This single-center retrospective cohort included 4,358 adults undergoing cardiac surgery with cardiopulmonary bypass in 2018–2024. Thirty-day mortality was 1.7% (75 deaths). Each 10 ml/min/m² decrease in indexed oxygen delivery was associated with higher mortality odds (adjusted OR 1.16, 95% CI 1.09–1.23). Adjusted mortality was 1.69% (95% CI 1.32–2.05%) at the 25th oxygen-delivery percentile versus 0.74% (95% CI 0.41–1.07%) at the 75th percentile. Lower oxygen delivery was also associated with acute kidney injury and longer ICU and hospital stays; no statistically significant association with stroke was observed.
Lower oxygen delivery during bypass was associated with worse postoperative outcomes. These findings support further investigation but do not establish that increasing oxygen delivery improves survival.
Study limitation: The retrospective, single-center design leaves residual confounding possible despite multivariable adjustment and limits causal interpretation.
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