• Gautam M Sreeram, Hilary P Grocott, William D White, Mark F Newman, and Mark Stafford-Smith.
• Department of Anesthesiology, Duke Heart Center, Duke University Medical Center, Durham, NC, USA. sreer001@mc.duke.edu
• J. Cardiothorac. Vasc. Anesth. 2004 Oct 1; 18 (5): 548-51.

ObjectiveTo examine the correlation between transcranial Doppler ultrasonography-detected emboli during coronary artery bypass graft surgery with cardiopulmonary bypass and renal dysfunction as determined by the postoperative change in creatinine.DesignRetrospective review of data from the anesthesia and cardiothoracic surgery databases.SettingTertiary care university hospital.ParticipantsTwo hundred eighty-six patients undergoing coronary artery bypass graft surgery.InterventionsTranscranial Doppler ultrasonography of the right middle cerebral artery was performed after induction of general anesthesia through completion of the operation. Doppler signals were recorded and emboli counts determined using an automated counting system.Measurements And Main ResultsRenal dysfunction was assessed as the change in creatinine from the preoperative value to the maximum postoperative value (Delta-Cr). There was a significant (p = 0.0003) univariate correlation between postoperative change in creatinine and total number of Doppler-detected emboli. The effect of total number of emboli remained significant (p = 0.0038) in the multivariable analysis after adjustment for covariables (age, sex, number of grafts, left ventricular ejection fraction, hypertension, history of congestive heart failure, diabetes, cardiopulmonary bypass time, preoperative creatinine, and maximum postoperative creatinine).ConclusionsIncreased numbers of Doppler-detected emboli during coronary artery bypass graft surgery are associated with postoperative renal dysfunction.

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