Predictors of aortic clamp time duration and intensive care unit length of stay in elective adult cardiac surgery
Abstract Background Aortic cross-clamp utilized during cardiac surgery facilitates motionless and bloodless surgical field. However, the duration of clamp time has an inverse effect on early post-operative recovery period. In this study, we sought to examine the predictors of aortic clamp duration a...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-10-01
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| Series: | The Egyptian Heart Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43044-021-00195-0 |
| _version_ | 1819044993104347136 |
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| author | Ashraf Fadel Moh’d Hayel Talal Al-Odwan Salah Altarabsheh Zeid Mohammad Makahleh Mohammad Abdallah Khasawneh |
| author_facet | Ashraf Fadel Moh’d Hayel Talal Al-Odwan Salah Altarabsheh Zeid Mohammad Makahleh Mohammad Abdallah Khasawneh |
| author_sort | Ashraf Fadel Moh’d |
| collection | DOAJ |
| description | Abstract Background Aortic cross-clamp utilized during cardiac surgery facilitates motionless and bloodless surgical field. However, the duration of clamp time has an inverse effect on early post-operative recovery period. In this study, we sought to examine the predictors of aortic clamp duration and intensive care unit length of stay. Results Six hundred and nine adult patients presented for elective cardiac surgery between December 2019 and December 2020 were enrolled. The age of patients ranged from 18 to 82 years (mean 55.62 years, SD ± 12.3 years). Male/female ratio is 4.6:1. Most patients (87.2%) were planned for coronary artery bypass grafting (CABG) and 78 patients (12.8%) for single heart valve procedure. Operative time (OT) ranged from 120 to 402 min and averaged 259.4 min (SD ± 45.9 min). ACC time ranged from 15 to 159 min and averaged 50.56 min (SD ± 19.4 min). Factors associated with significantly longer ACCT were: smoking (OR = 1.89 (95% CI 1.3–2.74), p value = 0.01), respiratory disease (OR = 0.48 (95% CI 0.24–0.96), p value = 0.039), obesity (OR = 1.76 (95% CI 1.18–2.63), p value = 0.005) and AVR (OR = 2.11 (95% CI 1.17–3.83), p value = 0.013). Low cardiac output syndrome (LCOS) was observed in 19.2% of patients. Longer than average ACCT was associated with increased use of inotropes (p value < 0.001), intra-aortic balloon pump (p value < 0.001) and first 24 h post-operative blood loss (p value < 0.001). The average intensive care unit length of stay (ICULOS) was 1.64 days (SD ± 1.1 days). Patients' ACCT converged positively and significantly on ICULOS (Beta coefficient = 1.013 (95% CI 1.01–1.015), p value < 0.001). Conclusion Aortic cross-clamping is a crucial method in cardiac surgery to achieve motionless field; however, prolongation of this method had an incremental risks for the development of low cardiac output syndrome, increased first 24 h post-operative blood loss and longer stay in the intensive care unit. |
| first_indexed | 2024-12-21T10:21:30Z |
| format | Article |
| id | doaj.art-9e1352d23ae14bc78228d65d2273ab0c |
| institution | Directory Open Access Journal |
| issn | 2090-911X |
| language | English |
| last_indexed | 2024-12-21T10:21:30Z |
| publishDate | 2021-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj.art-9e1352d23ae14bc78228d65d2273ab0c2022-12-21T19:07:25ZengSpringerOpenThe Egyptian Heart Journal2090-911X2021-10-0173111010.1186/s43044-021-00195-0Predictors of aortic clamp time duration and intensive care unit length of stay in elective adult cardiac surgeryAshraf Fadel Moh’d0Hayel Talal Al-Odwan1Salah Altarabsheh2Zeid Mohammad Makahleh3Mohammad Abdallah Khasawneh4Queen Alia Heart Institute/Jordanian Royal Medical ServicesQueen Alia Heart Institute/Jordanian Royal Medical ServicesCardiac Surgery Department, Queen Alia Heart Institute/Jordanian Royal Medical ServicesCardiac Surgery Department, Queen Alia Heart Institute/Jordanian Royal Medical ServicesQueen Alia Heart Institute/Jordanian Royal Medical ServicesAbstract Background Aortic cross-clamp utilized during cardiac surgery facilitates motionless and bloodless surgical field. However, the duration of clamp time has an inverse effect on early post-operative recovery period. In this study, we sought to examine the predictors of aortic clamp duration and intensive care unit length of stay. Results Six hundred and nine adult patients presented for elective cardiac surgery between December 2019 and December 2020 were enrolled. The age of patients ranged from 18 to 82 years (mean 55.62 years, SD ± 12.3 years). Male/female ratio is 4.6:1. Most patients (87.2%) were planned for coronary artery bypass grafting (CABG) and 78 patients (12.8%) for single heart valve procedure. Operative time (OT) ranged from 120 to 402 min and averaged 259.4 min (SD ± 45.9 min). ACC time ranged from 15 to 159 min and averaged 50.56 min (SD ± 19.4 min). Factors associated with significantly longer ACCT were: smoking (OR = 1.89 (95% CI 1.3–2.74), p value = 0.01), respiratory disease (OR = 0.48 (95% CI 0.24–0.96), p value = 0.039), obesity (OR = 1.76 (95% CI 1.18–2.63), p value = 0.005) and AVR (OR = 2.11 (95% CI 1.17–3.83), p value = 0.013). Low cardiac output syndrome (LCOS) was observed in 19.2% of patients. Longer than average ACCT was associated with increased use of inotropes (p value < 0.001), intra-aortic balloon pump (p value < 0.001) and first 24 h post-operative blood loss (p value < 0.001). The average intensive care unit length of stay (ICULOS) was 1.64 days (SD ± 1.1 days). Patients' ACCT converged positively and significantly on ICULOS (Beta coefficient = 1.013 (95% CI 1.01–1.015), p value < 0.001). Conclusion Aortic cross-clamping is a crucial method in cardiac surgery to achieve motionless field; however, prolongation of this method had an incremental risks for the development of low cardiac output syndrome, increased first 24 h post-operative blood loss and longer stay in the intensive care unit.https://doi.org/10.1186/s43044-021-00195-0Aortic cross-clampCardiopulmonary bypassIschaemia timeLength of stay |
| spellingShingle | Ashraf Fadel Moh’d Hayel Talal Al-Odwan Salah Altarabsheh Zeid Mohammad Makahleh Mohammad Abdallah Khasawneh Predictors of aortic clamp time duration and intensive care unit length of stay in elective adult cardiac surgery The Egyptian Heart Journal Aortic cross-clamp Cardiopulmonary bypass Ischaemia time Length of stay |
| title | Predictors of aortic clamp time duration and intensive care unit length of stay in elective adult cardiac surgery |
| title_full | Predictors of aortic clamp time duration and intensive care unit length of stay in elective adult cardiac surgery |
| title_fullStr | Predictors of aortic clamp time duration and intensive care unit length of stay in elective adult cardiac surgery |
| title_full_unstemmed | Predictors of aortic clamp time duration and intensive care unit length of stay in elective adult cardiac surgery |
| title_short | Predictors of aortic clamp time duration and intensive care unit length of stay in elective adult cardiac surgery |
| title_sort | predictors of aortic clamp time duration and intensive care unit length of stay in elective adult cardiac surgery |
| topic | Aortic cross-clamp Cardiopulmonary bypass Ischaemia time Length of stay |
| url | https://doi.org/10.1186/s43044-021-00195-0 |
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