Comparative Impact Of On Pump Versus Off Pump Cardiac Surgery On Intensive Care Unit Stay

Abstract

Background: Cardiac surgeries are commonly performed to treat various heart conditions, with two primary techniques being on-pump and off-pump coronary artery bypass grafting (CABG). On-pump surgery involves the use of cardiopulmonary bypass which temporarily takes over the function of the heart and lungs, whereas off-pump surgery is conducted on the beating heart without the use of a heart-lung machine.

Objective: comparative impact of on pump versus off pump cardiac surgery on intensive care unit stay.

Methodology: This study is an observational longitudinal comparison study. The research will include 50 patients undergoing elective cardiac surgeries, evenly divided into two groups: on-pump and off-pump procedures. The sample size was determined based on a standard formula for comparing two means, ensuring adequate power to detect significant differences at a 95% confidence level with a 5% margin of error. Exclusion criteria include redo surgeries, emergency procedures and incomplete medical records.

Results: There was a significant association between type of surgery and ICU stay (p < 0.0001), with longer ICU duration observed in the on-pump group compared to the off-pump group. No significant difference was observed in 30-day readmission between the groups (p = 1.000). Postoperative complications showed no statistically significant association with type of surgery (p = 0.102), although complications were numerically higher in the on-pump group. Overall, most clinical variables including discharge status, inotropic support, and readmission were not significantly associated with surgical technique, except for perioperative recovery outcomes such as ICU stay, mechanical ventilation, and operative time. Conclusion: The study shows that CABG procedure type significantly affects ICU stay. In patients having undergone off-pump surgeries ICU duration was lower and the majority of patients stayed in the ICU for six days. Arrhythmia was observed in patients having undergone off-pump surgeries. Preoperative and clinical indicators of both groups of patients did not differ.