Assessment Of The Impact Of Aortic Cross-Clamp Time On Postoperative Extubation Time In Adults Patients Undergoing Cardiopulmonary Bypass Cardiac Surgery

Abstract

Background- Aortic cross-clamping is a critical element of cardiac surgery under cardiopulmonary bypass (CPB). The duration of aortic cross clamp (ACC), however, may increase myocardial ischemia, inflammatory response and postoperative cardiopulmonary complications which may results in late postoperative extubation. Objective-To evaluate the effect of the length of aortic cross clamp on the time to extubation after cardiac surgery in adult patients who have undergone cardiopulmonary bypass surgery. Methodology- A cross-sectional observational study was carried out in 100 adult cardiac patients who underwent elective cardiac surgery under CPB in Omer hospital and cardiac care center and Gulab devi chest hospital. Data for demographics, intraoperative and postoperative information were extracted from the anesthesia records, perfusion chart and the ICU monitoring records.SPSS version 27 was used for data analysis for variables such as aortic cross-clamping time, CPB duration, and extubation time. Pearson correlation analysis were used to assess the relationship between ACC time and delayed extubation. Results- The mean age of patients was 49.80 ± 15.34 years, and 80% of the patients in the study were males. The mean CPB duration was 125.99 ± 34.13 minutes, while the mean ACC duration was 67.82 ± 50.19 minutes. Patients with delayed postoperative recovery had longer ACC duration than did patients with a stable recovery (71.96 ± 48.54 minutes versus 58.61 ± 53.36 minutes). Patients who had prolonged recovery had delayed extubation ≥8 hours more often (62.3% vs 41.9% p = 0.048). Logistic regression analysis showed that aortic cross-clamp time was an independent factor associated with delayed extubation (p = 0.002). Conclusion- A longer aortic cross-clamp time is strongly related to post-operative extubation delay in adult cardiac surgery patients undergoing CPB. Efforts to minimize ischemic exposure during surgery can enhance postoperative recovery and speed up extubation. Keywords- Aortic cross-clamp time, cardiopulmonary bypass, extubation time, cardiac surgery, myocardial ischemia, delayed extubation.