Investigating the Effect of Near Infra-Red Spectroscopy (NIRS) on Early Diagnosis of Cardiac Surgery-Associated Acute Kidney Injury

Abstract

Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a major adverse effect of cardiac surgery. The early detection of this complication can improve the quality of postoperative care and help prevent this phenomenon. Methods: In this prospective descriptive-analytical study, 148 patients were enrolled, 107 of whom were selected for analysis between February and September 2019 in the Cardiac Surgery Unit of Golestan Hospital, Ahvaz, Iran. Kidney tissue oxygen saturation was measured at multiple definite times during surgery. Hemoglobin, blood urea nitrogen, creatinine, and lactate were measured during and 48 hours after the surgery. Results: Forty-one patients were diagnosed with CSA-AKI according to the KDIGO criteria. Parametric and non-parametric analyses showed no significant difference between the CSA-AKI and non-CSA-AKI groups in the demographic parameters. Repeated measures ANOVA showed no significant difference in parameters, except for BUN. Repeated measures ANOVA showed a significant difference between both groups and time factors (P < 0.001, P = 0.0006, respectively). The ROC curve analyses showed that in a single point of time, the difference in the middle of CPB time from baseline had a high value in the prediction of AKI (AUC: 0.764; CI: 0.57 - 0.951). Conclusions: Kidney saturation monitoring could be considered in cardiac surgery for the rapid detection of CSA-AKI. Although kidney tissue saturation is not correlated directly to the arterial oxygen saturation, the physician and the surgery team can predict the chance of acute kidney injury.

Comparison of Bioimpedance Versus Pulse Contour Analysis for Intraoperative Cardiac Index Monitoring in Patients Undergoing Kidney Transplantation

“…Kidney transplantation is a high-risk surgery that requires hemodynamic monitoring to support goal-directed therapy, but transpulmonary thermodilution is not commonly used in kidney transplant surgery because of the risks posed by PAC insertion. Non-invasive approaches such as the bioimpedance method or near-infrared spectroscopy (NIRS) were proposed for global hemodynamic to regional kidney saturation monitoring to predict perioperative AKI ( 28 ). Bioimpedance cardiometry is a promising non-invasive technique for intraoperative hemodynamic monitoring ( 11 , 29 ).…”

Evaluation of the Relationship Between Changes in Potassium Concentration and Arrhythmia During Coronary Artery Bypass Grafting Surgery

“…During CPB, anesthesia was continued with continuous injections of anesthetics. In all patients, an attempt was made to main-tain the hematocrit of patients above 24 to 27%; for this purpose, blood was transfused if necessary (17). For this study, surgeons who used del Nido cardioplegia and had similar routines were used.…”

The Predictive Power of Near-Infrared Spectroscopy in Improving Cognitive Problems in Patients Undergoing Brain Surgeries: A Systematic Review

“…There have been several systematic reviews on various types of surgery. These studies have shown the positive role of this technology in preventing neurological complications (26)(27)(28)(29). However, since there is limited information on the use of NIRS in neurosurgical patients, this systematic review was carried out to review studies investigating the use of NIRS in the prevention of neurological complications during neurosurgery and postoperative care.…”