From: Epidemiology of perioperative RV dysfunction: risk factors, incidence, and clinical implications
A. Intraoperative acute RVF | |
---|---|
i) Difficult separation from CPB, characterized by either the following: | |
1 | Concurrent use of ≥ 1 vasopressor and ≥ 1 inotrope and/or inhaled pulmonary vasodilator OR |
2 | Requiring > 1 CPB weaning attempt for RVF OR |
3 | Mechanical support device to facilitate wean (i.e. IABP or RVAD) |
AND | |
ii) Anatomical visualization of impaired or absent RV wall motion by the following: | |
a | Direct intraoperative visual inspection* OR |
b |  > 20% reduction in RVFAC measured by 2D echocardiography |
OR | |
B. Postoperative acute RVF (haemodynamic criteria on arrival to ICU) | |
i | CVP > 15 mmHg or CI < 1.8 Lmin-1 m-2 AND |
ii | Absence of elevate LAP and PCWP > 18 mmHg, tamponade, VT, or pneumothorax** AND |
iii | RVSWI < 4 where RVSWI = 0.136 × SVI × (mPAP-RAP), and SVI = strove volume/BSA |