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The goal of this clinical trial is to learn about in postoperative acute kidney injury in cardiac surgery. The main questions it aims to answer are:
Participants will receive Transesophageal Ultrasound Doppler during cardiac surgery. If the participant is assigned to the intervention group, if the central venous pressure of the participant is ≥ 10mmHg 30 minutes after the end of cardiopulmonary bypass, he will receive nitroglycerin pumped to apply the controlled low central venous pressure (CLCVP) technology; If participants are assigned to the control group, no intervention measures will be taken.
The researchers will compare the intervention group with the control group to see the occurrence of AKI and AKD after cardiac surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention group | Experimental | Controlled low central venous pressure (CLCVP) technology |
|
| control group | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Controlled low central venous pressure (CLCVP) technology | Combination Product | Controlled low central venous pressure (CLCVP) technology: after cardiopulmonary bypass, pumping nitroglycerin (0.2-1 ug/kg * min) and other methods until the end of surgery to maintain the central venous pressure below 10 mmHg. |
| Measure | Description | Time Frame |
|---|---|---|
| Level of Serum creatinine | SCR | Before operation to 90 days after operation |
| Measure | Description | Time Frame |
|---|---|---|
| Neutrophil gelatinase associated lipid transporter (NGAL) | Neutrophil gelatinase associated lipid transporter | Before operation to 2 hours after operation |
| Kidney Injury Molecule-1 (KIM-1) | Kidney Injury Molecule-1 |
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Inclusion Criteria:
Patients aged above 18 years undergoing coronary artery bypass graft or heart valve surgery under cardiopulmonary bypass.
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nanjing First Hospital | Nanjing | Jiangsu | 210012 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35249707 | Result | Chen L, Hong L, Ma A, Chen Y, Xiao Y, Jiang F, Huang R, Zhang C, Bu X, Ge Y, Zhou J. Intraoperative venous congestion rather than hypotension is associated with acute adverse kidney events after cardiac surgery: a retrospective cohort study. Br J Anaesth. 2022 May;128(5):785-795. doi: 10.1016/j.bja.2022.01.032. Epub 2022 Mar 4. | |
| 33549321 |
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|
| Nitroglycerin | Drug | nitroglycerin (0.2-1 ug/kg * min) |
|
| Before operation to 12 hours after operation |
| Lopez MG, Shotwell MS, Morse J, Liang Y, Wanderer JP, Absi TS, Balsara KR, Levack MM, Shah AS, Hernandez A, Billings FT 4th. Intraoperative venous congestion and acute kidney injury in cardiac surgery: an observational cohort study. Br J Anaesth. 2021 Mar;126(3):599-607. doi: 10.1016/j.bja.2020.12.028. Epub 2021 Feb 4. |
| ID | Term |
|---|---|
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
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| ID | Term |
|---|---|
| D013672 | Technology |
| D005996 | Nitroglycerin |
| ID | Term |
|---|---|
| D013676 | Technology, Industry, and Agriculture |
| D009574 | Nitro Compounds |
| D009930 | Organic Chemicals |
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