Intraoperative High-Volume Diuresis During Off-Pump Coronary Artery Bypass Grafting: Risk Factors and Clinical Impact

Area of Science:

• Cardiology
• Anesthesiology
• Nephrology

Background:

• Intraoperative high-volume diuresis is frequent but poorly understood during off-pump coronary artery bypass grafting (OPCABG).
• Clinical factors and management implications require further characterization.

Purpose of the Study:

• To identify predictors of intraoperative high-volume diuresis in OPCABG patients.
• To assess the association between high-volume diuresis and postoperative outcomes.

Main Methods:

• Retrospective cohort study of 1274 adult patients undergoing elective OPCABG.
• High-volume diuresis defined as urine output ≥ 5 mL·kg^-1·h^-1.
• Multivariable logistic regression and ROC curve analysis (AUC = 0.756) were used.

Main Results:

• 39.6% of patients experienced high-volume diuresis.
• Older age, hypertension, and increased intraoperative fluids were associated with diuresis.
• Preoperative diuretics and hypotension inversely correlated with diuresis.

Conclusions:

• Intraoperative high-volume diuresis in OPCABG is predictable using patient and procedural factors.
• No significant differences in postoperative outcomes were observed between diuresis groups.
• Findings support individualized perioperative management based on urine output interpretation.