Six-month prognostic impact of hemodynamic profiling by short minimally invasive monitoring after cardiac surgery

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GIGLIOLI CRISTINA; CECCHI EMANUELE; Stefàno Pier Luigi; Spini Valentina; Fortini Giacomo; Chiostri Marco; Marchionni Niccolo; Romano Salvatore Mario

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Journal Paper

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Journal: Journal of Cardiovascular and Thoracic Research Year:2020 | Volume:12 | Issue:4 Page(s): 313-320

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Title

Six-month prognostic impact of hemodynamic profiling by short minimally invasive monitoring after cardiac surgery

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Keywords

Cardiac

Surgery Hemodynamic Profile Clinical Six Months Follow

Abstract

Introduction: Studies have shown that a hemodynamic-guided therapy improves the postoperative outcomes of high-risk patients. This study, evaluated if a short period through minimally invasive hemodynamic monitoring, pressure recording analytical method (PRAM), on admission to a post-Cardiac surgery step-down unit (SDU), may identify patients at higher risk of 6-month adverse events after Cardiac surgery. Methods: From December 2016-May 2017, 173 patients were admitted in SDU within 24-48 hours of major Cardiac surgery procedure, and submitted to clinical, laboratoristic and echocardiographic evaluation and a 1-hour PRAM recording to obtain a “ biohumoral snapshot” of individual patient’ s. 156 173 patients (17 patients were lost at follow-up) were phone interviewed six months after surgery, to evaluate, as a composite end-point, the adverse events during follow-up. A multivariable logistic regression analysis was used to identify a model clinical-biohumoral (CBM) and clinical-biohumoralhemodynamics (CBHM). Results: No data from past clinical history and no conventional risk score (EuroScore II, STS score) independently predicted the risk of 6-month major events in our study. The risk of adverse events at six-month follow-up was directly related, in the CBM, to sustained post-operative Cardiac arrhythmias, higher values of NT-proBNP and of arterial pH; inversely related to values of hs-C-reactive protein (hs-CRP) and, in the CBHM, to low values of Cardiac cycle efficiency (CCE) and dP/dtmax. Conclusion: Our study although limited by its observational nature and by the limited number of patients enrolled, showed that a short period of minimally invasive hemodynamic monitoring increased the accuracy to identify patients at major risk of mid-term events after Cardiac surgery.

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APA: Copy

GIGLIOLI, CRISTINA, CECCHI, EMANUELE, Stefàno, Pier Luigi, Spini, Valentina, Fortini, Giacomo, & Chiostri, Marco. (2020). Six-month prognostic impact of hemodynamic profiling by short minimally invasive monitoring after cardiac surgery. JOURNAL OF CARDIOVASCULAR AND THORACIC RESEARCH, 12(4), 313-320. SID. https://sid.ir/paper/781032/en

Vancouver: Copy

GIGLIOLI CRISTINA, CECCHI EMANUELE, Stefàno Pier Luigi, Spini Valentina, Fortini Giacomo, Chiostri Marco. Six-month prognostic impact of hemodynamic profiling by short minimally invasive monitoring after cardiac surgery. JOURNAL OF CARDIOVASCULAR AND THORACIC RESEARCH[Internet]. 2020;12(4):313-320. Available from: https://sid.ir/paper/781032/en

IEEE: Copy

CRISTINA GIGLIOLI, EMANUELE CECCHI, Pier Luigi Stefàno, Valentina Spini, Giacomo Fortini, and Marco Chiostri, “Six-month prognostic impact of hemodynamic profiling by short minimally invasive monitoring after cardiac surgery,” JOURNAL OF CARDIOVASCULAR AND THORACIC RESEARCH, vol. 12, no. 4, pp. 313–320, 2020, [Online]. Available: https://sid.ir/paper/781032/en

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