• C Scott Brudney, Peter Gosling, and Mav Manji.
• Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA. Charles.Brudney@Duke.edu
• J. Cardiothorac. Vasc. Anesth. 2005 Apr 1; 19 (2): 188-92.

ObjectiveThe purpose of this study was to compare perioperative capillary permeability during cardiac surgery with subsequent pulmonary and renal function.DesignAn observational prospective comparison of capillary permeability (microalbuminuria) during and after cardiopulmonary bypass (CPB), with postoperative pulmonary and renal function.SettingA university teaching hospital.ParticipantsForty patients, mean (range) age 67.8 (50-85) years, undergoing elective first-time coronary artery bypass grafting (CABG).InterventionsUrine albumin concentration (AC) and albumin creatinine ratio (ACR) were compared with PO2 /FIO2 ratio, mechanical ventilation (intermittent positive-pressure ventilation [IPPV]) duration, and renal function.Measurements And Main ResultsMedian (range) AC and ACR increased from 8.3 (1.6-184.2) mg/L and 0.65 (0.1-18.8) mg/mmol preoperatively to 13.6 (1.6-267.2) mg/L and 4.80 (0.3-54.2) mg/mmol 10 minutes postbypass (p = 0.003 for ACR Wilcoxon rank test: not significant for AC). AC 2 hours postbypass was associated with mean PO2 /FIO2 ratio 0 to 2 hours postbypass and AC 4 hours postbypass was associated with mean PO2 /FIO2 ratio 0 to 2 and 2 to 12 hours postbypass (p < 0.05 Spearman). ACR 2 hours postbypass was associated with mean PO2 /FIO2 ratio 0 to 2 and 2 to 12 hours postbypass (p < 0.05 Spearman). AC 10 minutes and 2 hours postbypass and ACR 2 hours postbypass were associated with the duration of IPPV (p < 0.03). Day 1 serum creatinine was associated with pre- and 4 hours postbypass AC and ACR (p < 0.05). Day 2 serum creatinine was associated with 2 and 4 hours postbypass ACR (p < 0.05).ConclusionsThe magnitude of increase in capillary permeability during CABG is associated with later pulmonary and renal function.

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