• Stefano Salis, Valeria V Mazzanti, Guido Merli, Luca Salvi, Calogero C Tedesco, Fabrizio Veglia, and Erminio Sisillo.
• Anesthesia and Intensive Care Unit, Centro Cardiologico Monzino IRCCS, Milan, Italy. stefano.salis@ccfm.it
• J. Cardiothorac. Vasc. Anesth. 2008 Dec 1;22(6):814-22.

ObjectiveThe aim of this study was to determine if there is a direct relationship between the duration of cardiopulmonary bypass (CPB time [CPBT]) and postoperative morbidity and mortality in patients undergoing cardiac surgery.DesignRetrospective study.SettingCardiac surgery unit, university hospital.ParticipantsFive thousand six patients, New York Heart Association classes 1 through 4, who underwent cardiac surgery between January 2002 and March 2008.InterventionsAll patients were subjected to CPB.Measurements And Main ResultsThe mean CPBT was 115 minutes (median 106). One hundred thirty-one patients (2.6%) died during the same hospitalization. The postoperative median blood loss was 600 mL. Reoperations for bleeding occurred in 193 patients (3.9%), and 1,001 patients received 3 or more units of red blood cells. There were 108 patients (2.2%) with neurologic sequelae, 391 patients (7.8%) with renal complications, 37 patients (0.7%) with abdominal complications, and 184 patients (3.7%) with respiratory complications. Seventy-two patients (1.4%) had an infective complication, and 80 patients (1.6%) had a postoperative multiorgan failure. The multivariate analysis confirmed the role of CPBT, considered in 30-minute increments, as an independent risk factor for postoperative death (odds ratio [OR] = 1.57, p < 0.0001), pulmonary (OR = 1.17, p < 0.0001), renal (OR 1.31, p < 0.0001), and neurologic complications (OR = 1.28, p < 0.0001), multiorgan failure (OR = 1.21, p < 0.0001), reoperation for bleeding (OR = 1.1, p = 0.0165), and multiple blood transfusions (OR = 1.58, p < 0.0001).ConclusionsProlonged CPB duration independently predicts postoperative morbidity and mortality after cardiac surgery.

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