Effects of cardiopulmonary bypass perfusion temperature on perioperative renal function in adult patients undergoing cardiac surgery

© 2020 Saudi Heart Association.

Bibliographische Detailangaben
Veröffentlicht in:Journal of the Saudi Heart Association. - 1999. - 32(2020), 1 vom: 09., Seite 40-45
1. Verfasser: Ramkumar, Jayavelan (VerfasserIn)
Weitere Verfasser: Gopinathan, Girish, Kavin, Karthick, Shanmugasundaram, Ramkumar, Stephen, George Miller, Pragasam, Annie Caroline, Thangavel, Periyasamy
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2020
Zugriff auf das übergeordnete Werk:Journal of the Saudi Heart Association
Schlagworte:Journal Article Acute kidney injury Albuminuria Cardiac Cardiopulmonary bypass Creatinine Creatinine clearance Heart valves Hypothermia Perfusion cardiac
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520 |a AIMS AND OBJECTIVE: The primary objective of this investigation was to study the effects of cardiopulmonary bypass (CPB) perfusion temperature on renal function parameters [serum creatinine, creatinine clearance, urine albumin, urine protein, and urine albumin/creatinine ratio (ACR)]. The secondary objective was to detect renal complications of CPB 
520 |a MATERIALS AND METHODS: This is a prospective longitudinal study of 30 adult patients (17 men, 13 women; mean age, 53.37 ± 16.02 years) who underwent valvular heart surgery [with or without coronary artery bypass grafting (CABG)]. Serum creatinine, creatinine clearance, urine protein, urine albumin, and urine ACR were collected during CPB (at 28 °C, 32 °C, and 37 °C) and postoperatively (at 12 hours, 24 hours, and 48 hours). Data were analyzed using one-way repeated-measures analysis of variance (ANOVA). A significant ANOVA was followed by a Bonferroni-Holm post hoc test 
520 |a RESULTS: Although serum creatinine (p < 0.001) and creatinine clearance (p = 0.0016) underwent a significant ANOVA change (p < 0.001 and p = 0.0016, respectively) after CPB, there was no statistically significant change compared with their baseline values. Urine ACR showed a significant change at 28 °C (p < 0.01), 32 °C (p < 0.01), and 37 °C (p < 0.05) as compared with baseline values. No significant change in urine albumin was observed during CPB or up to 24 hours. A significant change occurred after 48 hours of CPB (p < 0.05). A significant increase in urine protein was noted after CPB at 12 hours (p < 0.01), 24 hours (p < 0.01), and 48 hours (p < 0.01). Overall, 12 (40%) patients had acute kidney injury (AKI). Ten (33.33%) patients had stage I AKI, one patient progressed to AKI stage II, and another to AKI stage III. Of the 10 patients who had stage I AKI, eight had complete recovery within 48 hours 
520 |a CONCLUSIONS: CPB with moderate hypothermia for valvular heart surgeries can be performed safely in patients with adequate renal functional reserve. The glomerular permeability across the Bowman's capsule increases after CPB as evidenced by significant proteinuria at 12 hours and increased albuminuria at 48 hours after surgery. There is an increased risk of transient stage I AKI after CPB, from which patients recover within 48 hours 
650 4 |a Journal Article 
650 4 |a Acute kidney injury 
650 4 |a Albuminuria 
650 4 |a Cardiac 
650 4 |a Cardiopulmonary bypass 
650 4 |a Creatinine 
650 4 |a Creatinine clearance 
650 4 |a Heart valves 
650 4 |a Hypothermia 
650 4 |a Perfusion cardiac 
700 1 |a Gopinathan, Girish  |e verfasserin  |4 aut 
700 1 |a Kavin, Karthick  |e verfasserin  |4 aut 
700 1 |a Shanmugasundaram, Ramkumar  |e verfasserin  |4 aut 
700 1 |a Stephen, George Miller  |e verfasserin  |4 aut 
700 1 |a Pragasam, Annie Caroline  |e verfasserin  |4 aut 
700 1 |a Thangavel, Periyasamy  |e verfasserin  |4 aut 
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773 1 8 |g volume:32  |g year:2020  |g number:1  |g day:09  |g pages:40-45 
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