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Related Experiment Videos

Serial changes in renal function in cardiac surgical patients.

G S Weinstein1, P S Rao, G Vretakis

  • 1Division of Cardiothoracic Surgery, Long Island Jewish Medical Center, New Hyde Park, New York.

The Annals of Thoracic Surgery
|July 1, 1989
PubMed
Summary

Modern cardiopulmonary bypass techniques do not harm kidney function. Pre-bypass dehydration may lower urine output and creatinine clearance, which improves during and after the procedure.

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Area of Science:

  • Nephrology
  • Cardiovascular Surgery
  • Anesthesiology

Background:

  • Cardiopulmonary bypass (CPB) is often associated with renal injury.
  • Modern CPB techniques may have a lower incidence of renal dysfunction.

Purpose of the Study:

  • To re-evaluate the impact of modern CPB on renal function.
  • To assess urine output and creatinine clearance before, during, and after CPB.

Main Methods:

  • Monitored urine output and creatinine clearance in 18 adult patients undergoing nonpulsatile, hemodilution CPB.
  • Collected samples pre-CPB, during CPB (mean 105 min), and for 24 hours post-CPB.
  • Normalized values to a body surface area of 1.73 m2.

Main Results:

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  • Pre-CPB urine output (42 mL/h) and creatinine clearance (57 mL/min) were low, possibly due to dehydration.
  • During CPB, urine output increased to 305 mL/h and creatinine clearance to 252 mL/min.
  • Postoperatively, values stabilized (urine output ~60 mL/h, creatinine clearance ~75 mL/min) with no renal dysfunction observed.
  • Loop diuretics increased urine output and creatinine clearance for up to six hours post-administration.

    • Conclusions:

    • Modern CPB techniques are not injurious to renal function.
    • Preoperative dehydration may cause transient decreases in renal function markers.
    • Loop diuretics can improve renal function postoperatively.