Journal of cardiothoracic and vascular anesthesia最新文献

{"title":"Efficacy of Quantra-Qplus System for Rapid Diagnosis and Treatment of Hypofibrinogenemia and Thrombocytopenia After Cardiopulmonary Bypass","authors":"Hiroaki Suzuki MD, PhD ,&nbsp;Hironaga Ogawa MD, PhD ,&nbsp;Seiko Endo MD ,&nbsp;Takero Arai MD, PhD","doi":"10.1053/j.jvca.2024.12.009","DOIUrl":"10.1053/j.jvca.2024.12.009","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess whether the Quantra-Qplus can provide the cutoff values for predicting transfusion thresholds after cardiopulmonary bypass.</div></div><div><h3>Design</h3><div>Prospective observational study.</div></div><div><h3>Setting</h3><div>Single-center university hospital.</div></div><div><h3>Participants</h3><div>Adult patients undergoing cardiac surgery.</div></div><div><h3>Interventions</h3><div>The Quantra-Qplus and conventional laboratory coagulation test were performed.</div></div><div><h3>Measurements and Main Results</h3><div>We enrolled 50 adult patients, and collected blood samples at 4 times (preoperative, during cardiopulmonary bypass, after protamine administration, and at the end of surgery). We obtained the values of the Quantra-Qplus (fibrinogen contribution to clot stiffness [FCS] and platelet contribution to clot stiffness [PCS]) and the values of conventional laboratory coagulation test (fibrinogen concentration and platelet count). To determine the cutoff values for FCS and PCS predicting blood transfusion thresholds at after protamine, receiver operating characteristic curve, area under the curve (AUC) with 95% confidence intervals (95% CIs), and Youden index were used. The cutoff value of FCS for predicting a fibrinogen concentration of less than 150 mg/dL was 0.95 hPa (AUC = 0.94; 95% CI, 0.86-1.00), and PCS for predicting a platelet count of less than 50,000/mm³ was 7.05 hPa (AUC = 0.97; 95% CI, 0.92-1.00) at after protamine administration. The cutoff values of FCS and PC varied during cardiac surgery.</div></div><div><h3>Conclusions</h3><div>Our study provides potential cutoff values of FCS and PCS to guide fibrinogen administration or platelet transfusion in cardiac surgery patients after protamine administration. These cutoff values might vary during surgery, and different cutoff values for predicting transfusion thresholds during cardiac surgery might apply.</div></div>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 3","pages":"Pages 594-600"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Manual and Mechanical Ventilation During Intensive Care Unit Transport Following Cardiac Surgery: Impact on Oxygenation, Ventilation, and Hemodynamic Stability","authors":"Yoshihisa Morita MD ,&nbsp;Taro Kariya MD, PhD ,&nbsp;Marc Torjman PhD ,&nbsp;Doug Pfeil MD, PhD ,&nbsp;Kent Berg MD, MBA ,&nbsp;Luigi Vetrugno MD ,&nbsp;Jacob Raphael MD, FAHA ,&nbsp;Jordan Goldhammer MD","doi":"10.1053/j.jvca.2024.12.017","DOIUrl":"10.1053/j.jvca.2024.12.017","url":null,"abstract":"<div><h3>Objectives</h3><div>Following cardiac surgery, patients often require ventilatory support during transport to the intensive care unit (ICU). Manual ventilation using a bag valve mask (BVM) is commonly employed; however, mechanical ventilation may sometimes be preferred due to concerns regarding oxygenation, ventilation, and hemodynamic stability. The decision between manual and mechanical ventilation is typically based on clinical experience and surgical factors, as there is no established consensus or robust clinical evidence to guide this choice. The aim of this study was to compare oxygenation, ventilation, and hemodynamic parameters between manual ventilation with a BVM and mechanical ventilation using a transport ventilator.</div></div><div><h3>Design</h3><div>A prospective, single-blinded clinical trial.</div></div><div><h3>Setting</h3><div>A single-center tertiary academic hospital.</div></div><div><h3>Participants</h3><div>A total of 48 patients who underwent cardiac surgery and were transported to the ICU between September 2023 and August 2024 were enrolled.</div></div><div><h3>Interventions</h3><div>Patients meeting the inclusion criteria were randomly assigned to one of two groups: Patients in Arm 1received manual ventilation using a BVM during transport to the ICU; patients in Arm 2 received mechanical ventilation using a transport ventilator during transport to the ICU.</div></div><div><h3>Measurements and Main Results</h3><div>Percentage changes in the PaO₂/FiO₂ ratio and PaCO₂ pre- and post-transport were not significantly different between the two groups (p = 0.133 and 0.902, respectively). However, hypotension, defined as a &gt;10% decrease in mean arterial pressure, was significantly more frequent in the BVM group than in the mechanical ventilation group (p = 0.00986).</div></div><div><h3>Conclusions</h3><div>In patients who have undergone cardiac surgery<em>,</em> hypotension occurred more frequently in the BVM group than in the mechanical ventilation group during transport to the ICU. However, oxygenation and ventilation parameters were comparable between the two groups.</div></div>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 3","pages":"Pages 644-652"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy and Safety of Angiotensin II for Treatment of Vasoplegia in Critically Ill Patients: A Systematic Review","authors":"Yuki Kotani MD ,&nbsp;Martina Lezzi MD ,&nbsp;Carlotta Pia Murru MD ,&nbsp;Ashish K Khanna MD, FCCP, FCCM ,&nbsp;Alexander Zarbock MD, PhD ,&nbsp;Rinaldo Bellomo MD, PhD, FRACP, FCICM ,&nbsp;Giovanni Landoni MD","doi":"10.1053/j.jvca.2024.12.022","DOIUrl":"10.1053/j.jvca.2024.12.022","url":null,"abstract":"<div><h3>Objectives</h3><div>To summarize evidence regarding intravenous angiotensin II administration in critical illness and provide an updated understanding of its effects on various organ dysfunction and renin-angiotensin system (RAS) biomarkers.</div></div><div><h3>Design</h3><div>A systematic review.</div></div><div><h3>Setting</h3><div>A search of PubMed, Embase, and the Cochrane Library from inception to May 3, 2024. Randomized controlled trials (RCTs), nonrandomized trials, quasi-randomized trials, observational studies, case reports, and case series were included. Comparative studies (RCTs and observational studies with comparator) were used for the main analysis.</div></div><div><h3>Participants</h3><div>Critically ill adults and children.</div></div><div><h3>Interventions</h3><div>Intravenous angiotensin II administration.</div></div><div><h3>Measurements and Main Results</h3><div>Fifty-nine studies with a total of 2,918 participants (5 RCTs, 15 observational studies, and 39 case reports or case series) were analyzed. Septic shock and cardiac surgery were the most common clinical conditions (14 studies for each). In 14 comparative studies (5 RCTs and 9 observational studies), mortality was not different from that in controls, except in 1 observational study. Several studies reported decreased renal replacement therapy use, improved oxygenation and blood pressure response, and decreased rate of myocardial injury with angiotensin II therapy. There was no increase in thrombotic events or adverse events. Angiotensin II therapy reduced renin and angiotensin I levels without affecting other RAS biomarkers.</div></div><div><h3>Conclusions</h3><div>Intravenous angiotensin II has been reported in almost 3000 critically ill patients with diverse types of shock. Despite unclear mortality impacts, angiotensin II seems to confer beneficial effects on several organ systems and RAS derangements, without increasing adverse events.</div></div>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 3","pages":"Pages 653-665"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning for In-hospital Mortality Prediction in Critically Ill Patients With Acute Heart Failure: A Retrospective Analysis Based on the MIMIC-IV Database","authors":"Jun Li BSc ,&nbsp;Yiwu Sun MD ,&nbsp;Jie Ren MD ,&nbsp;Yifan Wu MD ,&nbsp;Zhaoyi He MD","doi":"10.1053/j.jvca.2024.12.016","DOIUrl":"10.1053/j.jvca.2024.12.016","url":null,"abstract":"<div><h3>Background</h3><div>The incidence, mortality, and readmission rates for acute heart failure (AHF) are high, and the in-hospital mortality for AHF patients in the intensive care unit (ICU) is higher. However, there is currently no method to accurately predict the mortality of AHF patients.</div></div><div><h3>Methods</h3><div>The Medical Information Mart for Intensive Care Ⅳ (MIMIC-Ⅳ) database was used to perform a retrospective study. Patients meeting the inclusion criteria were identified from the MIMIC-Ⅳ database and randomly divided into a training set (n = 3,580, 70%) and a validation set (n = 1,534, 30%). The variates collected include demographic data, vital signs, comorbidities, laboratory test results, and treatment information within 24 hours of ICU admission. By using the least absolute shrinkage and selection operator (LASSO) regression model in the training set, variates that affect the in-hospital mortality of AHF patients were screened. Subsequently, in the training set, five common machine learning (ML) algorithms were applied to construct models using variates selected by LASSO to predict the in-hospital mortality of AHF patients. The predictive ability of the models was evaluated for sensitivity, specificity, accuracy, the area under the curve of receiver operating characteristics, and clinical net benefit in the validation set. To obtain a model with the best predictive ability, the predictive ability of common scoring systems was compared with the best ML model.</div></div><div><h3>Results</h3><div>Among the 5,114 patients, in-hospital mortality was 12.5%. Comparing the area under the curve, the XGBoost model had the best predictive ability among all ML models, and the XGBoost model was chosen as the final model for its higher net benefit. Its predictive ability was superior to common scoring systems.</div></div><div><h3>Conclusions</h3><div>The XGBoost model can effectively predict the in-hospital mortality of AHF patients admitted to the ICU, which may assist clinicians in precise management and early intervention for patients with AHF to reduce mortality.</div></div>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 3","pages":"Pages 666-674"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of The 2024 ESC/EACTS Guidelines For The Management Of Atrial Fibrillation","authors":"Juan G. Ripoll MD ,&nbsp;Marvin G. Chang MD, PhD ,&nbsp;Edward A. Bittner MD, PhD, FCCM ,&nbsp;Jamel Ortoleva MD, FASE ,&nbsp;Maryna Khromava MD ,&nbsp;Derek T. Bradley MD ,&nbsp;Emily K. Griffin MD ,&nbsp;Juan C. Diaz Soto MD ,&nbsp;Patrick M. Wieruszewski PharmD, RPh ,&nbsp;Kitae Chang MD, MS ,&nbsp;Christoph S. Nabzdyk MD ,&nbsp;Harish Ramakrishna MD, FACC, FESC","doi":"10.1053/j.jvca.2024.11.020","DOIUrl":"10.1053/j.jvca.2024.11.020","url":null,"abstract":"<div><div>The 2024 European Society of Cardiology guidelines for atrial fibrillation (AF) emphasize a patient-centered approach to management, structured around the AF-CARE pathway: Comorbidity and risk factor management (C), Avoiding stroke and thromboembolism (A), Reducing symptoms through rate and rhythm control (R), and Evaluation and dynamic reassessment (E). This framework ensures that comorbidities such as hypertension, heart failure, diabetes, and obesity are effectively managed to prevent disease progression and improve outcomes. A key principle of the guidelines is shared decision making involving patients, families, caregivers, and healthcare teams to ensure individualized care that reflects patient preferences. The guidelines also stress healthcare equity, advocating for the elimination of disparities related to sex, ethnicity, disability, and socioeconomic status. For diagnosis, electrocardiographic confirmation of clinical AF is essential, followed by risk stratification using the CHA₂DS₂-VASc score to guide anticoagulation therapy. Direct oral anticoagulants are preferred for most patients because of their good safety profile. Stroke prevention is prioritized, with rhythm control as first-line treatment for suitable patients. For those with persistent symptoms despite medications, catheter ablation is recommended. Rate control strategies, including beta-blockers, digoxin, and calcium channel blockers, are used to manage heart rate and symptoms. Ongoing education for patients, families, and providers supports informed decision making and dynamic reassessment, optimizing patient outcomes and quality of life.</div></div>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 3","pages":"Pages 818-835"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Call for Diversity: Underrepresented Minorities and Cardiothoracic Anesthesiology Professional Development","authors":"Michele L. Sumler MD ,&nbsp;Michelle Capdeville MD ,&nbsp;Jennie Ngai MD ,&nbsp;Barbara Biney MPH ,&nbsp;Daryl Oakes MD","doi":"10.1053/j.jvca.2024.11.021","DOIUrl":"10.1053/j.jvca.2024.11.021","url":null,"abstract":"<div><div>The presence of underrepresented minorities (URMs) in cardiothoracic anesthesiology is underwhelming, and progress toward diversity has been slow at best. Despite decades of efforts, change seems hard to achieve. For example, it took more than 30 years for women to make up 50% of medical school matriculants. However, women continue to be underrepresented in our professional subspecialty and notably. This slow movement is not idiosyncratic to women but also applies to equity related to race and ethnicity. Given this current state, this article seeks to bring attention to the lack of diversity in cardiac anesthesiology and is a call to action to accelerate efforts and the pace of change toward greater equity both in our field and in medicine in general. This piece is the final part of a 4-part series exploring opportunities for improving diversity in cardiac anesthesiology. The authors focus specifically on the professional experience of URMs in medicine in our subspecialty and the opportunities for improving diversity. While many barriers for URM physicians reflect those of women, the experience of URM practicing physicians is unique and solutions need to incorporate.</div></div>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 3","pages":"Pages 576-583"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Causes of Newly Developed Mitral Valve Regurgitation after the Resection of a Giant Left Ventricular Tumor (Hemangioma)","authors":"Mingyi Piao,&nbsp;Xiangyong Zhou,&nbsp;Min Yan","doi":"10.1053/j.jvca.2024.10.042","DOIUrl":"10.1053/j.jvca.2024.10.042","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 3","pages":"Pages 759-764"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Outcomes in Congenital Heart Disease: A Review of Clinical Factors Associated With Prolonged Ventilation and Length of Stay in Four Common CHD Operations","authors":"A. Rebecca L. Hamilton MD, MSc ,&nbsp;Koichi Yuki MD, MBA ,&nbsp;Francis Fynn-Thompson MD ,&nbsp;James A. DiNardo MD ,&nbsp;Kirsten C. Odegard MD, MBA","doi":"10.1053/j.jvca.2024.11.008","DOIUrl":"10.1053/j.jvca.2024.11.008","url":null,"abstract":"<div><h3>Objectives</h3><div>Perioperative management strategies and outcomes for low-risk congenital heart disease (CHD) surgery vary between institutions. To date, no consensus exists on standardized management for pediatric patients undergoing cardiac surgery. This study seeks to benchmark the perioperative management of 4 common CHD lesions and explore clinical factors affecting postoperative outcomes.</div></div><div><h3>Design</h3><div>A retrospective review of CHD procedures performed between 2015 and 2020.</div></div><div><h3>Setting</h3><div>The study was conducted at a single academic tertiary pediatric hospital.</div></div><div><h3>Participants</h3><div>All patients presenting for repair of ventricular septal defects (VSDs), complete atrioventricular canal defects, tetralogy of Fallot (TOF), and transposition of the great arteries (TGA) were reviewed.</div></div><div><h3>Interventions</h3><div>Demographic and clinical data were collected; clinical outcomes were defined as postoperative length of ventilation (LOV) and hospital length of stay, divided into reference and prolonged course groups analyzed for variables associated with differences in outcomes.</div></div><div><h3>Measurements and Main Results</h3><div>We selected 931 patients for review. Prolonged length of ventilation and length of stay in all cohorts were associated with longer operative, cardiopulmonary bypass, and cross-clamp times; higher intraoperative requirements for inotropic support; more blood transfusions and higher opioid administration; lower pH preoperatively and higher lactic acid postoperatively. Worse outcomes were associated with younger age in VSD, older age in TGA, and lower weight in TOF and TGA. Worse outcomes were also associated with a higher preoperative hematocrit in VSD and TOF and elevated preoperative blood glucose in VSD and TGA.</div></div><div><h3>Conclusions</h3><div>A better understanding of clinical factors affecting outcomes may facilitate streamlining perioperative management strategies for pediatric patients undergoing low-risk cardiac surgery.</div></div>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 3","pages":"Pages 692-701"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Take a Deep Breath: Operating Room Extubation After Bilateral Lung Transplantation on Venoarterial Extracorporeal Membrane Oxygenation","authors":"Gabriel Prada MD ,&nbsp;Danisa Daubenspeck DO ,&nbsp;Ernest G. Chan MD, MPH ,&nbsp;Pablo G. Sanchez MD, PhD ,&nbsp;Archer Kilbourne Martin MD","doi":"10.1053/j.jvca.2024.11.023","DOIUrl":"10.1053/j.jvca.2024.11.023","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 3","pages":"Pages 836-848"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Blood Pressure Below Personalized Lower Cerebral Autoregulation Limit on Outcomes After Cardiac Surgery: A Retrospective Study","authors":"Domagoj Mladinov MD, PhD ,&nbsp;Ryan C. Godwin PhD ,&nbsp;David Benz MS ,&nbsp;Ibukun Mary Folorunso MS ,&nbsp;Dan E. Berkowitz MB, BCh ,&nbsp;Ryan L. Melvin PhD","doi":"10.1053/j.jvca.2024.12.019","DOIUrl":"10.1053/j.jvca.2024.12.019","url":null,"abstract":"<div><h3>Objective</h3><div>The clinical importance of individualized blood pressure management in optimizing cerebral perfusion during cardiac surgery has been well established. However, consensus on blood pressure goals is lacking. The authors studied the associations between cerebral autoregulation metrics, hemodynamic parameters, and postoperative outcomes, and hypothesized that increased time of mean arterial pressure (MAP) below the lower limit of autoregulation (LLA) is associated with major morbidity and mortality (MMOM) incidence.</div></div><div><h3>Design</h3><div>A retrospective, observational study.</div></div><div><h3>Setting</h3><div>A university hospital.</div></div><div><h3>Participants</h3><div>A total of 686 cardiovascular surgeries were included.</div></div><div><h3>Intervention</h3><div>None.</div></div><div><h3>Measurement and Main Results</h3><div>The area under the time-pressure curve (AUC) for MAP &lt; LLA and time below LLA (AUC_ABP&lt;LLA) were analyzed for associations with stroke, acute kidney injury, low cardiac output syndrome, mechanical ventilation lasting &gt;48 hours, and postoperative mortality (ie, MMOM). There was no significant association between AUC_ABP&lt;LLA and MMOM (p &gt; 0.05). Relationships were observed between components of MMOM—operative mortality (p &lt; 0.05) and low cardiac output syndrome (p &lt; 0.05)—and AUC_ABP&lt;LLA, when controlling for preoperative hemoglobin levels and logistic EuroSCORE.</div></div><div><h3>Conclusions</h3><div>These findings indicate that LLA-related metrics have limited utility for predicting MMOM. Future research should explore their applicability in various contexts and patient cohorts.</div></div>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 3","pages":"Pages 601-609"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}