General surgical complications can be predicted after cardiopulmonary bypass.

Abstract:

OBJECTIVE:The authors review the general surgical complications of cardiopulmonary bypass, including newer procedures such as heart and lung transplantation, to identify patients at higher risk. SUMMARY BACKGROUND DATA:Although rare, the general surgical complications of cardiopulmonary bypass are associated with high mortality. The early identification of patients at increased risk for these complications may allow for earlier detection and treatment of these problems to reduce mortality. METHODS:A retrospective review was performed of 1831 patients undergoing cardiopulmonary bypass from 1991 to 1993. This was done to identify factors that significantly contributed to an increased risk of general surgical complications. RESULTS:Factors associated with an increased risk of general surgical complications included prolonged cardiopulmonary bypass (p < 0.005) and intensive care unit stay (p < 0.002), occurrence of arrhythmias (p < 0.001), use of inotropic agents (preoperatively or postoperatively p < 0.001), insertion of the intra-aortic balloon pump (preoperatively p < 0.005, postoperatively p < 0.001), use of steroids (p < 0.001), and prolonged ventilator support (p < 0.001). Multivariate analysis identified use of the intra-aortic balloon pump (p < 0.001) as the strongest predictor of the general surgical complications of cardiopulmonary bypass. A variety of factors not contributing significantly to an increased risk also were identified. CONCLUSIONS:Factors indicative of or contributing to periods of decreased end-organ perfusion appear to be significantly related to general surgical complications after cardiopulmonary bypass.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Spotnitz WD,Sanders RP,Hanks JB,Nolan SP,Tribble CG,Bergin JD,Zacour RK,Abbott RD,Kron IL

doi

10.1097/00000658-199505000-00006

subject

Has Abstract

pub_date

1995-05-01 00:00:00

pages

489-96; discussion 496-7

issue

5

eissn

0003-4932

issn

1528-1140

journal_volume

221

pub_type

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