Early postoperative hemodynamic instability after heart transplantation – incidence and metabolic indicators

BMC Anesthesiology

Table 2 Hemodynamic parameters and inotropic and vasoactive agents requirement from first 48 h after HTX

	ALL HTX RECIPIENTS	WITH HEMODYNAMIC INSTABILITY	WITHOUT HEMODYNAMIC INSTABILITY	p-value
	*N = 45*	*N = 18*	*N = 27*	p-value
Hemodynamic parameters
LVEF_min, %	54.4 (12.4)	52.9 (15.5)	55.4 (10.2)	0.572
CI_min, l/min/m2	2.54 (0.67)	2.65 (0.58)	2.48 (0.71)	0.405
MAP_min, mmHg	61.8 (10.8)	51.4 (9.49)	67.8 (5.75)	< 0.001
HR_max, bpm	103 (20.9)	102 (21.7)	104 (20.9)	0.765
SBP_min, mmHg	94.7 (12.7)	84.3 (11.0)	101 (9.43)	< 0.001
PA_max, mmHg	39.5 (7.01)	41.9 (6.00)	38.1 (7.29)	0.081
CVP_max, mmHg	15.4 (3.10)	16.3 (2.85)	14.8 (3.16)	0.132
PCWP_max, mmHg	16.8 (3.02)	18.2 (3.30)	16.0 (2.60)	0.039
SVRI_min, dynsm2/cm5	1209 (369)	961 (288)	1328 (348)	0.002
Inotropic and vasoactive agents^a
0-24 h after HTX
ADR, μg/kg/min	0.15 (0.01-0.17)	0.25 (0.05-0.30)	0.09 (0.01-0.11)	0.002
NA, μg/kg/min	0.12 (0.00-0.15)	0.21 (0.06-0.27)	0.06 (0.00-0.13)	0.007
DB, μg/kg/min	7.48 (4.36-10.16)	7.83 (3.45-11.67)	7.29 (4.34-9.92)	0.714
MIL, μg/kg/min	0.27 (0.11-0.36)	0.34 (0.20-0.43)	0.24 (0.08-0.34)	0.257
Inotrope score^b	16.2 (9.8-41.4)	37.1 (14.7-79.8)	12.7 (9.2-30.9)	0.012
24-48 h after HTX
ADR, μg/kg/min	0.12 (0.01-0.14)	0.26 (0.04-0.36)	0.03 (0.00-0.04)	0.000
NA, μg/kg/min	0.09 (0.01-0.11)	0.21 (0.01-0.27)	0.03 (0.00-0.05)	0.002
DB, μg/kg/min	7.30 (4.30-9.89)	7.64 (2.14-11.98)	7.13 (4.24-9.51)	0.955
MIL, μg/kg/min	0.24 (0.10-0.36)	0.30 (0.13-0.40)	0.20 (0.09-0.32)	0.120
Inotrope score^b	13.3 (8.6-35.5)	35.1 (11.9-77.4)	11.3 (6.6-23.1)	0.011

Number (%), mean (SD) or median (Q1-Q3) are presented
LVEF left ventricle ejection fraction, CI cardiac index, MAP mean arterial pressure, HR heart rate, SBP systolic blood pressure, PA pulmonary artery systolic pressure, CVP central venous pressure, PCWP pulmonary capillary wedge pressure, SVRI systemic vascular resistance index, ADR epinephrine, NA norepinephrine, DB dobutamine, MIL milrinone
^a levosimendan was routinely used for all patients for first 24 h after induction of anesthesia (0.1 μg/kg/min)
^binotrope score calculated in accordance with ISHLT consensus⁴: (dopamine (×1) + dobutamine (×1) + amrinone (×1) + milrinone (× 15) + epinephrine (× 100) + norepinephrine (× 100) with each drug dosed in μg/kg/min)

ISSN: 1471-2253