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The effect of the cross clamp time on the post-operative ventilation in post CABG patients


Ahmed Sultan Mohamed, Mohamed Ezzeldin Azzam, Ahmed Hamdy Lamlom, Waleed Gamal Abo Senna, Mohamed Ibrahim Sewielam, Tarek Mohamed Kandeel

Abstract

Background: Coronary artery bypass grafting using cardio pulmonary bypass is a successful procedure in modern medicine; however, prolonged aortic cross clamp time is linked to adverse outcome following cardiac surgery. During aortic cross clamping, a period of global myocardial ischemia is followed by reperfusion injury that manifests as myocardial stunning, arrhythmia and changes in cardiac performance that needs inotropic support in early post-operative period, also associated with acute lung injury that needs mechanical ventilation of different duration. Objectives: To assess the effect of the aortic cross clamp time on the mechanical ventilation post-operatively. Patient and methods: Thirty elective patients of isolated ischemic heart disease undergoing on pump CABG, were collected from Cardio Thoracic Surgery department Elkasr Alainy Hospital. We assessed the post-operative ventilation time and inotropic support of those patients post-operatively. Results: Statistical analysis showed, when the mean time of the cross clamp was (±73minutes), the mechanical ventilation time was only up to one day in twenty-five patients (83.33%), but with increased time of the cross clamp, when the mean time was (±135 minutes), the post-operative ventilation was up to three days in four patients about (16%). Conclusion: Prolonged aortic cross clamp time correlates with post-operative morbidity and mortality studies to decrease this morbid effect are warranted.




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