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…

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The 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.

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Low 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.

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Balanced 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.

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The 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.

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Intermittent 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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