Effects of Advanced Hemodynamic Monitoring on the Postoperative Intubation Time in Patients With Moderate-to-Severe Left Ventricular Dysfunction Undergoing Cardiac Surgery

Abstract

<strong><em>Background:</em></strong>Advanced monitoring can lead to the early recovery of patients in complicated and high-risk surgical operations. The aim of this study was to evaluate the effects of advanced monitoring on the hemodynamics of patients undergoing cardiac surgery.

<strong><em>Methods:</em></strong>In this study, patients undergoing cardiac surgery were divided into 2 groups of control and advanced monitoring. In each group, 25 patients were examined. The patients had moderate-to-severe left ventricular dysfunction (ejection fraction < 35%). The patients in the case group were placed on the FloTrac cardiac output monitor, which is used as a therapeutic guide in the operating room and the intensive care unit (ICU).

<strong><em>Results:</em></strong>Upon ICU admission, the average stroke volume variation and the mean cardiac index in the advanced monitoring group in the first 6 hours were 10 and 2.7, respectively, and in the second 6 hours were 11 and 2.8, correspondingly. The mean serum level administered was 1000 cc in the first 6 hours and 500 cc in the second 6 hours. In the control group, the mean serum level administered was 2000 cc in the first 6 hours and 500 cc in the second 6 hours, which had a significant relationship between the 2 groups in the first 6 hours (<em>P</em> = 0.01). Additionally, 84% of the patients with advanced monitoring were extubated in the first 6 hours (<em>P</em> = 0.0).

<strong><em>Conclusions:</em></strong> This study showed that cardiac surgery in patients with moderate-to-severe left ventricular dysfunction using advanced monitoring and goal-directed hemodynamic therapy based on the cardiac index, the stroke volume variation, and the stroke volume index reduced the duration of intubation after surgery. <strong><em>(Iranian Heart Journal 2020; 21(4): 25-32)</em></strong>