A Randomized Controlled Trial Between the Interventional Strategy Vs Routine Institutional Perfusion Practice of NICS on Incidence of Haemolysis During Cardiopulmonary Bypass on Adult Cardiac Surgeries

This randomized controlled trial aims to compare the effects of a newly developed interventional perfusion strategy with the existing routine institutional perfusion practice at NICS on the incidence of haemolysis during cardiopulmonary bypass (CPB) in adult cardiac surgeries. Haemolysis, a common complication associated with CPB, can lead to adverse outcomes due to the release of free hemoglobin and other intracellular contents. The study evaluates whether the interventional strategy, potentially involving optimized pump settings such as occlusion method,  vacuum-assisted venous drainage pressures, and arterial line pressure of cardiopulmonary bypass, and also the patient parameters such as intraoperative hematocrit and mean arterial pressure of the patient, can significantly reduce hemolytic markers compared to standard practices. Adult patients undergoing elective cardiac surgery requiring CPB are randomly assigned to either the interventional group or the control group. Primary outcomes include the incidence of haemolysis based on biomarkers such as the serum-free hemoglobin (hemolysis index test), lactate dehydrogenase (LDH), and serum bilirubin levels. This trial seeks to establish evidence-based improvements in perfusion protocols that may enhance patient safety and outcomes during cardiac surgery.