Report of a substudy on warm versus cold cardiopulmonary bypass: Changes in creatinine clearance

Madhav Swaminathan, Christopher East, Barbara Phillips-Bute, Mark F. Newman, Joseph G. Reves, Peter K. Smith, Mark Stafford-Smith

Research output: Contribution to journalArticlepeer-review

44 Scopus citations

Abstract

Background. Renal dysfunction remains a major complication of cardiac operations. There is concern regarding the possibility of increased renal injury during warm cardiopulmonary bypass (CPB). Therefore, we tested the hypothesis that warm CPB is associated with a greater reduction in creatinine clearance after cardiac surgery than hypothermic CPB. Methods. We randomly assigned 300 patients who had elective coronary artery bypass grafting to warm (35.5 to 36.5°C) or cold (28°C to 30°C) CPB. Preoperative and peak postoperative serum creatinine values were recorded. Creatinine clearance was estimated using the Cockroft Gault equation. Univariate and multivariable analyses were performed to test the association of CPB temperature and perioperative change in creatinine clearance. Results. Demographic variables were similar between groups. Multivariable analysis did not confirm an association between temperature and change in creatinine clearance (p = 0.87). Conclusions. We did not confirm an association between warm CPB and increased renal dysfunction after cardiac operations compared With hypothermic CPB.

Original languageEnglish
Pages (from-to)1603-1609
Number of pages7
JournalAnnals of Thoracic Surgery
Volume72
Issue number5
DOIs
StatePublished - 2001

Bibliographical note

Funding Information:
This work was supported in part by National Institutes of Health grants R01-AG09663-4 (MFN), GM08600-02 (JGR), and MO1-RR-30 (National Center for Research Resources, Clinical Research Centers Program, National Institutes of Health) and the Division of Cardiothoracic Anesthesia and Critical Care Medicine of the Department of Anesthesiology, Duke University Medical Center (DUMC), Durham, NC. The authors gratefully acknowledge the assistance of Alina M Grigore, MD, Cardiothoracic Anesthesia Fellow (1998–2000), and David Kaemmer, CCP, Senior Clinical Perfusionist, and the secretarial efficiency of Ms LaTanya Rhames, Department of Anesthesiology, DUMC, in the preparation of this manuscript.

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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