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The association of lowest hematocrit during cardiopulmonary bypass with acute renal injury after coronary artery bypass surgery  Madhav Swaminathan, MD,

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Presentation on theme: "The association of lowest hematocrit during cardiopulmonary bypass with acute renal injury after coronary artery bypass surgery  Madhav Swaminathan, MD,"— Presentation transcript:

1 The association of lowest hematocrit during cardiopulmonary bypass with acute renal injury after coronary artery bypass surgery  Madhav Swaminathan, MD, Barbara G Phillips-Bute, PhD, Peter J Conlon, MD, Peter K Smith, MD, Mark F Newman, MD, Mark Stafford- Smith, FRCPC  The Annals of Thoracic Surgery  Volume 76, Issue 3, Pages (September 2003) DOI: /S (03)

2 Fig 1 This figure is based on a predictive model for “typical” patients relating lowest hematocrit (Hct) during bypass to peak percentage change in creatinine (%ΔCr), where the following covariates were adjusted for: prebypass glucose = 130 mg/dL, Charlson comorbodity score = 1, preoperative hematocrit = 40%, preoperative creatinine = 1.5 mg/dL, and no intraaortic balloon pump, inotropes, transfusion, or diabetes. The regression equations are %ΔCr = for 75 kg (triangles), (lowest Hct during bypass*0.604); for 100 kg (asterisks), (lowest Hct during bypass*−0.791); for 125 kg (circles), (lowest Hct during bypass*−2.186); for 150 kg (squares), (lowest Hct during bypass*−3.581). The Annals of Thoracic Surgery  , DOI: ( /S (03) )

3 Fig 2 The relationship of lowest hematocrit (Hct) during bypass to peak percentage change in creatinine (%ΔCr) in patients (n = 776) with weight 75 kilos or more, with 95% confidence limits (dashed lines). The regression equation is %ΔCr = (lowest Hct during bypass*−1.10). The Annals of Thoracic Surgery  , DOI: ( /S (03) )

4 Fig 3 This figure is based on a predictive model for “typical” patients relating lowest hematocrit (Hct) during bypass to (CrmaxPost), where the following covariates were adjusted for: prebypass glucose = 130 mg/dL, Charlson comorbodity score = 1, preoperative hematocrit = 40%, preoperative creatinine = 1.5 mg/dL, and no intraaortic balloon pump, inotropes, transfusion, or diabetes. The regression equations are CrmaxPost = for 75 kg (triangles), (lowest Hct during bypass*0.007); for 100 kg (asterisks), (lowest Hct during bypass*−0.006); for 125 kg (circles), (lowest Hct during bypass*−0.03); for 150 kg (squares), (lowest Hct during bypass*−0.05). The Annals of Thoracic Surgery  , DOI: ( /S (03) )

5 Fig 4 The influence of blood transfusion on the relationship between lowest hematocrit (Hct) during cardiopulmonary bypass and peak postoperative fractional change in creatinine (%ΔCr). RBCs: 9 (asterisks); 6 (triangles); 3 (circles); 0 (squares). (RBCs = number of units of packed red blood cells transfused intraoperatively.) The Annals of Thoracic Surgery  , DOI: ( /S (03) )

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