What is the expected impact of prolonged cardiopulmonary bypass (CPB) time on patients?

Prolonged cardiopulmonary bypass (CPB) time is associated with various physiological changes, one of which is an increased incidence of coagulopathies. During CPB, blood is diverted and circulated through an artificial circuit, which can lead to a number of complications. One significant impact is the activation of the coagulation cascade and the consumption of clotting factors, often resulting in a dilutional coagulopathy. These alterations occur due to the exposure of blood components to the artificial surfaces of the bypass machine, as well as the hemodilution that occurs when large volumes of crystalloid or colloid solutions are used to prime the bypass circuit.

With increased CPB duration, patients may experience a greater degree of hemostatic disturbance, leading to difficulties in managing bleeding during and after surgery. This can result in excessive blood loss, increased need for blood product transfusions, and a longer recovery period. The establishment of coagulopathy can also contribute to complications such as thrombocytopenia and impaired platelet function, further complicating the perioperative management of these patients.

The other options do not correlate with the expected impacts of prolonged CPB time; for example, prolonged CPB typically does not lead to early extubation. Instead,