Cardiac Cycle Efficiency and Vasoactive-Inotropic Support After Cardiac Surgery

This study aims to find out whether Cardiac Cycle Efficiency (CCE), measured with the MostCare Up monitor 30 minutes after coming off cardiopulmonary bypass, can predict which adult patients will need high doses of vasoactive and inotropic drugs (maximum Vasoactive-Inotropic Score ≥15) in the first 24 hours after open-heart surgery. No additional procedures or treatments will be applied; data will be collected from the routinely placed arterial catheter.

Inclusion Criteria: * Age 18 years or older * ASA physical status II-IV * Elective coronary artery bypass grafting, valve surgery, or combined CABG and valve surgery with cardiopulmonary bypass * Written informed consent Exclusion Criteria: * Emergency surgery * Preoperative mechanical circulatory support (IABP, ECMO, Impella, etc.) * Permanent pacemaker dependency * Severe arrhythmia (uncontrolled atrial fibrillation, ventricular arrhythmia, etc.) * Redo cardiac surgery * Aortic dissection * Pregnancy * Unreliable arterial pressure waveform * Need for IABP, ECMO, or temporary epicardial pacing during weaning from bypass or during surgery