Date of Award
Medical Doctor (MD)
Ala S. Haddadin
Abbel A. Mangi
Vasoplegia represents the constellation of hypotension, vasodilation, and elevated cardiac output - most often described around the context of cardiac surgery. This manuscript aims to universally define vasoplegia and examine risk factors and outcomes in an open-heart surgery patient population. We retrospectively obtained information on a population of patients who had undergone open-heart surgery between 2009 and 2011. Data were available for a total of 1992 patients. We propose a standard definition moving forward: vasoplegia is MAP< 60 mmHg, CI >2.4 L/min/m2, SVR <800 dyn·s·cm−5, and the requirement of concurrent vasopressors. The incidence of vasoplegia is 17.2% in our study population. Of those, 66.6% experienced mild, 24.8% experienced moderate, and 8.7% experienced severe vasoplegia. Beta-blockers were found protective of vasoplegia development. Factors that increase the risk of vasoplegia include increasing age, mitral valve replacement, myocardial infarction, atrial fibrillation, cardiopulmonary bypass, and others. A novel Vasoplegia Risk Assessment and Stratification (VARAS) score was shown to predict risk of vasoplegia in our population. We recommend all open-heart patients be stratified using the VARAS score to clinically anticipate risk of vasoplegia. Vasoplegia is associated with ICU length of stay (+2.8 days, 95% CI 2.1 - 3.6 days) and total hospital length of stay (+4.1 days, 95% CI 2.0 - 6.3 days). Vasoplegia increases the risk of 30-day mortality [OR 3.2, 95% (CI 1.25 - 6.87)] but not 30-day readmission [OR 1.35, 95% CI (0.94 - 1.94).
Venker, Eric, "Vasoplegia: A Retrospective Evaluation Of Risk Factors And Outcomes In Open-Heart Surgery Patients" (2015). Yale Medicine Thesis Digital Library. 2021.