Article description

Summary:

• This systematic review and meta-analysis aimed to identify different vasoplegia definitions used in cardiac surgery studies/ differences in the reported vasoplegia incidence and their influence in intensive care unit (ICU) length of stay (LOS), and 30-day mortality rates.
• Studies with 20 or more patients undergoing cardiac surgery on cardiopulmonary bypass, irrespective of design, reporting vasoplegia incidence, ICU LOS, or 30-day mortality, published from 1977 to 2023, were included for meta-analysis.
• One hundred studies were reviewed systematically. Sixty studies were finally included. MAP and cardiac index thresholds varied considerably among the studies (<50-80 mmHg and 2.0-3.5 L·min-1m-2, respectively), leading to categorization according to the used mean arterial pressure (MAP) thresholds. Vasopressor dosages needed as thresholds also differed. The reported incidence of vasoplegia also varied largely between the studies (2.5%-66.3%; I2 = 97%; p < 0.0001. Accordingly, the effect of vasoplegia on ICU length of stay and 30-day mortality was very heterogeneous among studies (I2 = 99% and I2 = 73%, respectively).

Conclusions:

There is a large variability in vasoplegia definitions which leads to significant heterogeneity regarding incidence and clinical outcomes. Moreover, it prevents consistent patient diagnosis and impedes comparability of published vasoplegia-relevant studies.