Cardiothoracic & vascular anesthesia
Effects of Increased Cardiopulmonary Bypass Pump Flow on Renal Filtration, Perfusion, Oxygenation, and Tubular Injury in Cardiac Surgical Patients: A Randomized Controlled Trial
Authors' conclusion
A 20% higher-than-standard CPB flow during cardiac surgery improved renal function, whereas no change in renal blood flow or oxygen demand-supply relationship could be detected. Higher CPB flow was associated with a less pronounced tubular injury marker release compared with standard flow.
Study context
- Population
- Adults undergoing cardiac surgery with cardiopulmonary bypass (CPB)
- Participants
- 36 adults
- Comparison
- High vs standard CPB flow
- High flown = 19
- Standard flown = 17reference
Methodological detailsnonblinded, parallel-arm
- Nonblinded
- Parallel-arm
Primary result
As reported in the abstract
During CPB
- No differences in renal blood flow or oxygen extraction between groups
Further findings
Norepinephrine dose to maintain target MAP · During CPB
Cohen's dz 0.62 · P = 0.048
Peak urinary N-acetyl-β-d-glucosaminidase excretion
P = 0.049
| Outcome | High flow | Standard flow | Cohen's dz | P value |
|---|---|---|---|---|
| Change in systemic oxygen delivery · During CPB | 100 (95% CI 60–141) ml · min −1 · m −2 | 31 (95% CI 1.9–65) ml · min −1 · m −2 | 0.59 | P < 0.001 |
| Change in glomerular filtration rate · During CPB | 6.4 (CI 1.9–10.9) ml · min −1 · 1.73 m −2 | −2.3 (CI −10.9–6.2) ml · min −1 · 1.73 m −2 | 0.66 | P = 0.044 |
Safety
Events
| Outcome | High flow | Standard flow |
|---|---|---|
| Perfusion-related adverse events | 0 | 0 |
Original publication
Effects of Increased Cardiopulmonary Bypass Pump Flow on Renal Filtration, Perfusion, Oxygenation, and Tubular Injury in Cardiac Surgical Patients: A Randomized Controlled Trial. Anesthesiology. Published 7 July 2025. doi:10.
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