The association between intraoperative cardiopulmonary bypass power and complications after cardiac surgery.

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  • Additional Information
    • Source:
      Publisher: SAGE Publications Country of Publication: England NLM ID: 8700166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-111X (Electronic) Linking ISSN: 02676591 NLM ISO Abbreviation: Perfusion Subsets: MEDLINE
    • Publication Information:
      Publication: London : SAGE Publications
      Original Publication: [London] : Edward Arnold, [c1986-
    • Subject Terms:
      Cardiopulmonary Bypass*/adverse effects ; Cardiopulmonary Bypass*/methods ; Cardiac Surgical Procedures*/adverse effects ; Cardiac Surgical Procedures*/methods; Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Postoperative Complications/etiology ; Risk Factors
    • Abstract:
      Background: Low cardiac power (product of flow and pressure) has been shown to be associated with mortality in patients with cardiogenic shock after acute myocardial infarction, but has not been studied in cardiac surgical patients. This study's hypothesis was that cardiac power during cardiopulmonary bypass for cardiac surgery would have a greater association with adverse events than either flow or MAP (mean arterial pressure) alone.
      Methods: We undertook a retrospective observational study using patient data from February 2015 to March 2022 undergoing cardiac surgery at Fiona Stanley Hospital in Perth Australia. Excluded were patient age less than 18 years old, patients undergoing thoracic transplantation, ventricular assist devices, off pump cardiac surgery and aortic surgery. The primary outcome was a composite outcome of 30-days mortality, stroke or new-onset renal insufficiency.
      Results: Overall, 1984 cardiac surgeries were included in the analysis. Neither duration nor area below thresholds tested for power, MAP or flow was associated with the primary composite outcome. However, we found that an area below MAP thresholds 35-50 mmHg was associated with new renal insufficiency (adjusted odds ratio 1.17 [95% CI 1.02 to 1.35] for patients spending 10 min at 10 mmHg below 50 mmHg MAP compared to those who did not).
      Conclusions: This study suggests that MAP during cardiopulmonary bypass, but not power or flow, was an independent risk factor for adverse renal outcomes for cardiac surgical patients.
      Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
    • Publication Date:
      Date Created: 20230713 Date Completed: 20241001 Latest Revision: 20241029
    • Publication Date:
      20241031
    • Accession Number:
      10.1177/02676591231187958
    • Accession Number:
      37442644