Metabolic changes and clinical outcomes in patients undergoing on and off pump coronary artery bypass surgery

Objective Though the advent of cardiopulmonary bypass saw a dramatic increase in the number of coronary bypass surgeries performed annually, a few surgeons continued to use off pump technique mainly for economic reasons. But the adverse effects of cardiopulmonary bypass necessitated a relook at the off pump technique. The study aims to assess the metabolic changes and clinical outcomes in patients undergoing on or off pump coronary bypass surgery. Methods One hundred patients with severe left ventricular dysfunction undergoing coronary bypass surgery on or off pump, fifty in each group, were studied for the metabolic changes and clinical outcomes. The results were statistically analysed using student’s t test. Results The off pump group showed better postoperative renal function, and less incidence of lactic acidosis and oxidative stress than the cardiopulmonary bypass group. The former also had lesser need for ventilator support, shorter intensive care and hospital stay. Conclusions The off pump technique is associated with reduced myocardial injury, inflammatory response, and postoperative morbidity. This study was supported by a financial grant from Rameshwardas Birla Smarak Kosh, and Dr. P.K. Sen Research Society, Mumbai.