Abstract
Objectives: A recent meta-analysis suggested that volatile anesthetics reduce postoperative mortality after cardiac surgery. Nonetheless, whether volatile anesthetics improve the outcome of cardiac surgical patients is still a matter of debate. The authors investigated whether the use of volatile anesthetics reduces mortality in cardiac surgery. Design, Setting, and Interventions: A longitudinal study of 34,310 coronary artery bypass graft interventions performed in Italy estimated the risk-adjusted mortality ratio for each center. A survey was conducted among these centers to investigate whether the use of volatile anesthetics showed a correlation with mortality. Measurements and Main Results: All 64 eligible centers provided the required data. The median unadjusted 30-day mortality among participating centers was 2.2% (0.3-8.8), whereas the median risk-adjusted 30-day mortality was 1.8% (0.1-7.2). Risk-adjusted analysis showed that the use of volatile anesthetics was associated with a significantly lower rate of risk-adjusted 30-day mortality (β = -1.172 [-2.259, -0.085], R2 = 0.070, p = 0.035). Dichotomization into centers using volatile anesthetics in at least 25% of their cases or in less than 25% yielded even more statistically significant results (p = 0.003). Furthermore, a longer use of volatile anesthetics was associated with a significantly lower death rate (p = 0.022); and exploring the impact of the specific volatile anesthetic agent, the use of isoflurane was associated with significant reductions in risk-adjusted mortality rates (p = 0.039). Conclusions: This survey among 64 Italian centers shows that risk-adjusted mortality may be reduced by the use of volatile agents in patients undergoing coronary artery bypass graft surgery.
| Original language | English |
|---|---|
| Pages (from-to) | 594-599 |
| Number of pages | 6 |
| Journal | Journal of Cardiothoracic and Vascular Anesthesia |
| Volume | 23 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Oct 2009 |
Fingerprint
Keywords
- cardiac anesthesia
- cardiac surgery
- coronary artery bypass graft surgery
- halogenated anesthetics
- mortality
- myocardial damage
- total intravenous anesthesia
- volatile anesthetics
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Anesthesiology and Pain Medicine
Cite this
Volatile Anesthetics Reduce Mortality in Cardiac Surgery. / Bignami, Elena; Biondi-Zoccai, Giuseppe; Landoni, Giovanni; Fochi, Oliviero; Testa, Valentina; Sheiban, Imad; Giunta, Francesco; Zangrillo, Alberto.
In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 23, No. 5, 10.2009, p. 594-599.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Volatile Anesthetics Reduce Mortality in Cardiac Surgery
AU - Bignami, Elena
AU - Biondi-Zoccai, Giuseppe
AU - Landoni, Giovanni
AU - Fochi, Oliviero
AU - Testa, Valentina
AU - Sheiban, Imad
AU - Giunta, Francesco
AU - Zangrillo, Alberto
PY - 2009/10
Y1 - 2009/10
N2 - Objectives: A recent meta-analysis suggested that volatile anesthetics reduce postoperative mortality after cardiac surgery. Nonetheless, whether volatile anesthetics improve the outcome of cardiac surgical patients is still a matter of debate. The authors investigated whether the use of volatile anesthetics reduces mortality in cardiac surgery. Design, Setting, and Interventions: A longitudinal study of 34,310 coronary artery bypass graft interventions performed in Italy estimated the risk-adjusted mortality ratio for each center. A survey was conducted among these centers to investigate whether the use of volatile anesthetics showed a correlation with mortality. Measurements and Main Results: All 64 eligible centers provided the required data. The median unadjusted 30-day mortality among participating centers was 2.2% (0.3-8.8), whereas the median risk-adjusted 30-day mortality was 1.8% (0.1-7.2). Risk-adjusted analysis showed that the use of volatile anesthetics was associated with a significantly lower rate of risk-adjusted 30-day mortality (β = -1.172 [-2.259, -0.085], R2 = 0.070, p = 0.035). Dichotomization into centers using volatile anesthetics in at least 25% of their cases or in less than 25% yielded even more statistically significant results (p = 0.003). Furthermore, a longer use of volatile anesthetics was associated with a significantly lower death rate (p = 0.022); and exploring the impact of the specific volatile anesthetic agent, the use of isoflurane was associated with significant reductions in risk-adjusted mortality rates (p = 0.039). Conclusions: This survey among 64 Italian centers shows that risk-adjusted mortality may be reduced by the use of volatile agents in patients undergoing coronary artery bypass graft surgery.
AB - Objectives: A recent meta-analysis suggested that volatile anesthetics reduce postoperative mortality after cardiac surgery. Nonetheless, whether volatile anesthetics improve the outcome of cardiac surgical patients is still a matter of debate. The authors investigated whether the use of volatile anesthetics reduces mortality in cardiac surgery. Design, Setting, and Interventions: A longitudinal study of 34,310 coronary artery bypass graft interventions performed in Italy estimated the risk-adjusted mortality ratio for each center. A survey was conducted among these centers to investigate whether the use of volatile anesthetics showed a correlation with mortality. Measurements and Main Results: All 64 eligible centers provided the required data. The median unadjusted 30-day mortality among participating centers was 2.2% (0.3-8.8), whereas the median risk-adjusted 30-day mortality was 1.8% (0.1-7.2). Risk-adjusted analysis showed that the use of volatile anesthetics was associated with a significantly lower rate of risk-adjusted 30-day mortality (β = -1.172 [-2.259, -0.085], R2 = 0.070, p = 0.035). Dichotomization into centers using volatile anesthetics in at least 25% of their cases or in less than 25% yielded even more statistically significant results (p = 0.003). Furthermore, a longer use of volatile anesthetics was associated with a significantly lower death rate (p = 0.022); and exploring the impact of the specific volatile anesthetic agent, the use of isoflurane was associated with significant reductions in risk-adjusted mortality rates (p = 0.039). Conclusions: This survey among 64 Italian centers shows that risk-adjusted mortality may be reduced by the use of volatile agents in patients undergoing coronary artery bypass graft surgery.
KW - cardiac anesthesia
KW - cardiac surgery
KW - coronary artery bypass graft surgery
KW - halogenated anesthetics
KW - mortality
KW - myocardial damage
KW - total intravenous anesthesia
KW - volatile anesthetics
UR - http://www.scopus.com/inward/record.url?scp=70349326452&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70349326452&partnerID=8YFLogxK
U2 - 10.1053/j.jvca.2009.01.022
DO - 10.1053/j.jvca.2009.01.022
M3 - Article
C2 - 19303327
AN - SCOPUS:70349326452
VL - 23
SP - 594
EP - 599
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 5
ER -