RISK FACTORS OF PATIENTS UNDERGOING CONTINUOUS RENAL REPLACEMENT AFTER CARDIOPULMONARY BYPASS: A SINGLE-CENTER RETROSPECTIVE STUDY

Introduction: To evaluate the risk factors of continuous renal replacement therapy (CRRT) after cardiopulmonary bypass (CPB). Materials and methods: From May 2009 to June 2014, 66 patients underwent CRRT after CPB in Department of Cardiovascular Surgery of West China Hospital were enrolled (38 males and 28 females and the average age was 59.11 +/- 12.62 years). The patients were divided into survival group (n=18) and death group (n=48) according to the clinical outcomes when they were discharged. Logistic regression analysis was used to analyze the risk factors of patients who underwent CRRT after CPB due to renal insufficiency. Results: The statistically single factor analysis revealed that alternative risks affected the mortality significantly in different time frame: 1. intraoperative: blood loss, the amount of blood transfusion, intraoperative blood glucose level, the peak of blood lactate; 2. 24 hours postoperative: total bilirubin, platelet count, hypotension 3. postoperative: lung infection, multiple organ dysfunction syndrome (MODS) and the time from oliguria to hemodialysis (all p<0.05). Comparatively, multivariate logistic regression analysis showed that the time from oliguria to hemodialysis, 24 hours postoperative hypotension and platelet count were statistically significant (all p< 0.05). Conclusion: Perioperative management on reducing blood loss, controlling blood glucose, treating low blood pressure, pulmonary infection, MODS, timely starting renal replacement therapy, 24 hours postoperative blood pressure and platelet count monitoring were significantly correlated with the mortality rate after CPB undergoing CRRT.