Pub Date : 2017-04-01DOI: 10.1097/01.sa.0000516023.95234.0a
L. Putz, C. Dransart, J. Jamart, M. Marotta, Geraldine Delnooz, P. Dubois
{"title":"Operating Room Discharge After Deep Neuromuscular Block Reversed With Sugammadex Compared With Shallow Block Reversed With Neostigmine: A Randomized Controlled Trial","authors":"L. Putz, C. Dransart, J. Jamart, M. Marotta, Geraldine Delnooz, P. Dubois","doi":"10.1097/01.sa.0000516023.95234.0a","DOIUrl":"https://doi.org/10.1097/01.sa.0000516023.95234.0a","url":null,"abstract":"","PeriodicalId":22104,"journal":{"name":"Survey of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73636243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.1097/01.sa.0000515846.07542.a3
R. Champaneria, L. Shah, Matthew J A Wilson, J. Daniels
{"title":"Clinical Effectiveness of Transversus Abdominis Plane (TAP) Blocks for Pain Relief After Caesarean Section: A Meta-analysis","authors":"R. Champaneria, L. Shah, Matthew J A Wilson, J. Daniels","doi":"10.1097/01.sa.0000515846.07542.a3","DOIUrl":"https://doi.org/10.1097/01.sa.0000515846.07542.a3","url":null,"abstract":"","PeriodicalId":22104,"journal":{"name":"Survey of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75283283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.1097/01.sa.0000516017.85017.00
D. Hoofwijk, R. Reij, B. Rutten, G. Kenis, W. Buhre, E. Joosten
{"title":"Genetic Polymorphisms and Their Association With the Prevalence and Severity of Chronic Postsurgical Pain: A Systematic Review","authors":"D. Hoofwijk, R. Reij, B. Rutten, G. Kenis, W. Buhre, E. Joosten","doi":"10.1097/01.sa.0000516017.85017.00","DOIUrl":"https://doi.org/10.1097/01.sa.0000516017.85017.00","url":null,"abstract":"","PeriodicalId":22104,"journal":{"name":"Survey of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86448795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.1097/SA.0000000000000294
P. Augustin, Sébastien Tanaka, V. Chhor, S. Provenchère, Darko Arnaudovski, H. Ibrahim, M. Dilly, N. Allou, P. Montravers, I. Philip
Aortic stenosis (AS) is the most frequent heart valve disease in octogenarians, and aortic valve replacement (AVR) remains the primary treatment for AS. This observational study conducted in the postoperative surgical intensive care unit (ICU) of a tertiary care facility in Paris, France, aimed to evaluate the mortality rate of octogenarians experiencing prolonged hospitalization in the ICU following cardiac surgery and to define the best cutoff for prolonged ICU length of stay (LOS). The secondary objective was to determine the risk factors associated with prolonged ICU LOS. For the purposes of this study, prolonged ICU
{"title":"Prognosis of Prolonged Intensive Care Unit Stay After Aortic Valve Replacement for Severe Aortic Stenosis in Octogenarians","authors":"P. Augustin, Sébastien Tanaka, V. Chhor, S. Provenchère, Darko Arnaudovski, H. Ibrahim, M. Dilly, N. Allou, P. Montravers, I. Philip","doi":"10.1097/SA.0000000000000294","DOIUrl":"https://doi.org/10.1097/SA.0000000000000294","url":null,"abstract":"Aortic stenosis (AS) is the most frequent heart valve disease in octogenarians, and aortic valve replacement (AVR) remains the primary treatment for AS. This observational study conducted in the postoperative surgical intensive care unit (ICU) of a tertiary care facility in Paris, France, aimed to evaluate the mortality rate of octogenarians experiencing prolonged hospitalization in the ICU following cardiac surgery and to define the best cutoff for prolonged ICU length of stay (LOS). The secondary objective was to determine the risk factors associated with prolonged ICU LOS. For the purposes of this study, prolonged ICU","PeriodicalId":22104,"journal":{"name":"Survey of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83907939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.1097/01.sa.0000515828.70301.21
Matthew Umholtz, John Cilnyk, Christopher K Wang, Jahan Porhomayon, L. Pourafkari, N. Nader
Posttraumatic stress disorder (PTSD) is a psychiatric condition common among veterans that is marked by symptoms of reexperiencing, avoidance, and hyperarousal following a stressful or traumatic event. Military nurse anesthetists have recently reported an increased prevalence of emergence delirium (EDL) in US combat veterans. Emergence delirium is characterized by psychomotor agitation or combativeness upon emergence from general anesthesia. It is more common in children than in adults but has a prevalence of 3.0% to 21.3% in the adult population after general anesthesia. The aim of this study was to examine whether surgical patients with a history of PTSD had a higher incidence of EDL than did patients without PTSD. The authors also examined whether duration of stay in the postanesthesia care unit (PACU) was higher in patients with a history of PTSD. In this retrospective cohort study conducted at a US military combat veteran surgical population at Veterans Administration Medical Center in Buffalo, NY, 1763 consecutive cases requiring general anesthesia for surgical procedures were collected. A total of 317 patients were identified with a history of PTSD and grouped together, and the 1446 patients without this history were placed in the control group. Postanesthesia care unit nursing notes were reviewed for the presence of the following phrases to indicate agitation: “attempting to sit up,” “agitated,” “pulling intravenous lines,” “trying to remove surgical dressing,” “climbing over bed rail,” “physically pushing or pulling staff,” “moving side-to-side,” “does not calm or follow verbal reminding,” and “requires physical restraints.” Emergence delirium was reported in 37 cases (2.1%) after general anesthesia; EDL was identified in 15 of the 317 patients with a history of PTSD and 22 of the 1446 patients without a history of PTSD (P = 0.002). After propensity matching, there were 8 patients with EDL in the PTSD group and only 2 patients with EDL among controls. Patients with a history of PTSD had higher incidence of EDL with varying degrees of agitation in the PACU compared with those without this diagnosis (odds ratio, 3.22; 95% confidence interval, 1.65–6.27; P = 0.002). Furthermore, PTSD was found to be an independent predictor of EDLwith an odds ratio of 6.66 and a 95% confidence interval of 2.04 to 21.72 (P = 0.002). The duration of stay in the PACU was not significantly different between the groups (P = 0.137). Despite important limitations to this study including the use of International Classification of Diseases, Ninth Revision codes to identify the diagnosis of PTSD and a retrospective, nonblinded design, the authors conclude that PTSD is an important risk factor for confusion and agitation in the early postanesthesia recovery period. Careful history taking and the development of a PTSD registry involving all veterans could help
{"title":"Postanesthesia Emergence in Patients With Post-traumatic Stress Disorder","authors":"Matthew Umholtz, John Cilnyk, Christopher K Wang, Jahan Porhomayon, L. Pourafkari, N. Nader","doi":"10.1097/01.sa.0000515828.70301.21","DOIUrl":"https://doi.org/10.1097/01.sa.0000515828.70301.21","url":null,"abstract":"Posttraumatic stress disorder (PTSD) is a psychiatric condition common among veterans that is marked by symptoms of reexperiencing, avoidance, and hyperarousal following a stressful or traumatic event. Military nurse anesthetists have recently reported an increased prevalence of emergence delirium (EDL) in US combat veterans. Emergence delirium is characterized by psychomotor agitation or combativeness upon emergence from general anesthesia. It is more common in children than in adults but has a prevalence of 3.0% to 21.3% in the adult population after general anesthesia. The aim of this study was to examine whether surgical patients with a history of PTSD had a higher incidence of EDL than did patients without PTSD. The authors also examined whether duration of stay in the postanesthesia care unit (PACU) was higher in patients with a history of PTSD. In this retrospective cohort study conducted at a US military combat veteran surgical population at Veterans Administration Medical Center in Buffalo, NY, 1763 consecutive cases requiring general anesthesia for surgical procedures were collected. A total of 317 patients were identified with a history of PTSD and grouped together, and the 1446 patients without this history were placed in the control group. Postanesthesia care unit nursing notes were reviewed for the presence of the following phrases to indicate agitation: “attempting to sit up,” “agitated,” “pulling intravenous lines,” “trying to remove surgical dressing,” “climbing over bed rail,” “physically pushing or pulling staff,” “moving side-to-side,” “does not calm or follow verbal reminding,” and “requires physical restraints.” Emergence delirium was reported in 37 cases (2.1%) after general anesthesia; EDL was identified in 15 of the 317 patients with a history of PTSD and 22 of the 1446 patients without a history of PTSD (P = 0.002). After propensity matching, there were 8 patients with EDL in the PTSD group and only 2 patients with EDL among controls. Patients with a history of PTSD had higher incidence of EDL with varying degrees of agitation in the PACU compared with those without this diagnosis (odds ratio, 3.22; 95% confidence interval, 1.65–6.27; P = 0.002). Furthermore, PTSD was found to be an independent predictor of EDLwith an odds ratio of 6.66 and a 95% confidence interval of 2.04 to 21.72 (P = 0.002). The duration of stay in the PACU was not significantly different between the groups (P = 0.137). Despite important limitations to this study including the use of International Classification of Diseases, Ninth Revision codes to identify the diagnosis of PTSD and a retrospective, nonblinded design, the authors conclude that PTSD is an important risk factor for confusion and agitation in the early postanesthesia recovery period. Careful history taking and the development of a PTSD registry involving all veterans could help","PeriodicalId":22104,"journal":{"name":"Survey of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87375588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.1097/01.sa.0000515903.42360.fe
O. Ozmete, C. Bali, O. Cok, Hatıce Evren Eker Turk, N. B. Ozyilkan, Soner Çivi, A. Arıboğan
Sugammadex is a selective muscle relaxant binding agent with a γ-cyclodextrin structure, which reverses rocuroniumand vecuronium-induced neuromuscular blockade by chemical encapsulation. The objective of this retrospective, observational study was to evaluate the efficacy and safety of sugammadex for the reversal of profound neuromuscular blockade by rocuronium in infant patients. Twenty-six infants between the ages of 2 and 12 months (weight, 3–11 kg) with an American Society of Anesthesiologists classification I, II, or III scheduled to undergo neurosurgical procedures were included. The surgeries included in the 26 cases were shunt (n = 12), spinal fusion (n = 6), external ventricular drainage (n = 6), and meningomyelocele repair (n = 2). Anesthesia was induced with 5 mg/kg thiopental, 1 μg/kg fentanyl, and 0.6 mg/kg rocuronium, and sevoflurane was administered to all patients after intubation. Train-of-four (TOF) stimuli acceleromyography was used to monitor the block. If deep neuromuscular block (TOF, 0) persisted at the end of the surgery, 3 mg/kg sugammadex was administered for reversal. The time between sugammadex administration and reversal of the block (TOF ratio, >0.9) was recorded, and complications during and after extubation were noted. The mean recovery time of the TOF ratio of 0.9 was 112.65 ± 35.60 seconds. No clinical evidence of recurarization or residual curarization was observed in this study. The only adverse effects noted were cough in 3 patients and agitation in 2 patients. None of the patients had nausea, vomiting, bradycardia, tachycardia, rash, or hypersensitivity during extubation. The findings of this study support use of sugammadex at a dose of 3 mg/kg as both an effective and safe reversal agent in infants for profound neuromuscular block achieved by rocuronium under sevoflurane anesthesia.
{"title":"Sugammadex Given for Rocuronium-Induced Neuromuscular Blockade in Infants: A Retrospective Study","authors":"O. Ozmete, C. Bali, O. Cok, Hatıce Evren Eker Turk, N. B. Ozyilkan, Soner Çivi, A. Arıboğan","doi":"10.1097/01.sa.0000515903.42360.fe","DOIUrl":"https://doi.org/10.1097/01.sa.0000515903.42360.fe","url":null,"abstract":"Sugammadex is a selective muscle relaxant binding agent with a γ-cyclodextrin structure, which reverses rocuroniumand vecuronium-induced neuromuscular blockade by chemical encapsulation. The objective of this retrospective, observational study was to evaluate the efficacy and safety of sugammadex for the reversal of profound neuromuscular blockade by rocuronium in infant patients. Twenty-six infants between the ages of 2 and 12 months (weight, 3–11 kg) with an American Society of Anesthesiologists classification I, II, or III scheduled to undergo neurosurgical procedures were included. The surgeries included in the 26 cases were shunt (n = 12), spinal fusion (n = 6), external ventricular drainage (n = 6), and meningomyelocele repair (n = 2). Anesthesia was induced with 5 mg/kg thiopental, 1 μg/kg fentanyl, and 0.6 mg/kg rocuronium, and sevoflurane was administered to all patients after intubation. Train-of-four (TOF) stimuli acceleromyography was used to monitor the block. If deep neuromuscular block (TOF, 0) persisted at the end of the surgery, 3 mg/kg sugammadex was administered for reversal. The time between sugammadex administration and reversal of the block (TOF ratio, >0.9) was recorded, and complications during and after extubation were noted. The mean recovery time of the TOF ratio of 0.9 was 112.65 ± 35.60 seconds. No clinical evidence of recurarization or residual curarization was observed in this study. The only adverse effects noted were cough in 3 patients and agitation in 2 patients. None of the patients had nausea, vomiting, bradycardia, tachycardia, rash, or hypersensitivity during extubation. The findings of this study support use of sugammadex at a dose of 3 mg/kg as both an effective and safe reversal agent in infants for profound neuromuscular block achieved by rocuronium under sevoflurane anesthesia.","PeriodicalId":22104,"journal":{"name":"Survey of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75207305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-01DOI: 10.1097/01.sa.0000525644.95080.0a
Mark G. Thomas, Thomas Engelhardt
{"title":"Think drink! Current fasting guidelines are outdated.","authors":"Mark G. Thomas, Thomas Engelhardt","doi":"10.1097/01.sa.0000525644.95080.0a","DOIUrl":"https://doi.org/10.1097/01.sa.0000525644.95080.0a","url":null,"abstract":"","PeriodicalId":22104,"journal":{"name":"Survey of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90611724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-02-01DOI: 10.1097/01.sa.0000513302.95493.92
H. Batoz, F. Semjen, Maryline Bordes-demolis, A. Bénard, K. Nouette-Gaulain
{"title":"Chronic Postsurgical Pain in Children: Prevalence and Risk Factors. A Prospective Observational Study","authors":"H. Batoz, F. Semjen, Maryline Bordes-demolis, A. Bénard, K. Nouette-Gaulain","doi":"10.1097/01.sa.0000513302.95493.92","DOIUrl":"https://doi.org/10.1097/01.sa.0000513302.95493.92","url":null,"abstract":"","PeriodicalId":22104,"journal":{"name":"Survey of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87305795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-02-01DOI: 10.1097/SA.0000000000000285
O. Ozmete, C. Bali, O. Cok, P. Ergenoğlu, N. B. Ozyilkan, Ş. Akın, H. Kalaycı, A. Arıboğan
{"title":"Preoperative Paracetamol Improves Post-Cesarean Delivery Pain Management: A Prospective, Randomized, Double-blind, Placebo-Controlled Trial","authors":"O. Ozmete, C. Bali, O. Cok, P. Ergenoğlu, N. B. Ozyilkan, Ş. Akın, H. Kalaycı, A. Arıboğan","doi":"10.1097/SA.0000000000000285","DOIUrl":"https://doi.org/10.1097/SA.0000000000000285","url":null,"abstract":"","PeriodicalId":22104,"journal":{"name":"Survey of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91102272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-02-01DOI: 10.1097/SA.0000000000000305
M. Haanschoten, H. Kreeftenberg, R. Arthur Bouwman, A. V. van Straten, W. Buhre, M. A. Soliman Hamad
OBJECTIVES In the present study, the authors investigated the predictive value of postoperative peak arterial lactate levels for early and late mortality after cardiac surgery. DESIGN Retrospective analysis of prospectively collected data. SETTING Single-center study in an academic hospital. PARTICIPANTS Adult patients who underwent cardiac surgery between 2004 and 2014 (n = 16,376). INTERVENTIONS Different cardiac surgical procedures. MEASUREMENTS AND RESULTS Patients were classified according to the peak arterial lactate level (PALL) within 3 days postoperatively. Logistic regression analysis and Cox regression analysis were performed to identify postoperative peak arterial lactate level as a predictor for early and late mortality respectively. In 8460 patients (51.7%), lactate was not measured postoperatively because these patients were managed according to the fast-track protocol. These patients constituted group 1 in our population but were excluded from the regression analysis. The remaining patients (n = 7,916; 48.3%) were divided according to the postoperative peak arterial lactate level (PALL): PALL<5 mmol/L (group 2), PALL 5 to 10 mmol/L (group 3), and PALL of>10 mmol/L (group 4). Early mortality was 3.7%, 20.4%, and 62.9% in groups 2, 3, and 4 respectively (p<0.0001). This mortality rate was significantly higher than that of group 1 (1.6%); p<0.0001. Multivariate regression analyses revealed postoperative peak arterial lactate as a significant predictor of 30-day mortality (odds ratio = 1.44 [1.39-1.48], p<0.001) as well as for late mortality (hazard ratio = 1.05 [1.01-1.10], p<0.025). CONCLUSIONS Postoperative peak arterial lactate level in patients undergoing cardiac surgery is an independent predictor for both early and late mortality.
{"title":"Use of Postoperative Peak Arterial Lactate Level to Predict Outcome After Cardiac Surgery.","authors":"M. Haanschoten, H. Kreeftenberg, R. Arthur Bouwman, A. V. van Straten, W. Buhre, M. A. Soliman Hamad","doi":"10.1097/SA.0000000000000305","DOIUrl":"https://doi.org/10.1097/SA.0000000000000305","url":null,"abstract":"OBJECTIVES\u0000In the present study, the authors investigated the predictive value of postoperative peak arterial lactate levels for early and late mortality after cardiac surgery.\u0000\u0000\u0000DESIGN\u0000Retrospective analysis of prospectively collected data.\u0000\u0000\u0000SETTING\u0000Single-center study in an academic hospital.\u0000\u0000\u0000PARTICIPANTS\u0000Adult patients who underwent cardiac surgery between 2004 and 2014 (n = 16,376).\u0000\u0000\u0000INTERVENTIONS\u0000Different cardiac surgical procedures.\u0000\u0000\u0000MEASUREMENTS AND RESULTS\u0000Patients were classified according to the peak arterial lactate level (PALL) within 3 days postoperatively. Logistic regression analysis and Cox regression analysis were performed to identify postoperative peak arterial lactate level as a predictor for early and late mortality respectively. In 8460 patients (51.7%), lactate was not measured postoperatively because these patients were managed according to the fast-track protocol. These patients constituted group 1 in our population but were excluded from the regression analysis. The remaining patients (n = 7,916; 48.3%) were divided according to the postoperative peak arterial lactate level (PALL): PALL<5 mmol/L (group 2), PALL 5 to 10 mmol/L (group 3), and PALL of>10 mmol/L (group 4). Early mortality was 3.7%, 20.4%, and 62.9% in groups 2, 3, and 4 respectively (p<0.0001). This mortality rate was significantly higher than that of group 1 (1.6%); p<0.0001. Multivariate regression analyses revealed postoperative peak arterial lactate as a significant predictor of 30-day mortality (odds ratio = 1.44 [1.39-1.48], p<0.001) as well as for late mortality (hazard ratio = 1.05 [1.01-1.10], p<0.025).\u0000\u0000\u0000CONCLUSIONS\u0000Postoperative peak arterial lactate level in patients undergoing cardiac surgery is an independent predictor for both early and late mortality.","PeriodicalId":22104,"journal":{"name":"Survey of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77184600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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