Post cardiac surgery stunning reduces stroke work, but leaves cardiac power output unchanged in patients with normal ejection fraction

• Published in: Physiological reports 2018-07, Vol.6 (13), p.e13781-n/a
• Main Authors: Tannvik, Tomas D., Rimehaug, Audun E., Skjærvold, Nils K., Kirkeby‐Garstad, Idar
• Format: Article
• Language: English
• Subjects: Anesthesia; Bypass; Cardiac power; cardiac power output; cardiac stunning; Cardiovascular Conditions, Disorders and Treatments; Catheters; Circulation; Coronary artery; Coronary artery disease; Coronary vessels; Data processing; Ejection fraction; Heart; Heart surgery; Original Research; Pulmonary arteries; Pulmonary artery; Stroke; stroke work; Veins & arteries; Ventricle
• ISSN: 2051-817X
• DOI: 10.14814/phy2.13781

This study assesses positional changes in cardiac power output and stroke work compared with classic hemodynamic variables, measured before and after elective coronary artery bypass graft surgery. The hypothesis was that cardiac power output was altered in relation to cardiac stunning. The study is a retrospective analysis of data from two previous studies performed in a tertiary care university hospital. Thirty‐six patients scheduled for elective coronary artery bypass graft surgery, with relatively preserved left ventricular function, were included. A pulmonary artery catheter and a radial artery catheter were placed preoperatively. Cardiac power output and stroke work were calculated through thermodilution both supine and standing prior to induction of anesthesia and again day one postoperatively. Virtually all systemic hemodynamic parameters changed significantly from pre‐ to postoperatively, and from supine to standing. Cardiac power output was maintained at 0.9–1.0 (±0.3) W both pre‐ and postoperatively and from supine to standing on both days. Stroke work fell from pre‐ to postoperatively from 1.1 to 0.8 J (P