Study of Low-Volume Fluid Replacement During Acute Normovolemic Hemodilution in Adults Undergoing Coronary Artery Bypass Surgery to Assess Kidney Injury Risk

What this Trial Is About

Researchers are investigating the use of acute normovolemic hemodilution ANH during elective coronary artery bypass graft CABG surgery to evaluate its effect on kidney injury risk. ANH is a blood conservation technique where some blood is removed before surgery and given back after, aiming to reduce blood transfusions and related complications. The study focuses on adult patients under 70 years old undergoing CABG with anticipated cardiopulmonary bypass CPB under two hours. The study randomly assigns participants to two groups one managed with ANH involving blood removal at 12cckg and volume replacement with balanced crystalloid solution, and the other managed without ANH receiving a 7cckg bolus of balanced crystalloid before CPB. Blood removed in the ANH group is stored at room temperature during surgery and returned after CPB. Both groups receive standard perioperative management following hospital protocols. Participants will be monitored for urinary biomarkers NGAL and KIM-1 within 24 hours as primary outcomes to assess kidney injury, with secondary outcomes including acute kidney injury defined by KDIGO criteria within 72 hours. The study excludes patients with significant kidney, heart, liver, lung conditions, or bleeding disorders, weighing less than 70kg or with low hemoglobin. The total study duration and follow-up are aligned with perioperative and early postoperative periods to evaluate kidney injury risks related to ANH.

Acute Normovolemic Hemodilution on Urine Neutrophil Gelatinase-associated Lipocalin Levels