Complications associated with cardiopulmonary bypass for open heart surgery: prospective study, Kenyatta National Hospital, February 2002-February 2003

Abstract

The advent of cardiopulmonary bypass (CPB) has revolutionised cardiac surgery over the past three decades. CPB has come to be appreciated as an essential component of cardiac surgery, facilitating operations in a bloodless and still field. The procedure itself is however fraught with complications. Several studies done have detailed such complications and highlighted methods of avoiding the same, ultimately aiming at improving morbidity and mortality-associated with cardiac surgery in general and CPB in particular. This has led to alterations and improvements in designs of the various implements utilised in CPB, contributing to the dynamism characteristic of the medical field. Through a prospective analytical study, this research aims to document complications associated with CPB, as applied during cardiac surgery, at the Kenyatta National Hospital, over a one-year period, from February 2002 to February 2003. Sources of data include intra-operative and post-operative patient records. Interpretation of the results and significance of the same is done using statistical inference methods. The overall objective of the study has been to identify shortfalls of CPB during cardiac surgery and to suggest possible improvements to the mortality and morbidity associated with CPB, as well as improving outcome an:' reducing costs. While performance at KNH largely compares favourably to other centres worldwide as depicted in the discussion on mortality and morbidity, there are some areas where complications are occasioned by lack of materials necessary or useful in the conduct of cardiopulmonary bypass, and in the subsequent management of patients undergoing cardiac surgery. An attempt has been made to identify possible improvement strategies.