The Effect Of The Different Levels Of Blood Pressure In The Cpb Early Of Beating Heart Surgery On Renal Function

Objective To explore different blood pressure levels on renal function under the cardiopulmonary bypass earlyMethods Sixtey adult patients (ASA class Ⅱ or Ⅲ, NYHA grade Ⅱ or Ⅲ) with rheumatic heart disease undergoing mitral valve replacement at beating heart Surgery between March2011to September2011. At the beginning of CPB, the lowest MAP41mmHg and the highest91mmHg in60adult patients. They were included in this experiment if the mean arterial pressure (MAP) in4065mmHg at the beginning CPB, otherwise rejected. Using a double blind method randomized into experimental group and control group,21cases in the experiment group,19cases in the control group. The control group with vasoconstrictor drugs to immediately improved MAP to65-80mmHg undergoing CPB early, the experimental group without any treatment. The plasma concentrations of α1-MG, SCr and BUN were measured respectively before CPB (TO), at the end of CPB (T1), at6h (T2), at1h (T3),12h (T4),24h (T5) and48h (T6) after surgery. The urine were recorded before CPB, during CPB, after CPB, at24h and48h after surgery.Results There were no significant differences in all outcomes between the two groups before induction of anesthesia (P>0.05); There were no significant differences in1-MG, SCr, BUN and urine between the two groups at each time point (P>0.05); Plasma of1-MG, SCr and BUN were rising at the beganing CPB, reaching the peak at12hour after surgery, then gradually decreased and back to the original level.Conclusion There are no harmful effects between40mmHg to65mmHg and between65mmHg to80mmHg on renal function in the CPB early(15min).