Hemodynamic Changes, Mechanical Ventilation, Respiratory Acidosis in ICU Patients, Right Ventricular (RV) Dysfunction
Conditions
Brief summary
Right heart dysfunction remains a frequent cause of morbidity and mortality after cardiac surgery. Respiratory acidosis, particularly when accompanied by hypoxemia, plays a significant role in right heart failure, primarily by increasing right ventricular afterload through pulmonary vasoconstriction and elevated pulmonary arterial pressures. This phenomenon leads to increased right ventricular workload, causing dilation, decreased contractility, and ultimately right heart failure. The study aims to evaluate the effect of respiratory acidosis on right ventricular function after cardiac surgery.
Detailed description
Post hoc analysis of data from two separate studies previously approved by the Research Ethics Board NCT05886413 and NCT06826794. A stratification according to respiratory acidosis defined by a pH \<7.35 with PaCO₂ \>45mmHg on the first arterial blood gas analysis at the intensive care unit arrival will be done.
Interventions
OTHERNot applicable- observational study
No intervention
Sponsors
Laval University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Previously included and complete study NCT05886413 or NCT06826794
Exclusion criteria
* Absence of one or more of the following hemodynamic measurements: systolic or diastolic pulmonary artery pressure, central venous pressure, cardiac output * Absence of arterial blood gas on arrival to the intensive care unit
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Right ventricular function per central hemodynamic assessment | At intensive care unit admission - within the first 4 hours | Calculation of different predictor: Cardiac index, PAPi (pulmonary artery pulse pressure over central venous pressure) , RVSWI ((mean pulmonary artery pressure- central venous pressure) X stroke volume index X 0.0136) and RV-CPO |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intensive care unit length of stay | Up to 28 days | Intensive care unit admission through Intensive care unit discharge |
| Mechanical ventilation duration | Day 28 | Time spent with invasive mechanical ventilation between intensive care unit admission and hospital discharge |
| Vasopressor duration | Day 28 | Duration of vasopressor or inotrope administration |
| Acute renal failure | Day 28 | Rate of acute renal failure during coronary unit length of stay. Renal failure will be defined according to the usual criteria, i.e., an increase of \>27 umol/L creatinine in 48 hours or 1.5x over the baseline |
| Mortality | Day 28 | Mortality in intensive care unit |
Countries
Canada
Contacts
CONTACTEtienne Couture
Outcome results
None listed