off-pump and on-pump coronary artery bypass grafting surgery? Eur. J. Cardiothorac. Surg., October 1, 2008; 34(4): 820 - 825. [Abstract] [Full Text] [PDF]

				S. G. Raja and N. Fida Should angiotensin converting enzyme inhibitors/angiotensin II receptor antagonists be omitted before cardiac surgery to avoid postoperative vasodilation? Interactive CardioVascular and Thoracic Surgery, June 1, 2008; 7(3): 470 - 475. [Abstract] [Full Text] [PDF]

				M. Egi, R. Bellomo, C. Langenberg, M. Haase, A. Haase, L. Doolan, G. Matalanis, S. Seevenayagam, and B. Buxton Selecting a Vasopressor Drug for Vasoplegic Shock After Adult Cardiac Surgery: A Systematic Literature Review Ann. Thorac. Surg., February 1, 2007; 83(2): 715 - 723. [Abstract] [Full Text] [PDF]

				A. D. Maslow, G. Stearns, P. Batula, C. S. Schwartz, J. Gough, and A. K. Singh The hemodynamic effects of methylene blue when administered at the onset of cardiopulmonary bypass. Anesth. Analg., July 1, 2006; 103(1): 2 - 8. [Abstract] [Full Text] [PDF]

				G. Shanmugam Vasoplegic syndrome--the role of methylene blue Eur. J. Cardiothorac. Surg., November 1, 2005; 28(5): 705 - 710. [Abstract] [Full Text] [PDF]

				E. Ozal, E. Kuralay, V. Yildirim, S. Kilic, C. Bolcal, N. Kucukarslan, C. Gunay, U. Demirkilic, and H. Tatar Preoperative Methylene Blue Administration in Patients at High Risk for Vasoplegic Syndrome During Cardiac Surgery Ann. Thorac. Surg., May 1, 2005; 79(5): 1615 - 1619. [Abstract] [Full Text] [PDF]

				J. G. Byrne, M. Leacche, S. Paul, T. Mihaljevic, J. D. Rawn, S. K. Shernan, G. H. Mudge, and L. W. Stevenson Risk factors and outcomes for 'vasoplegia syndrome' following cardiac transplantation Eur. J. Cardiothorac. Surg., March 1, 2004; 25(3): 327 - 332. [Abstract] [Full Text] [PDF]

				R. G. Leyh, T. Kofidis, M. Struber, S. Fischer, K. Knobloch, B. Wachsmann, C. Hagl, A. R. Simon, and A. Haverich Methylene blue: The drug of choice for catecholamine-refractory vasoplegia after cardiopulmonary bypass? J. Thorac. Cardiovasc. Surg., June 1, 2003; 125(6): 1426 - 1431. [Abstract] [Full Text] [PDF]

				W. J. Gomes, M. R. Erlichman, M. L. Batista-Filho, M. Knobel, D. R. Almeida, A. C. Carvalho, R. Catani, and E. Buffolo Vasoplegic syndrome after off-pump coronary artery bypass surgery Eur. J. Cardiothorac. Surg., February 1, 2003; 23(2): 165 - 169. [Abstract] [Full Text] [PDF]

				V. R. Conti and C. McQuitty Vasodilation and Cardiopulmonary Bypass : The Role of Bradykinin and the Pulmonary Vascular Endothelium Chest, December 1, 2001; 120(6): 1759 - 1761. [Full Text] [PDF]