Relationship between oxygen supply and the incidence of acute renal failure in adult patients undergoing cardiac surgery with extracorporeal circulation.

Abstract

Introduction: Extracorporeal circulation (CPB) can lead to a series of alterations which can lead to serious morbidities for the patient. One of the most worrying complications in cardiac surgery is acute

kidney injury (AKI). The oxygen supply (DO₂) is a determining parameter for whether AKI occurs or not.

Objectives: Determine the relationship between oxygen delivery and acute renal failure in patients undergoing extracorporeal circulation for cardiac surgery in adults in the period of May 2022 - April 2023

at Mayagüez Medical Center, Mayagüez, Puerto Rico. To relate the variables: age, sex, creatinine levels, blood pressure and urine output in CPB, hypertension, diabetes, mechanical ventilation time, CPB and aortic clamping time with the incidence of AKI.

Material and Method: A retrospective descriptive observational cohort study was carried out on patients who undergoing cardiac surgery with CPB at Mayagüez Medical Center, in the period between May 2022 and April 2023. The DO₂ of each patient was determined and they were categorized into two groups: Adult patients whose DO₂ during CPB was ≥ 272 ml/min/m², identified as group 1 and adult patients whose DO₂ during CPB was < 272 ml/min/m², identified as group 2. The behavior of creatinine was evaluated at the first 24 hours in both groups and the different variables were related to the incidence of AKI using Pearson's correlation.

Results: Of 127 patients studied, 42 patients belonged to Group 1 (33%) and 85 patients belonged to Group 2 (67%) of which 5 patients (12%) in group 1 developed AKI and 17 patients (20%) in the Group 2.

After performing a subgroup analysis only with the patients who had AKI, more statistically significant results were obtained among the different variables studied.

Conclusion: According to the results obtained in this study, there is a significant correlation of the development of acute renal failure with the maintenance of oxygen delivery less than 272 ml/min/ m².