کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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4281261 | 1611572 | 2009 | 8 صفحه PDF | دانلود رایگان |

BackgroundThis study examined the impact of intraoperative myocardial acidosis and adverse postoperative outcomes on the cost of cardiac surgical care.MethodsMyocardial tissue pH corrected to 37°C (pH37C) was measured in 162 patients with cross-clamp (XC) duration of 119 minutes or longer. Perioperative data and outcomes were collected prospectively. The Veterans Affairs cost accounting system was used to determine the cost of care in a subset of 57 patients.ResultsLong XC duration was associated with significantly increased acidosis and adverse postoperative outcomes. The cost of care for patients with adverse outcomes was increased by 110% (P < .0001). Patients with acidosis at the end of reperfusion had significantly (P = .0470) increased costs of care. End reperfusion of myocardial tissue pH37C of less than 7.0, diabetes mellitus, and body surface area were significant determinants of postoperative adverse outcomes.ConclusionsIntraoperative myocardial acidosis is a determinant of postoperative adverse outcomes and cost in cardiac surgery. Reducing XC duration and improving intraoperative myocardial protection should improve outcomes and reduce cost.
Journal: The American Journal of Surgery - Volume 197, Issue 2, February 2009, Pages 203–210