Key result
Dexmedetomidine infusion during cardiac surgery alters 2-hour serum NGAL levels vs placebo.
Why the study?
Postcardiac surgery-associated acute kidney injury carries mortality rates up to 60%, prompting evaluation of the renal-protective effect of dexmedetomidine in reducing its incidence after cardiac surgery.
Does dexmedetomidine infusion reduce serum neutrophil gelatinase-associated lipocalin levels in patients undergoing cardiac surgery with cardiopulmonary bypass?
RCT (n=40)
Double-blind
Randomly allocated into two equal groups
Does dexmedetomidine infusion reduce serum neutrophil gelatinase-associated lipocalin levels in patients undergoing cardiac surgery with cardiopulmonary bypass?
Dexmedetomidine infusion during cardiac surgery with CPB may offer renal protection as evidenced by reduced serum NGAL levels, though it is associated with more frequent bradycardia.
Answers are grounded in this paper and cite their sources.
Suggests possible renal protection in CPB surgery; extends NGAL biomarker data but clinical AKI outcomes remain unproven.
Background and objectives Postcardiac surgery-associated acute kidney injury (AKI) is associated with up to 60% mortality rates of all cardiac surgery patients. This study aimed to study the renal-protective effect of dexmedetomidine in reducing the incidence of AKI following cardiac surgery.Patients and methods A total of 40 patients scheduled for cardiac surgery with cardiopulmonary bypass (CPB) were randomly allocated into two equal groups. In the study group, dexmedetomidine was given as an infusion of 0.4 μg/kg/h from induction of anesthesia till the end of surgery while in the control group, the patients received an equal volume of normal saline. The primary outcome of this study was the level of serum neutrophil gelatinase-associated lipocalin. The secondary outcomes were serum creatinine, hemodynamic parameters, operative time, aortic cross-clamp time, CPB time, and duration of ICU stay.Results Intraoperative and postoperative time variables and number of patients who developed hypotension were comparable between groups. Bradycardia developed more frequently in the dexmedetomidine group than in the placebo group. Serum neutrophil gelatinase-associated lipocalin after 2 h showed a statistically significant difference between groups. Serum creatinine showed no statistically significant difference between groups.Conclusion Dexmedetomidine could have a protective role in renal function during cardiac surgery using the CPB.
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El-Hamid et al. (2019) conducted an RCT in Cardiac surgery with cardiopulmonary bypass (n=40). Dexmedetomidine vs. Normal saline was evaluated on Level of serum neutrophil gelatinase-associated lipocalin. Dexmedetomidine infusion during cardiac surgery with cardiopulmonary bypass resulted in a statistically significant difference in serum neutrophil gelatinase-associated lipocalin after 2 hours.
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