Occurrence of Low Cardiac Index During Normotensive Periods in Cardiac Surgery: A Prospective Cohort Study Using Continuous Noninvasive Cardiac Output Monitoring
Authors' conclusion
In a prospective cohort of patients undergoing CAB surgery, low CI was common even when blood pressure was normal. CI and MAP were correlated modestly. Correlation was higher before than after CPB with substantial heterogeneity among individuals.
Study context
- Population
- Adults ≥18 undergoing isolated coronary bypass (CAB) surgery with cardiopulmonary bypass (CPB) at a tertiary medical center, July 2021 to November 2023analysed
- Participants
- 101 adults
- Outcome
- Time with low CI (<2 L/min/m 2) and proportion of time with low CI and normal MAP
Methodological detailssingle-centre, continuous noninvasive cardiac output monitoring
- Single-centre
- Continuous noninvasive cardiac output monitoring
Main finding
As reported in the abstract
- Total intraoperative time with low CI, mean (SD), minutes
- 86.4 (62)
- Low CI pre-CPB, minutes
- 61.2 (42)
- Low CI post-CPB, minutes
- 25.2 (31)
- Total time with low CI and normal MAP, minutes
- 66.5 (56)
- Proportion of low-CI time with normal MAP, mean (SD)
- 69% (23%)
- Low CI and normal MAP pre-CPB, minutes
- 45.8 (38)
- Low CI and normal MAP post-CPB, minutes
- 20.6 (27)
Observational data: associations, not effects.
Further findings
Correlation between CI and MAP, overall
- Correlation, mean (SD)
- 0.33 (0.31)
Correlation between CI and MAP, pre-CPB vs post-CPB
- Pre-CPB correlation, mean (SD)
- 0.53 [0.32]
- Post-CPB correlation, mean (SD)
- 0.29 [0.28]
- CI for difference
- 0.18-0.34
- P
- P < 0.001
- 95% CI for difference
- Substantial heterogeneity among participants
Correlation accounting for central venous pressure (CVP) (secondary analyses)
- Accounting for CVP did not alter the correlation between CI and MAP
Duration of low CI and postoperative AKI (exploratory)
- OR for postoperative AKI per duration of low CI
- 1.09
- 95% CI
- 1.01-1.13
- P
- P = 0.018
- Exploratory analyses
Original publication
Occurrence of Low Cardiac Index During Normotensive Periods in Cardiac Surgery: A Prospective Cohort Study Using Continuous Noninvasive Cardiac Output Monitoring. Anesth Analg. Published 16 December 2024. doi:10.
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