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Cardiopulmonary complications in high‐risk surgical patients: the value of preoperative radionuclide cardiography
Author(s) -
Pedersen T.,
KelbÆk H.,
Munck O.
Publication year - 1990
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1990.tb03067.x
Subject(s) - medicine , ejection fraction , cardiology , heart failure , prospective cohort study , heart disease , stroke volume , cardiopulmonary bypass , incidence (geometry) , diastole , anesthesia , surgery , blood pressure , physics , optics
In a prospective study we examined the strength of association between preoperative left ventricular performance measured by radionuclide cardiography in patients with cardiac or pulmonary insufficiency (high‐risk patients) and cardiopulmonary complications associated with anaesthesia and surgery. Detailed pre‐, intra‐and postoperative data collected for 7306 anaesthetized patients were included in the study. One hundred and thirty‐one patients (1.8%) were classified as high‐risk patients, and 95 patients were examined with radionuclide cardiography. The results demonstrated a 58% incidence of cardiovascular complications for high‐risk patients when the left ventricular ejection fraction (LVEF) was abnormal (<50% or 70%) compared with 12% when LVEF was normal (50–70%). In addition, high‐risk patients with left ventricular end‐diastolic volume (LVEDV) > 140 ml developed cardiovascular complications in 37% of the cases. Patients admitted to major surgery with LVEF < 50 or > 70% were at greater risk than patients with LVEF = 50–70% as demonstrated by a significant increase in the total incidence of cardiopulmonary complications, 70% vs. 17%. It is appropriate to measure LVEF in patients admitted for major surgery who have an increased risk of cardiopulmonary complications as clinically evidenced by heart failure or severe ischaemic heart disease. As the predictive information given by LVEDV was less than that given by LVEF, there are no clinical reasons for measurement of LVEDV.