A Meta-Analysis of Renal Function After Adult Cardiac Surgery With Pulsatile Perfusion

Myung Ji Nam, Choon Hak Lim, Hyun Jung Kim, Yong Hwi Kim, Hyuk Choi, Ho Sung Son, Hae Ja Lim, Kyung Sun

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

The aim of this meta-analysis was to determine whether pulsatile perfusion during cardiac surgery has a lesser effect on renal dysfunction than nonpulsatile perfusion after cardiac surgery in randomized controlled trials. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were used to identify available articles published before April 25, 2014. Meta-analysis was conducted to determine the effects of pulsatile perfusion on postoperative renal functions, as determined by creatinine clearance (CrCl), serum creatinine (Cr), urinary neutrophil gelatinase-associated lipocalin (NGAL), and the incidences of acute renal insufficiency (ARI) and acute renal failure (ARF). Nine studies involving 674 patients that received pulsatile perfusion and 698 patients that received nonpulsatile perfusion during cardiopulmonary bypass (CPB) were considered in the meta-analysis. Stratified analysis was performed according to effective pulsatility or unclear pulsatility of the pulsatile perfusion method in the presence of heterogeneity. NGAL levels were not significantly different between the pulsatile and nonpulsatile groups. However, patients in the pulsatile group had a significantly higher CrCl and lower Cr levels when the analysis was restricted to studies on effective pulsatile flow (P<0.00001, respectively). The incidence of ARI was significantly lower in the pulsatile group (P<0.00001), but incidences of ARF were similar. In conclusion, the meta-analysis suggests that the use of pulsatile flow during CPB results in better postoperative renal function.

Original languageEnglish
Pages (from-to)788-794
Number of pages7
JournalArtificial Organs
Volume39
Issue number9
DOIs
Publication statusPublished - 2015 Sep 1

    Fingerprint

Keywords

  • Cardiopulmonary bypass
  • Meta-analysis
  • Pulsatile perfusion
  • Renal function

ASJC Scopus subject areas

  • Biomaterials
  • Biomedical Engineering
  • Bioengineering
  • Medicine (miscellaneous)

Cite this