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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CPB time ≥ 120 minutes | Patients will be grouped into a prolonged CPB group (CPB ≥120 minutes) |
| |
| CPB time < 120 minutes | Patients will be grouped into a normal CPB group (CPB <120 minutes) . |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Prolonged ≥ 120 minutes | Other | No intervention, regular therapy |
|
| Measure | Description | Time Frame |
|---|---|---|
| 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. | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Return Time of Bowel Sounds | The time to first detection of bowel sounds after surgery, monitored daily in the morning and evening by auscultation. | 1 month |
| Frequency of Bowel Sounds | The number of bowel sounds counted at 12-hour intervals, recorded twice daily to assess gastrointestinal motility. |
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Inclusion Criteria:
Exclusion Criteria:
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Patients undergoing heart valve replacement with differ CPB durations.
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| Name | Affiliation | Role |
|---|---|---|
| Wenbo Meng | Hepatopancreatobiliary Surgery Institute of Gansu Province | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hepatopancreatobiliary Surgery Institute of Gansu Province | Lanzhou | Gansu | 730000 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32855033 | Background | Gallitto E, Sobocinski J, Mascoli C, Pini R, Fenelli C, Faggioli G, Haulon S, Gargiulo M. Fenestrated and Branched Thoraco-abdominal Endografting after Previous Open Abdominal Aortic Repair. Eur J Vasc Endovasc Surg. 2020 Dec;60(6):843-852. doi: 10.1016/j.ejvs.2020.07.071. Epub 2020 Aug 24. | |
| 32772778 | Background |
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| 1 month |
| Time to First Defecation | The time to the first defecation was asked morning and evening after surgery. | 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. | 1 month |
| 5.C-Reactive Protein (CRP) | Maximum CRP level recorded within the first week after surgery. | 1 month |
| Procalcitonin (PCT) | Maximum PCT level recorded within the first week after surgery. | 1 month |
| Alanine Aminotransferase (ALT) | The investigators defined it as the maximum value of ALT within 7 days after surgery. | 1 month |
| Aspartate Aminotransferase (AST) | The investigators defined it as the maximum value of ALT within 7 days after surgery. | 1 month |
| Creatinine | The investigators defined it as the maximum value of Creatinine within 7 days after surgery. | 1 month |
| Left Ventricular Ejection Fraction (LVEF) | LVEF assessed through echocardiography on days 1 and 3 post-surgery to monitor cardiac function. | 1 month |
| Ventilator assisted time (VAT) | VAT was defined as the sum time of ventilator assisted post-surgery. | 1 month |
| Days of ICU stay | Total number of days during ICU, reflecting overall recovery and the impact of any gastrointestinal or systemic complications. | 3 months |
| Seilitz J, Edstrom M, Skoldberg M, Westerling-Andersson K, Kasim A, Renberg A, Jansson K, Friberg O, Axelsson B, Nilsson KF. Early Onset of Postoperative Gastrointestinal Dysfunction Is Associated With Unfavorable Outcome in Cardiac Surgery: A Prospective Observational Study. J Intensive Care Med. 2021 Nov;36(11):1264-1271. doi: 10.1177/0885066620946006. Epub 2020 Aug 10. |
| 22310869 | Background | Reintam Blaser A, Malbrain ML, Starkopf J, Fruhwald S, Jakob SM, De Waele J, Braun JP, Poeze M, Spies C. Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal Problems. Intensive Care Med. 2012 Mar;38(3):384-94. doi: 10.1007/s00134-011-2459-y. Epub 2012 Feb 7. |
| 40234981 | Derived | Yang X, Lu N, Yang L, Li B, Zhou W, Li Y, Song B, Yuan J, Meng W. Impact of prolonged cardiopulmonary bypass on gastrointestinal complications in cardiac surgery: a retrospective cohort study. Perioper Med (Lond). 2025 Apr 15;14(1):42. doi: 10.1186/s13741-025-00524-w. |