Multiorgan failure in a cardiac surgical intensive care unit

ABSTRACT

To find out incidence and various risk factors associated with multiorgans failure [MOF] in patient after cardiac surgery. Design: A prospective study of 935 consecutive admissions to cardiac intensive care CSICU over a period of one year [April 1994 to March 1995]. Setting: Cardiac surgical intensive care unit AFIC / NIHD Rawalpindi. Subjects: Nine hundred thirty five patients admitted to CSICU after cardiac surgery. Main outcome measures: Risk factors, incidence, mortality in multiorgan failure. Mean age of patients was 29.6 years. Males were 66.8%. As regards preoperative risk factors, 24.3% had systemic disease, 19.5% had cardiac dysfunction, 7.5% and 3.4% had hepatic and renal dysfunction respectively, 7.3% underwent emergency surgery. Seventy% of patients underwent surgery on cardiopulmonary bypass [CPB]. Postoperatively 18.3% patients developed low cardiac output syndrome [LCOS]. Respiratory, acute renal and hepatic failure were seen in 7.5%, 4.6% and 2.9% respectively. 2.8% patients developed septicaemia and 2.2% developed MOF. Mean duration of ICU stay was 1.9 days. Conclusions: Cardiac surgical patients form a separate subset of MOF with different predisposing factors, pathophysiology and outcome. Pre-existing organ dysfunction clinical status, surgery on CPB, postoperative LCOS and septicaemia play significant role in causing MOF