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https://doi.org/10.23736/S0021-9509.17.09864-0
Title: | Cardiopulmonary bypass time: Every minute counts | Authors: | Madhavan S. Chan S.-P. Tan W.-C. Eng J. Li B. Luo H.-D. Teoh L.-K.K. |
Keywords: | Coronary artery bypass Health care Mortality Outcome assessment |
Issue Date: | 24-Jul-2017 | Publisher: | Edizioni Minerva Medica | Citation: | Madhavan S., Chan S.-P., Tan W.-C., Eng J., Li B., Luo H.-D., Teoh L.-K.K. (2017-07-24). Cardiopulmonary bypass time: Every minute counts. Journal of Cardiovascular Surgery 59 (2) : 274-281. ScholarBank@NUS Repository. https://doi.org/10.23736/S0021-9509.17.09864-0 | Abstract: | BACKGROUND: This study was conducted to examine the impact of CPB times on postoperative outcomes. We sought to determine the optimum cut-offs of CPB per graft time and cumulative CPB time and their predictive accuracy for mortality in conjunction with EuroSCORE II. METHODS: The de-identified data of 1960 patients who had undergone isolated on-pump CABG from 2009 to 2014 were analyzed. The risk strata of cardiopulmonary bypass (CPB)/graft and cumulative CPB times, identified with a decision tree, were added into an augmented model for predicting short-And intermediate-Term postoperative clinical events. RESULTS: Prolonged cumulative CPB time (>180 minutes) was significant in predicting mortality while adjusting for EuroSCORE II, postoperative complications, prolonged ICU stay and prolonged mechanical ventilation. Whereas prolonged CPB/graft time (>56 minutes) was marginally non-significant in terms of its direct effects, its indirect effect on mortality could be manifested through enhanced risks of complications, prolonged ICU stay (>48 hours) and prolonged mechanical ventilation (>24 hours). CONCLUSIONS: Prolonged CPB times could predict postoperative clinical events, in particular mortality. To minimize the occurrence of unfavorable adverse outcomes, it is recommended that the CPB/graft time and cumulative CPB time be kept below 56 minutes and 180 minutes respectively. � 2018 Edizioni Minerva Medica. | Source Title: | Journal of Cardiovascular Surgery | URI: | http://scholarbank.nus.edu.sg/handle/10635/146724 | ISSN: | 00219509 | DOI: | 10.23736/S0021-9509.17.09864-0 |
Appears in Collections: | Staff Publications |
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