Key result
Off-pump CABG is linked to an absolute ~14% lower AKI incidence vs on-pump surgery.
Why the study?
The incidence of acute kidney injury after cardiac surgery and the impact of cardiopulmonary bypass on AKI remain uncertain, requiring comparison of outcomes with and without CPB.
Does off-pump coronary artery bypass reduce the incidence of acute kidney injury compared to on-pump bypass in patients undergoing CABG?
Cohort (n=167)
No
Does off-pump coronary artery bypass reduce the incidence of acute kidney injury compared to on-pump bypass in patients undergoing CABG?
Answers are grounded in this paper and cite their sources.
Off-pump coronary artery bypass grafting reduces the risk of post-operative acute kidney injury and need for blood transfusions compared to conventional on-pump surgery.
Background: The incidence of acute kidney injury commonly follows cardiac surgery.Some studies have demonstrated better outcomes following off-pump cardiac surgery.Objectives: This study was conducted to compare the incidence of acute kidney injury and laboratory findings in patients undergoing cardiac surgery with or without cardiopulmonary bypass.Methods: In a retrospective study, 167 patients who underwent coronary artery bypass grafts (CABG) with or without cardiopulmonary bypass were selected by systematic randomized sampling method from the list of Jamaran heart hospital (Tehran) patients and the incidence of acute kidney injury and laboratory findings were compared.Results: There was no significant difference in the demographics (age, sex, drug history, and chronic disease) between the groups (P > 0.05).The acute kidney injury (AKI) was observed in 19.3 and 33.7% of the off-pump and on-pump patients, respectively.A total number of16 (19.3%) in the off-pump and 44 (52.9%) in on-pump group needed blood transfusion.The mean hospital stay was 6.74 ± 1.86 days for OPCAB and 7.2 ± 1.72 for on-pump patients.Haemoglobin and haematocrit level, also, were higher in OPCAB.Conclusions: This study showed that off-pump coronary artery bypass (OPCAB) is superior in acute kidney injury, blood transfusion, blood glucose management, and hospital stay.Considering these complications and those adverse effects, it seems that off-pump technique is better in selected patients, but it is proposed that more prospective multi-disciplinary studies with larger sample sizes should be done.
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Moradian et al. (2016) conducted a cohort in Coronary artery disease requiring CABG (n=167). Off-pump coronary artery bypass (OPCAB) vs. On-pump coronary artery bypass (with cardiopulmonary bypass) was evaluated on Acute kidney injury 24 hours after surgery (p=0.04). Off-pump coronary artery bypass surgery was associated with a significantly reduced incidence of acute kidney injury compared to on-pump surgery (19.3% vs 33.7%, p=0.04).
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