TY - JOUR T1 - Low cardiac output syndrome in the postoperative period of cardiac surgery. Profile, differences in clinical course and prognosis. The ESBAGA study JO - Medicina Intensiva (English Edition) T2 - AU - Pérez Vela,J.L. AU - Jiménez Rivera,J.J. AU - Alcalá Llorente,M.Á. AU - González de Marcos,B. AU - Torrado,H. AU - García Laborda,C. AU - Fernández Zamora,M.D. AU - González Fernández,F.J. AU - Martín Benítez,J.C. SN - 21735727 M3 - 10.1016/j.medine.2018.03.001 DO - 10.1016/j.medine.2018.03.001 UR - https://medintensiva.org/en-low-cardiac-output-syndrome-in-articulo-S2173572718300481 AB - ObjectivesAn analysis is made of the clinical profile, evolution and differences in morbidity and mortality of low cardiac output syndrome (LCOS) in the postoperative period of cardiac surgery, according to the three diagnostic subgroups defined by the SEMICYUC Consensus 2012. DesignA multicenter, prospective cohort study was carried out. SettingIntensive Care Units of Spanish hospitals with cardiac surgery. PatientsA consecutive sample of 2070 cardiac surgery patients was included, with the analysis of 137 patients presenting LCOS. InterventionsNo. ResultsThe mean patient age was 68.3±9.3 years (65.2% males), with a EuroSCORE II of 9.99±13. NYHA functional class III and IV (52.9%), left ventricular ejection fraction <35% (33.6%), acute myocardial infarction (31.9%), severe pulmonary hypertension (21.7%), critical preoperative condition (18.8%), prior cardiac surgery (18.1%), PTCA/stent placement (16.7%). According to subgroups, 46 patients fulfilled hemodynamic criteria of LCOS (group A), 50 clinical criteria of LCOS (group B), and the rest (n=41) presented cardiogenic shock (group C). Significant differences were observed over the evolutive course between the subgroups in terms of time subjected to mechanical ventilation (114.4, 135.4 and 180.3min in groups A, B and C, respectively; p<0.001), renal replacement requirements (11.4%, 14.6% and 36.6%; p=0.007), multiorgan failure (16.7%, 13% and 47.5%), and mortality (13.6%, 12.5% and 35.9%; p=0.01). The mean maximum lactate concentration was higher in cardiogenic shock patients (p=0.002). ConclusionsThe clinical evolution of these patients leads to high morbidity and mortality. Differences were found between the subgroups in terms of postoperative clinical course and mortality. ER -