Pulse Brain · Growing Health Evidence Index
Tier 3 — Observational / field trialPeer-reviewed

Higher perfusion pressure and pump flow during cardiopulmonary bypass are beneficial for kidney function–a single-centre prospective study

Jakub Udzik, Jerzy Pacholewicz, Andrzej Biskupski, Krzysztof Safranow, Iwona Wojciechowska‐Koszko, Paweł Kwiatkowski, Paulina Roszkowska, Karolina Rogulska, Violetta Dziedziejko, Zuzanna Marcinowska, Sebastian Kwiatkowski, Ewa Kwiatkowska

Frontiers in Physiology · 2024

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Summary

This prospective cohort study of 109 adult cardiac surgery patients evaluated the impact of maintaining higher mean arterial pressure (MAP > 90 mmHg) during cardiopulmonary bypass on kidney function. Whilst higher MAP did not reduce acute kidney injury incidence, it significantly increased intraoperative and postoperative diuresis, decreased renin release, and appeared safe for cerebral perfusion with a trend towards lower postoperative delirium incidence. The findings suggest that MAP > 90 mmHg during bypass confers renal protective benefits by reducing hypoperfusion-related stress responses.

UK applicability

The findings are applicable to UK cardiac surgery practice, as cardiopulmonary bypass techniques are standardised internationally. The study's recommendations on MAP targets during bypass may inform perioperative management protocols in UK cardiac centres, though local clinical guidelines and patient-specific factors would determine adoption.

Key measures

Mean arterial pressure (MAP), cardiopulmonary bypass pump flow (L/min/m²), intraoperative and postoperative diuresis, renin release, incidence of cardiac surgery-associated acute kidney injury (CSA-AKI), cerebrovascular complications, postoperative delirium

Outcomes reported

The study measured intraoperative and postoperative kidney function metrics, diuresis, renin release, and incidence of acute kidney injury (CSA-AKI) and postoperative delirium in patients undergoing cardiopulmonary bypass at different mean arterial pressure targets.

Theme
Nutrition & health
Subject
Other / interdisciplinary
Study type
Research
Study design
Prospective observational cohort
Source type
Peer-reviewed study
Status
Published
System type
Human clinical
DOI
10.3389/fphys.2024.1257631
Catalogue ID
SNmojj1i3d-qpl2qd

Topic tags

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