M. Bagherinasab et al.: J Extra Corpor Technol 2026, 58, 73--78 75
Table 1. Demographic data and risk factors.
Characteristic |
Fast( n = 30) |
Slow( n = 30) |
P-value |
Age( years) |
65.16 ± 7.76 |
63.96 ± 7.99 |
0.55 |
Male n(%) |
17( 56.7 %) |
18( 60 %) |
0.79 |
Body surface area( m 2) |
1.77 ± 0.19 |
1.74 ± 0.15 |
0.41 |
Ejection fraction(%) |
43.00 ± 7.94 |
45.33 ± 7.53 |
0.24 |
Circuit priming volume |
1773.33 ± 141.25 |
1765.00 ± 131.40 |
0.81 |
Preoperative creatinine |
1.09 ± 0.23 |
1.10 ± 0.21 |
0.77 |
Hypertension |
20( 66.7 %) |
19( 63.3) |
0.78 |
Data are presented as mean ± SD, or as absolute numbers( percentage). Statistical significance was determined using Student’ s t-test and the chi-square test, with a p-value threshold set at less than 0.05.
Table 2. Intra and postoperative data.
Characteristic |
Fast( n = 30) |
Slow( n = 30) |
P-value |
CPB time( minutes) |
71.63 ± 21.79 |
70.50 ± 24.25 |
0.85 |
Aortic cross-clamp time( minutes) |
51.93 ± 20.81 |
73.30 ± 15.72 |
0.46 |
Hemofilter( mL) |
2293.33 ± 500.29 |
2080.00 ± 518.88 |
0.11 |
Urine output( mL) |
526.66 ± 176.52 |
641.66 ± 355.76 |
0.11 |
Mechanical ventilation( minutes) |
687.66 ± 411.61 |
641.00 ± 282.35 |
0.61 |
ICU stay( day) |
3.90 ± 0.80 |
3.43 ± 0.81 |
0.03 |
Data are presented as mean ± SD, or as absolute numbers( percentage). Statistical significance was determined using Student’ s t-test and the chi-square test, with a p-value threshold set at less than 0.05. CPB = Cardiopulmonary bypass.
tions were conducted while the subjects were awake, prior to the administration of anesthesia, followed by subsequent measurements throughout CPB.
The perioperative and postoperative data encompassed several parameters, including aortic cross-clamp time, CPB duration, circuit priming volume, maximum CPB flow rate, duration of mechanical ventilation, and length of stay in the intensive care unit( ICU).
The Confusion Assessment Method( CAM-ICU) emerged as the predominant instrument utilized for evaluating the occurrence of delirium following surgery [ 6 ]. The CAM-ICU-7 score is quantified on a scale from 0 to 7, with a score of 7 indicating the highest severity of delirium. The scores are subsequently classified into three categories: scores ranging from 0 to 2 indicate the absence of delirium, scores from 3 to 5 reflect mild to moderate delirium, and scores between 6 and 7 denote severe delirium [ 7 ].
The Richmond Agitation-Sedation Scale( RASS) and CAM-ICU scales were evaluated twice daily, in the morning and evening, over a four-day period following the surgical procedure.
A power analysis was performed prior to study initiation. Assuming an alpha of 0.05 and a power of 80 %, a minimum of 25 patients per group was required to detect a 20 % difference in the primary outcome( TOI).
Statistical analysis
Data are presented in tables as mean ± standard deviation, median, or absolute percentages. The Student’ s t-test was employed for continuous parametric variables, while the Wilcoxon rank-sum test was utilized for nonparametric continuous variables. Statistical variations across the different time periods were evaluated using repeated measures analysis of variance, accompanied by Wilks’ Lambda. Results were deemed statistically significant when the associated P-values were below the threshold of 0.05.
Results
Demographic information and intraoperative and postoperative data The demographic characteristics of the patients, along with their comorbidities, as well as intraoperative and postoperative variables, are detailed in Tables 1 and 2, respectively. No statistically significant differences were identified among the groups concerning demographic characteristics and intraoperative variables. Patients in the slow CPB initiation group exhibited a significantly reduced duration of stay in the ICU when compared to those in the fast initiation group( P < 0.05).
Key variable variations pertinent to the primary study objectives( HCT, PaO 2, TOI) among the study groups are illustrated in Table 3. AsindicatedinTable 3, there were no statistically significant differences observed in HCT and TOI among the study groups during the initial 180 s. Patients in the fast group exhibited a significantly lower paO2 during the initial 180 s when compared to those in the slow group( P < 0.05). It is noteworthy that at baseline( T0, before anesthesia induction), the fast group already demonstrated a statistically significant lower PaO 2( 190.7 ± 37.3 mmHg) than the slow group( 233.2 ± 69.5 mmHg), with a difference of approximately 42.5 mmHg. During the initiation of CPB( T1-- T4), the