Comparison of Renal Function in Coronary Artery Bypass Graft Surgery with Pulsatile versus Non-pulsatile Perfusion: A Randomized Clinical Trial

Background: Despite numerous studies on tissue perfusion, capillary circulation, and their related factors, there is still no consensus on the utilization of pulsatile versus non-pulsatile perfusion methods to provide proper perfusion in patients undergoing Coronary Artery Bypass Graft (CABG) surgery.
Objectives: This study aimed to compare the effects of pulsatile versus non-pulsatile perfusion methods on renal function in patients undergoing CABG surgery in Shahid Mohammadi hospital, Bandar Abbas, Iran in 2018.
Methods: In this randomized clinical trial, 50 patients aged > 18 years who underwent CABG surgery were randomly divided into a pulsatile and a non-pulsatile group (n = 25 in each group). The two groups were compared in terms of laboratory findings including the plasma levels potassium, sodium, creatinine, and blood urea nitrogen, Glomerular Filtration Rate (GFR), urinary output, and ejection fraction.
Results: The results revealed a significant difference between the two groups regarding the trend of GFR changes during the study (P = 0.01). Accordingly, postoperative GFR increased more in the pulsatile group than in the non-pulsatile group. Moreover, creatinine and blood urea nitrogen levels reduced in the pulsatile group compared to the baseline. However, no significant differences were observed in the mean levels of potassium, sodium, and creatinine, urinary output, and ejection fraction in the two groups before and after the surgery.
Conclusions: According to the results, pulsatile method was preferred to the non-pulsatile perfusion method due to its positive effects on creatinine and blood urea nitrogen levels as well as on GFR during and after the CABG surgery.