کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5990664 1578643 2011 10 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Effect of normothermic cardiopulmonary bypass on renal injury in pediatric cardiac surgery: A randomized controlled trial
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Effect of normothermic cardiopulmonary bypass on renal injury in pediatric cardiac surgery: A randomized controlled trial
چکیده انگلیسی

ObjectiveHypothermic cardiopulmonary bypass (CPB), although associated with a reduction in oxygen requirement, has a number of disadvantages including detrimental effects on enzymatic function, energy generation, and cellular integrity. Normothermic perfusion is potentially a more physiologic method to maintain the functional integrity of major organ systems. One of the aims of this trial was to compare the effect of normothermic and hypothermic CPB on renal injury in pediatric patients undergoing cardiac surgery.MethodsFifty-nine children (median age, 78 months; interquartile range, 39-130) undergoing corrective cardiac surgery were randomized to either hypothermic (28°C) or normothermic (35°C-37°C) CPB. Urinary albumin, retinal binding protein (RBP) and N-acetyl-β-glucosaminidase (NAG) were measured preoperatively, end of CPB, 4, and 24 hours postoperatively and were expressed as a ratio of urinary creatinine. Serum creatinine was measured preoperatively, end of CPB, and 24 and 48 hours postoperatively. Results are expressed as a difference in means (normotheric − hypothermic) or as a ratio of geometric means (normothermic/hypothermic).ResultsBaseline characteristics were similar in both groups. For these biochemical markers no significant interactions between treatment and postintervention time were found. Serum creatinine (−2.10; 95% confidence interval [CI], −6.51-2.31), RBP (ratio, 0.96; 95% CI, 0.65-1.41), and NAG (ratio, 0.86; 95% CI, 0.56-1.36) were similar in the 2 groups (P ≥ .34), but the urinary albumin was significantly lower in the normothermic group (ratio, 0.63; 95% CI, 0.42-0.95, P = .03).ConclusionsNormothermic CPB is associated with similar renal impairment to hypothermic CPB in children undergoing heart surgery.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Thoracic and Cardiovascular Surgery - Volume 142, Issue 5, November 2011, Pages 1114-1121.e2
نویسندگان
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