Report of a substudy on warm versus cold cardiopulmonary bypass: changes in creatinine clearance.
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 degrees C) or cold (28 degrees C to 30 degrees 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.
Swaminathan
M
M
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA.
East
C
C
Phillips-Bute
B
B
Newman
M F
MF
Reves
J G
JG
Smith
P K
PK
Stafford-Smith
M
M
D000368:Aged; D002315:Cardiopulmonary Bypass / Q000379:methods*; D003404:Creatinine / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013696:Temperature
D003404:Creatinine