Assessing hemodynamic changes before and after pump in CABG surgery and its factors

评估冠状动脉旁路移植术中体外循环前后血流动力学变化及其影响因素

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Abstract

BACKGROUND: One of the main complications after coronary artery bypass grafting (CABG) is postoperative clinical and para-clinical changes, which present a significant challenge. METHODS: This descriptive cross-sectional study included 109 patients who were candidates for CABG and were admitted to the surgical intensive care unit at Tehran Heart Center Hospital, selected using random sampling and a checklist. Relationships between variables were analyzed with the Kolmogorov-Smirnov (K-S) test, paired t-test, and regression. RESULTS: The findings from the mean changes before and after the pump showed that blood sugar (28.23 ± 33.43), lactate (6.59 ± 5.63), potassium (0.75 ± 0.47), and heart rate (12.36 ± 15.46) increased significantly after the pump compared to before the pump (p < 0.05), while hemoglobin (-2.5 ± 1.28), hematocrit (-6.61 ± 3.44), pH (-0.03 ± 0.06), PaO₂ (-92.95 ± 94.01), bicarbonate (-1.83 ± 2.38), and mean blood pressure (-2.25 ± 13.01) decreased significantly (p < 0.05). Gender had a significant effect on cerebral oximetry values on both the right (β = 5.461, p = 0.002) and left (β = 4.835, p = 0.004) sides, hemoglobin (β = 0.644, p = 0.017), and hematocrit (β = 2.055, p = 0.004). In addition, patients' comorbidities also had a positive effect on PaO₂ (β = 11.340, p = 0.044). CONCLUSION: The clinical and para-clinical status in patients undergoing CABG surgery changes after on-pump surgery. In addition, comorbidities of patients have a positive and significant effect on PaO₂, as well as gender, on cerebral oximetry, hemoglobin, and hematocrit values.

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