Effects of Hypothermia on Renal Functions for Patients undergo Coronary Artery Bypass Graft Surgery

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26/5/2014 11:25 AM

Effects of Hypothermia on Renal Functions for Patients undergo Coronary Artery Bypass Graft Surgery



Khalid M. Sabri, M.Sc.*
Hakema S. Hassan, Ph.D.**
*Academic Nurses Specialist, Iraqi Center of Heart Diseases , Ministry of Health.
**Professor, Adult Nursing Department, College of Nursing, University of Baghdad.


Abstract

Objective: To determine the effectiveness of hypothermia on renal functions for patients undergoing coronary artery bypass graft CABG surgery. Methodology: A purposive (non-probability) sample of (50) patients undergoing Isolated coronary artery bypass graft surgery consecutively admitted to the surgical ward, and they were followed up in the intraoperative, Intensive Care Unit (ICU) and in the postoperative (surgical ward). Post-operative renal function test (glumeruler filteration rate (GFR) by using the Crockroft-Gault formula and serum creatinine level) was determined first week post operative and post operative renal function was classified on the base of peak of the serum creatinine level and decline of glomeruler filteration rate(GFR) as following : normal renal function serum creatinine concentration and decline in(GFR) less than 25% from preoperative, moderate renal dysfunction increase serum creatinine concentration and decline in(GFR) 25%-50% from preoperative, sever renal dysfunction increase serum creatinine concentration and decline in(GFR) more than 50% from preoperative test.
Results: results of this study show that (78%) from the sample develop post operative renal dysfunction and the highly percentage of them are male (50%), advance age 60-70 (60%), smoking (47.0%), diabetes mellitus DM (68%), cardiopulmonary bypass 180 and more (57.20%), New York Heart Association calcification NYHA class III(47.5%) and patient without Intra Aortic Balloon Pump IABP(50,0%) . We conclude from the study that highly percentage of patient undergoing isolated CABG may develop postoperative renal dysfunction even when using hypothermic strategy as a protective measure and the patients with DM, male, advance age, smoker, prolong time of CPB (more than 180 minutes), NYHA class III and patient without IABP are considered as patient at high risk to develop postoperative renal dysfunction.
Recommendations: The researcher recommended that to find addition strategy rather than hypothermia to protect renal function especially with the high risk patients during isolated CABG surgery.
Keywords: Renal dysfunction, coronary artery bypass graft (CABG) surgery, Hypothermia




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