Posts Tagged ‘AKI’
41st Annual Cardiothoracic Surgery Symposium (CREF 2022)
The 41st Annual Cardiothoracic Surgery Symposium (CREF 2022) offers cutting-edge presentations, interactive discussions and debates, hands-on workshops, and extracurricular education on topics related to cardiac surgery, cardiopulmonary bypass, extracorporeal perfusion, and extracorporeal life support. It offers Category 1 CME and CEU credits, meeting the specific educational needs of CVOR and CVICU teams: cardiac anesthesiologists, cardiac…
Read MoreThe Role of Race on Acute Kidney Injury Following Cardiac Surgery
Despite accounting for differences in risk factors and intra-operative practices, Black patients had a 50% increased odds for developing moderate-severe post-operative AKI compared to White patients. Additional evaluations are warranted to identify potential targets to address racial disparities in AKI outcomes.
Read MoreProlonged Blood Storage and Risk of Posttransfusion Acute Kidney Injury
In a population of patients without severely impaired baseline renal function receiving fewer than 10 erythrocyte units, duration of blood storage had no effect on the incidence of posttransfusion acute kidney injury.
Read MorePlasma from Patients Undergoing Coronary Artery Bypass Graft Surgery Does Not Activate Endothelial Cells under Shear Stress in Vitro
Patients undergoing CPB surgery showed mild systemic inflammation and kidney injury. However, the plasma components did not stimulate endothelial inflammation and adhesion molecule expression in vitro.
Read MoreImpact of Partial Pressure of Oxygen Trajectories on the Incidence of Acute Kidney Injury in Patients Undergoing Cardiopulmonary Bypass
Patients with persistent hyperoxia had a higher incidence of AKI than those with transient hyperoxia. Further studies are required to determine potential underlying mechanisms.
Read MoreUltrafiltration and Cardiopulmonary Bypass Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis
UF in cardiac surgery is not associated with increased AKI incidence and may be safely used even in baseline chronic injury patients.
Read MoreLow Mean Arterial Pressure During Cardiopulmonary Bypass and the Risk of Acute Kidney Injury: A Propensity Score Matched Observational Study
Low MAP periods during CPB are associated with an increased occurrence of post-operative AKI, leading to 1) higher creatinine levels; 2) decreased GFR and 3) longer ICU and ward lengths of stay. Both consecutive and cumulative periods of low MAP are associated with an increased risk of AKI. MAP appears to be an important contributor to post-operative AKI and should be carefully managed during CPB. Further studies must address if MAP variations lead to definitive and long-term consequences.
Read MoreAssociation Between Exogenous Nitric Oxide Given During Cardiopulmonary Bypass and the Incidence of Postoperative Kidney Injury in Children
This single-center, retrospective, cohort study found no change in the incidence and severity of postoperative AKI after the administration of nitric oxide into the cardiopulmonary bypass circuit in children.
Read MoreStrategies to Prevent Acute Kidney Injury after Pediatric Cardiac Surgery – A Network Meta-Analysis
Current evidence from randomized controlled trials does not support the efficacy of most strategies to prevent AKI in the pediatric population, apart from limited evidence for dexmedetomidine and remote ischemic preconditioning.
Read MoreBrain and Muscle Oxygen Saturation Combined with Kidney Injury Biomarkers Predict Cardiac Surgery Related Acute Kidney Injury
Brain and muscle oxygen saturation 20 min after CPB could be considered early parameters possibly related to CS-AKI risk, especially in patients with increased cystatin C and NGAL levels.
Read MoreEarly Biochemical Markers in the Assessment of Acute Kidney Injury in Children after Cardiac Surgery
We showed that plasma CysC and urinary NGAL could reliably predict the development of acute kidney injury. Measurement of early biochemical markers in plasma and urine, individually and combination, may predict the development of cardiac surgery-associated acute kidney injury in children.
Read MorePrevention of Cardiac Surgery–Associated Acute Kidney Injury by Implementing the KDIGO Guidelines in High-Risk Patients Identified by Biomarkers: The PrevAKI-Multicenter Randomized Controlled Trial
Implementation of a KDIGO-derived treatment bundle is feasible in a multinational setting. Furthermore, moderate to severe AKI was significantly reduced in the intervention group.
Read MoreAcute Kidney Injury in Extracorporeal Membrane Oxygenation Patients: National Analysis of Impact of Age
AKI is common and is increasing among patients on ECMO support. Patients on ECMO have high mortality and AKI is an independent predictor of mortality. Though age is also an independent predictor of mortality in patients on ECMO, it is neither a predictor of AKI nor does not modify the relationship between AKI and mortality.
Read MoreBlood Pressure Variability during Pediatric Cardiac Surgery is Associated with Acute Kidney Injury
Greater BPV during cardiac surgery with CPB was associated with development of postoperative AKI in infants, suggesting that BPV is a potentially modifiable risk factor for AKI in this high-risk population.
Read MoreBalanced Forced-Diuresis as A Renal Protective Approach in Cardiac Surgery: Secondary Outcomes of Electrolyte Changes
Balanced forced-diuresis with the RG reduced AKI rates after on-pump cardiac surgery compared to controls. Although the RG group required higher doses of IV potassium replacement in the postoperative period, normal serum levels of potassium were maintained by appropriate intravenous potassium supplementation and the clinical outcomes between groups were similar.
Read MoreAcute Kidney Injury During Extracorporeal Membrane Oxygenation: VA ECMO Versus VV ECMO
Although mortality rates related to AKI/severe AKI during VV ECMO are high, the occurrence of AKI/severe AKI during VA ECMO should be given greater attention, as these instances are considered strong indicators of patient deterioration and even death. Additional studies are needed to corroborate these findings.
Read MoreThe Association of Matrix Metalloproteinases With Acute Kidney Injury Following CPB-Supported Cardiac Surgery
Although the pilot study may have limitations, it has demonstrated that the serum and urine levels of activity of MMP-2 and MMP-9 are associated with the clinical endpoint of AKI and appear to have earlier rising levels as compared with those of serum creatinine. Furthermore, in depth, exploration is underway with a larger sample size to attempt validation of the analytical performance and reproducibility of the assay for MMP-2 and MMP-9 to aid in earlier diagnosis of AKI following CPB-supported cardiac surgery.
Read MoreThe Albumin-to-Fibrinogen Ratio Independently Predicts Acute Kidney Injury in Infants With Ventricular Septal Defect Undergoing Cardiac Surgery With Cardiopulmonary Bypass
This study demonstrated that a low AFR (<9.35) during CPB was an independent risk factor for AKI in VSD infants following cardiac surgery with CPB.
Read MoreCosts And Consequences of Acute Kidney Injury after Cardiac Surgery: A Cohort Study
AKI remains an important indicator of mortality and health care costs postcardiac surgery.
Read MoreIntraoperative Renal Hypoxia and Risk of Cardiac Surgery-Associated Acute Kidney Injury
Intraoperative change in pEPO does not predict AKI. However, UPO2 shows promise, particularly in patients with higher risk of operative mortality. The disparity between these two markers of renal hypoxia may indicate that UPO2 reflects medullary oxygenation whereas pEPO reflects cortical oxygenation.
Read MoreNoninvasive Urine Oxygen Monitoring and the Risk of Acute Kidney Injury in Cardiac Surgery
Low urinary oxygen partial pressures after CPB may be associated with the subsequent development of AKI after cardiac surgery.
Read MoreReversal of Renal Tissue Hypoxia During Experimental Cardiopulmonary Bypass in Sheep by Increased Pump Flow And Arterial Pressure
Renal hypoxia during experimental CPB can be corrected by increasing target pump flow and mean arterial pressure within a clinically feasible range.
Read MoreEffect of Strict Intraoperative Blood Pressure Management Strategy on Postoperative Acute Kidney Injury in Non-Cardiac Surgery: A Meta-Analysis of Randomised Controlled Trials
Strict BP management is significantly more effective than conventional therapy for the prevention of postoperative AKI. Supranormal target of intraoperative BP management may be considered a more appealing option for the prevention of AKI.
Read MoreIntermittent Urine Oxygen Tension Monitoring for Predicting Acute Kidney Injury After Cardiovascular Surgery: A Preliminary Prospective Observational Study
Intermittent PuO2 values at six and 12 hours after ICU admission may be predictors of AKI, although the AUCs to predict AKI were low (0.68 and 0.64). AKI prediction by PuO2 was not possible immediately after induction of general anesthesia (not statistically significant) and immediately after ICU admission (AUC was very low). Further studies are required to confirm the validity of intermittent PuO2 monitoring.
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