LOW CARDIAC OUTPUT SYNDROME (LCOS) AT SEPARATION FROM CARDIOPULMONARY BYPASS (CPB): OUR EXPERIENCE AT QUEEN ALIA HEART INSTITUTE, AMMAN JORDAN

Abstract

Objective: To determine the perioperative risk factors that are associated withincreased likelihood of low cardiac output syndrome at separation fromcardiopulmonary bypass.

Methodology: This retrospective cross sectional study included patients whopresented for cardiac surgical procedures due to different cardiac pathologies atQueen Alia Heart Institute between December 2013 and June 2014. Data wascollected in a special form and included patient’s particulars. Patients weredivided into two groups according to age: Group 1 up to 60 years of age andGroup 2 more than 61 years. Also patients were divided into two groupsaccording to CPB time: Group A with less than 2 hours and Group B of more thantwo hours. EUROSCORE (European system for cardiac operative risk evaluation)value was calculated.

Results: A total of 108 patients were included with mean age of 58.3 years ofboth genders. Average EUROSCORE of study sample was 1.35. Inotropicsupport was used in 40 patients with 31% of females developed LCOS, (p= 0.6)and 44 patients had preoperative left ventricular impairment with 35 of themneeded inotropic support (79.5%). About 63 patients were < 60 years old(p=0.03). Urgent cases had higher incidence of LCOS (p=0.05). About 30patients had chronic respiratory disease (53.3%) (p=0.03). Hypertensivepatients were 79 patients, (43%) (p=0.033). The average EUROSCORE forpatients who developed LCOS was higher than study population (2 vs. 1.35)(p=0.05)

Conclusion: LCOS was associated more often with preoperative left ventriculardysfunction, old age, urgent surgery, preoperative chronic respiratory diseaseand hypertension. EUROSCORE can help predict LCOS and the likelihood for theneed of inotropes.