Targeted Blood-pressure Management and Acute Kidney Injury After Coronary Artery Bypass Surgery

Condition(s) studied

Investigational drug(s) / intervention(s)

Targeted blood-pressure management: Prophylactic norepinephrine infusion is started before anesthetic induction and maintained throughout surgery. The target is to maintain systolic blood pressure at 110 mmHg or higher.

Routine blood-pressure management: Phenylephrine (25-50 ug) is injected or vasopressors is infused only when necessary. The target is to maintain systolic blood pressure at 90 mmHg or higher during surgery.

Study summary

Acute renal injury (AKI) is a common complication after cardiac surgery and is associated with worse outcomes. It is now realized that intraoperative hypotension is an important risk factor for the development of AKI. In a recent randomized controlled trial of patients undergoing major noncardiac surgery, intraoperative individualized blood-pressure management reduced the incidence of postoperative organ dysfunction. The investigators hypothesize that, for patients undergoing off-pump CABG, targeted blood-pressure management during surgery may also reduce the incidence of postoperative AKI.

Eligibility

Primary outcome measure(s)

• Incidence of acute kidney injury (AKI) within 7 days after surgery — Up to 7 days after surgery
  Development of AKI within 7 days after surgery is diagnosed according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria

Trial sites (1)

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