Impaired right ventricular ejection fraction after cardiac surgery is associated with a complicated ICU stay

Table 2 Postoperative details

	RVEF < 20%	RVEF 20–30%	RVEF > 30%	p value
Mortality ICU (%)	4.2%	1.2%	0.7%	0.008*
LVEF (%) (TEE)
Good (> 55%)	52	69	72
Moderate (30–49%)	31	24	21	< 0.001*
Poor (< 30%)	17	8	9
Markers of morbidity
Length of stay ICU (days)	2 [2–5]	2 [2–3]	2 [2–2]	< 0.001*
Mechanical ventilation (h)	5.5 [3.5–17.8]	4.5 [3–8]	3.8 [2.5–5.6]	< 0.001*
Fluid balance (l)	1.9 [1.2–3.2]	1.6 [0.8–2.8]	1.1 [0.3–2.0]	< 0.001*
Use of inotropic drugs (%)	76	61	48	< 0.001*
Postoperative laboratory details
Delta creatinine (μmol/l)^‡	12 [− 13–41]	5 [−9–28]	0 [−10–19]	0.004*
Peak lactate (mmol/l)	2.6 [1.9–3.4]	2.7 [2.0–3.5]	2.7 [2.0–3.5]	0.431
Peak CK-MB (U/l)	39 [24–72]	44 [28–76]	40 [27–66]	0.095
Postoperative complications (%)
Re-sternotomy	7.4	6.6	6.8	0.910
Tamponade	4.6	3.6	4.8	0.686
CVVHD	4.2	1.9	1.4	0.101
Haemodynamic variables†
RVEF (%)	18 [15–19]	25 [23–27]	32 [31–34]	< 0.001*
Mean PAP (mmHg)	20 [17–25]	19 [15–22]	18 [16–21]	< 0.001*
Cardiac index (l/min/m²)	2.2 [2.0–2.5]	2.4 [2.2–2.7]	2.7 [2.4–3.0]	< 0.001*
EDVi (ml/m²)	143 [124–167]	113 [100–128]	101 [85–115]	< 0.001*
CVP (mmHg)	8 [5–10]	7 [5–9]	7 [5–9]	0.081
SvO₂ (%)	64 [59–68]	65 [60–69]	68 [63–71]	< 0.001*
PHT (%)	24	9	7	< 0.001*

^‡Postoperative delta creatinine is the difference between preoperative creatinine and postoperative peak value creatinine. †Mean values measured with a pulmonary artery catheter over the first 24 h of ICU admission
Abbreviations: ICU, intensive care unit; CK-MB, creatine kinase-myoglobin binding; CVVHD, continuous veno-venous haemodialysis; LV, left ventricular; RVEF, right ventricular ejection fraction; PAP, pulmonary artery pressure; EDVi, end-diastolic volume index; CVP, central venous pressure; SvO_2, mixed venous oxygen saturation; PHT, pulmonary hypertension; TEE, transoesophageal echocardiography

ISSN: 2052-0492