Incidence and prognosis of abdominal complications after cardiopulmonary bypass
Introduction
The development of abdominal complications after cardiac surgery, using cardiopulmonary bypass, is rare, and in retrospective studies the reported incidence was between 0.5 and 3.0% 1, 2. Although clinical occurrence is sporadic, abdominal complications are associated with high mortality (12-67%) 2, 3. Identification of risk factors for the development of abdominal complications has remained largely speculative. Several studies have shown that gastrointestinal complications are connected with prolonged cardiovascular bypass time [4]and insufficient splanchnic perfusion, which may be inadequate for metabolic needs 2, 4. The objective of this study was to determine the incidence of abdominal complications that occur after cardiac surgery using cardiovascular bypass, and to find the common factors that identify patients who are at risk from developing abdominal complications.
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Material and methods
From January 1991 to October 1996, 4288 adult patients underwent open-heart surgery using cardiovascular bypass, coronary bypass grafting, valve surgery, combined surgery (coronary bypass grafting and valve surgery) and other operations, such as correction of atrial or ventricular septal defects. Only patients with abdominal complications arising within 30 days of the cardiac procedure were considered in this study.
Antacid and H2 blockers were administered as a prophylaxis against stress
Results
Of the 4288 patients who underwent cardiac surgery using cardiopulmonary bypass, 59 patients (1.4%) developed early postoperative abdominal complications. Analysis of the demographic data from these patients, with regard to common risk factors for abdominal complications compared with other patients who had undergone an operation, showed no significant difference in the χ2-test at α=0.05 (Table 1) with the exception of chronic obstructive lung disease, which was more frequent in the group
Discussion
In the authors' department the incidence of abdominal complications after cardiopulmonary bypass is low (1.4%), but when they do occur they are associated with a high mortality (13.5%). The morbidity (0.5–3.0%) and mortality of the authors' patients (12-63%) are similar to those reported by others 1, 2, 3, 6, 7, 8, 10, 12, 13, 14.
An analysis of the types of abdominal complications shows that some are related to cardiac surgery (perfusion with extracorporeal circulation, valve replacement,
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