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Journal of Clinical Monitoring and Computing
Published in: Journal of Clinical Monitoring and Computing 1/2018

01-02-2018 | Original Research

Endotracheal bioimpedance cardiography improves immediate postoperative outcome: a case-control study in off-pump coronary surgery

Authors: Thomas Leclercq, Marc Lilot, Thomas Schulz, Alexandre Meyer, Fadi Farhat, Jean-Luc Fellahi

Published in: Journal of Clinical Monitoring and Computing | Issue 1/2018

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Abstract

The feasibility and clinical utility of the endotracheal cardiac output monitor (ECOM) to optimize intraoperative hemodynamics and improve short-term outcome in off-pump coronary artery bypass grafting (OPCAB) is unknown. We aimed to compare ECOM with a standard of care in that specific surgical setting. Twenty consecutive adult ECOM-monitored patients undergoing OPCAB were prospectively included (ECOM group) and retrospectively compared to 42 patients scheduled for similar surgery without ECOM monitoring (Control group). The primary endpoint was the global rate of postoperative admission to the intensive care unit (ICU). Secondary endpoints were the time to extubation, the length of stay in ICU and in hospital, the postoperative levels of lactate and troponin and the feasibility of ECOM. The rate of postoperative admission to the ICU was 38/42 (90%) in the Control group versus 11/20 (55%) in the ECOM group, P = 0.008. None unexpected admission for hemodynamic instability was observed in the ECOM group. The time to extubation, the length of stay in ICU, and both troponin level at admission and lactate level at H6 were all significantly decreased in the ECOM group. On a scale ranging from 0 to 5, convenience and satisfaction regarding ECOM were 4.30 ± 1.17 and 3.45 ± 0.68, respectively. The systematic use of ECOM is associated with a significant reduction in the rate of admission to the ICU and an improvement in immediate outcome in OPCAB.
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Metadata
Title
Endotracheal bioimpedance cardiography improves immediate postoperative outcome: a case-control study in off-pump coronary surgery
Authors
Thomas Leclercq
Marc Lilot
Thomas Schulz
Alexandre Meyer
Fadi Farhat
Jean-Luc Fellahi
Publication date
01-02-2018
Publisher
Springer Netherlands
Published in
Journal of Clinical Monitoring and Computing / Issue 1/2018
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-017-9996-z

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