Impact of Cardiopulmonary Bypass Time on Gastrointestinal Complications

Hepatopancreatobiliary Surgery Institute of Gansu Province1,444 enrolled

Overview

This retrospective study investigates the relationship between cardiopulmonary bypass (CPB) duration and the incidence of gastrointestinal complications (GICs) in patients undergoing heart valve replacement. Patients will be grouped into a normal CPB group (CPB \<120 minutes) and a prolonged CPB group (CPB ≥120 minutes). The study aims to determine whether prolonged CPB time is associated with a higher risk of GICs and to evaluate the outcomes and recovery process for patients who develop GICs postoperatively.

Heart valve replacement with CPB carries a risk of GICs due to potential ischemia-reperfusion injury to the gastrointestinal tract. GICs in the postoperative period can lead to increased morbidity and prolong recovery. Prolonged CPB time may serve as a predictive factor for the development of GICs following heart valve replacement. This study will utilize established diagnostic criteria to define GICs, which include clinical symptoms, laboratory tests, and imaging as necessary, based on standards from critical care and gastrointestinal surgery guidelines. By understanding this correlation, the study aims to reduce the incidence and severity of postoperative GICs and improve surgical outcomes.

Study Type

OBSERVATIONAL

Enrollment

1,444

Conditions

Valvular Disease

Interventions

Prolonged ≥ 120 minutesOTHER

No intervention, regular therapy

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients undergoing heart valve replacement with CPB * Age ≥ 18 years and ≤ 75 years Exclusion Criteria: * Have received major gastrointestinal surgery within 5 years. * History of severe infection (e.g., pneumonia, urinary tract infection) requiring hospitalization within 1 month prior to surgery. * Inflammatory bowel disease (IBD), including ulcerative colitis, Crohn's disease, or colitis. * Acute gastroenteritis. * Clostridium difficile or Helicobacter pylori infection. * Chronic constipation. * Peptic ulcer. * Polyps in the stomach or intestines. * Gastrointestinal neoplasms. * Abdominal hernia. * Irritable bowel syndrome. * Acute or chronic cholecystitis, hepatitis. * Patients who died intraoperatively or within 24 hours postoperatively. * Patients with digestive system tumors. * Pregnancy or breastfeeding could affect postoperative medication use and study observations. * Involvement in other studies that may interfere with the objective results of this study.

Locations (1)

Hepatopancreatobiliary Surgery Institute of Gansu Province

Lanzhou, Gansu, China

Outcomes

Primary Outcomes

The acute gastrointestinal injury (AGI) score

The AGI score of the patient within the seventh postoperative day was performed daily according to the European Society of critical care (2012) guidelines for AGI. Determined the severity with grade 1-4,The higher the score, the more serious it is.

Time frame: 1 month

Secondary Outcomes

Return Time of Bowel Sounds

The time to first detection of bowel sounds after surgery, monitored daily in the morning and evening by auscultation.

Time frame: 1 month

Frequency of Bowel Sounds

The number of bowel sounds counted at 12-hour intervals, recorded twice daily to assess gastrointestinal motility.

Time frame: 1 month

Time to First Defecation

The time to the first defecation was asked morning and evening after surgery.

Time frame: 1 month

Proportion of Cocci and Bacilli in Feces

Analysis of bacterial composition in the first stool sample post-surgery, focusing on the ratio of cocci to bacilli.

Time frame: 1 month

5.C-Reactive Protein (CRP)

Maximum CRP level recorded within the first week after surgery.

Time frame: 1 month

Procalcitonin (PCT)

Maximum PCT level recorded within the first week after surgery.

Time frame: 1 month

Alanine Aminotransferase (ALT)

Data from ClinicalTrials.gov

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