Cardiopulmonary bypass may result in renal impairment but there is little investigative data on the effect of differing flowrates on postoperative renal function. One hundred and twenty-two patients presenting for cardiac surgery were randomly assigned to receive either a fixed CPB flow of 2.4 l.m-2 or a bypass flow tailored to maintain a venous return oxygen saturation of 75–80%. Vasoactive drugs were given to maintain a perfusion pressure of 50 to 80 mmHg. Patients were assessed by serum creatinine, creatinine clearance, arterial blood gases, serum lactates and electrolytes. The results show an overall decline in postoperative renal function compared with preoperative levels, with no significant differences between the two groups.
Physiological studies upon prolonged cardiopulmonary bypass with the pump oxygenator with particular reference to (1) acid base balance (2) siphon caval drainage.J Thorac Surg1957; 34: 570–579.
2.
HarrisE.A., SedgeE.R., Barratt-BoyesB.G.On the availability of oxygen to the body during cardiopulmonary bypass in man.Br J Anaesth1974; 46: 425–431.
3.
FoxL.S., BlackstoneE.H., KirklinJ.W., StewartR.W., SamuelsonP.N.Relationship of whole body oxygen consumption to perfusion flow rate during hypothermic cardiopulmonary bypass.J Thorac Cardiovasc Surg1982; 83: 239–248.
StockardJ.J., BickfordR.G., MeyersR.R.Hypotension-induced changes in cerebral function during cardiac surgery.Stroke1974; 5: 730.
6.
VennG.E.Cerebral vascular autoregulation during cardiopulmonary bypass.Perfusion1989; 4: 105–113.
7.
MurkinJ.M., FarrarJ.K., TweedA., McKenzieF.N., GuiraudonG.Cerebral autoregulation and flow/metabolism during cardiopulmonary bypass: the influence of PaCO2.Anesth Analg1987; 66: 825–832.
8.
SangerP.W., RobiscekF., TaylorF.H., ReesT.T., StamR.E.Vasomotor regulation during extracorporeal circulation and open-heart surgery.J Thorac Cardiovasc Surg1960; 40: 355–374.
9.
FeddersenK., AurellM., DelinK., HaggendalJ., ArenC., RadegranK.Effects of cardiopulmonary bypass and prostacyclin on plasma catecholamines, angiotensin II, and argininevasopressin.Acta Anaesthesiol Scand1985; 29: 224–230.
10.
RevesJ.G., KarpR.B., ButtnerE.E.Neuronal and adrenomedullary catecholamine release in response to cardiopulmonary bypass in man.Circulation1982; 66: 49–55.
11.
YeboahE.D., PetrieA., ReadJ.L.Acute renal failure and open heart surgery.Br Med J1972; 1: 415–418.
12.
BhatJ.G., GluckM., LowensteinJ., BaldwinD.S.Renal failure after open heart surgery.Ann Intern Med1976; 84: 677–682.
13.
UrzuaJ., TroncosoS., BugedoG., CanessaR., MunozH.Renal function and cardiopulmonary bypass: effect of perfusion pressure.J Cardiothor Vasc Anesth1992; 6: 299–303.
14.
AbelR.M., BuckleyM.J., AustenW.G., BarnettG.O., BeckC.H.Jr., FischerJ.E.Etiology, incidence, and prognosis of renal failure following cardiac operations.J Thorac Cardiovasc Surg1976; 71: 323–333.
StanleyT.H., Istern-AmaralJ.Periodic analysis of mixed venous oxygen tension to monitor the adequacy of perfusion during and after cardiopulmonary bypass.Can Anaesth Soc J1974; 21: 454–460.
17.
BarakaA.Continuous venous oximetry should be used routinely during cardio-pulmonary bypass.J Cardiothor Vasc Anes1992; 6(1): 105–108.
18.
MerrinG.M.Continuous blood gas monitoring should not be a standard during cardiopulmonary bypass.J Cardiothor Vasc Anes1992; 6(1): 109–110.
19.
SwanH., SanchezM., TyndallM., KochC.Quality control of perfusion: monitoring venous blood oxygen tension to prevent hypoxic acidosis.J Thorac Cardiovasc Surg1990; 99: 868–72.
