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Effect of a Single Bolus of Erythropoietin on Renoprotection in Patients Undergoing Thoracic Aortic Surgery With Moderate Hypothermic Circulatory Arrest

 Ji Eun Kim  ;  Suk Won Song  ;  Jong Yeop Kim  ;  Hyun Joo Lee  ;  Kum-Hee Chung  ;  Yon Hee Shim 
 ANNALS OF THORACIC SURGERY, Vol.101(2) : 690-696, 2016 
Journal Title
Issue Date
Acute Kidney Injury/etiology* ; Acute Kidney Injury/prevention & control* ; Adult ; Aged ; Aged, 80 and over ; Circulatory Arrest, Deep Hypothermia Induced/adverse effects* ; Circulatory Arrest, Deep Hypothermia Induced/methods ; Double-Blind Method ; Erythropoietin/administration & dosage* ; Female ; Humans ; Male ; Middle Aged
BACKGROUND: Acute kidney injury (AKI) is associated with high morbidity and mortality. Recombinant human erythropoietin has been shown to exert cytoprotection against ischemia. This study examined the effect of erythropoietin in preventing AKI during thoracic aortic surgery with moderate hypothermic circulatory arrest.
METHODS: In this double-blind, randomized study, 66 patients undergoing thoracic aortic surgery with moderate hypothermic circulatory arrest (target temperature, 28°C) randomly received either erythropoietin 500 IU·kg(-1) or the same amount of normal saline intravenously after anesthesia induction. The primary endpoint was incidence of AKI defined according to the RIFLE criteria during the first 7 postoperative days.
RESULTS: AKI occurred in 60% of all patients. The two groups did not show any differences in the incidence and severity of AKI. Also, there was no difference in the level of serum neutrophil gelatinase-associated lipocalin between the groups. The cardiac index was higher in the erythropoietin group, however, immediately after weaning from cardiopulmonary bypass (p = 0.02). Furthermore, postoperative cardiac complications and prolonged vasopressor dependence were reduced in the erythropoietin group (p = 0.04 and p = 0.049, respectively).
CONCLUSIONS: A single bolus administration of erythropoietin 500 IU·kg(-1) at anesthesia induction failed to provide renoprotection in patients who underwent thoracic aortic surgery with moderate hypothermic circulatory arrest. However, erythropoietin significantly reduced cardiac complications, and lowered the incidence of prolonged vasopressor dependence.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ji Eun(김지은)
Song, Suk Won(송석원) ORCID logo https://orcid.org/0000-0002-9850-9707
Shim, Yon Hee(심연희) ORCID logo https://orcid.org/0000-0003-1921-3391
Lee, Hyun Joo(이현주)
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