Role of urinary PO 2 analysis during conventional versus conventional and modified ultrafiltration techniques in adult cardiac surgery.

Autor: Burra V; Department of Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru, Karnataka, India., Sunil PK; Department of Cardiovascular and Thoracic Surgery, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru, Karnataka, India., Praveen NB; Department of Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru, Karnataka, India., Nagaraja PS; Department of Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru, Karnataka, India., Singh NG; Department of Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru, Karnataka, India., Manjunatha N; Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru, Karnataka, India., Basappanavar VS; Department of Anesthesiology, Pediatric Cardiac Anesthesiologist, Al Jalila Childrens Hospital, Dubai, UAE.
Jazyk: angličtina
Zdroj: Annals of cardiac anaesthesia [Ann Card Anaesth] 2020 Jan-Mar; Vol. 23 (1), pp. 43-47.
DOI: 10.4103/aca.ACA_2_19
Abstrakt: Background: Medullary hypoxia is the initial critical event for kidney injury during cardiopulmonary bypass, and therefore urinary PO 2 with its potential of detecting medullary oxygenation for its management. Therefore, we tested the role of urinary PO 2 in predicting kidney injury in those undergoing conventional versus combined (conventional and modified) ultrafiltration during cardiac surgery in adults.
Methodology: We prospectively evaluated 32 adults between 18 and 65 years of age undergoing elective on-pump cardiac surgery with ejection fraction >35% by conventional (group C) versus combined ultrafiltration (group CM). Urine samples were analyzed for PO 2 after induction, 30 min, 3 h, and 6 h post filtration along with blood urea and serum creatinine after induction, at 6 h, 24 h, and 48 h post filtration. Demographic variables, cardiopulmonary bypass duration, flow rates, inotropic score, ventilation duration, diuretic use, and intensive care unit (ICU) stay were assessed between two groups.
Results: Both the groups (16 in each group) had comparable urinary PO 2 after induction (P = 0.387) with significant decrease in group C at 30 min, 3 h, and 6 h post filtration (P < 0.05). There was a statistically significant increase in serum creatinine (mg/dL) at 48 h in group C compared with group CM (1.57 vs. 1.25, respectively; P ≤ 0.05). There was an increased diuretic usage and length of ICU stay in group C.
Conclusion: Combined ultrafiltration technique had renoprotective effect in cardiac surgery analyzed by urinary PO 2 levels.
Competing Interests: None
Databáze: MEDLINE
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