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Letters to the Editor

Priming of cardiopulmonary bypass: effect on renal function

Department of Anaesthesiology, Pontificia Universidad Católica de Chile, PO Box 114-D, 833-0024 Santiago, Chile

Received 6 October 2008; accepted 10 December 2008.

^_* Corresponding author. Tel.: +56 2 6863415; fax: +56 2 6394409. (Email: glema{at}med.puc.cl).

Key Words: Anaesthesia • Cardiac, other • Congenital, acyanotic • Extracorporeal circulation

I have read with interest the work by Loeffelbein et al. regarding the use of high colloid pressure priming on cardiopulmonary bypass (CPB) [1].

The benefits of such therapeutic actions are important. However I would disagree with some of their conclusions.

The authors state in the conclusion that ‘...does not affect renal function more severely than in paediatric patients undergoing cardiac surgery on CPB with blood priming’, moreover in the discussion they mention that ‘According to our results, renal damage on CPB may be a temporary effect, which normalises quickly’.

It has been reported that in some paediatric populations undergoing CPB with blood priming, renal function does not deteriorate; on the contrary some of the specific tests used to study renal function in those patients show that renal function is well preserved [2].

As in adults, CPB in paediatric patients has not been shown to be an independent risk factor for renal dysfunction or acute renal failure [3]. The focus should be the postoperative period with all the haemodynamic changes and the therapeutic manoeuvres that patients go through. To our knowledge there is no study, so far, showing specific data from that complex surgical period.

Footnotes

The authors of the original paper [1] were invited to reply to this Letter to the Editor but they did not respond.

References

1. Loeffelbein F, Zirell U, Benk C, Schlensak C, Dittrich S. High colloid oncotic pressure priming of cardiopulmonary bypass in neonates and infants: implications on haemofiltration, weight and renal function. Eur J Cardiothorac Surg 2008;34:648-652.[Abstract/Free Full Text]
2. Lema G, Vogel A, Canessa R, Jalil R, Carvajal C, Becker P, Jaque MP, Fajardo C, Urzua J. Renal function and cardiopulmonary bypass in pediatric cardiac surgical patients. Pediatr Nephrol 2006;21:1446-1451.[CrossRef][Medline]
3. Lema G, Vogel A, Canessa R. Cardiopulmonary bypass as a risk factor in paediatric cardiac surgical patients. Acta Anaesthesiol Scan 2008;52:720-721.[Medline]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lema, G. Search for Related Content PubMed Articles by Lema, G. Related Collections Anesthesia Cardiac - other Congenital - acyanotic Extracorporeal circulation