Hemmati Maslakpak Masumeh, Bilejani Eisa, Negargar Sohrab, Khalili Ahmadali, Alinejad Vahid, Faravan Amir
Maternal and Childhood Obesity Research Center, Nursing and Midwifery School, Urmia University of Medical, Urmia, Iran.
Department of Anesthesia, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
J Cardiovasc Thorac Res. 2024;16(3):146-151. doi: 10.34172/jcvtr.32992. Epub 2024 Sep 20.
Mannitol, an osmotic diuretic solution, is commonly utilized in priming cardiopulmonary bypass (CPB) and can impact kidney function. This study was conducted to investigate the impact of mannitol use during CPB on kidney function in patients undergoing coronary artery bypass surgery.
This randomized, double-blind clinical trial studied 90 patients undergoing coronary artery bypass surgery. In the control group (n=45), the prime solution included Ringer's lactate, and in the intervention group (n=45), the prime solution had 200 ml of mannitol 20% and Ringer's lactate. A -value<0.05 was considered significant. The primary endpoint of this study is renal function.
Demographic characteristics and risk factors were not significantly different between the two groups (>0.05). Additionally, there was no statistically significant difference between two groups in terms of CPB time, aortic cross-clamp time, length of time connected to mechanical ventilation, 30-day mortality, ICU, and hospital stay time (>0.05). Furthermore, no statistically significant difference was observed between the two groups in serum creatinine levels (=0.53) or BUN levels (=0.13). The study also found no statistically significant difference in the diuresis rate between the two groups (=0.10).
The present study has shown that adding mannitol to the prime has no effect on kidney function, length of time connected to mechanical ventilation, length of stay in the ICU, or 30-day mortality. Therefore, it suggests that mannitol cannot be used as a preventative strategy for acute kidney injury after cardiac surgery.
甘露醇是一种渗透性利尿溶液，常用于体外循环（CPB）预充，可能会影响肾功能。本研究旨在探讨CPB期间使用甘露醇对冠状动脉搭桥手术患者肾功能的影响。
这项随机、双盲临床试验研究了90例接受冠状动脉搭桥手术的患者。对照组（n = 45）的预充液为乳酸林格氏液，干预组（n = 45）的预充液为200 ml 20%甘露醇和乳酸林格氏液。P值<0.05被认为具有统计学意义。本研究的主要终点是肾功能。
两组间的人口统计学特征和危险因素无显著差异（P>0.05）。此外，两组在CPB时间、主动脉阻断时间、机械通气时间、30天死亡率、ICU停留时间和住院时间方面也无统计学显著差异（P>0.05）。此外，两组间血清肌酐水平（P = 0.53）或血尿素氮水平（P = 0.13）也无统计学显著差异。该研究还发现两组间的利尿率无统计学显著差异（P = 0.10）。
本研究表明，在预充液中添加甘露醇对肾功能、机械通气时间、ICU停留时间或30天死亡率没有影响。因此，这表明甘露醇不能用作心脏手术后急性肾损伤的预防策略。
