Cardiopulmonary bypass time: every minute counts

Madhavan, Sudharsan; Chan, Siew‐Pang; Tan, Wei-Chuan; Eng, Jolane; Li, Bowen; Luo, Haidong; Teoh, Leok-Kheng Kristine

doi:10.23736/s0021-9509.17.09864-0

Cited by 82 publications

(70 citation statements)

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“…Frequency of complications related to CPB rise when surgery exceeds 180 min 26 . In the present study, changes in microvascular function in favor of PF developed between 3 and 6 h, while studies failing to demonstrate benefits of PF, often are limited to less than 3 h on pump 27 .…”

Section: Discussionmentioning

confidence: 52%

Ocular surface microcirculation is better preserved with pulsatile versus continuous flow during cardiopulmonary bypass—An experimental pilot

et al. 2021

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Background: Non-pulsatile cardiopulmonary bypass (CPB) may induce microvascular dysregulation. In piglets, we compared ocular surface microcirculation during pulsatile versus continuous flow (CF) bypass.Methods: Ocular surface microcirculation in small tissue volumes (~0.1 mm 3 ) at limbus (high metabolic rate) and bulbar conjunctiva (low metabolic rate) was examined in a porcine model using computer assisted video microscopy and diffuse reflectance spectroscopy, before and after 3 and 6 h of pulsatile (n = 5 piglets) or CF (n = 3 piglets) CPB. Functional capillary density, capillary flow velocity and microvascular oxygen saturation were quantified.Results: At limbus, velocities improved with pulsatility (p < 0.01) and deteriorated with CF (p < 0.01). In bulbar conjunctiva, velocities were severely reduced with CF (p < 0.01), accompanied by an increase in capillary density (p < 0.01).Microvascular oxygen saturation decreased in both groups. Conclusion:Ocular surface capillary densities and flow patterns are better preserved with pulsatile versus CF during 6 h of CPB in sleeping piglets.

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Section: Discussionmentioning

confidence: 52%

Ocular surface microcirculation is better preserved with pulsatile versus continuous flow during cardiopulmonary bypass—An experimental pilot

et al. 2021

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“…Third, inflammatory status might also account for increased levels of BNPs, apart from cardiac and renal dysfunction (40). In this study, non-survivors had longer CPB time and aortic clamp time than survivors, which led to a more severe systemic inflammatory reaction and consequently increased the risk of mortality (41,42).…”

Section: Discussionmentioning

confidence: 73%

Serum N-terminal Pro-B-type Natriuretic Peptide Predicts Mortality in Cardiac Surgery Patients Receiving Renal Replacement Therapy

Hou

Zhang

et al. 2020

Front. Med.

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Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a useful cardiac biomarker that is associated with acute kidney injury (AKI) and mortality after cardiac surgery. However, its prognostic value in cardiac surgical patients receiving renal replacement therapy (RRT) remains unclear.Objectives: Our study aimed to assess the prognostic value of NT-proBNP in patients with established AKI receiving RRT after cardiac surgery.Methods: A total of 163 cardiac surgical patients with AKI requiring RRT were enrolled in this study. Baseline characteristics, hemodynamic variables at RRT initiation, and NT-proBNP level before surgery, at RRT initiation, and on the first day after RRT were collected. The primary outcome was 28-day mortality after RRT initiation.

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“…We found that CPB time is an independent risk factor on hospital mortality by univariate analysis (OR = 1.016; 95% CI: 1.002–1.029, p = .02). Previous studies already reported that CPB time increases the risk of mortality 16,17 . Salis et al reported that 30‐min increments in CPB time are an independent risk factor for postoperative death (OR = 1.57, p < .0001) 17 .…”

Section: Discussionmentioning

confidence: 98%

“…Previous studies already reported that CPB time increases the risk of mortality. 16,17 Salis et al reported that 30-min increments in CPB time are an independent risk factor for postoperative death (OR = 1.57, p < .0001). 17 We know that lower body weight increases mortality from previous studies.…”

Section: Discussionmentioning

confidence: 99%

Repair of complete atrioventricular canal defects: Early and midterm results and comparison of the left anterior leaflet augmentation technique with traditional technics

Başgöze

Yıldız

Öztürk

et al. 2021

Journal of Cardiac Surgery

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Background Complete atrioventricular septal defects (CAVSD) include a variable spectrum of congenital malformations with different forms of clinical findings. We examined early and midterm outcomes, the need for reoperation, postoperative residual AV valve regurgitation, and other risk factors after various CAVSD repairs. Methods Between 2014 and 2018, we have performed 89 isolated CAVSD repairs. We retrospectively reviewed the patients' medical records. Patients were divided into three groups according to their repair techniques modified one patch repair (MP) (n = 16); two patch repair (TP) (n = 49); and left anterior leaflet augmentation (ALA) technique (n = 24). Results Eighty patients (89.8%) survived hospital discharge. Early mortality rates were three (18.8%) in the group MP, five (10.2%) in the group TP, and one (4.2%) in the group ALA. Thirteen patients died during the follow‐up period. Late mortality rates were three (18.8%) in the group MP, four (16.6%) in the group ALA, and six (12.2%) in the group TP. The mean follow‐up time was 35.9 ± 22.97 months (range: 0.3–77 months). The morbidity and mortality results were similar between‐group TP and ALA but worse in the MP group. Low body weight (<4 kg) and younger age at surgery (<4 months) were found to be risk factors on mortality by univariate and multivariate analysis. Surgical technic was not found to be an independent risk factor. Conclusion In our series, TP and ALA techniques had satisfactory results in early and midterm periods. Younger age and small bodyweight might increase early mortality and the need for reoperation.

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Cardiopulmonary bypass time: every minute counts

Cited by 82 publications

References 0 publications

Ocular surface microcirculation is better preserved with pulsatile versus continuous flow during cardiopulmonary bypass—An experimental pilot

Ocular surface microcirculation is better preserved with pulsatile versus continuous flow during cardiopulmonary bypass—An experimental pilot

Serum N-terminal Pro-B-type Natriuretic Peptide Predicts Mortality in Cardiac Surgery Patients Receiving Renal Replacement Therapy

Repair of complete atrioventricular canal defects: Early and midterm results and comparison of the left anterior leaflet augmentation technique with traditional technics

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