Volume 11 Supplement 2
Vasoplegic syndrome after cardiopulmonary bypass surgery – associated factors and clinical outcomes: a nested case-control study
© BioMed Central Ltd. 2007
Published: 22 March 2007
Vasoplegic syndrome (VS) following heart surgery using cardiopulmonary bypass (CPB) has been recently recognized and implicated in life-threatening complications. The aim of this study was to identify associated factors for the development of VS after CPB.
We performed a nested case–control study of 50 patients undergoing CPB, 27 (54%) men and 23 (46) women, mean age 66.5 (SD 9.6) years. VS was defined as systemic vascular resistance index <1,600 dyn∙seg/cm5/m2 and cardiac index >2.5 l/min/m2 within the first postoperative 4 hours. Vasoplegic shock was defined as vasoplegic patients that needed norepinephrine for at least 4 hours, after failure to respond to appropriate volume expansion. Excessive bleeding was defined as blood loss >1 l/24 hours, while total bleeding was considered as blood loss until chest tube withdrawal. Demographic variables, surgical procedures and postoperative variables were collected. We recorded data related to coagulation, fibrinolysis, complement, inflammation, blood loss at different time points, preoperative, at 0, 4 and 24 hours after surgery, and hemoderivative requirements. We used the Pearson chi-squared test, the Fisher exact test, the Student t test and the Mann–Whitney U test for nonparametric variables. SPSS version 12.1 was used.
VS post-CPB was associated with activation of serin protease systems, which leads to higher blood loss and excessive bleeding.