The Incidence of Acute Kidney Injury after Coronary Artery Bypass Surgery with or without Cardiopulmonary Bypass

S. Moradian, A. Ebadi, F. Faizi, M. Motamedi, M. Ghiasi
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Abstract

Background: The incidence of acute kidney injury commonly follows cardiac surgery. Some studies have demonstrated better outcomes following off-pump cardiac surgery. Objectives: This study was conducted to compare the incidence of acute kidney injury and laboratory findings in patients undergoing cardiac surgery with or without cardiopulmonary bypass. Methods: In a retrospective study, 167 patients who underwent coronary artery bypass grafts (CABG) with or without cardiopulmonary bypass were selected by systematic randomized sampling method from the list of Jamaran heart hospital (Tehran) patients and the incidence of acute kidney injury and laboratory findings were compared. Results: There was no significant difference in the demographics (age, sex, drug history, and chronic disease) between the groups (P > 0.05). The acute kidney injury (AKI) was observed in 19.3 and 33.7% of the off-pump and on-pump patients, respectively. A total number of16 (19.3%) in the off-pump and 44 (52.9%) in on-pump group needed blood transfusion. The mean hospital stay was 6.74± 1.86 days for OPCAB and 7.2 ± 1.72 for on-pump patients. Haemoglobin and haematocrit level, also, were higher in OPCAB. Conclusions: This study showed that off-pump coronary artery bypass (OPCAB) is superior in acute kidney injury, blood transfusion, blood glucose management, and hospital stay. Considering these complications and those adverse effects, it seems that off-pump technique is better in selected patients, but it is proposed that more prospective multi-disciplinary studies with larger sample sizes
冠状动脉搭桥术合并或不合并体外循环后急性肾损伤的发生率
背景:急性肾损伤通常发生在心脏手术后。一些研究表明,非体外循环心脏手术的效果更好。目的:本研究旨在比较心脏手术合并或不合并体外循环患者急性肾损伤的发生率和实验室检查结果。方法:采用系统随机抽样的方法,从德黑兰Jamaran心脏医院患者名单中选择167例合并或不合并体外循环的冠状动脉旁路移植术(CABG)患者,比较急性肾损伤发生率和实验室检查结果。结果:两组患者年龄、性别、用药史、慢性疾病等人口统计学差异无统计学意义(P > 0.05)。停泵组和开泵组的急性肾损伤发生率分别为19.3%和33.7%。停泵组16例(19.3%)需要输血,有泵组44例(52.9%)需要输血。OPCAB组平均住院时间为6.74±1.86天,非泵组平均住院时间为7.2±1.72天。OPCAB患者血红蛋白和红细胞压积水平也较高。结论:本研究表明非体外循环冠状动脉搭桥术(OPCAB)在急性肾损伤、输血、血糖管理和住院时间方面具有优势。考虑到这些并发症和不良反应,停泵技术似乎在选定的患者中更好,但建议更多的前瞻性多学科研究和更大的样本量
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