Association of Cardiopulmonary Bypass and Aortic Cross-Clamp Durations with ICU Length of Stay in Cardiac Surgery Patients: A Retrospective Study at Nasiriya Heart Center

Q: What are the key findings of this study?

Prolonged cardiopulmonary bypass time (p=0.047) and aortic cross-clamp time (p=0.005) were significantly associated with extended ICU length of stay after elective cardiac surgery.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Elective cardiac surgery requiring cardiopulmonary bypass (n=100). Intervention: Prolonged cardiopulmonary bypass time (CPBT) and aortic cross-clamp time (ACCT) vs. Shorter CPBT (<60 minutes) and ACCT (<60 minutes). Primary outcome: Length of intensive care unit (ICU) stay (r = 0.325 for CPBT; r = 0.302 for ACCT, p=0.047 for CPBT; 0.005 for ACCT).

Q: What does this research mean for the field?

Prolonged cardiopulmonary bypass time and aortic cross-clamp time are significantly associated with extended ICU length of stay following elective cardiac surgery. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Hussein Ali Hussein; Myasar Jasim Mohammed; Qusay Abdulazahraa Yaqoob; Mohammed AbdulZahra Sasaa; Majid Fakhir Alhamaidah; Hussein J Alkhfaji; Ammar Hoom Mahdi; Abbass Hussein Haydar

doi:10.18502/aacc.v12i6.22963

October 19, 2026Archives of Anesthesia and Critical CareOpen Access

Association of Cardiopulmonary Bypass and Aortic Cross-Clamp Durations with ICU Length of Stay in Cardiac Surgery Patients: A Retrospective Study at Nasiriya Heart Center

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Key result

Prolonged CPB and aortic cross-clamp times linked to longer ICU stays after cardiac surgery.

r = 0.325 for CPBT; r = 0.302 for ACCT
P=0.047 for CPBT; 0.005 for ACCT
n=100

Why the study?

Prolonged cardiopulmonary bypass and aortic cross-clamp durations are linked to delayed recovery and increased ICU resource use, making it important to assess their impact on ICU stay in elective cardiac surgery.

Does prolonged cardiopulmonary bypass time and aortic cross-clamp time increase postoperative ICU length of stay in adult patients undergoing elective cardiac surgery?

Key Points

To evaluate the impact of cardiopulmonary bypass time and aortic cross-clamp time on the duration of intensive care unit stay following elective cardiac surgery.
Retrospective clinical study conducted at Nasiriya Heart Center in Iraq between September 2023 and September 2024.
Evaluated 100 elective cardiac surgery patients aged 18–65 years (mean age 44.1 ± 15.9 years; 47% male, 53% female).
Analyzed associations between postoperative intensive care unit length of stay and intraoperative variables, specifically cardiopulmonary bypass time and aortic cross-clamp time.
Prolonged cardiopulmonary bypass time (mean 112.6 ± 44.2 minutes) was significantly associated with longer intensive care unit stay (P = 0.047).
Prolonged aortic cross-clamp time (mean 69.0 ± 34.5 minutes) was significantly associated with extended intensive care unit stay (P = 0.005).
Older age was significantly associated with prolonged intensive care unit stay (P = 0.001), while patient gender showed no significant association (P = 0.089).

Study Design

Type

Cohort (n=100)

Multicenter

No

Structured PICO

Does prolonged cardiopulmonary bypass time and aortic cross-clamp time increase postoperative ICU length of stay in adult patients undergoing elective cardiac surgery?

P

Population

100 adults (mean age 44.1 years, 53% female) undergoing elective cardiac surgery with cardiopulmonary bypass at a single center in Iraq over a 1-year period, excluding emergency surgeries and early postoperative deaths.

E

Exposure

Elective cardiac surgery with cardiopulmonary bypass (mean CPB time 112.6 ± 45.2 minutes, median 110, range 48-242 minutes) and aortic cross-clamping (mean ACC time 69.0 ± 38.1 minutes, median 65, range 4-208 minutes).

O

Outcome

Duration of postoperative intensive care unit (ICU) stay (stratified into 1-3 days, 4-6 days, and >6 days; prolonged stay defined as >4 days).

Main Result

Effect estimate: r = 0.325 for CPBT; r = 0.302 for ACCT

p-value: p=0.047 for CPBT; 0.005 for ACCT

Limitations

Retrospective, single-center study design unable to establish causality
Small sample size (N=100) with insufficient mortality events for statistical calculation
Inability to assess specific postoperative complications (e.g., pneumonia, mechanical ventilation duration) due to incomplete medical records
Lack of adjustment for confounding perioperative comorbidities such as diabetes, hypertension, and infections
Retrospective study design
Single-center study
Unable to establish causality
Unable to assess certain postoperative outcomes (e.g., pulmonary complications, shock, mediastinitis, infection, duration of mechanical ventilation) due to incomplete reports
Small sample size and insufficient mortality events for survival calculations

Implication

Extended cardiopulmonary bypass time, longer aortic cross-clamp duration, and older patient age are significantly associated with prolonged postoperative ICU length of stay following elective cardiac surgery.

Abstract

Background: Cardiopulmonary bypass (CPB) and aortic cross-clamping are essential components of many cardiac surgical procedures. However, prolonged durations have been linked to adverse outcomes, including delayed recovery and increased intensive care unit (ICU) resource utilization. Understanding their impact is critical for improving perioperative management and optimizing patient outcomes. We aimed to assess how cardiopulmonary bypass time (CPBT) and aortic cross-clamp time (ACCT) affect the length of ICU stay in patients undergoing elective cardiac surgery. Methods: Our study was retrospective clinical study which conducted at Nasiriya Heart Center, Iraq, between September 2023 and September 2024. A total of 100 patients (aged 18–65 years) who underwent elective cardiac surgery were included. Demographic data, type of surgery, admission and discharge dates, and intraoperative variables (CPBT and ACCT) were collected. Associations between CPBT, ACCT, and ICU stay were analysed by using suitable statistical approaches. Results: Of the 100 patients, 47% were male and 53% female, with a mean age of 44 years. The mean CPBT was 112.6 ± 44.2 minutes, and the mean ACCT was 69.0 ± 34.5 minutes. Gender showed no significant effect on ICU stay. In contrast, both prolonged CPBT and ACCT were significantly associated with longer ICU stays (P = 0.047 and P = 0.005, respectively). Conclusion: Extended CPBT and ACCT are significant predictors of prolonged ICU stay after cardiac surgery. Strategies to minimize intraoperative times may help reduce postoperative ICU occupancy and improve overall resource allocation in cardiac surgical care.

Discussion

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Cite This Study

Hussein et al. (2026) conducted a cohort in Elective cardiac surgery requiring cardiopulmonary bypass (n=100). Prolonged cardiopulmonary bypass time (CPBT) and aortic cross-clamp time (ACCT) vs. Shorter CPBT (<60 minutes) and ACCT (<60 minutes) was evaluated on Length of intensive care unit (ICU) stay (r = 0.325 for CPBT; r = 0.302 for ACCT, p=0.047 for CPBT; 0.005 for ACCT). Prolonged cardiopulmonary bypass time (p=0.047) and aortic cross-clamp time (p=0.005) were significantly associated with extended ICU length of stay after elective cardiac surgery.

synapsesocial.com/papers/6ae28e75cbadf70daf6c42b9 https://doi.org/10.18502/aacc.v12i6.22963

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Association of Cardiopulmonary Bypass and Aortic Cross-Clamp Durations with ICU Length of Stay in Cardiac Surgery Patients: A Retrospective Study at Nasiriya Heart Center

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Association of Cardiopulmonary Bypass and Aortic Cross-Clamp Durations with ICU Length of Stay in Cardiac Surgery Patients: A Retrospective Study at Nasiriya Heart Center

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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