Central Venous Pressure and acute kidney injury in off-pump coronary artery bypass grafting

Abstract

A retrospective study investigated the relationship between Central Venous Pressure (CVP) levels during off-pump coronary artery bypass grafting (CABG) surgery and postoperative outcomes including Acute Kidney Injury (AKI), Low Cardiac Output Syndrome (LCOS), re-intubation, and in-hospital mortality. Data from 1,146 OPCABG cases from two hospitals were analyzed. Patients were divided into high CVP (≥ 10.1 mmHg) and low CVP (< 10.1 mmHg) groups based on Receiver Operating Characteristic (ROC) curve analysis. The high CVP group had significantly higher rates of AKI (47.21% vs. 20.04%) and LCOS (8.93% vs. 3.08%) compared to the low CVP group. An intraoperative CVP ≥ 10.1 mmHg was identified as an independent risk factor for post-OPCABG AKI. The multivariable regression model showed a 40% increased risk of AKI with CVP > 10.1 mmHg (OR: 1.434, p < 0.001). This study suggests that maintaining an average intraoperative CVP < 10.1 mmHg may help reduce the risk of OPCABG-associated AKI.