Elevated Renal Oxygen Extraction During Open Abdominal Aortic Aneurysm Repair Is Related to Postoperative Renal Dysfunction

Abstract

Kidney function was affected after open abdominal aortic aneurysm repair likely related to limited renal blood flow. We take the increase in renal oxygen extraction and reduction in frontal lobe oxygenation to suggest that mean arterial pressure and hemoglobin were too low to maintain renal and cerebral circulation in vascular surgical patients.

Renal Hemodynamics, Function, and Oxygenation in Critically Ill Patients and after Major Surgery

“…Impaired renal oxygenation measured by renal vein catheterization is associated with tubular injury and increased postoperative creatinine levels (50,60). However, invasive measurements may be technically challenging, and the method is not suitable for general use.…”

Renal Near-Infrared Spectroscopy for Assessment of Renal Oxygenation in Adults Undergoing Cardiac Surgery: A Method Validation Study

“…Impaired renal oxygenation measured by renal vein catheterization is associated with tubular injury 6 and increased postoperative creatinine levels. 7,8 However, invasive measurements may be technically challenging, and the method is not suitable for general use. Near-infrared spectroscopy (NIRS) is a noninvasive, optical technique that continuously measures the difference between oxygenated and deoxygenated hemoglobin within a regional tissue area, thus obtaining regional oxygen saturation (rSO 2 ).…”

Adding Value by Going Beyond

“…The last original article by Olesen and colleagues, from Rigshospitalet in Copenhagen, Denmark, describes an interesting approach to investigating mechanisms involved in the occurrence of acute kidney injury after open abdominal aortic aneurysm repair. 15 The authors determined renal oxygen extraction via renal arterial and venous catheterization and correlated that data with intraoperative presence of decreased cerebral oxygen saturation measured by near-infrared spectroscopy. An increased renal oxygen extraction was associated with postoperative increase in serum creatinine.…”