Effect of del nido cardioplegia use on kidney injury after coronary bypass operations

Aims Initially developed for myocardial protection in immature cardiomyocytes, del Nido cardioplegia has been increasingly used over the past decade in adult patients. Our aim is to analyse the results from randomized controlled trials and observational studies comparing early mortality and postoperative troponin release in patients who underwent cardiac surgery using del Nido solution and blood cardioplegia. Methods A literature search was performed through three online databases between January 2010 and August 2022. Clinical studies providing early mortality and/or postoperative troponin evaluation were included. A random-effects meta-analysis with a generalized linear mixed model, incorporating random study effects, was implemented to compare the two groups. Results Forty-two articles were included in the final analysis for a total of 11 832 patients, 5926 of whom received del Nido solution and 5906 received blood cardioplegia. del Nido and blood cardioplegia populations had comparable age, gender distribution, history of hypertension and diabetes mellitus. There was no difference in early mortality between the two groups. There was a trend towards lower 24 h [mean difference −0.20; 95% confidence interval (CI) −0.40 to 0.00; I 2 = 89%; P = 0.056] and lower peak postoperative troponin levels (mean difference −0.10; 95% CI −0.21 to 0.01; I 2 = 0.87; P = 0.087) in the del Nido group. Conclusion del Nido cardioplegia can be safely used in adult cardiac surgery. The use of del Nido solution was associated with similar results in terms of early mortality and postoperative troponin release when compared with blood cardioplegia myocardial protection.

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“…Supplemental Table 4, http://links.lww.com/JCM/A545 lists the 42 studies ultimately included in this meta-analysis 15–28,30–34,36–40,43,46–48 …”

Section: Resultsmentioning

confidence: 99%

“…The PRISMA search flow diagram and checklist are available in Supplemental Figure 1 Supplemental Table 4, http://links.lww.com/JCM/A545 lists the 42 studies ultimately included in this meta-analysis. [15][16][17][18][19][20][21][22][23][24][25][26][27][28][30][31][32][33][34][36][37][38][39][40]43,[46][47][48]…”

Section: Study Selectionmentioning

confidence: 99%

del Nido versus blood cardioplegia in adult cardiac surgery: a meta-analysis

Malvindi

Tian

Bifulco

et al. 2023

Journal of Cardiovascular Medicine

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“…5 Various studies have shown that prolonged extracorporeal circulation times increase the risk of AKI. 6,7 In your study, perfusion times were found to be higher in the AKI group, but there was no statistically significant difference. Recently, centrifugal perfusion circuits can be used in some patient groups.…”

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confidence: 77%

Heart surgery and postoperative acute kidney injury

Engin

Aydın

Tatli

et al. 2022

Journal of Cardiac Surgery

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We read with great interest the article entitled "Urinary TIMP-2 and IGFBP-7 protein levels as early predictors of acute kidney injury after cardiac surgery." 1 We would like to congratulate the authors for their valuable contribution. However, we would like to discuss some points about acute kidney injury (AKI) occurring after heart surgery. We also congratulate Teruhiko Imamura for their valuable contribution to this article. 2

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“…Diagnosis of postoperative AKI was determined according to the Kidney Disease Improving Global Outcomes (KDIGO) classification 7 . According to the results of this evaluation, patients who did not develop AKI in the postoperative period were recorded as group 1 (n=55), and patients who developed any of the KDIGO stages were recorded as the renal failure group (group 2, n=24).…”

Section: Methodsmentioning

confidence: 99%

Syndecan-1 as a marker to predict acute kidney injury after isolated coronary artery bypass graft operations

Engin

Sunbul

et al. 2023

Rev. Assoc. Med. Bras.

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OBJECTIVE:Postoperative acute kidney injury is an important problem that can occur after coronary artery bypass graft operations, and it is important to identify risky patient groups preoperatively. This study aimed to investigate the importance of preoperative syndecan-1 levels in predicting acute kidney injury after elective coronary artery bypass graft operations accompanied by cardiopulmonary bypass. METHODS: Patients who underwent coronary artery bypass graft operation in our clinic between March 1 and May 10, 2022, were included in this prospective study. Patients who did not develop acute kidney injury in the postoperative period were recorded as group 1 and patients who developed it were recorded as group 2. RESULTS: A total of 79 patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass were included in the study. There were 55 patients in group 1 and 24 patients in group 2. There was no difference between the groups in terms of age, gender, diabetes mellitus, body mass index, smoking, and hyperlipidemia rates. In multivariate logistic regression analysis, increased blood product use (odds ratio 1.634; 95%CI 1.036-2.579; p=0.035), preoperative high creatinine (odds ratio 59.387; 95%CI 3.034-1162.496; p=0.007), and high syndecan-1 (odds ratio 1.015; 95%CI 1.002-1.028; p=0.025) were independent predictors of acute kidney injury. CONCLUSION: This study revealed that elevated preoperative syndecan-1 is associated with acute kidney injury after isolated coronary artery bypass graft accompanied by cardiopulmonary bypass and has prognostic utility independent of other recognized risk factors.

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Effect of del nido cardioplegia use on kidney injury after coronary bypass operations

Cited by 10 publications

References 16 publications

del Nido versus blood cardioplegia in adult cardiac surgery: a meta-analysis

del Nido versus blood cardioplegia in adult cardiac surgery: a meta-analysis

Heart surgery and postoperative acute kidney injury

Syndecan-1 as a marker to predict acute kidney injury after isolated coronary artery bypass graft operations

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