Association between cardiopulmonary bypass time and clinical outcomes among patients with acute respiratory distress syndrome after cardiac surgery

Hu, Jiaxin; Liu, Yan; Huang, Liying; Song, Man; Zhu, Guangfa

doi:10.21203/rs.3.rs-2400883/v1

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…13 Hu et al depicted that optimal cut-off duration of CPB was less than 160 min for ICU and inhospital mortality. 14 Nadeem et al illustrated that CPB time duration acts to affect clinical outcomes adversely and is associated with prolonged postoperative mechanical ventilation. 15 Therefore, with the intention of finding the optimal limit of safe CPB duration, we conducted this retrospective observational study of 202 patients; we divided the patients into groups according to the duration of CPB and observed intraoperative and postoperative recovery parameters in each group.…”

Section: Discussionmentioning

confidence: 99%

Impact of duration of cardiopulmonary bypass on recovery after open heart surgery

Aladwan,

Alshoubaki,

Alqaisi

et al. 2024

Int J Adv Med

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Background: Objective of the study was to examine the impact of cardiopulmonary bypass (CPB) duration on recovery from cardiac surgery. Methods: This is an observational retrospective study. Data from adult cardiac surgical patients presented at Queen Alia Heart Institute (QAHI) in the duration between September 2023 and February 2024 was retrospectively analysed. The impact of CPB duration was examined. Patients were divided into groups according to CPB duration (0 to 60 minutes, 60 to 120 minutes, 120 to 180 minutes, 180 to 240 minutes and 240 to 300 minutes). For each group intra-operative and post-operative variable were examined. The intra-operative variables studied were need for blood transfusion, haemofiltration and intra-aortic balloon pump. The post-operative variables studied were duration of post-operative mechanical ventilation, intensive care unit (ICU) stay, hospitalization time and mortality. Results: Consecutive data of 202 adult cardiac surgical patients (34 females and 168 males) was analysed. Average age of patients was 57.149 years. Average duration of CPB was 109.9 minutes (ranged from 29 to 300 minutes). Half of the patients (50.5%) had CPB duration between 1 and 2 hours. Blood transfusion was needed in 88 patients (43.6%). Haemofiltration was used in 32 patients (15.8%) and intra-aortic balloon pump (IABP) was used in 29 patients (14.4%). The average postoperative time of mechanical ventilation was 34 hours and the average ICU stay was 5.5 days. Chest re-exploration was needed in 30 patients (15%). Hospital stay was on average 12 days and in-hospital mortality was witnessed in 20 patients (9.9%). Patients who had CPB for less than one hour (17.3%) had the lowest incidence of blood transfusion (37.1%), lowest incidence of haemofiltration (8.6%), low incidence of IABP use (11%). They also had lowest incidence of chest re-opening (5.7%), shortest time of postoperative mechanical ventilation (13 hours) and shortest ICU and hospital stay (4.1 and 8.5 days, respectively). There was a significant increase in postoperative sternal re-opening and postoperative mortality when the duration of CPB exceeded 3 hours. Conclusions: Duration of CPB is a key predictor of recovery and outcome of cardiac surgery. Shorter CPB time was associated with earlier extubation, less ICU stay and shorter hospitalisation time. Prolonged CPB was associated with higher rates of complications, delayed recovery, longer ICU stay, protracted hospitalisation and higher mortality rates.

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Section: Discussionmentioning

confidence: 99%

Impact of duration of cardiopulmonary bypass on recovery after open heart surgery

Aladwan,

Alshoubaki,

Alqaisi

et al. 2024

Int J Adv Med

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“…10 The higher mortality in the haemofiltration group can be attributed to longer CPB and AXC durations. [11][12][13] Prolonged CPB times could predict postoperative clinical events, in particular mortality. 14 In our study, the postoperative benefits of using haemofiltration during CPB were earlier tracheal extubation and shorter hospital stay (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Intraoperative haemofiltration during on-pump cardiac surgery at Queen Alia Heart Institute

Awamlah,

Hadidi,

Shobaki

et al. 2024

Int J Adv Med

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Background: Objective of the study was to determine the frequency, indications and benefits of utilizing haemofiltration during cardiopulmonary bypass in adult cardiac surgical patients. Methods: This is a prospective observational analysis of data of adult cardiac surgical patients presented for on-pump cardiac surgery in the period between September 2023 and December 2023 at Queen Alia Heart Institute. Data was collected using Google Forms online and was subsequently recorded on Excel sheaths. Patients were divided into two groups: the haemofiltration group and the non-haemofiltration group. Both groups were compared according to perioperative laboratory and clinical variables. Statistical analysis of results using Microsoft excel followed data collection. Ethical committee approval was obtained. Results: Data from 130 adult cardiac surgical patients (105 males and 25 females) enrolled in this analysis showed that haemofiltration was used in 25 patients (19.2%). The most frequent indication for intraoperative haemofiltration was haemodilution in 14 patients (56%). Blood transfusion was needed in 17 (68%) of patients who had haemofiltration and in 35 (33.4%) of patients who did not need haemofiltration. Patients from the haemofiltration group were extubated 5 hours earlier than patients from the non-haemofiltration group, as the duration of mechanical ventilation in the ICU was 17.9 hours in the haemofiltration group versus 24.9 hours in the non-haemofiltration group. The average overall hospital stay was 3 days less in the haemofiltration group. Conclusions: Haemofiltration during cardiopulmonary bypass main indications were severe haemodilution, hyperkalaemia and preoperative renal impairment. The use of haemofiltration during CPB was associated with earlier tracheal extubation and shorter hospital stay.

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“…The development of ARDS is likely multifactorial, and the presence of preexisting cardiac dysfunction theoretically aggravates the degree of pulmonary edema in patients who develop ARDS. 17 An accurate diagnosis of ARDS is critical because optimal treatment strategieswhich include the use of high PEEP, low tidal volume (V T ) ventilation, and permissive hypercapnia 18 -may conflict with treatment for cardiac surgical patients, specific patients with poor RV function, and patients with recent sternotomy. Furthermore, the increased risk of ARDS after cardiac surgery has traditionally been associated with the use of cardiopulmonary bypass (CPB), the need for blood product transfusions, large volume shifts, mechanical ventilation, and direct surgical insult.…”

Section: Diagnosis After Surgerymentioning

confidence: 99%

Acute Respiratory Distress Syndrome in Patients with Cardiovascular Disease

Zainab,

Gooch,

Tuazon

2023

Methodist DeBakey Cardiovascular Journal

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Heart and lung interaction within the thoracic cavity is well known during inhalation and exhalation, both spontaneously and during mechanical ventilation. Disease and dysfunction of one organ affect the function of the other. A review of the cause-and-effect relationship between cardiovascular disease and acute respiratory distress syndrome (ARDS) is of significance, as the disease burden of both conditions has both a national and global impact on health care. This literature review examines the relationship between cardiovascular disease and ARDS over the past 25 years.

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Association between cardiopulmonary bypass time and clinical outcomes among patients with acute respiratory distress syndrome after cardiac surgery

Cited by 3 publications

References 27 publications

Impact of duration of cardiopulmonary bypass on recovery after open heart surgery

Impact of duration of cardiopulmonary bypass on recovery after open heart surgery

Intraoperative haemofiltration during on-pump cardiac surgery at Queen Alia Heart Institute

Acute Respiratory Distress Syndrome in Patients with Cardiovascular Disease

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