Combs Pamela S, Imamura Teruhiko, Siddiqi Umar, Mirzai Saeid, Spiller Robert, Stonebraker Corinne, LaBuhn Colleen, Bullard Heather, Simone Pamela, Jeevanandam Valluvan
Department of Medicine, University of Chicago Medical Center.
Second Department of Medicine, University of Toyama.
Int Heart J. 2020 May 30;61(3):547-552. doi: 10.1536/ihj.19-660. Epub 2020 Apr 29.
The use of opioids during left ventricular assist device (LVAD) support is increasing, but the implication remains unknown. We investigated the association between the use of opioid and morbidities during LVAD supports. We retrospectively reviewed the clinical data of patients who received LVAD between 2014 and 2017, which were stratified by the use of opioid at post-LVAD 3 months. Among 136 patients, 77 (57%) were in the opioid group. Hemoglobin and albumin were lower, and C-reactive protein was higher at baseline and 3 months later in the opioid group (P < 0.05 for all). The opioid group displayed worse hemodynamics, with higher pulmonary capillary wedge pressure and central venous pressure (P < 0.05 for both). Furthermore, the opioid group had higher incidences of gastrointestinal bleeding (31% versus 17%, P = 0.043) and sepsis (30% versus 13%, P = 0.036) during the 1 year observational period, whereas survivals were not stratified by the use of opioid (83% versus 90%, P = 0.27). Opioid use was associated with morbidities accompanied by poor hemodynamics during LVAD supports. The detailed causality of opioid use on morbidities remains a future concern.
