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.
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.
Study Type
OBSERVATIONAL
Enrollment
220
No intervention
Institut universitaire de cardiologie et de pneumologie de Quebec - Universite Laval
Québec, Quebec, Canada
Right ventricular function per central hemodynamic assessment
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
Time frame: At intensive care unit admission - within the first 4 hours
Intensive care unit length of stay
Intensive care unit admission through Intensive care unit discharge
Time frame: Up to 28 days
Mechanical ventilation duration
Time spent with invasive mechanical ventilation between intensive care unit admission and hospital discharge
Time frame: Day 28
Vasopressor duration
Duration of vasopressor or inotrope administration
Time frame: Day 28
Acute renal failure
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
Time frame: Day 28
Mortality
Mortality in intensive care unit
Time frame: Day 28
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