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The Effect of Continuous Low Tidal Volume Ventilation During Cardiopulmonary Bypass on Renal Resistive Index

Not yet recruiting
Conditions
Postoperative Complications
Registration Number
NCT07044102
Lead Sponsor
Konya City Hospital
Brief Summary

Postoperative acute kidney injury following cardiopulmonary bypass surgery represents a significant barrier to patient recovery and is closely associated with increased postoperative morbidity and mortality. Studies have shown that the incidence of AKI aftercardiopulmonary bypass surgeryranges between 5% and 30%.

The Renal Resistive Index, measured by Doppler ultrasonography, is an increasingly utilized parameter that provides valuable insights into renal hemodynamics and vascular resistance. A normal RRI is typically below 0.70; elevated values may indicate increased renal vascular resistance or microvascular damage. Bossard et al. demonstrated that increased RRI in the early postoperative period is associated with the development of AKI. Early evaluation of renal blood flow thus facilitates prompt detection of AKI. Both preoperative and postoperative RRI measurements are considered useful tools for identifying early renal dysfunction. Monitoring RRI before and after CABG may provide critical information for preventing postoperative renal complications.

Detailed Description

Postoperative acute kidney injury following cardiopulmonary bypass surgery represents a significant barrier to patient recovery and is closely associated with increased postoperative morbidity and mortality. Studies have shown that the incidence of AKI after CABG ranges between 5% and 30%.

The Renal Resistive Index, measured by Doppler ultrasonography, is an increasingly utilized parameter that provides valuable insights into renal hemodynamics and vascular resistance. A normal RRI is typically below 0.70; elevated values may indicate increased renal vascular resistance or microvascular damage. Bossard et al. demonstrated that increased RRI in the early postoperative period is associated with the development of AKI. Early evaluation of renal blood flow thus facilitates prompt detection of AKI. Both preoperative and postoperative RRI measurements are considered useful tools for identifying early renal dysfunction. Monitoring RRI before and after CABG may provide critical information for preventing postoperative renal complications.In recent years, significant advancements have been made in both surgical and anesthetic techniques in cardiac surgery. During CABG, the commonly used ventilation strategy during cardiopulmonary bypass is apneic ventilation. However, low tidal volume ventilation has been proposed as an alternative, with a growing body of literature supporting its use. LTV has been associated with reduced postoperative pulmonary complications, earlier extubation, and prevention of atelectasis and pulmonary edema.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Patients scheduled for elective cardiac bypass surgery
  • Male and female patients over 18 years of age
  • Patients with an American Society of Anesthesiologists (ASA) physical status classification of II, III, or IV
Exclusion Criteria
  • Chronic renal failure requiring dialysis
  • Patients requiring emergency surgery

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Renal resistive ındexPostoperative 45 minutes

Measurement of Changes in Renal Resistive Index Associated With Low Tidal Volume and Apneic Ventilation

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Konya City Hospital

🇹🇷

Konya, Turkey

Konya City Hospital
🇹🇷Konya, Turkey
Esra GOGER, MD
Contact
5359337429
dr.esragoger@gmail.com

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