The association of clinical oparation data with acute kidney injury following CPB for cardiac surgery

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K12747
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 90150:Medical assistive technology-related
• Research Institution: Kindai University
• Principal Investigator: Tokumine Asako 近畿大学, 生物理工学部, 講師 (90435058)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 人工心肺 / 急性腎不全 / 開心術 / 適正灌流量

Outline of Final Research Achievements

This project is a retrospective study to understand the effects of cardiopulmonary bypass in open-heart surgery. In recent years, many observational studies have been reported in foreign countries to understand the relationship between oxygen supply and demand balance and inappropriate perfusion associated with the current technique of cardiopulmonary bypass. There is a risk of organ failure if proper perfusion is not maintained.
In order to effect the impact of the use of artificial heart-lung machine in open-heart surgery, from the preoperative, intraoperative, and postoperative patient data and operational data of cases of circulatory arrest due to the use of CPB at a single institution, the factors most involved in the onset of postoperative AKI were analyzed logistically. It was examined and discussed using regression analysis. It was shown that ⊿eGFR was likely involved.

Free Research Field

体外循環

Academic Significance and Societal Importance of the Research Achievements

心臓手術や大血管手術では、心臓のポンプ機能を代替して血液循環を確保し、人工的にガス交換をおこなうのが人工心肺である。人工心肺を使用した心臓手術後の急性腎不全(AKI)は重大な合併症である。人工心肺後のAKIは30％程度で生じる合併症とされ、不適正灌流に起因する可能性が示唆されている。体外循環中も正常な組織活動が維持されるという条件下での適正灌流量が採用され、統一した操作が行われているのが現状である。患者個人の生体条件に合わせた酸素等の需給バランスを考慮した体外循環を行うことを目的として、より生理的な循環の代替療法を可能にするものと考える。