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Ann Thorac Surg 2001;72:1603-1609
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

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

Madhav Swaminathan, MDa, Christopher East, MDa, Barbara Phillips-Bute, PhDa, Mark F. Newman, MDa, Joseph G. Reves, MDa, Peter K. Smith, MDb, Mark Stafford-Smith, FRCPC*a

a Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA
b Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA

Accepted for publication August 8, 2001.

* Address reprint requests to Dr Stafford-Smith, Duke University Medical Center, North Hospital, Room 3450, Erwin Road, Durham, NC 27710, USA
e-mail: staff002{at}mc.duke.edu

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.




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