Projects per year
Abstract
Aim: Blood transfusion may improve renal oxygenation during cardiopulmonary bypass (CPB). In an ovine model of experimental CPB, we tested whether increasing blood haemoglobin concentration [Hb] from ~7 g dL−1 to ~9 g dL−1 improves renal tissue oxygenation. Methods: Ten sheep were studied while conscious, under stable isoflurane anaesthesia, and during 3 hours of CPB. In a randomized cross-over design, 5 sheep commenced bypass at a high target [Hb], achieved by adding 600 mL donor blood to the priming solution. After 90 minutes of CPB, PlasmaLyte® was added to the blood reservoir to achieve low target [Hb]. For the other 5 sheep, no blood was added to the prime, but after 90 minutes of CPB, 800-900 mL of donor blood was given to achieve a high target [Hb]. Results: Overall, CPB was associated with marked reductions in renal oxygen delivery (−50 ± 12%, mean ± 95% confidence interval) and medullary tissue oxygen tension (PO2, −54 ± 29%). Renal fractional oxygen extraction was 17 ± 10% less during CPB at high [Hb] than low [Hb] (P =.04). Nevertheless, no increase in tissue PO2 in either the renal medulla (0 ± 6 mmHg change, P >.99) or cortex (−19 ± 13 mmHg change, P =.08) was detected with high [Hb]. Conclusions: In experimental CPB blood transfusion to increase Hb concentration from ~7 g dL−1 to ~9 g dL−1 did not improve renal cortical or medullary tissue PO2 even though it decreased whole kidney oxygen extraction.
Original language | English |
---|---|
Article number | e13583 |
Number of pages | 11 |
Journal | Acta Physiologica |
Volume | 231 |
Issue number | 3 |
DOIs | |
Publication status | Published - Mar 2021 |
Keywords
- acute kidney injury
- blood transfusion
- cardiac surgery
- hypoxia
- renal circulation
Projects
- 2 Finished
-
Targeting renal hypoxia to avoid cardiac surgery associated acute kidney injury
Lankadeva, Y. R., May, C. N., Evans, R. & Cochrane, A.
1/10/20 → 31/12/22
Project: Research
-
Towards Prevention of Acute Kidney Injury after Cardiac Surgery
Evans, R., May, C., Smith, J., Smith, D., Thrift, A., Gardiner, B. & Cochrane, A.
National Health and Medical Research Council (NHMRC) (Australia)
1/01/17 → 31/12/19
Project: Research