Skip to main content

Prognostic value of low cardiac output early after cardiac surgery


The benefit of routine measurement of cardiac output after cardiac surgery is still discussed. Some studies found no benefit of routine right heart catheterisation [1] while others found a reduce length of stay [2]. Clinical prediction of cardiac output is poor after cardiac surgery [3]. Clinicians also do not really know what value of cardiac output is necessary after cardiac surgery. The aim of the present study was to verify whether the commonly accepted lower value of cardiac index of 2.2 l/min/m2 [4] at arrival in the ICU was a good predictor of complications after cardiac surgery.


Seventy-three consecutive patients with a value of cardiac index lower than or equal to 2.2 were included in a prospective observational study. Right heart catheterisation was decided in the operating room if the patient had a complex surgery or a left ventricular dysfunction. Routine hemodynamic measurements were performed at arrival in the ICU, 2, 6 and 18 hours later and included arterial and mixed venous blood gases. Postoperative complications were defined as death, renal insufficiency, and need for prolonged mechanical ventilation.


Fifty-one patients had no complication (Group 1), and 22 patients (Group 2) present a postoperative complication (including four deaths). No difference was found between the two groups for preoperative or intraoperative data (age, ejection fraction, EuroSCORE, length of bypass or aortic clamp) or for the blood lactate level, pH or base excess. At the arrival in the ICU and 18 hours later, hemodynamic parameters were similar between the two groups. Complicated patients had lower cardiac output and SVO2 values 2 and 6 hours after the arrival in ICU. In the logistic regression analysis, a reduced cardiac index at 2 and 6 hours after admission in the ICU had the strongest independent predictive value for postoperative complication.


A low cardiac output 2 or 6 hours after arrival in the ICU is associated with a high level of postoperative complication. Using right heart catheterisation allows early prediction and treatment of low cardiac output in order to prevent postoperative complication [2].


  1. Tuman KJ: Anesthesiology 1989, 70: 199-206.

    Article  CAS  PubMed  Google Scholar 

  2. Polonen P: Acta Anaesthesiol Scand 1997, 41: 810-817.

    Article  CAS  PubMed  Google Scholar 

  3. Linton RA: J Cardiothorac Vasc Anesth 2002, 16: 4-7. 10.1053/jcan.2002.29631

    Article  PubMed  Google Scholar 

  4. Forrester JS: N Engl J Med 1976, 295: 1356-1362.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

Reprints and Permissions

About this article

Cite this article

Berthet, M. Prognostic value of low cardiac output early after cardiac surgery. Crit Care 8 (Suppl 1), P64 (2004).

Download citation

  • Published:

  • DOI: