医学
急性肾损伤
围手术期
心脏外科
肾脏疾病
重症监护医学
并发症
入射(几何)
内科学
心脏病学
外科
物理
光学
作者
Sreekanth Cheruku,Jacob Raphael,Javier A. Neyra,Amanda A. Fox
出处
期刊:Anesthesiology
[Lippincott Williams & Wilkins]
日期:2023-10-09
卷期号:139 (6): 880-898
被引量:45
标识
DOI:10.1097/aln.0000000000004734
摘要
Acute kidney injury (AKI) is a common complication in cardiac surgery patients, with a reported incidence of 20 to 30%. The development of AKI is associated with worse short- and long-term mortality, and longer hospital length of stay. The pathogenesis of cardiac surgery–associated AKI is poorly understood but likely involves an interplay between preoperative comorbidities and perioperative stressors. AKI is commonly diagnosed by using increases in serum creatinine or decreased urine output and staged using a standardized definition such as the Kidney Disease Improving Global Outcomes classification. Novel biomarkers under investigation may provide earlier detection and better prediction of AKI, enabling mitigating therapies early in the perioperative period. Recent clinical trials of cardiac surgery patients have demonstrated the benefit of goal-directed oxygen delivery, avoidance of hyperthermic perfusion and specific fluid and medication strategies. This review article highlights both advances and limitations regarding the prevention, prediction, and treatment of cardiac surgery–associated AKI.
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