TITLE:
Renal Function after Coronary Artery Bypass Graft Using Dexmedetomidine
AUTHORS:
Alexandre Fabricio Martucci, Yara Marcondes Machado Castiglia
KEYWORDS:
Acute Kidney Injury; Dexmedetomidine; Cardiopulmonary Bypass; Coronary Artery Bypass Graft
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.3 No.9,
November
21,
2013
ABSTRACT: Acute kidney injury (AKI) is defined
by 0.3 mg/dL increase in serum creatinine (SCr) and is associated with higher
incidence of postoperative mortality after coronary artery bypass graft (CABG).
There are few clinical studies on the effect of dexmedetomidine (DEX) on renal
function. We evaluated AKI after coronary artery bypass graft with and without
cardiopulmonary bypass (CPB) under anesthesia with DEX. Method: In this retrospective study, we performed serial
analysis of serum creatinine (SCr) up to 48 hours after surgery in 286 patients
who underwent CABG. We tested the similarities between groups, evaluating patients separately for use of CPB and DEX.
Each patient was evaluated for his or her SCr at the following points in time:
preoperative, immediately postoperative, 24 hours postoperative, and 48 hours
postoperative. Preoperative SCr was used as the baseline value for each
patient. If the SCr increased ≥0.3 mg/dL in at least one of
the periods, the patient was classified as having AKI. We also assessed the
risk for AKI in patients with altered preoperative SCr (values between 1.1 to
2.0 mg/dL for women or 1.3 to 2.0 mg/dL for men) compared to patients with
normal SCr. Results: The groups
were similar for preoperative weight, age, and altered SCr. Patients were
anesthetized with DEX and who underwent CPB exhibited higher incidence of AKI
(p = 0.043).
Without CPB, there was higher incidence of AKI after using DEX (p = 0.066). Conclusion: Anaesthesia with DEX increased the incidence of
AKI after myocardial revascularization surgery in patients who underwent CPB.