Leitman et al identified risk factors associated with intra-abdominal complications associated with cardiopulmonary bypass surgery. These can help to identify a patient who may benefit from more aggressive management. The authors are from New York Hospital-Cornell Medical Center in New York City.

Intra-abdominal complications include:

(1) gastrointestinal bleeding

(2) ischemic bowel disease

(3) acalculous cholecystitis

(4) small bowel obstruction

(5) pancreatitis

(6) perforated peptic ulcer

(7) hepatic necrosis

(8) splenic injury


Risk factors for these complications:

(1) advanced age (average age 73 years)

(2) emergency surgery

(3) valvular replacement surgery

(4) hypotension (systolic blood pressure <= 70 mm Hg for >= 30 minutes)

(5) use of an intra-aortic balloon pump

(6) use of pressors to maintain the blood pressure

(7) reoperation/re-exploration

(8) prolonged time on the cardiopulmonary bypass pump


The more risk factors that are present the more likely that the patient will have an intra-abdominal complication. These complications can have a high morbidity and mortality unless they are treated early and aggressively.

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