CPB and Aortic Cross-Clamp Durations and ICU Length of Stay After CABG Retrospective Observational Cohort Study

Association of Cardiopulmonary Bypass and Aortic Cross-Clamp Durations With Intensive Care Unit Length of Stay in Elective Isolated Coronary Artery Bypass Graft Surgery: A Retrospective Observational Cohort Study

Cardiopulmonary bypass (CPB) and aortic cross-clamp (ACC) durations are important intraoperative factors that may influence postoperative recovery following coronary artery bypass graft (CABG) surgery. Prolonged CPB and ACC durations may be associated with increased postoperative morbidity and extended intensive care unit (ICU) stay.

This retrospective observational cohort study aims to evaluate the independent associations of CPB and ACC durations with postoperative ICU length of stay in adult patients undergoing elective isolated CABG surgery. Electronic medical records of eligible patients who underwent surgery between January 1, 2019, and December 31, 2025, at a single tertiary care center will be retrospectively reviewed. Multivariable regression analyses will be performed to assess these associations after adjustment for clinically relevant potential confounders.

Study Overview

• Status: Recruiting
• Conditions: Coronary Artery Disease
• Intervention / Treatment: Other: Cardiopulmonary Bypass Duration; Other: Aortic Cross-Clamp Duration

Detailed Description

Cardiopulmonary bypass (CPB) and aortic cross-clamp (ACC) are essential components of coronary artery bypass graft (CABG) surgery. Prolonged CPB and ACC durations may contribute to systemic inflammatory responses, alterations in organ perfusion, and postoperative morbidity, potentially resulting in delayed postoperative recovery and prolonged intensive care unit (ICU) stay.

This single-center retrospective observational cohort study is designed to investigate the association of CPB and ACC durations with postoperative ICU length of stay in adult patients undergoing elective isolated CABG surgery. The electronic medical records of patients who underwent elective isolated CABG surgery between January 1, 2019, and December 31, 2025, will be retrospectively reviewed.

Demographic and preoperative clinical characteristics, including age, sex, body mass index, left ventricular ejection fraction, diabetes mellitus, chronic obstructive pulmonary disease, and chronic kidney disease, will be collected. Intraoperative data will include operative duration, CPB duration, and ACC duration. Postoperative ICU length of stay will be defined as the time from postoperative ICU admission to transfer from the ICU to the hospital ward.

The primary outcome of the study is postoperative ICU length of stay. CPB and ACC durations will be evaluated as continuous exposure variables measured in minutes. Their independent associations with ICU length of stay will be assessed using separate multivariable regression models adjusted for clinically relevant potential confounders. The distribution of ICU length of stay will be evaluated before multivariable analysis. Depending on the distributional characteristics of the outcome, multivariable linear regression after appropriate transformation or a generalized linear model with an appropriate distribution and link function will be used.

The study involves retrospective analysis of routinely collected clinical data and does not include any additional intervention, diagnostic procedure, or treatment related to the research.

• Study Type: Observational
• Enrollment (Estimated): 400

Contacts and Locations

• Study Contact: Name: Fatma Acil, M.D.; Phone Number: +905337225225; Email: acilfatma@gmail.com
• Study Contact Backup: Name: Andaç Dedeoğlu, M.D.; Phone Number: +905326848626; Email: anderen77@hotmail.com

Study Locations

• Turkey (Türkiye)
  • Outside of the US
    • Diyarbakır, Outside of the US, Turkey (Türkiye), 21070
      • Recruiting
      • Fatma Acil
      • Contact: Fatma Acil, M.D.; Phone Number: 05337225225; Email: acilfatma@gmail.com
      • Sub-Investigator: Andaç Dedeoğlu, M.D.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

Adult patients who underwent elective isolated coronary artery bypass graft surgery at a single tertiary care center between January 1, 2019, and December 31, 2025. All patients meeting the predefined eligibility criteria and with complete electronic medical records required for the study analyses will be included in the retrospective cohort.

Description

Inclusion Criteria:

• Age 18 years or older
• Underwent elective isolated coronary artery bypass graft surgery
• Surgery performed between January 1, 2019, and December 31, 2025
• Availability of complete electronic medical records required for the study analyses

Exclusion Criteria:

• Emergency coronary artery bypass graft surgery
• Concomitant valve surgery
• Concomitant aortic surgery
• Reoperation cases
• Incomplete study-related data
• Intraoperative death

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Elective Isolated CABG Cohort; Adult patients who underwent elective isolated coronary artery bypass graft surgery between January 1, 2019, and December 31, 2025, and met the predefined eligibility criteria. Cardiopulmonary bypass and aortic cross-clamp durations will be evaluated as continuous exposure variables.

Other: Cardiopulmonary Bypass Duration; Cardiopulmonary bypass duration, defined as the total duration of cardiopulmonary bypass during elective isolated coronary artery bypass graft surgery and recorded in minutes. This exposure will be evaluated as a continuous variable based on routinely collected perfusion records.; Other: Aortic Cross-Clamp Duration; Aortic cross-clamp duration, defined as the total duration of aortic cross-clamping during elective isolated coronary artery bypass graft surgery and recorded in minutes. This exposure will be evaluated as a continuous variable based on routinely collected operative and perfusion records.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Intensive Care Unit Length of Stay	Postoperative intensive care unit length of stay will be defined as the duration from admission to the intensive care unit following surgery until transfer from the intensive care unit to the hospital ward and will be recorded in days. Patients who die during the intensive care unit stay will not be included in the primary intensive care unit length-of-stay analysis.	Up to 30 days after surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative Atrial Fibrillation	Occurrence of new-onset atrial fibrillation during the postoperative period, identified from electrocardiographic findings and clinical records.	Up to 30 days after surgery
Acute Kidney Injury	Occurrence of postoperative acute kidney injury defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria as an increase in serum creatinine of ≥0.3 mg/dL within 48 hours, an increase in serum creatinine to ≥1.5 times baseline within 7 days, or urine output <0.5 mL/kg/h for at least 6 hours.	Up to 30 days after surgery
Postoperative Respiratory Failure	Occurrence of postoperative respiratory failure, defined as the need for invasive mechanical ventilation for more than 48 hours after surgery, unplanned reintubation due to respiratory failure following initial extubation, or the need for noninvasive ventilatory support due to persistent or worsening respiratory failure during the postoperative period.	Up to 30 days after surgery
30-Day All-Cause Mortality	Death from any cause occurring within 30 days after surgery.	Within 30 days after surgery

Collaborators and Investigators

• Sponsor: Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital
• Investigators: Principal Investigator: Fatma Acil, M.D., Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital

Publications and helpful links

General Publications

• Anastasiadis K, Antonitsis P, Voucharas C, Apostolidou-Kiouti F, Deliopoulos A, Haidich AB, Argiriadou H. Minimal invasive extracorporeal circulation versus conventional cardiopulmonary bypass in cardiac surgery: a contemporary systematic review and meta-analysis. Eur J Cardiothorac Surg. 2025 Mar 28;67(4):ezaf112. doi: 10.1093/ejcts/ezaf112.

Study record dates

Study Major Dates

• Study Start (Actual): July 20, 2026
• Primary Completion (Estimated): August 30, 2026
• Study Completion (Estimated): August 30, 2026

Study Registration Dates

• First Submitted: July 14, 2026
• First Submitted That Met QC Criteria: July 14, 2026
• First Posted (Actual): July 17, 2026

Study Record Updates

• Last Update Posted (Actual): July 21, 2026
• Last Update Submitted That Met QC Criteria: July 20, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Cardiac Surgery
• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Heart Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Coronary Disease; Myocardial Ischemia; Coronary Artery Disease
• Other Study ID Numbers: 05.06.2026-276

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No