1998 Volume 31 Issue 12 Pages 1443-1448
Between January 1996 and August 1997, 13 hemodialyzed patients with chronic renal failure underwent open cardiac surgery. Ten of these patients had coronary artery bypass grafting, and 3 had valve replacement. They received 3-day hemodialysis in the preoperative period, intraoperative hemodialysis connected to cardiac pulmonary bypass (CPB), and continuous hemodiafiltration in the early postoperative period (HD group). The perioperative clinical parameters of the HD group were compared to those of 22 age-matched patients with normal renal function undergoing open cardiac surgery as controls (NRF group). When the perioperative variables were compared, no significant differences were seen in total operation time, CPB time or postoperative fasting time, but we noted significant increases in the mean volume of transfused blood for 6 days before the operation, postoperative intubation time, and time spent in the intensive care unit. Levels of central venous pressure, systolic blood pressure and daily fluid balance of the HD group were the same as the control in the early postoperative period. In addition, the levels of serum creatinine, urea nitrogen, potassium, and hematocrit of the HD group were mostly constant in the early postoperative period. The hospital mortality of the HD and NRF groups was 0%. In conclusion, our intensive perioperative dialysis program may successfully manage the perioperative clinical course of hemodialyzed patients with a slightly greater risk than that of patients with normal renal function undergoing open cardiac surgery.
