Intraoperative hemodynamic instability (IOHI) is a common occurrence during cardiac surgery and is associated with organ hypoperfusion. However, the specific impact of IOHI on composite adverse outcomes remains unclear. This prospective cohort study aims to evaluate the association between intraoperative hemodynamic instability (defined as MAP \< 65 mmHg or vasopressor requirement) and major postoperative complications (Delirium, Acute Kidney Injury, Stroke, or Mortality) in adult patients undergoing elective cardiac surgery with cardiopulmonary bypass.
Patients aged 18 years or older.
Scheduled for elective cardiac surgery (CABG, Valve replacement/repair, or combined procedures).
Surgery performed under cardiopulmonary bypass (CPB).
Preoperative sinus rhythm.
Emergency or salvage surgery.
Off-pump coronary artery bypass grafting.
Preoperative mechanical circulatory support (IABP, ECMO) requirement.
Pre-existing chronic renal failure requiring dialysis (HD/PD).
Adult patients undergoing elective cardiac surgery with cardiopulmonary bypass at a tertiary care university hospital.
Cohort
Prospective
Not listed
Incidence of Composite Adverse Events
A composite endpoint defined as the occurrence of any of the following within 30 days post-surgery: Postoperative Delirium (assessed by CAM-ICU), Acute Kidney Injury (KDIGO criteria stage 1 or higher), Stroke (new neurological deficit confirmed by imaging), or All-cause Mortality.
Duration of Mechanical Ventilation
Time from ICU admission to successful extubation (in hours).
Length of Hospital Stay
Total duration of hospital stay from surgery to discharge (in days)
Length of Intensive Care Unit (ICU) Stay
Time from admission to the Intensive Care Unit immediately after surgery until discharge to the ward (in days).
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