Comparison of Patient's Kidney Function Based on Kidney Disease Improving Global Outcomes (KDIGO) Criteria and Clinical Parameters in Isolated Coronary Artery Bypass Graft (CABG) Surgery in On-Pump and Off-pump Methods in Patients with Low Cardiac Output Syndrome (LCOS) After Surgery.
Acute Kidney Injury
Coronary Artery Bypass Graft Surgery
Coronary Artery Disease
Journal
Anesthesiology and pain medicine
ISSN: 2228-7523
Titre abrégé: Anesth Pain Med
Pays: Netherlands
ID NLM: 101585412
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
26
12
2019
revised:
10
03
2020
accepted:
16
03
2020
entrez:
6
8
2020
pubmed:
6
8
2020
medline:
6
8
2020
Statut:
epublish
Résumé
Acute kidney injury (AKI) is one of the serious complications of cardiac surgery. It is worsened when accompanied by low cardiac output syndrome. In this study, we compared kidney function based on the KDIGO criteria in isolated on-pump and off-pump coronary artery bypass graft (CABG) surgery. In this cohort study, 52 patients with LCOS were enrolled after on-pump (28 patients) and off-pump (24 patients) CABG. In the first six hours after ICU entrance, blood samples were taken for serum creatinine based on routine. For determining AKI after surgery, we used the KDIGO criteria as a primary endpoint. Also, some clinical parameters were recorded before, during, and after surgery. The data were analyzed by SPSS software, version 24, using paired and independent There was no significant difference in age (P = 0.3) and gender (P = 0.57) between the two groups. Among cardiac disease risk factors, only hypertension (P = 0.02) had a significant difference between the two groups, but AKI in patients with hypertension did not show a significant difference (P = 0.09). In paraclinical parameters, serum creatinine showed a significant difference before and after surgery in on-pump (P < 0.001) and off-pump (P = 0.007) groups. Also, this parameter had a significant difference at 6 h, 12 h, 24 h, and 48 h after surgery between the on-pump and on-pump groups. The AKI incidence showed a significant difference between the two groups (P < 0.001). The incidence of AKI was more in on-pump patients than in off-pump patients. Also, a significant difference was observed between their clinical parameters. Thus, to improve the patients' clinical outcomes and lower the health costs, we suggest that patients with a high risk of LCOS be followed up after CABG, especially on-pump CABG.
Sections du résumé
BACKGROUND
BACKGROUND
Acute kidney injury (AKI) is one of the serious complications of cardiac surgery. It is worsened when accompanied by low cardiac output syndrome.
OBJECTIVES
OBJECTIVE
In this study, we compared kidney function based on the KDIGO criteria in isolated on-pump and off-pump coronary artery bypass graft (CABG) surgery.
METHODS
METHODS
In this cohort study, 52 patients with LCOS were enrolled after on-pump (28 patients) and off-pump (24 patients) CABG. In the first six hours after ICU entrance, blood samples were taken for serum creatinine based on routine. For determining AKI after surgery, we used the KDIGO criteria as a primary endpoint. Also, some clinical parameters were recorded before, during, and after surgery. The data were analyzed by SPSS software, version 24, using paired and independent
RESULTS
RESULTS
There was no significant difference in age (P = 0.3) and gender (P = 0.57) between the two groups. Among cardiac disease risk factors, only hypertension (P = 0.02) had a significant difference between the two groups, but AKI in patients with hypertension did not show a significant difference (P = 0.09). In paraclinical parameters, serum creatinine showed a significant difference before and after surgery in on-pump (P < 0.001) and off-pump (P = 0.007) groups. Also, this parameter had a significant difference at 6 h, 12 h, 24 h, and 48 h after surgery between the on-pump and on-pump groups. The AKI incidence showed a significant difference between the two groups (P < 0.001).
CONCLUSIONS
CONCLUSIONS
The incidence of AKI was more in on-pump patients than in off-pump patients. Also, a significant difference was observed between their clinical parameters. Thus, to improve the patients' clinical outcomes and lower the health costs, we suggest that patients with a high risk of LCOS be followed up after CABG, especially on-pump CABG.
Identifiants
pubmed: 32754433
doi: 10.5812/aapm.100517
pmc: PMC7352649
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e100517Informations de copyright
Copyright © 2020, Author(s).
Déclaration de conflit d'intérêts
Conflict of Interests: The authors declare no conflict of interest in this study.
Références
Braz J Cardiovasc Surg. 2018 Jan-Feb;33(1):40-46
pubmed: 29617500
Perfusion. 2018 Jan;33(1):62-70
pubmed: 28581343
Medicine (Baltimore). 2016 May;95(22):e3757
pubmed: 27258505
Acta Med Iran. 2017 Sep;55(9):578-584
pubmed: 29202551
J Am Soc Nephrol. 2012 Aug;23(8):1389-97
pubmed: 22595302
J Thorac Cardiovasc Surg. 2007 Feb;133(2):378-88
pubmed: 17258568
Circulation. 1997 Feb 18;95(4):878-84
pubmed: 9054745
J Thorac Cardiovasc Surg. 2003 Apr;125(4):797-808
pubmed: 12698142
J Res Med Sci. 2015 Oct;20(10):937-43
pubmed: 26929757
Clin Appl Thromb Hemost. 2014 Jul;20(5):473-7
pubmed: 23344996
Circulation. 2012 May 22;125(20):2431-9
pubmed: 22523305
Arch Med Res. 2010 Nov;41(8):618-22
pubmed: 21199731
J Thorac Cardiovasc Surg. 2016 Jul;152(1):235-42
pubmed: 27016793
Rev Port Cir Cardiotorac Vasc. 2017 Jul-Dec;24(3-4):154
pubmed: 29701385
Asian Cardiovasc Thorac Ann. 2017 Sep-Oct;25(7-8):504-508
pubmed: 28847152
Semin Intervent Radiol. 2014 Dec;31(4):378-88
pubmed: 25435665
Semin Cardiothorac Vasc Anesth. 2015 Dec;19(4):270-87
pubmed: 26660051
Ann Thorac Surg. 2010 Jun;89(6):1881-8
pubmed: 20494043
Chest. 2005 Mar;127(3):892-901
pubmed: 15764773
JAMA. 2014 Jun 4;311(21):2191-8
pubmed: 24886787
Nephrol Dial Transplant. 2008 Sep;23(9):2853-60
pubmed: 18388121
Korean J Intern Med. 2016 Nov;31(6):1093-1100
pubmed: 27052265
Heart Surg Forum. 2016 Dec 16;19(6):E289-E293
pubmed: 28054900
J Cardiothorac Vasc Anesth. 2004 Dec;18(6):698-703
pubmed: 15650976
N Engl J Med. 2009 Nov 5;361(19):1827-37
pubmed: 19890125
J Am Coll Cardiol. 2004 Nov 16;44(10):1945-56
pubmed: 15542275
Int Heart J. 2015;56(2):144-9
pubmed: 25740396
Indian J Crit Care Med. 2015 Oct;19(10):576-9
pubmed: 26628821
Rev Bras Cir Cardiovasc. 2014 Jul-Sep;29(3):299-307
pubmed: 25372901
Onco Targets Ther. 2018 Sep 27;11:6277-6285
pubmed: 30310291
Eur J Cardiothorac Surg. 2006 Jun;29(6):964-70
pubmed: 16675230
Clin J Am Soc Nephrol. 2006 Jan;1(1):19-32
pubmed: 17699187
Interact Cardiovasc Thorac Surg. 2010 May;10(5):777-82
pubmed: 20172909