GENERAL SURGICAL COMPLICATIONS CAN BE PREDICTED AFTER CARDIOPULMONARYBYPASS

Objective The authors review the general surgical complications of car diopulmonary bypass, including newer procedures such as heart and lung transplantation, to identify patients at higher risk. Summary Backgro und Data Although rare, the general surgical complications of cardiopu lmonary bypass are associated with high mortality. The early identific ation of patients at increased risk for these complications may allow for earlier detection and treatment of these problems to reduce mortal ity. Methods A retrospective review was performed of 1831 patients und ergoing cardiopulmonary bypass from 1991 to 1993. This was done to ide ntify factors that significantly contributed to an increased risk of g eneral surgical complications. Results Factors associated with an incr eased risk of general surgical complications included prolonged cardio pulmonary bypass (p < 0.005) and intensive care unit stay (p < 0.002), occurrence of arrhythmias (p < 0.001), use of inotropic agents (preop eratively or postoperatively p < 0.001), insertion of the intra-aortic balloon pump (preoperatively p < 0.005, postoperatively p < 0.001), u se of steroids (p < 0.001), and prolonged ventilator support (p < 0.00 1). Multivariate analysis identified use of the intra-aortic balloon p ump (p < 0.001) as the strongest predictor of the general surgical com plications of cardiopulmonary bypass. A variety of factors not contrib uting significantly to an increased risk also were identified. Conclus ions Factors indicative of or contributing to periods of decreased end -organ perfusion appear to be significantly related to general surgica l complications after cardiopulmonary bypass.