MD Doctor of Medicine

Introduction: Coronary Artery Bypass Grafting (CABG) is part of the standard treatment for ischemic heart disease. It mainly focuses on the revascularization of the ischemic area by creating alternative routes using arterial or venous grafts. Several pre-, peri-, and post-operative factors contribute to the success of a CABG operation. In terms of postoperative management hemodynamic instability and extubation time play a crucial role. Purpose: The purpose of this study was to compare the duration of mechanical ventilation until the time of extubation, the hemodynamic status, and the length of hospital stay in post-CABG patients. Methodology: The study has the form of a retrospective single-centered cohort study. The data collection was done by reviewing the medical files of ninety-two patients undergone isolated on-pump CABG operation from July 2021 until December 2022 in the cardiac surgery department of Apollonion Private Hospital in Nicosia, Cyprus. After completion of data collection, all the reported variables were subcategorized as pre-, peri- and postoperative. Additionally, the patients involved in the study were further subdivided based on their time of extubation into three groups, “very early,” “early” and “regular/late”. Afterward, bivariate and multiple linear regression analyses were performed in order to assess the relationships between extubation time and specific predictor variables. Results: All the included participants were of advanced age (mean=67.58 years). Additionally, a correlation between cardiopulmonary bypass time and cross-clamp time and an association between postoperative volume balance and CRP were, also, revealed. The hemodynamic status seemed to be unaffected by the timing of extubation as atrial fibrillation and duration of vasopressor use did not have any statistical difference. Conclusion: The extubation time does not influence the postoperative status in terms of hemodynamic instability, postoperative complications, and length of hospitalization.

Introduction: Coronary artery disease is the leading cause of death worldwide. In Cyprus, it constitutes a major disease entity, accounting for numerous deaths. Management is based both on conservative and revascularization options, with the latter being implemented progressively in the past years, notably, CABG being the prime intervention. In Cyprus specifically, the number of patients submitted to revascularization operations is evidently exhibiting one of the forefront frequencies among European countries. Various novel clinical practices aiming to optimize postoperative end-results are currently emerging, one being the introduction of noninvasive ventilation following early extubation of patients that have undergone CABG. Purpose: The primary goal is to demonstrate whether the use of non-invasive ventilation following early extubation on patients having undergone CABG surgery denoted any effect on postoperative complications appearance and severity, and on the length of hospital stay. iii Methodology: A retrospective cohort study including 66 patients from a single center in Nicosia that have had CABG surgery is conducted. They are categorized according to their extubation time; “very early” patients were extubated immediately postoperatively, “early” patients were extubated within 6 hours, and the “regular/late” ones more than 6 hours after completion of the surgery. The sequential use of non-invasive ventilation and any complications that the patients may have encountered, including their length of stay in the hospital, are vital parameters of the study. Results: The demographic profile of the patients had noteworthy differences; gender inequalities were apparent throughout the groups, the age of the patients appeared to be increased and the BMI status of the “regular/late” group was of particular interest. Preoperatively, the three groups of patients displayed uniformity. Intraoperatively, the CPB and CC time noted some differences. Postoperatively, important variations were recorded in terms of WBC count, CRP and volume balances. The use of NIV and the length of hospital stay did not signify any major differences. Conclusions: The patients did not differ in terms of NIV use, and their length of hospitalization appeared to be consistent. Fundamental variations were, however, documented. Further research is necessary to draw definite conclusions.