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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
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.
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
ISSN: 00219509
DOI: 10.23736/S0021-9509.17.09864-0
Appears in Collections:Staff Publications

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