Back to Search
Start Over
Can pulsatile cardiopulmonary bypass prevent perioperative renal dysfunction during myocardial revascularization in elderly patients?
- Source :
-
Nephron. Clinical practice [Nephron Clin Pract] 2009; Vol. 111 (4), pp. c229-35. Date of Electronic Publication: 2009 Mar 14. - Publication Year :
- 2009
-
Abstract
- Backgrounds/aims: We recently demonstrated that pulsatile cardiopulmonary bypass (CPB) versus standard linear CPB is associated with better perioperative renal function. Since older subjects have a higher risk of acute renal failure, we have extended our study to evaluate the specific impact of pulsatile CPB on the perioperative renal function in elderly patients.<br />Methods: We enrolled 50 patients with normal preoperative renal function: they were stratified by age (65-75 vs. 50-64 years) and randomized to nonpulsatile (group A) or pulsatile CPB (group B). Twenty-seven patients aged > or =50 years and <65 years were randomized to group A (n = 12) or to group B (n = 15) and 23, aged > or =65 years and < or =75 years, to group A (n = 13) or to group B (n = 10). Glomerular filtrate rate (GFR), daily diuresis, lactatemia and other parameters were measured during the pre- and perioperative period.<br />Results: The percent perioperative decrease in GFR was lower in group A than in group B (p < 0.001), without differences between older and younger patients. By contrast, perioperative plasma lactate levels were higher in group A than in group B (p < 0.001), both in older and younger patients. No difference was observed for 24 h urine output and blood urea nitrogen.<br />Conclusions: Pulsatile CPB preserves renal function better than standard CPB even in patients older than 65. CPB could be adopted as the procedure of choice in this subgroup of patients.<br /> (Copyright (c) 2009 S. Karger AG, Basel.)
Details
- Language :
- English
- ISSN :
- 1660-2110
- Volume :
- 111
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Nephron. Clinical practice
- Publication Type :
- Academic Journal
- Accession number :
- 19287182
- Full Text :
- https://doi.org/10.1159/000208991