The use of the RenalGuard system in cardiac surgery with cardiopulmonary bypass: a first in man prospective, observational, feasibility pilot study

2.50
Hdl Handle:
http://hdl.handle.net/2436/620791
Title:
The use of the RenalGuard system in cardiac surgery with cardiopulmonary bypass: a first in man prospective, observational, feasibility pilot study
Authors:
Luckraz, Heyman ( 0000-0003-1218-1243 ) ; Giri, Ramesh; Wrigley, Benmjamin; Hennessy, Anne-Marie; Nicholas, Johann; Nevill, Alan M.
Abstract:
Objectives As proof of concept, this prospective, observational study assessed the feasibility and early clinical outcomes of performing on-pump cardiac surgery with the RenalGuard system. Background Acute kidney injury (AKI) is reported in up to 30% of patients undergoing cardiac surgery and is a recognised independent predictor of both morbidity and mortality. Forced diuresis with the RenalGuard system reduces the incidence of AKI during percutaneous coronary intervention procedures but its use in cardiac surgery has not been explored. Methods Ten consecutive patients who were at risk of developing AKI during cardiac surgery were selected. The RenalGuard system was used to facilitate forced diuresis using weight-adjusted intravenous furosemide while maintaining neutral fluid balance by matched intravenous fluid replacement. This regimen was initiated preoperatively in all patients and continued for 6–12 hours postoperatively. Serum creatinine, electrolytes and need for renal replacement were documented in all patients. Results The RenalGuard system functioned successfully in all patients and facilitated high perioperative urine outputs, even when patients were placed on cardiopulmonary bypass (CPB). There were no incidences of significant (A) electrolyte imbalance, (B) changes in haemoglobin levels or (C) pulmonary oedema. No patients developed AKI within 36 hours of surgery despite one patient developing cardiac tamponade 8 hours postoperatively and one patient developing paralytic ileus. One patient, however, was ‘electively’ haemofiltered on day 2 after developing acute right ventricular failure. The median intensive care stay was 1.5 (1, 5) days. Conclusion The RenalGuard system can be used successfully in patients undergoing cardiac surgery with CPB and may reduce the incidence of AKI in at-risk patients.
Citation:
The use of the RenalGuard system in cardiac surgery with cardiopulmonary bypass: a first in man prospective, observational, feasibility pilot study 2017, 4 (2):e000669 Open Heart
Publisher:
BMJ Publishing Group
Journal:
Open Heart
Issue Date:
10-Oct-2017
URI:
http://hdl.handle.net/2436/620791
DOI:
10.1136/openhrt-2017-000669
Additional Links:
http://openheart.bmj.com/lookup/doi/10.1136/openhrt-2017-000669
Type:
Article
Language:
en
ISSN:
2053-3624
Appears in Collections:
Sport, Exercise and Health Research Group

Full metadata record

DC FieldValue Language
dc.contributor.authorLuckraz, Heymanen
dc.contributor.authorGiri, Rameshen
dc.contributor.authorWrigley, Benmjaminen
dc.contributor.authorHennessy, Anne-Marieen
dc.contributor.authorNicholas, Johannen
dc.contributor.authorNevill, Alan M.en
dc.date.accessioned2017-10-19T13:17:44Z-
dc.date.available2017-10-19T13:17:44Z-
dc.date.issued2017-10-10-
dc.identifier.citationThe use of the RenalGuard system in cardiac surgery with cardiopulmonary bypass: a first in man prospective, observational, feasibility pilot study 2017, 4 (2):e000669 Open Hearten
dc.identifier.issn2053-3624en
dc.identifier.doi10.1136/openhrt-2017-000669-
dc.identifier.urihttp://hdl.handle.net/2436/620791-
dc.description.abstractObjectives As proof of concept, this prospective, observational study assessed the feasibility and early clinical outcomes of performing on-pump cardiac surgery with the RenalGuard system. Background Acute kidney injury (AKI) is reported in up to 30% of patients undergoing cardiac surgery and is a recognised independent predictor of both morbidity and mortality. Forced diuresis with the RenalGuard system reduces the incidence of AKI during percutaneous coronary intervention procedures but its use in cardiac surgery has not been explored. Methods Ten consecutive patients who were at risk of developing AKI during cardiac surgery were selected. The RenalGuard system was used to facilitate forced diuresis using weight-adjusted intravenous furosemide while maintaining neutral fluid balance by matched intravenous fluid replacement. This regimen was initiated preoperatively in all patients and continued for 6–12 hours postoperatively. Serum creatinine, electrolytes and need for renal replacement were documented in all patients. Results The RenalGuard system functioned successfully in all patients and facilitated high perioperative urine outputs, even when patients were placed on cardiopulmonary bypass (CPB). There were no incidences of significant (A) electrolyte imbalance, (B) changes in haemoglobin levels or (C) pulmonary oedema. No patients developed AKI within 36 hours of surgery despite one patient developing cardiac tamponade 8 hours postoperatively and one patient developing paralytic ileus. One patient, however, was ‘electively’ haemofiltered on day 2 after developing acute right ventricular failure. The median intensive care stay was 1.5 (1, 5) days. Conclusion The RenalGuard system can be used successfully in patients undergoing cardiac surgery with CPB and may reduce the incidence of AKI in at-risk patients.en
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.relation.urlhttp://openheart.bmj.com/lookup/doi/10.1136/openhrt-2017-000669en
dc.rightsArchived with thanks to Open Hearten
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.titleThe use of the RenalGuard system in cardiac surgery with cardiopulmonary bypass: a first in man prospective, observational, feasibility pilot studyen
dc.typeArticleen
dc.identifier.journalOpen Hearten
dc.date.accepted2017-09-12-
rioxxterms.funderinternalen
rioxxterms.identifier.projectUOW191017ANen
rioxxterms.versionVoRen
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc/4.0/en
rioxxterms.licenseref.startdate2017-10-19en
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