Postępowanie w okresie okołooperacyjnym u chorych z ryzykiem wystąpienia ostrego uszkodzenia nerek, poddawanych operacjom kardiochirurgicznym

Krzych, Łukasz J.; Wybraniec, Maciej T.; Chudek, Jerzy; Bochenek, Andrzej

doi:10.5603/ait.2013.0033

Cited by 5 publications

(2 citation statements)

References 66 publications

(75 reference statements)

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“…Accordingly, individuals, who had a higher score, were at a higher risk of AKI. Age, primary disease of the kidney, renal artery disease, hypertension, and atherosclerosis have been identified in other studies as risk factors ( 1 , 3 , 13 , 15 ).…”

Section: Introductionmentioning

confidence: 89%

Evaluation of the Effect of Aminophylline in Reducing the Incidence of Acute Kidney Injury After Cardiac Surgery

2017

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ObjectivesAcute renal failure is a common complication of major cardiovascular surgeries (One-third of patients). Adenosine release as a vascular vasodilator increases after cardiac surgery, which reduces renal and glomerular blood flow and subsequently causes kidney ischemic damage. The present study aimed at evaluating the impact of aminophylline as an adenosine receptor antagonist on renal function after cardiac surgery hoping to find an appropriate method to reduce acute kidney injury.MethodsThe patients in the intervention group received 5 mg/kg aminophylline bolus after induction of anesthesia; then, 0.25 mg/kg/hr of the drug was administered intraoperatively and up to 48 hours after surgery in the ICU cardiac surgery. Similar volume of normal saline was injected to the patients of the second group. Serum BUN, Cr, and GFR were measured pre- and postoperatively and 3 days postsurgery. Patients’ 24- hour urine output and RIFLE were also calculated.ResultsThose patients who received medication were extubated earlier (P = 0.018) and received lower amount of inotropic drugs (P < 0001). According to the RIFLE criteria, most of the patients experienced no change or even improved GFR and Cr amounts compared to the control group (p < 0.05). GFR and Cr value of all the patients with Cleveland score, less and more than 6, showed a significant difference between the 2 groups (P = 0.001 and P = 0.01, respectively). According to the RIFLE criteria, most of the patients experienced no change or even improved GFR.ConclusionsAminophylline in cardiac surgery can reduce the frequency of acute kidney injury according to RIFLE criteria and could be used in the prevention of AKI as a safe and efficient modality in high-risk patients. Also, the use of this drug may reduce the need for inotropic medication at the time of surgery, intensive care unit stay length, and extubation time.

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Section: Introductionmentioning

confidence: 89%

Evaluation of the Effect of Aminophylline in Reducing the Incidence of Acute Kidney Injury After Cardiac Surgery

2017

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“…The protocol contains 22 rules (Fig. 1), which seem very logical and are almost intuitively chosen by us; however, they are not always strictly followed in everyday perioperative care [27][28][29][30]. A single intervention will not affect the treatment outcomes; only consistent and synergistic use of interventions results in good effects.…”

Section: Enhanced Recovery After Surgerymentioning

confidence: 99%

It is time for enhanced recovery after surgery in cardiac surgery

Krzych

Kucewicz‐Czech²

2017

Kardiol Pol

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Acute kidney injury after pediatric cardiac surgery

Yuan

2019

Pediatrics & Neonatology

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Acute kidney injury (AKI) is a common complication of pediatric cardiac surgery and is associated with increased morbidity and mortality. Literature of AKI after pediatric cardiac surgery is comprehensively reviewed in terms of incidence, risk factors, biomarkers, treatment and prognosis. The novel RIFLE (pediatric RIFLE for pediatrics), Acute Kidney Injury Network (AKIN) and Kidney Disease Improving Global Outcomes (KDIGO) criteria have brought about unified diagnostic standards and comparable results for AKI after cardiac surgery. Numerous risk factors, either renal or extrarenal, can be responsible for the development of AKI after cardiac surgery, with low cardiac output syndrome being the most pronounced predictor. Early fluid overload is also crucial for the occurrence of AKI and prognosis in pediatric patients. Three sensitive biomarkers, neutrophil gelatinase-associated lipocalin, cystatin C (CysC) and liver fatty acid-binding protein, are regarded as the earliest (increase at 2-4 h), and another two, kidney injury molecule-1 and interleukin-18 represent the intermediate respondents (increase at 6-12 h after surgery). To ameliorate the cardiopulmonary bypass techniques, improve renal perfusion and eradicate the causative risk factors are imperative for the prevention of AKI in pediatric patients. The early and intermediate biomarkers are helpful for an early judgment of occurrence of postoperative AKI. Improved survival has been achieved by prevention, renal support and modifications of hemofiltration techniques. Further development is anticipated in small children.

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Postępowanie w okresie okołooperacyjnym u chorych z ryzykiem wystąpienia ostrego uszkodzenia nerek, poddawanych operacjom kardiochirurgicznym

Cited by 5 publications

References 66 publications

Evaluation of the Effect of Aminophylline in Reducing the Incidence of Acute Kidney Injury After Cardiac Surgery

Evaluation of the Effect of Aminophylline in Reducing the Incidence of Acute Kidney Injury After Cardiac Surgery

It is time for enhanced recovery after surgery in cardiac surgery

Acute kidney injury after pediatric cardiac surgery

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