Intraoperative myocardial acidosis as a risk for hospital readmission after cardiac surgery

Dharam J. Kumbhani, Nancy A. Healey, Hemant S. Thatte, Vladimir Birjiniuk, Michael D. Crittenden, Patrick R. Treanor, Shukri F. Khuri

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: This study elucidates the relationship between intraoperative myocardial acidosis/ischemia and the risk of unplanned hospital readmissions within 30 days and 6 months after cardiac surgery. Methods: Myocardial tissue pH (corrected to 37°C: pH37C) was monitored in 221 patients during cardiac surgery. Regional myocardial acidosis was defined in terms of specific pH thresholds. Results: Fourteen percent and 27% of the patients were readmitted within 30 days and 6 months postoperatively, respectively. The mean number of readmissions was 1.67 ± 1.24; pH37C <6.85 at the end of cardiopulmonary bypass (CPB) was identified as the threshold most significantly associated with readmission. This threshold was associated with a 6-fold increased risk of readmission within 30 days and a 5-fold increased risk within 6 months. Conclusions: Persistent regional myocardial acidosis after weaning from CPB independently determines unplanned readmission rates up to 6 months postoperatively. This study underscores the importance of avoiding myocardial tissue acidosis during cardiac surgery.

Original languageEnglish (US)
Pages (from-to)373-380
Number of pages8
JournalAmerican Journal of Surgery
Volume198
Issue number3
DOIs
StatePublished - Sep 2009

Fingerprint

Patient Readmission
Acidosis
Thoracic Surgery
Cardiopulmonary Bypass
Weaning
Myocardial Ischemia

Keywords

  • Cardiopulmonary bypass
  • Coronary artery bypass graft surgery
  • Ischemia
  • Myocardial protection
  • Outcomes
  • Reperfusion

ASJC Scopus subject areas

  • Surgery

Cite this

Kumbhani, D. J., Healey, N. A., Thatte, H. S., Birjiniuk, V., Crittenden, M. D., Treanor, P. R., & Khuri, S. F. (2009). Intraoperative myocardial acidosis as a risk for hospital readmission after cardiac surgery. American Journal of Surgery, 198(3), 373-380. https://doi.org/10.1016/j.amjsurg.2009.01.013

Intraoperative myocardial acidosis as a risk for hospital readmission after cardiac surgery. / Kumbhani, Dharam J.; Healey, Nancy A.; Thatte, Hemant S.; Birjiniuk, Vladimir; Crittenden, Michael D.; Treanor, Patrick R.; Khuri, Shukri F.

In: American Journal of Surgery, Vol. 198, No. 3, 09.2009, p. 373-380.

Research output: Contribution to journalArticle

Kumbhani, DJ, Healey, NA, Thatte, HS, Birjiniuk, V, Crittenden, MD, Treanor, PR & Khuri, SF 2009, 'Intraoperative myocardial acidosis as a risk for hospital readmission after cardiac surgery', American Journal of Surgery, vol. 198, no. 3, pp. 373-380. https://doi.org/10.1016/j.amjsurg.2009.01.013
Kumbhani, Dharam J. ; Healey, Nancy A. ; Thatte, Hemant S. ; Birjiniuk, Vladimir ; Crittenden, Michael D. ; Treanor, Patrick R. ; Khuri, Shukri F. / Intraoperative myocardial acidosis as a risk for hospital readmission after cardiac surgery. In: American Journal of Surgery. 2009 ; Vol. 198, No. 3. pp. 373-380.
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