Renal Replacement Therapy in Adult Patients After Cardiac Surgery

Borisov, A. S.; Malov, Andrey A.; Колесников, С. В.; Ломиворотов, В. В.

doi:10.1053/j.jvca.2019.02.023

Cited by 8 publications

(6 citation statements)

References 157 publications

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“… 4 CRRT is generally preferred over intermittent hemodialysis in hemodynamically unstable patients. 5 A double lumen percutaneous hemodialysis catheter is the preferred access to establish CRRT. The preferred site for cannulation is the right IJV followed by the right or left femoral vein.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Placement of a Hemodialysis Catheter into the Distal Femoral Vein in a Patient with Multiple Catheters: A Case Report

Morishige¹,

Yamaguchi²,

Nakajima³

et al. 2022

IMCRJ

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Cardiac surgery-associated acute kidney injury may require postoperative renal replacement therapy. Although the right internal jugular vein and femoral veins are generally the preferred insertion sites for the hemodialysis catheter for continuous renal replacement therapy, the presence of other indwelling catheters or prior thrombotic events from previous catheters may preclude use of these sites. We present a case in which the hemodialysis catheter was inserted into the distal femoral vein using point-of-care ultrasound in a patient with multiple catheter insertions after coronary artery bypass grafting. Although the tip of the dialysis catheter was more distal than the classic femoral approach, renal replacement therapy was performed without problems. Moreover, it was easier for the nurses to keep the insertion site clean and to change the patient’s position.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Placement of a Hemodialysis Catheter into the Distal Femoral Vein in a Patient with Multiple Catheters: A Case Report

Morishige¹,

Yamaguchi²,

Nakajima³

et al. 2022

IMCRJ

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“…]20 Kg. CRRT is the mode of choice over conventional hemodialysis for post operative cardiac surgery patients due to improved hemodynamic tolerance 14 .…”

Section: Commentsmentioning

confidence: 99%

The Use of Ultrafiltration in High-Risk Post-operative Coronary Artery Bypass Grafting Patients.

Beckles

Tavilla

Malhotra

et al. 2022

Preprint

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Abstract:Background: Fluid overload (FO) and acute kidney injury (AKI) after CABG surgery are due to multiple perioperative etiologies associated with high failure to rescue rates (FTR) and associated with poor outcomes . Diuretics, fluid restriction, ultrafiltration (UF) and renal replacement therapies are the treatment modalities implemented as monotherapy or in combination to address this severe complication. There is limited data on the use of simplified UF therapy as a fluid management strategy in post-operative cardiac surgery patients. Methods: A retrospective review of our post operative isolated CABG patients was done from Jan 1 , 2020 to July 31 , 2021. Those subjected to a simplified UF protocol incorporating Goal Directed Therapy (GDT) to treat fluid overload and/or acute kidney injury were evaluated for 30-day survival and readmission rates. Results: A total of 254 isolated CABG procedures were performed during this period. Ultrafiltration was used in 17 (6.7%) patients. The 30-day mortality for the entire CABG cohort was 5/254 (2.0%) patients and in the UF group 0/17 (0%). The mean age of UF therapy patients was 65.8 years (Range 41-89). The mean Society of Thoracic Surgeons STS mortality score of UF patients was 5.7% (Range 0.6-50.0). The 30-day survival for the 17 patients placed on UF therapy was 100% and their readmission rate was 2/17 (11.7%). Conclusions: The use of ultrafiltration in this patient population with relatively high STS scores provided a safe and effective modality to manage fluid balance but further studies are needed.

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“…CVVH is the preferred choice over conventional HD for postoperative cardiac surgery patients due to improved hemodynamic tolerance. 14 Adult cardiac surgery patients mostly present acutely after many years of chronic medical conditions and modifiable risk factors, including HTN, DM, obesity, hyperlipidemia, physical inactivity, and smoking. HTN and DM were seen in 88% and 76% of our 17 UF patients, respectively.…”

Section: Clinical Case: Patient #12mentioning

confidence: 99%

The use of simple ultrafiltration technology as a fluid management strategy for high‐risk coronary artery bypass grafting surgery

Beckles

Tavilla

Malhotra

et al. 2022

Journal of Cardiac Surgery

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Renal Replacement Therapy in Adult Patients After Cardiac Surgery

Cited by 8 publications

References 157 publications

Ultrasound-Guided Placement of a Hemodialysis Catheter into the Distal Femoral Vein in a Patient with Multiple Catheters: A Case Report

Ultrasound-Guided Placement of a Hemodialysis Catheter into the Distal Femoral Vein in a Patient with Multiple Catheters: A Case Report

The Use of Ultrafiltration in High-Risk Post-operative Coronary Artery Bypass Grafting Patients.

The use of simple ultrafiltration technology as a fluid management strategy for high‐risk coronary artery bypass grafting surgery

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