Cardio-pulmonary-bypass time has important independent influence on mortality and morbidity

Wesselink, R. M. J.; Boer, A. De; Morshuis, W. J.; Leusink, J.A.

doi:10.1016/s1010-7940(97)01217-7

Cited by 38 publications

(29 citation statements)

References 31 publications

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“…While preoperative factors are important surgical outcome predictors, the length of CPB time can be used as a valuable risk‐stratifying tool (49). The time a patient is exposed to CPB relates both to surgical complexity and outcome (49). Patients with CPB times exceeding 90 min demonstrate a significantly increased OR for severe bleeding (OR = 2.3).…”

Section: Discussionmentioning

confidence: 99%

Centrifugal Pump and Roller Pump in Adult Cardiac Surgery: A Meta‐Analysis of Randomized Controlled Trials

et al. 2012

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Centrifugal pump (CP) and roller pump (RP) designs are the dominant main arterial pumps used in cardiopulmonary bypass (CPB). Trials reporting clinical outcome measures comparing CP and RP are controversial. Therefore, a meta‐analysis was undertaken to evaluate clinical variables from randomized controlled trials (RCTs). Keyword searches were performed on Medline (1966–2011), EmBase (1980–2011), and CINAHL (1981–2011) for studies comparing RP and CP as the main arterial pump in adult CPB. Pooled fixed‐effects estimates for dichotomous and continuous data were calculated as an odds ratio and weighted‐mean difference, respectively. The P value was utilized to assess statistical significance (P < 0.05) between CP and RP groups. Eighteen RCTs met inclusion criteria, which represented 1868 patients (CP = 961, RP = 907). The prevailing operation was isolated coronary artery bypass graft surgery (CP = 88%, RP = 87%). Fixed‐effects pooled estimates were performed for end‐of‐CPB (ECP) and postoperative day one (PDO) for platelet count (ECP: P = 0.51, PDO: P = 0.16), plasma free hemoglobin (ECP: P = 0.36, PDO: P = 0.24), white blood cell count (ECP: P = 0.21, PDO: P = 0.66), and hematocrit (ECP: P = 0.06, PDO: P = 0.51). No difference was demonstrated for postoperative blood loss (P = 0.65) or red blood cell transfusion (P = 0.71). Intensive care unit length of stay (P = 0.30), hospital length of stay (P = 0.33), and mortality (P = 0.91) were similar between the CP and RP groups. Neurologic outcomes were not amenable to pooled analysis; nevertheless, the results were inconclusive. There was no reported pump‐related malfunction or mishap. The meta‐analysis of RCTs comparing CP and RP in adult cardiac surgery suggests no significant difference for hematological variables, postoperative blood loss, transfusions, neurological outcomes, or mortality.

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Section: Discussionmentioning

confidence: 99%

Centrifugal Pump and Roller Pump in Adult Cardiac Surgery: A Meta‐Analysis of Randomized Controlled Trials

et al. 2012

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“…[1][2][3] Moreover, according to some investigators, a transient decline in the renal function is a regular consequence of extracorporeal circulation. [4] AKI after cardiac surgery is associated with a dramatic rise in mortality rate. Depending on definition of AKI, mortality reaches up to 10-20% in non-dialyzed patients [3,5] and up to 54-70% in dialyzed patients.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Profile for Acute Kidney Injury after Cardiac Surgery Is Different According to the Level of Baseline Renal Function

Lombardi¹,

Ferreiro

2008

Renal Failure

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Acute kidney injury (AKI) occurs frequently after cardiac surgery. Although numerous variables were identified as predictors for AKI, there is a lack of information about possible differences in risk factors according to the level of preoperative renal function. Preoperative, intraoperative, and postoperative data from 4118 adult patients submitted to cardiac surgery from January 1, 2000, to December 31, 2005, were included in the study. AKI was defined by an increase in serum creatinine (S Cr ) ≥ 0.3 mg/dL after surgery. Patients were stratified into two groups: group 1, C Cr ≥ 60 mL/min/1.73 m 2 BSA; group 2, C Cr < 60 mL/min/1.73 m 2 BSA. Risk factors were assessed using a multiple logistic regression model. In all, 749 patients (42.5%) developed AKI. The mortality rate of the entire population was a 5.2%. In patients of group 1 (n = 2678), the variables independently associated with the onset of AKI were age, diabetes, preoperative use of diuretics, non-scheduled surgery, cardiopulmonary by-pass (CPB) time, CPB mean arterial pressure, hemodilution, and postoperative use of norepinephrine. Baseline S Cr was associated with AKI only in patients of group 2 (n = 1440). Age, EuroSCORE, non-coronary surgery, hemodilution, and postoperative use of vasoactive drugs were also predictors of AKI in this group of patients. The mortality rate was significantly higher in group 2 than group 1 (8.5% vs. 3.6%, p = 0.000). In conclusion, the present study demonstrated a difference in variables associated with postoperative AKI, according to baseline renal function. The degree of preoperative renal function was a predictor of AKI only in patients with CKD stages 3-4, as well as other risk factors. In addition to other well known risk factors for AKI in this setting, the use of diuretics in patients of group 1 and the level of hemodilution during CPB in both groups should be emphasized, as they are potentially modifiable.

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“…Different studies have illustrated the effect of the duration of cardiopulmonary bypass on morbidity and mortality. [17][18][19] In our study, the mean duration of cardiopulmonary bypass was 80.66 ± 22.92 (27-128) min, the mean duration of cross-clamp was 67.88 ± 19.59 min, and the mean number of bypasses was 2.25 ± 0.83 (1)(2)(3)(4)(5). During the early postoperative intensive care period, 9 (13%) of the patients required inotropic support, while 1 (1.4%) of the patients required IABP.…”

Section: Discussionmentioning

confidence: 99%

Coronary Bypass Surgery in Patients with Pulmonary Hypertension: Assessment of Early and Long Term Results

Akça

Erdil

Disli

et al. 2015

ATCS

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IntroductionPulmonary hypertension (PH) is one of the main causes of increased mortality and morbidity rates in open heart surgery. Left heart disease is probably the most frequent cause of PH. 1) Left-sided ventricular or valvular diseases may lead to an increase in left atrial pressure, and the passive backward transmission of this pressure may result in increased pulmonary arterial pressure (PAP). 2) Despite intensive postoperative medical treatment, an increase is observed in mortality and morbidity rates following coronary bypass surgery in patients with PH and right heart failure. 3,4) PH has a significant effect on right ventricular afterload. Various studies have shown that patients with right ventricle dysfunction display higher rates of early perioperative mortality and poor long term survival. 5,6) In this study, we investigated the effect of preoperative PH on the early-and long term results of patients who underwent isolated coronary artery bypass surgery, as well as its effect on the quality of life and the changes in The late mortality of cases was 5.79%. In our study, during 33.9 ± 17 (9-100) months follow up period, life expectancy was calculated as 94.7 months. Conclusion: Preoperative evaluation of these patients for appropriate medical treatment at peroperative and postoperative period, coronary bypass can be performed with low morbidity and mortality rates. In the late period after surgical revascularization PH showed no significant change and had no adverse effect on quality of life.

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Cardio-pulmonary-bypass time has important independent influence on mortality and morbidity

Cited by 38 publications

References 31 publications

Centrifugal Pump and Roller Pump in Adult Cardiac Surgery: A Meta‐Analysis of Randomized Controlled Trials

Centrifugal Pump and Roller Pump in Adult Cardiac Surgery: A Meta‐Analysis of Randomized Controlled Trials

Risk Factors Profile for Acute Kidney Injury after Cardiac Surgery Is Different According to the Level of Baseline Renal Function

Coronary Bypass Surgery in Patients with Pulmonary Hypertension: Assessment of Early and Long Term Results

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