Potential Reno-Protective Effect of Dexmedetomidine Versus N. Acetylcysteine Among Patients Undergoing Cardiac Surgery

Oraby, Mohamed Elzouk; Asida, Salah Mostafa; Mohamed, Hatem Saber; Abdel Zaher, Ahmed Yosof Ahmed; Ali, Abdallah Elaiw Mohamed

doi:10.21608/svuijm.2021.105368.1240

Potential Reno-Protective Effect of Dexmedetomidine Versus N. Acetylcysteine Among Patients Undergoing Cardiac Surgery

Document Type : Original research articles

Authors

¹ Department of Anesthesia, ICU and Pain management, Faculty of Medicine, South Valley University, Qena, Egypt

² Department of Clinical and Chemical Pathology, ICU and Pain management, Faculty of Medicine, South Valley University, Qena, Egypt

10.21608/svuijm.2021.105368.1240

Abstract

Background: Acute kidney injury (AKI) is one of the severe complications after cardiac surgeries, raising morbidities and mortalities.
Objectives: The study aimed to compare the potential reno-protective effect of continuous I.V infusion of Dexmedetomidine (DEX) and N-Acetylcysteine (NAC) among cases undergoing Cardiac surgeries.
Patients and Methods: This randomized, double-blind, placebo-controlled trial was done at Qena University Hospitals and Sohag Cardiac Institute in period between October 2019 to October 2021, including 90 cases listed for elective on pump open-heart surgeries.
Results: Regarding Urine Output(UOP), the DEX group showed a significantly higher UOP value than both NAC and placebo groups at day 1 postoperatively. Still on day 2 postoperatively, the DEX group showed a statistically significant higher UOP value than the placebo group only. Also, there were non-statistically significant differences between pre-operative and postoperative values in each group (between basal and final values). Regarding urinaryNeutrophil Gelatinase-associated Lipocalin (NGAL), there were non-statistically significant differences between groups at baseline, but the DEX group showed a significantly lower NGAL values than the placebo group at T1 and T2 postoperatively. Also, there were statistically significant differences between pre-operative and postoperative values in all groups.DEX group showed significantly lower postoperative AKI incidencethan placebo group.
Conclusion: DEX could have a more reno-protective effect among patients undergoing cardiac surgery than N-acetylcysteine or placebo. This was demonstrated by lower urinary NGAL level, raised UOP, and lower postoperative AKI among cases treated with DEX.

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