• J L Pérez Vela, J J Jiménez Rivera, M Á Alcalá Llorente, B González de Marcos, H Torrado, C García Laborda, M D Fernández Zamora, F J González Fernández, J C Martín Benítez, and en representación del Grupo ESBAGA.
• Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España. Electronic address: jpvela@salud.madrid.org.
• Med Intensiva. 2018 Apr 1; 42 (3): 159-167.

ObjectivesAn analysis is made of the clinical profile, evolution and differences in morbidity and mortality of low cardiac output syndrome (LCOS) in the postoperative period of cardiac surgery, according to the 3 diagnostic subgroups defined by the SEMICYUC Consensus 2012.DesignA multicenter, prospective cohort study was carried out.SettingICUs of Spanish hospitals with cardiac surgery.PatientsA consecutive sample of 2,070 cardiac surgery patients was included, with the analysis of 137 patients with LCOS.InterventionsNo intervention was carried out.ResultsThe mean patient age was 68.3±9.3 years (65.2% males), with a EuroSCORE II of 9.99±13. NYHA functional class III-IV (52.9%), left ventricular ejection fraction<35% (33.6%), AMI (31.9%), severe PHT (21.7%), critical preoperative condition (18.8%), prior cardiac surgery (18.1%), PTCA/stent placement (16.7%). According to subgroups, 46 patients fulfilled hemodynamic criteria of LCOS (group A), 50 clinical criteria (group B), and the rest (n=41) presented cardiogenic shock (group C). Significant differences were observed over the evolutive course between the subgroups in terms of time subjected to mechanical ventilation (114.4, 135.4 and 180.3min in groups A, B and C, respectively; P<.001), renal replacement requirements (11.4, 14.6 and 36.6%; P=.007), multiorgan failure (16.7, 13 and 47.5%), and mortality (13.6, 12.5 and 35.9%; P=.01). The mean maximum lactate concentration was higher in cardiogenic shock patients (P=.002).ConclusionsThe clinical evolution of these patients leads to high morbidity and mortality. We found differences between the subgroups in terms of the postoperative clinical course and mortality.Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

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