Effect Of Centrifugal Pump And Roller Pump For Cardiopulmonary Bypass On Kidney Function

Objective:To explore the influence of centrifugal pump and roller pump to kidney function after Cardiopulmonary bypass(CPB).Methods:23 patients undergoing cardiac double valves replacement (mitral valve and aortic valve) were randomly assigned into either centrifugal pump(n=11) or roller pump(n=12). The status of hemodynamic of each group were monitored at operating time and at 48 hours after operation. Blood loss and urine output were recorded at operating time and at 48 hours after operation.The time of ICU-staying and hospitalization were also recorded.The level of free serum hemoglobin were measured after induction of anesthesia, at the end of CPB,and at lh,4h and 24h after CPB.Serum creatinine and urine concentrations ofβ-NAG and al-MG were measured after induction of anesthesia,at the end of operation,and at24h and 48h after operation.Results:Age,weight,duration of CPB and cross-clap time were comparable in the two groups. There were no significant differences in hemodynamics, blood loss and urine output, ICU-staying time and hospitalization between the two groups.At the end of CPB,and at 1h and 4h after CPB termination,the levels of free plasma haemoglobin of roller pump group were significantly higher than centrifugal pump group (89.8±8.6vs77.8±11.8 mg/L; 74.1±6.7vs65.2±6.5mg/L;66.7±6.9vs52.6±5.6mg/L).Serum creatinine was elevated significantly in the two groups at 24h after operation (CP,from 68.3±11.2 to 85.6±16.4μmol/L;RP,from 65.7±10.2 to 90.7±14.2μmol/L) and remained normal without group differences during the entire study period. Urine concentrations ofβ-NAG and al-MG increased significantly at 24h after operation,showing the highest significant increase in the roller pump group (RP,β-NAG from4.4±1.1to17.5±2.2U/L, al-MG from 6.8±1.2to29.6±3.8 mg/L; CP,β-NAG from 4.2±1.2to12.9±1.8U/L, al-MG from7.2±1.4to21.5±3.2mg/L).There were significant group differences at the end of operation,and at 24h and 48h after operation. Conclusion:Patients with centrifugal pump showed less pronounced hamolys and kidney injury than patients with roller pump.