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Caridi-Scheible M, Leiendecker ER. Dead-Space Ventilation Indices and Mortality: Finally Addressing the Other Reason We Breathe. Crit Care Med 2023; 51:1442-1444. [PMID: 37707384 DOI: 10.1097/ccm.0000000000005965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Affiliation(s)
- Mark Caridi-Scheible
- Both authors: Department of Anesthesiology, Emory Healthcare, Anesthesiology, Atlanta, GA
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Auld SC, Harrington KRV, Adelman MW, Robichaux CJ, Overton EC, Caridi-Scheible M, Coopersmith CM, Murphy DJ. Trends in ICU Mortality From Coronavirus Disease 2019: A Tale of Three Surges. Crit Care Med 2022; 50:245-255. [PMID: 34259667 PMCID: PMC8796834 DOI: 10.1097/ccm.0000000000005185] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To determine the association between time period of hospitalization and hospital mortality among critically ill adults with coronavirus disease 2019. DESIGN Observational cohort study from March 6, 2020, to January 31, 2021. SETTING ICUs at four hospitals within an academic health center network in Atlanta, GA. PATIENTS Adults greater than or equal to 18 years with coronavirus disease 2019 admitted to an ICU during the study period (i.e., Surge 1: March to April, Lull 1: May to June, Surge 2: July to August, Lull 2: September to November, Surge 3: December to January). MEASUREMENTS AND MAIN RESULTS Among 1,686 patients with coronavirus disease 2019 admitted to an ICU during the study period, all-cause hospital mortality was 29.7%. Mortality differed significantly over time: 28.7% in Surge 1, 21.3% in Lull 1, 25.2% in Surge 2, 30.2% in Lull 2, 34.7% in Surge 3 (p = 0.007). Mortality was significantly associated with 1) preexisting risk factors (older age, race, ethnicity, lower body mass index, higher Elixhauser Comorbidity Index, admission from a nursing home); 2) clinical status at ICU admission (higher Sequential Organ Failure Assessment score, higher d-dimer, higher C-reactive protein); and 3) ICU interventions (receipt of mechanical ventilation, vasopressors, renal replacement therapy, inhaled vasodilators). After adjusting for baseline and clinical variables, there was a significantly increased risk of mortality associated with admission during Lull 2 (relative risk, 1.37 [95% CI = 1.03-1.81]) and Surge 3 (relative risk, 1.35 [95% CI = 1.04-1.77]) as compared to Surge 1. CONCLUSIONS Despite increased experience and evidence-based treatments, the risk of death for patients admitted to the ICU with coronavirus disease 2019 was highest during the fall and winter of 2020. Reasons for this increased mortality are not clear.
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Affiliation(s)
- Sara C Auld
- Emory Critical Care Center (ECCC), Atlanta, GA
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA
- Georgia Clinical and Translational Science Alliance (CTSA), Atlanta, GA
- Office of Quality and Risk, Emory Healthcare, Atlanta, GA
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
- Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Kristin R V Harrington
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | - Max W Adelman
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Chad J Robichaux
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA
- Georgia Clinical and Translational Science Alliance (CTSA), Atlanta, GA
| | | | - Mark Caridi-Scheible
- Emory Critical Care Center (ECCC), Atlanta, GA
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
| | - Craig M Coopersmith
- Emory Critical Care Center (ECCC), Atlanta, GA
- Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - David J Murphy
- Emory Critical Care Center (ECCC), Atlanta, GA
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Office of Quality and Risk, Emory Healthcare, Atlanta, GA
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Creel-Bulos C, Auld SC, Caridi-Scheible M, Barker NA, Friend S, Gaddh M, Kempton CL, Maier CL, Nahab F, Sniecinski R. Fibrinolysis Shutdown and Thrombosis in a COVID-19 ICU. Shock 2021; 55:316-320. [PMID: 32769822 PMCID: PMC8858425 DOI: 10.1097/shk.0000000000001635] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
ABSTRACT The coronavirus disease (COVID-19) pandemic has threatened millions of lives worldwide with severe systemic inflammation, organ dysfunction, and thromboembolic disease. Within our institution, many critically ill COVID-19-positive patients suffered major thrombotic events, prompting our clinicians to evaluate hypercoagulability outside of traditional coagulation testing.We determined the prevalence of fibrinolysis shutdown via rotational thromboelastometry (ROTEM, Instrumentation Laboratories, Bedford, Mass) in patients admitted to the intensive care unit over a period of 3 weeks. In 25 patients who had a ROTEM test, we found that 11 (44%) met criteria for fibrinolysis shutdown. Eight of 9 (73%) of the VTE patients met criteria for fibrinolysis shutdown.Given the high rate of fibrinolysis shutdown in these patients, our data support using viscoelastic testing to evaluate for the presence of impaired fibrinolysis. This may help identify patient subsets who might benefit from the administration of fibrinolytics.
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Affiliation(s)
- Christina Creel-Bulos
- Emory Critical Care Center, Division of Critical Care Medicine, Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia
| | - Sara C. Auld
- Emory Critical Care Center, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Mark Caridi-Scheible
- Emory Critical Care Center, Division of Critical Care Medicine, Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia
| | | | - Sarah Friend
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia
| | - Manila Gaddh
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia
| | - Christine L. Kempton
- Hemophilia of Georgia Center for Bleeding and Clotting Disorders of Emory and Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia
| | - Cheryl L. Maier
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Fadi Nahab
- Division of Vascular Neurology, Department of Neurology and Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Roman Sniecinski
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia
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Hernandez-Romieu AC, Adelman MW, Hockstein MA, Robichaux CJ, Edwards JA, Fazio JC, Blum JM, Jabaley CS, Caridi-Scheible M, Martin GS, Murphy DJ, Auld SC. Timing of Intubation and Mortality Among Critically Ill Coronavirus Disease 2019 Patients: A Single-Center Cohort Study. Crit Care Med 2020; 48:e1045-e1053. [PMID: 32804790 PMCID: PMC7448713 DOI: 10.1097/ccm.0000000000004600] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Increasing time to mechanical ventilation and high-flow nasal cannula use may be associated with mortality in coronavirus disease 2019. We examined the impact of time to intubation and use of high-flow nasal cannula on clinical outcomes in patients with coronavirus disease 2019. DESIGN Retrospective cohort study. SETTING Six coronavirus disease 2019-specific ICUs across four university-affiliated hospitals in Atlanta, Georgia. PATIENTS Adults with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection who received high-flow nasal cannula or mechanical ventilation. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Among 231 patients admitted to the ICU, 109 (47.2%) were treated with high-flow nasal cannula and 97 (42.0%) were intubated without preceding high-flow nasal cannula use. Of those managed with high-flow nasal cannula, 78 (71.6%) ultimately received mechanical ventilation. In total, 175 patients received mechanical ventilation; 44.6% were female, 66.3% were Black, and the median age was 66 years (interquartile range, 56-75 yr). Seventy-six patients (43.4%) were intubated within 8 hours of ICU admission, 57 (32.6%) between 8 and 24 hours of admission, and 42 (24.0%) greater than or equal to 24 hours after admission. Patients intubated within 8 hours were more likely to have diabetes, chronic comorbidities, and higher admission Sequential Organ Failure Assessment scores. Mortality did not differ by time to intubation (≤ 8 hr: 38.2%; 8-24 hr: 31.6%; ≥ 24 hr: 38.1%; p = 0.7), and there was no association between time to intubation and mortality in adjusted analysis. Similarly, there was no difference in initial static compliance, duration of mechanical ventilation, or ICU length of stay by timing of intubation. High-flow nasal cannula use prior to intubation was not associated with mortality. CONCLUSIONS In this cohort of critically ill patients with coronavirus disease 2019, neither time from ICU admission to intubation nor high-flow nasal cannula use were associated with increased mortality. This study provides evidence that coronavirus disease 2019 respiratory failure can be managed similarly to hypoxic respiratory failure of other etiologies.
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Affiliation(s)
- Alfonso C Hernandez-Romieu
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Max W Adelman
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Maxwell A Hockstein
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
- Emory Critical Care Center (ECCC), Atlanta, GA
| | - Chad J Robichaux
- Department of Biomedical Informatics, Emory University, Atlanta, GA
- Georgia Clinical and Translational Science Alliance, Atlanta, GA
| | - Johnathan A Edwards
- Department of Biomedical Informatics, Emory University, Atlanta, GA
- Georgia Clinical and Translational Science Alliance, Atlanta, GA
| | - Jane C Fazio
- Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - James M Blum
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
- Emory Critical Care Center (ECCC), Atlanta, GA
- Department of Biomedical Informatics, Emory University, Atlanta, GA
- Georgia Clinical and Translational Science Alliance, Atlanta, GA
| | - Craig S Jabaley
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
- Emory Critical Care Center (ECCC), Atlanta, GA
| | - Mark Caridi-Scheible
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
- Emory Critical Care Center (ECCC), Atlanta, GA
| | - Greg S Martin
- Emory Critical Care Center (ECCC), Atlanta, GA
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - David J Murphy
- Emory Critical Care Center (ECCC), Atlanta, GA
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Office of Quality and Risk, Emory Healthcare, Atlanta, GA
| | - Sara C Auld
- Emory Critical Care Center (ECCC), Atlanta, GA
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
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Auld SC, Caridi-Scheible M, Blum JM, Robichaux C, Kraft C, Jacob JT, Jabaley CS, Carpenter D, Kaplow R, Hernandez-Romieu AC, Adelman MW, Martin GS, Coopersmith CM, Murphy DJ. ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019. Crit Care Med 2020; 48:e799-e804. [PMID: 32452888 PMCID: PMC7255393 DOI: 10.1097/ccm.0000000000004457] [Citation(s) in RCA: 277] [Impact Index Per Article: 69.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To determine mortality rates among adults with critical illness from coronavirus disease 2019. DESIGN Observational cohort study of patients admitted from March 6, 2020, to April 17, 2020. SETTING Six coronavirus disease 2019 designated ICUs at three hospitals within an academic health center network in Atlanta, Georgia, United States. PATIENTS Adults greater than or equal to 18 years old with confirmed severe acute respiratory syndrome-CoV-2 disease who were admitted to an ICU during the study period. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Among 217 critically ill patients, mortality for those who required mechanical ventilation was 35.7% (59/165), with 4.8% of patients (8/165) still on the ventilator at the time of this report. Overall mortality to date in this critically ill cohort is 30.9% (67/217) and 60.4% (131/217) patients have survived to hospital discharge. Mortality was significantly associated with older age, lower body mass index, chronic renal disease, higher Sequential Organ Failure Assessment score, lower PaO2/FIO2 ratio, higher D-dimer, higher C-reactive protein, and receipt of mechanical ventilation, vasopressors, renal replacement therapy, or vasodilator therapy. CONCLUSIONS Despite multiple reports of mortality rates exceeding 50% among critically ill adults with coronavirus disease 2019, particularly among those requiring mechanical ventilation, our early experience indicates that many patients survive their critical illness.
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Affiliation(s)
- Sara C Auld
- Emory Critical Care Center (ECCC), Atlanta, GA
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA
- Georgia Clinical and Translational Science Alliance (CTSA), Atlanta, GA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Department of Pathology, Emory University School of Medicine, Atlanta, GA
- Emory University Hospital, Emory Healthcare, Atlanta, GA
- Department of Surgery, Emory University School of Medicine, Atlanta, GA
- Office of Quality and Risk, Emory Healthcare, Atlanta, GA
| | - Mark Caridi-Scheible
- Emory Critical Care Center (ECCC), Atlanta, GA
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
| | - James M Blum
- Emory Critical Care Center (ECCC), Atlanta, GA
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA
- Georgia Clinical and Translational Science Alliance (CTSA), Atlanta, GA
| | - Chad Robichaux
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA
- Georgia Clinical and Translational Science Alliance (CTSA), Atlanta, GA
| | - Colleen Kraft
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Department of Pathology, Emory University School of Medicine, Atlanta, GA
| | - Jesse T Jacob
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Craig S Jabaley
- Emory Critical Care Center (ECCC), Atlanta, GA
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
| | | | - Roberta Kaplow
- Emory University Hospital, Emory Healthcare, Atlanta, GA
| | - Alfonso C Hernandez-Romieu
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Max W Adelman
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Greg S Martin
- Emory Critical Care Center (ECCC), Atlanta, GA
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Georgia Clinical and Translational Science Alliance (CTSA), Atlanta, GA
| | - Craig M Coopersmith
- Emory Critical Care Center (ECCC), Atlanta, GA
- Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - David J Murphy
- Emory Critical Care Center (ECCC), Atlanta, GA
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Office of Quality and Risk, Emory Healthcare, Atlanta, GA
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Auld SC, Caridi-Scheible M, Blum JM, Robichaux C, Kraft C, Jacob JT, Jabaley CS, Carpenter D, Kaplow R, Hernandez-Romieu AC, Adelman MW, Martin GS, Coopersmith CM, Murphy DJ. ICU and ventilator mortality among critically ill adults with COVID-19. medRxiv 2020:2020.04.23.20076737. [PMID: 32511599 PMCID: PMC7276026 DOI: 10.1101/2020.04.23.20076737] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
We report preliminary data from a cohort of adults admitted to COVID-designated intensive care units from March 6 through April 17, 2020 across an academic healthcare system. Among 217 critically ill patients, mortality for those who required mechanical ventilation was 29.7% (49/165), with 8.5% (14/165) of patients still on the ventilator at the time of this report. Overall mortality to date in this critically ill cohort is 25.8% (56/217), and 40.1% (87/217) patients have survived to hospital discharge. Despite multiple reports of mortality rates exceeding 50% among critically ill adults with COVID-19, particularly among those requiring mechanical ventilation, our early experience indicates that many patients survive their critical illness.
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Affiliation(s)
- Sara C. Auld
- Emory Critical Care Center (ECCC)
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine
- Department of Epidemiology, Emory University Rollins School of Public Health
| | - Mark Caridi-Scheible
- Emory Critical Care Center (ECCC)
- Department of Anesthesiology, Emory University School of Medicine
| | - James M. Blum
- Emory Critical Care Center (ECCC)
- Department of Anesthesiology, Emory University School of Medicine
- Department of Biomedical Informatics, Emory University School of Medicine
- Georgia Clinical and Translational Science Alliance (CTSA)
| | - Chad Robichaux
- Department of Biomedical Informatics, Emory University School of Medicine
- Georgia Clinical and Translational Science Alliance (CTSA)
| | - Colleen Kraft
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine
- Department of Pathology, Emory University School of Medicine
| | - Jesse T. Jacob
- Department of Epidemiology, Emory University Rollins School of Public Health
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine
| | - Craig S. Jabaley
- Emory Critical Care Center (ECCC)
- Department of Anesthesiology, Emory University School of Medicine
| | | | | | | | - Max W. Adelman
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine
| | - Greg S. Martin
- Emory Critical Care Center (ECCC)
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine
- Georgia Clinical and Translational Science Alliance (CTSA)
| | - Craig M. Coopersmith
- Emory Critical Care Center (ECCC)
- Department of Surgery, Emory University School of Medicine
| | - David J. Murphy
- Emory Critical Care Center (ECCC)
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine
- Office of Quality and Risk, Emory Healthcare
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Hamilton J, Caridi-Scheible M. Anesthetic Management for Minimally Invasive Cardiac Surgery. Anesthesiology 2018. [DOI: 10.1007/978-3-319-74766-8_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mazzeffi M, Hammer B, Chen E, Caridi-Scheible M, Ramsay J, Paciullo C. Methylene blue for postcardiopulmonary bypass vasoplegic syndrome: A cohort study. Ann Card Anaesth 2017; 20:178-181. [PMID: 28393777 PMCID: PMC5408522 DOI: 10.4103/aca.aca_237_16] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Methylene blue (MB) has been used to treat refractory hypotension in a variety of settings. AIMS We sought to determine whether MB improved blood pressure in postcardiopulmonary bypass (CPB) vasoplegic syndrome (VS) in a complex cardiac surgery population. Furthermore, to determine variables that predicted response to MB. SETTING AND DESIGN This was conducted in a tertiary care medical center; this study was a retrospective cohort study. MATERIALS AND METHODS Adult cardiac surgery patients who received MB for post-CPB VS over a 2-year period were studied. Mean arterial blood pressure (MAP) and vasopressor doses were compared before and after MB, and logistic regression was used to model which variables predicted response. RESULTS Eighty-eight patients received MB for post-CPB VS during the study period. MB administration was associated with an 8 mmHg increase in MAP (P = 0.004), and peak response occurred at 2 h. Variables that were associated with a positive drug response were deep hypothermic circulatory arrest during surgery and higher MAP at the time of drug administration (P = 0.006 and 0.02). A positive response had no correlation with in-hospital mortality (P = 0.09). CONCLUSIONS MB modestly increases MAP in cardiac surgery patients with VS. Higher MAP at the time of drug administration and surgery with deep hypothermic circulatory arrest predict a greater drug response.
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Affiliation(s)
- Michael Mazzeffi
- Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Benjamin Hammer
- Department of Pharmacy, Children's National Medical Center, Washington, DC 20010, USA
| | - Edward Chen
- Department of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Mark Caridi-Scheible
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - James Ramsay
- Department of Anesthesiology, University of California, San Francisco School of Medicine, San Francisco, CA 94131, USA
| | - Christopher Paciullo
- Department of Pharmacy, Emory University School of Medicine, Atlanta, GA 30322, USA
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