&lt;p&gt;Acute kidney injury after cardiac surgery: prevalence, impact and management challenges&lt;/p&gt;

Vives, Marc; Hernández, Arelys Falcón; Parramón, F; Estanyol, Nuria; Pardina, Berta; Múñoz, Alfredo; Alvarez, Pablo; Hernández, Carmen

doi:10.2147/ijnrd.s167477

Cited by 135 publications

(126 citation statements)

References 103 publications

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“…AKI occurs in around 30% of cardiac surgery patients and is associated with increased ICU stay, healthcare costs, and mortality 150,151 . A retrospective analysis of a cardiac surgery cohort identified perioperative transfusion of packed red blood cells and postoperative use of furosemide as modifiable risk factors for AKI 152 .…”

Section: Human Albumin Solution For Renal Protectionmentioning

confidence: 99%

Phases of fluid management and the roles of human albumin solution in perioperative and critically ill patients

Wiedermann¹

2020

Current Medical Research and Opinion

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Objective: Positive fluid balance is common among critically ill patients and leads to worse outcomes, particularly in sepsis, acute respiratory distress syndrome, and acute kidney injury. Restrictive fluid infusion and active removal of accumulated fluid are being studied as approaches to prevent and treat fluid overload. Use of human albumin solutions has been investigated in different phases of restrictive fluid resuscitation, and this narrative literature review was undertaken to evaluate hypoalbuminemia and the roles of human serum albumin with respect to hypovolemia and its management.

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Section: Human Albumin Solution For Renal Protectionmentioning

confidence: 99%

Phases of fluid management and the roles of human albumin solution in perioperative and critically ill patients

Wiedermann¹

2020

Current Medical Research and Opinion

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“…A idade avançada também é reconhecida como fator de risco para LRA 4,18 , dada redução fisiológica do fluxo sanguíneo renal e a menor capacidade de adaptação hemodinâmica desses pacientes, quando expostos a CEC e drogas nefrotóxicas 19 . O tempo prolongado de CEC tem se mostrado como uma das principais causas de LRA no pós-operatório de cirúrgica cardíaca 20 , além de predispor a redução de hemoglobina e deflagração da necessidade de transfusão de hemocomponentes, exacerbando risco de comprometimento renal 21 .…”

Section: Discussionunclassified

Redução de hemoglobina: risco para lesão renal aguda após revascularização do miocárdio

et al. 2020

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Objetivo: verificar se a redução da taxa de hemoglobina no pós-operatório de revascularização do miocárdio interfere na função renal dos pacientes. Método: estudo observacional e prospectivo, desenvolvido entre fevereiro e junho de 2016, com 51 pacientes que realizaram cirurgia de revascularização do miocárdio em um hospital especializado em cardiologia do Distrito Federal. Os dados foram coletados por meio de um instrumento estruturado. O teste exato de Fisher, Qui-quadrado e Kruskal-Wallis foram empregados para análise estatística. Considerou-se significativo resultados com p≤0,05. Projeto de pesquisa aprovado pelo Comitê de Ética, protocolo 44999215.9.0000.0026. Resultados: Entre os pacientes, 45 (78,9%) evoluíram com lesão renal aguda após revascularização do miocárdio. Idade mais elevada (64±9 anos, p=0,05), tempo de circulação extracorpórea (p=0,05), índice de massa corporal (p=0,02), uso de antibióticos (p=0,03) e redução da taxa de hemoglobina (p=0,04), contribuíram para lesão renal aguda. Conclusão: a redução da taxa de hemoglobina foi associada estatisticamente à lesão renal aguda após revascularização do miocárdio.

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“…Multiple factors, including pre-, intra-, and post-cardiac surgery, make the kidney susceptible to injury, which is known as cardiac surgery-associated acute kidney injury (CSA-AKI) (2). There are more than 30 different diagnostic criteria for CSA-AKI such as RIFLE, KDIGO, AKIN, etc., resulting in different ranges of CSA-AKI incidence, up to 30% in the literature (3). Recently, new CSA-AKI markers such as neutrophil gelatinase-associated lipocalin (NGAL) have been discovered, but the common criteria for diagnosis are still based on the increase of plasma creatinine levels (4).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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.

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<p>Acute kidney injury after cardiac surgery: prevalence, impact and management challenges</p>

Cited by 135 publications

References 103 publications

Phases of fluid management and the roles of human albumin solution in perioperative and critically ill patients

Phases of fluid management and the roles of human albumin solution in perioperative and critically ill patients

Redução de hemoglobina: risco para lesão renal aguda após revascularização do miocárdio

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

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