[Gastrointestinal complications after on-pump cardiac surgery]

Area of Science:

• Cardiology
• Gastroenterology
• Surgical Outcomes

Background:

• Gastrointestinal complications (GICs) are a significant concern following on-pump cardiac surgery.
• Identifying predictors and preventive strategies for GICs is crucial for improving patient outcomes.

Purpose of the Study:

• To determine the incidence and independent predictors of GICs after on-pump cardiac surgery.
• To explore potential preventive measures against GICs during cardiopulmonary bypass (CPB).

Main Methods:

• Retrospective analysis of 9559 adult patients undergoing cardiac surgery between 2012 and 2017.
• Patients were categorized into two groups: those with GICs requiring surgery (0.5%) and those without (95.5%).

Main Results:

• Independent predictors of GICs included age >65 years, previous atrial fibrillation (AF), multifocal atherosclerosis, left ventricular ejection fraction (LVEF) <40%, aortic cross-clamping time >90 min, intraoperative blood loss >600 ml, postoperative serum creatinine >140 μmol/l, and mechanical ventilation >24 hours.
• Specific CPB strategies such as reduced hemodilution, warm blood cardioplegia, and optimized perioperative hemoglobin, hematocrit, and oxygen delivery (IDO2) may prevent ischemic injury to abdominal organs.

Conclusions:

• Several patient-related and intraoperative factors significantly predict the occurrence of GICs post-cardiac surgery.
• Optimizing CPB management and perioperative parameters may mitigate the risk of GICs, particularly in prolonged procedures.