The Effect of Cross Clamp Time on the Post-Operative Ventilation and Inotropic Support in Post Coronary Artery Bypass Grafting Patients

Background: Ischemic heart disease is one of the major causes of death, disability and health care resource utilization worldwide. CABG is very effective at relieving angina and improving survival, which are the primary indications for the operation. Aim of Study: To determine the effect of Aortic cross clamp time on postoperative ventilation and inotropic support in CABG surgery in patients underwent coronary artery bypass grafting for three vessels or more. Patients and Methods: A comparative cross-sectional ret-rospective study that was conducted at department of cardio-thoracic surgery, Ain Shams University Hospitals from 2021 to 2023 included 100 ischemic patients who are candidates for isolated on-pump CABG surgery. Results: The comparison of additional postoperative out-comes between Group A and Group B reveals important find-ings regarding patient recovery and hospital course. Firstly, there were no cases of stroke in either group, suggesting that prolonged cross-clamp times did not increase the risk of this specific complication. However, significant differences were noted in the duration of ICU stay (p=0.001) and a trend towards longer hospital stays in Group A, although this difference did not reach statistical significance (p=0.134). Group A had a me-dian ICU stay of 3.32 days compared to 2.01 days in Group B, indicating a prolonged need for intensive care management in patients with longer cross-clamp times. Despite these differenc-es, there were no significant disparities in mortality between the groups, with the majority of patients surviving their hospitaliza-tion in both Group A (94.6%) and Group B (97.7%). These find-ings suggest that while prolonged cross-clamp times may lead to increased ICU stays, they do not necessarily impact mortality rates following CABG surgery. However, further investigation is warranted to explore the potential long-term implications of prolonged cross-clamp times on patient outcomes. Conclusion: Our study highlights the significant impact of prolonged aortic cross-clamp times on various postoperative outcomes in patients undergoing isolated on-pump coronary artery bypass grafting (CABG) surgery. Patients with longer cross-clamp times experienced a higher duration of mechan-ical ventilation, increased requirement for inotropic support, and prolonged ICU stays compared to those with shorter cross-clamp times. Additionally, there was a trend towards longer hospital stays in the prolonged cross-clamp group, although mortality rates were comparable between the groups. These findings underscore the importance of minimizing ischemic times during CABG surgery to optimize postoperative recovery and reduce the need for intensive care interventions. Further research is needed to elucidate the long-term implications of prolonged cross-clamp times and to develop strategies aimed at improving surgical outcomes in this patient population.