Cardiothoracic & vascular anesthesia
Association Between Ionized Calcium Concentrations During Weaning From Cardiopulmonary Bypass and Postoperative Low Cardiac Output Syndrome: A Retrospective Cohort Study
Authors' conclusion
Both low and high iCa levels at CPB weaning were associated with an increased risk of postoperative LCOS in patients undergoing cardiovascular surgery.
Study context
- Population
- Adults (≥ 18 years) undergoing cardiovascular surgery with cardiopulmonary bypass (CPB), three Japanese hospitals, September 2012–December 2022
- Participants
- 2,382 adults · 3 hospitals
- Exposure
- Ionized calcium (iCa) quartiles during CPB weaning vs standard iCa
- Outcome
- Low cardiac output syndrome (LCOS) on ICU admission (postoperative MCS use, cardiac index <2.0 L min-1 m-2, or ≥2 inotropes at 1 hour after end of surgery)
- Follow-up
- ICU admission
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
LCOS
Each group vs standard iCaAdjusted odds ratio (95% CI)P value
Low iCa
1.45(1.06–1.99)
P = 0.020Moderate-high iCa
1.42(1.01–2.00)
P = 0.046High iCa
1.36(0.95–1.94)
P = 0.094- Overall low cardiac output syndrome (LCOS) incidence
- 501 cases (21%)
Observational data: associations, not effects.
Original publication
Association Between Ionized Calcium Concentrations During Weaning From Cardiopulmonary Bypass and Postoperative Low Cardiac Output Syndrome: A Retrospective Cohort Study. Anesth Analg. Published 24 March 2026. doi:10.
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