Format

Send to

Choose Destination
See comment in PubMed Commons below
Am J Surg. 2009 Feb;197(2):203-10. doi: 10.1016/j.amjsurg.2008.01.023. Epub 2008 Aug 22.

Impact of intraoperative myocardial tissue acidosis on postoperative adverse outcomes and cost of care for patients undergoing prolonged aortic clamping during cardiopulmonary bypass.

Author information

  • 1Cardiothoracic Surgery (112), VA Boston Healthcare System, West Roxbury, MA 02132, USA.

Abstract

BACKGROUND:

This study examined the impact of intraoperative myocardial acidosis and adverse postoperative outcomes on the cost of cardiac surgical care.

METHODS:

Myocardial tissue pH corrected to 37 degrees C (pH(37C)) was measured in 162 patients with cross-clamp (XC) duration of 119 minutes or longer. Perioperative data and outcomes were collected prospectively. The Veterans Affairs cost accounting system was used to determine the cost of care in a subset of 57 patients.

RESULTS:

Long XC duration was associated with significantly increased acidosis and adverse postoperative outcomes. The cost of care for patients with adverse outcomes was increased by 110% (P < .0001). Patients with acidosis at the end of reperfusion had significantly (P = .0470) increased costs of care. End reperfusion of myocardial tissue pH(37C) of less than 7.0, diabetes mellitus, and body surface area were significant determinants of postoperative adverse outcomes.

CONCLUSIONS:

Intraoperative myocardial acidosis is a determinant of postoperative adverse outcomes and cost in cardiac surgery. Reducing XC duration and improving intraoperative myocardial protection should improve outcomes and reduce cost.

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk