期刊
JOURNAL OF INTENSIVE CARE MEDICINE
卷 36, 期 11, 页码 1264-1271出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/0885066620946006
关键词
cardiac surgery; mortality; outcome; complications; gastrointestinal tract
资金
- Research Committee of Region Orebro County
- Nyckelfonden at Orebro University Hospital
- ALF Funding at Region Orebro County
- Swedish Society for Medical Research
Early gastrointestinal dysfunction following cardiac surgery is associated with unfavorable outcomes. The AGI grade can be a useful tool to screen for gastrointestinal issues in postoperative patients. Increased attention to gastrointestinal function in cardiac surgery patients is warranted.
Objective: The distribution of postoperative gastrointestinal (GI) dysfunction and its association with outcome were investigated in cardiac surgery patients. Gastrointestinal function was evaluated using the Acute Gastrointestinal Injury (AGI) grade proposed by the European Society of Intensive Care Medicine. Design: Prospective observational study at a single center. Setting: University hospital. Patients: Consecutive patients presenting for elective cardiac surgery with extracorporeal circulation (ECC). Interventions: None. Results: Daily assessment using the AGI grade was performed on the first 3 postoperative days in addition to standard care. For analysis, 3 groups were formed based on the maximum AGI grade: AGI 0, AGI 1, and AGI >= 2. Five hundred and one patients completed the study; 32.7%, 65.1%, and 2.2% of the patients scored a maximum AGI 0, AGI 1, and AGI >= 2, respectively. Patients with AGI grade >= 2 had more frequently undergone thoracic aortic surgery and had longer surgery duration and time on ECC. Patients with AGI grade >= 2 had statistically significant higher frequency of GI complications within 30 days (63.6% vs 1.2% and 5.5% in patients with AGI 0 and AGI 1) and higher 30-day mortality (9.1% vs 0.0% and 1.8% in patients with AGI 0 and AGI 1). Conclusions: Early GI dysfunction following cardiac surgery was associated with an unfavorable outcome. Increased attention to GI dysfunction in cardiac surgery patients is warranted and the AGI grade could be a helpful adjunct to a structured approach.
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