Impact of Ventilation Discontinuation During Cardiopulmonary Bypass: A Prospective Observational Study

Tatyana A. Li, Azhar Zhailauova, Iwan Wachruschew, Aidyn Kuanyshbek, Shaimurat Tulegenov, Perizat Bukirova, Bekaidar Zhakupbekov, Ilya Nikitin, Dauren Ayaganov, Timur Kapyshev

3 more authors

Robertas Stasys Samalavicius, Andrew L. Melnikov, Theodoros K. Aslanidis

2025

Full text Open access: Gold Metadata (CSL-JSON)
DOI 10.3390/jcm14228215
Data confidence 70 medium
How this score is calculated

It is built from checkable properties of the record itself: whether the article has a DOI, how many independent sources confirmed its data, whether the required fields are filled in, and how recent the latest confirmation is. Disagreement between sources and a missing identifier lower it. A value of 80 or above means the record was published without further checking; 60 to 79 means it is published at reduced confidence, with a manual check advisable. A record verified by an editor by hand is never pushed below 90 by a recalculation. This scores our data about the article, not the article itself.

Abstract

Background: Discontinuing mechanical ventilation during cardiopulmonary bypass (CPB) is common but may adversely affect postoperative pulmonary function. This study aimed to evaluate the impact of stopping ventilation during CPB on postoperative gas exchange, radiographic findings, intensive care unit (ICU) length of stay (LOS), mortality, reintubation, re-exploration, and bleeding. Methods: A prospective observational study was performed involving adult patients scheduled for elective cardiac surgery requiring CPB. Participants were divided into ventilated and non-ventilated groups according to intraoperative strategy. Postoperative arterial carbon dioxide levels (PaCO2), arterial partial pressure of oxygen (PaO2), the PaO2/FiO2 ratio (P/F ratio), arterial oxygen saturation (SaO2), and the ratio of PaCO2 to minute ventilation (PaCO2/MV) were measured before the induction of anesthesia (within 5 min after transportation into the operating room), postoperatively within 5–10 min after transportation to the ICU, and in a 24 h postoperative period. Chest X-ray data, mechanical ventilation time, LOS in ICU, re-exploration, reintubation, and bleeding parameters were documented. Analyses were also conducted with the estimation of the age effect and BMI. Results: Individuals in the non-ventilated group exhibited lower postoperative P/F ratios and elevated postoperative PaCO2 and PaCO2/MV ratios. The difference in gas exchange leveled off within 24 h. There was no difference in the incidence of atelectasis (postoperatively in a 24 h period), mechanical ventilation time, LOS in ICU, or mortality. However, the incidence of bleeding was higher in the non-ventilated group (χ2 = 5.78, p = 0.016). Interestingly, postoperative PaCO2 and PaCO2/MV peaked in the 50-year age group. Conclusions: Continued mechanical ventilation during CPB correlates with better postoperative gas exchange, better CO2 clearance, and fewer bleeding events. The results suggest that maintaining low tidal volume ventilation during CPB may provide benefits, especially for patients aged 50 years.