Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Difference between pre-operative and cardiopulmonary bypass mean arterial pressure is independently associated with early cardiac surgery-associated acute kidney injury. | Kanji et al. Journal of Cardiothoracic Surgery 2010 5 71 http content 5 1 71 JOTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Difference between pre-operative and cardiopulmonary bypass mean arterial pressure is independently associated with early cardiac surgery-associated acute kidney injury 1 3 1 Hussein D Kanji Costas J Schulze Marilou Hervas-Malo Peter Wang David B Ross Mohamad Zibdawi Sean M Bagshaw2 3 4 Abstract Background Cardiac surgery-associated acute kidney injury CSA-AKI contributes to increased morbidity and mortality. However its pathophysiology remains incompletely understood. We hypothesized that intra-operative mean arterial pressure MAP relative to pre-operative MAP would be an important predisposing factor for CSA-AKI. Methods We performed a prospective observational study of 157 consecutive high-risk patients undergoing cardiac surgery with cardiopulmonary bypass CPB . The primary exposure was delta MAP defined as the preoperative MAP minus average MAP during CPB. Secondary exposure was CPB flow. The primary outcome was early CSA-AKI defined by a minimum RIFLE class - RISK. Univariate and multivariate logistic regression were performed to explore for association between delta MAP and CSA-AKI. Results Mean SD age was years were male had isolated coronary bypass graft CABG surgery had isolated valve surgery and had combined procedures. Mean SD pre-operative intra-operative and delta MAP were and mmHg respectively. Sixty-five patients 41 developed CSA-AKI within in the first 24 hours post surgery. By multivariate logistic regression a delta MAP 26 mmHg odds ratio OR 95 CI p and CPB flow rate 54 mL kg min OR p were independently associated with CSA-AKI. Additional variables associated with CSA-AKI included use of a side-biting aortic clamp OR p and body mass index 25 OR .
