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Renal injury in cardiac surgery

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https://www.readbyqxmd.com/read/29891225/acute-kidney-injury-after-pediatric-cardiac-surgery
#1
REVIEW
Shi-Min Yuan
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...
March 30, 2018: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29886301/predictors-of-30-day-outcomes-in-octogenarians-with-traumatic-c2-fractures-undergoing-surgery
#2
John K Yue, Angel Ordaz, Ethan A Winkler, Hansen Deng, Catherine G Suen, John F Burke, Andrew K Chan, Geoffrey T Manley, Sanjay S Dhall, Phiroz E Tarapore
OBJECTIVE: Predictors of surgical outcomes following traumatic axis (C2) fractures in octogenarians remain undercharacterized. METHODS: Patients aged ≥80-years undergoing cervical spine surgery following traumatic C2 fractures were extracted from the National Sample Program of the National Trauma Data Bank (2003-2012). Outcomes include overall inpatient complications, individual complications >1% incidence, hospital length of stay (HLOS), discharge disposition, and mortality...
June 7, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29884141/sex-differences-in-acute-kidney-injury-requiring-dialysis
#3
Joel Neugarten, Ladan Golestaneh, Nitin V Kolhe
BACKGROUND: Female sex has been included as a risk factor in models developed to predict the risk of acute kidney injury (AKI) associated with cardiac surgery, aminoglycoside nephrotoxicity and contrast-induced nephropathy. The commentary acompanying the Kidney Disease Improving Global Outcomes Clinical Practice Guideline for Acute Kidney Injury concludes that female sex is a shared susceptibility factor for acute kidney injury based on observations that female sex is associated with the development of hospital-acquired acute kidney injury...
June 8, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29870383/clinical-outcomes-and-prognosis-markers-of-patients-with-liver-disease-undergoing-transcatheter-aortic-valve-replacement-a-propensity-score-matched-analysis
#4
Gabriela Tirado-Conte, Josep Rodés-Cabau, Ramón Rodríguez-Olivares, Marco Barbanti, Thibault Lhermusier, Ignacio Amat-Santos, Stefan Toggweiler, Asim N Cheema, Antonio J Muñoz-García, Vicenc Serra, Francesca Giordana, Gabriela Veiga, Pilar Jiménez-Quevedo, Francisco Campelo-Parada, Lucca Loretz, Denise Todaro, María Del Trigo, José M Hernández-García, Bruno García Del Blanco, Francesco Bruno, José M de la Torre Hernández, Pieter Stella, Corrado Tamburino, Carlos Macaya, Luis Nombela-Franco
BACKGROUND: Chronic liver disease is a known risk factor for perioperative morbidity and mortality in patients undergoing cardiac surgery. Very little data exist about such patients treated with transcatheter aortic valve replacement (TAVR). Our objective was to evaluate early and late clinical outcomes in a large cohort of patients with liver disease undergoing TAVR and to determine predictive factors of mortality among these patients. METHODS AND RESULTS: This multicenter study collected data from 114 patients with chronic liver disease who underwent TAVR in 12 institutions...
March 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29864792/rejuvenation-of-allogenic-red-cells-benefits-and-risks
#5
REVIEW
H Aujla, M Woźniak, T Kumar, G J Murphy
BACKGROUND AND OBJECTIVES: To review preclinical and clinical studies that have evaluated the effects of red cell rejuvenation in vivo and in vitro and to assess the potential risks and benefits from their clinical use. MATERIALS AND METHODS: A systematic review and narrative synthesis of the intervention of red cell rejuvenation using a red cell processing solution containing inosine, pyruvate, phosphate and adenine. Outcomes of interest in vitro were changes in red cell characteristics including adenosine triphosphate (ATP), 2,3-diphosphoglycerate (2,3-DPG), deformability and the accumulation of oxidized lipids and other reactive species in the red cell supernatant...
June 4, 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29793583/reduction-of-vascular-leakage-by-imatinib-is-associated-with-preserved-microcirculatory-perfusion-and-reduced-renal-injury-markers-in-a-rat-model-of-cardiopulmonary-bypass
#6
N J Koning, F de Lange, M van Meurs, R M Jongman, Y Ahmed, L A Schwarte, G P van Nieuw Amerongen, A B A Vonk, H W Niessen, C Baufreton, C Boer
BACKGROUND: Cardiopulmonary bypass during cardiac surgery leads to impaired microcirculatory perfusion. We hypothesized that vascular leakage is an important contributor to microcirculatory dysfunction. Imatinib, a tyrosine kinase inhibitor, has been shown to reduce vascular leakage in septic mice. We investigated whether prevention of vascular leakage using imatinib preserves microcirculatory perfusion and reduces organ injury markers in a rat model of cardiopulmonary bypass. METHODS: Male Wistar rats underwent cardiopulmonary bypass after treatment with imatinib or vehicle (n=8 per group)...
June 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29778331/goal-directed-perfusion-to-reduce-acute-kidney-injury-a-randomized-trial
#7
Marco Ranucci, Ian Johnson, Timothy Willcox, Robert A Baker, Christa Boer, Andreas Baumann, George A Justison, Filip de Somer, Paul Exton, Seema Agarwal, Rachael Parke, Richard F Newland, Renard G Haumann, Dirk Buchwald, Nathaen Weitzel, Rajamiyer Venkateswaran, Valeria Pistuddi
OBJECTIVE: To determine whether a goal-directed perfusion (GDP) strategy aimed at maintaining oxygen delivery (DO2 ) at ≥280 mL·min-1 ·m-2 reduces the incidence of acute kidney injury (AKI). METHODS: This multicenter randomized trial enrolled a total of 350 patients undergoing cardiac surgery in 9 institutions. Patients were randomized to receive either GDP or conventional perfusion. A total of 326 patients completed the study and were analyzed. Patients in the treatment arm were treated with a GDP strategy during cardiopulmonary bypass (CPB) aimed to maintain DO2 at ≥280 mL·min-1 ·m-2 ...
April 18, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29777769/a-combined-approach-for-the-early-recognition-of-acute-kidney-injury-after-adult-cardiac-surgery
#8
Cédrick Zaouter, Julien Potvin, Marie-Lise Bats, Marie-Christine Beauvieux, Alain Remy, Alexandre Ouattara
BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a frequent complication. The current criteria to detect CSA-AKI rise only when organic dysfunction has occurred. The Doppler Renal Resistive Index (RRI) and the urinary G1 cell cycle arrest proteins (TIMP-2 and IGFBP7) have been advocated to predict CSA-AKI at an early stage after cardiac surgery. The primary objective was to determine the predictive value of these new markers to detect CSA-AKI after elective heart surgery in patients at risk to develop AKI...
May 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29769287/the-protective-role-of-macrophage-migration-inhibitory-factor-in-acute-kidney-injury-after-cardiac-surgery
#9
Christian Stoppe, Luisa Averdunk, Andreas Goetzenich, Josefin Soppert, Arnaud Marlier, Sandra Kraemer, Jil Vieten, Mark Coburn, Ana Kowark, Bong-Song Kim, Gernot Marx, Steffen Rex, Akinobu Ochi, Lin Leng, Gilbert Moeckel, Andreas Linkermann, Omar El Bounkari, Alexander Zarbock, Jürgen Bernhagen, Sonja Djudjaj, Richard Bucala, Peter Boor
Acute kidney injury (AKI) represents the most frequent complication after cardiac surgery. Macrophage migration inhibitory factor (MIF) is a stress-regulating cytokine that was shown to protect the heart from myocardial ischemia-reperfusion injury, but its role in the pathogenesis of AKI remains unknown. In an observational study, serum and urinary MIF was quantified in 60 patients scheduled for elective conventional cardiac surgery with the use of cardiopulmonary bypass. Cardiac surgery triggered an increase in MIF serum concentrations, and patients with high circulating MIF (>median) 12 hours after surgery had a significantly reduced risk of developing AKI (relative risk reduction, 72...
May 16, 2018: Science Translational Medicine
https://www.readbyqxmd.com/read/29756690/preoperative-predictive-model-for-acute-kidney-injury-after-elective-cardiac-surgery-a-prospective-multicentre-cohort-study
#10
Raquel Callejas, Alfredo Panadero, Marc Vives, Paula Duque, Gemma Echarri, Pablo Monedero
BACKGROUND: Predictive models of CS-AKI include emergency surgery and patients with haemodynamic instability. Our objective was to evaluate the performance of validated predictive models (Thakar and Demirjian) in elective cardiac surgery and to propose a better score in the case of poor performance. METHODS: A prospective, multicentre, observational study was designed. Data were collected from 942 patients undergoing cardiac surgery, after excluding emergency surgery and patients with an intraaortic balloon pump...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29753670/intraoperative-renal-resistive-index-as-an-acute-kidney-injury-biomarker-development-and-validation-of-an-automated-analysis-algorithm
#11
Benjamin Y Andrew, Elias Y Andrew, Anne D Cherry, Jennifer N Hauck, Alina Nicoara, Carl F Pieper, Mark Stafford-Smith
OBJECTIVE: Intraoperative Doppler-determined renal resistive index (RRI) is a promising early acute kidney injury (AKI) biomarker. As RRI continues to be studied, its clinical usefulness and robustness in research settings will be linked to the ease, efficiency, and precision with which it can be interpreted. Therefore, the authors assessed the usefulness of computer vision technology as an approach to developing an automated RRI-estimating algorithm with equivalent reliability and reproducibility to human experts...
April 4, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29742788/-the-relevance-of-hemolysis-in-anesthesia-and-intensive-care-medicine
#12
Jan A Graw, David M Baron, Roland C E Francis
Hemolysis leads to an increase of circulating intravascular cell-free hemoglobin. Increased plasma concentrations of cell-free hemoglobin are relevant in critically ill patients because cell-free hemoglobin causes vasoconstriction by depletion of endothelial nitric oxide, oxidative stress, and inflammation. Furthermore, cell-free hemoglobin contributes to tissue injuries such as renal failure and intestinal mucosa damage after cardiac surgery. High concentrations of cell-free hemoglobin are associated with an increased mortality in patients with sepsis...
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29726039/relationship-between-intraoperative-serum-lactate-and-hemoglobin-levels-on-postoperative-renal-function-in-patients-undergoing-elective-cardiac-surgery
#13
Steven C Mitchell, Anirudh Vinnakota, Salil V Deo, Alan H Markowitz, Basar Sareyyupoglu, Yakov Elgudin, Benjamin Medalion, Adam Tzagournis, Joseph Sabik, Soon J Park
BACKGROUND AND AIM: We examined the relationship between serum lactate and hemoglobin levels on renal function and postoperative outcome in low-risk elective coronary artery bypass graft (CABG) patients. METHODS: Intraoperative hemoglobin and lactate levels were measured in elective isolated CABG patients. Patients with renal dysfunction (baseline creatinine>2 mg/dL) were excluded. Multivariate logistic regression was used to determine associations between lactate, hemoglobin, and acute kidney injury (AKI)...
June 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29718383/levosimendan-versus-placebo-in-cardiac-surgery-a-systematic-review-and-meta-analysis
#14
María Ángeles Tena, Stefano Urso, Jesús María González, Luis Santana, Rafael Sadaba, Paula Juarez, Leonor González, Francisco Portela
The aim of this meta-analysis was to review all published randomized clinical trials comparing levosimendan versus placebo in patients undergoing cardiac surgery. PubMed, EMBASE and the Cochrane library database of clinical trials were searched for prospective randomized clinical trials investigating the perioperative use of levosimendan versus placebo in patients undergoing adult cardiac surgery from 1 May 2000 to 10 April 2017. Binary outcomes from individual studies were analysed to compute individual and pooled risk ratios (RRs) with pertinent 95% confidence intervals (CIs)...
April 30, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29716763/expanding-eligibility-for-the-ross-procedure-a-reasonable-proposition
#15
Aly Ghoneim, Ismail Bouhout, Katie Losenno, Nancy Poirier, Raymond Cartier, Philippe Demers, Michael Tousch, Linruo Guo, Michael W A Chu, Ismail El-Hamamsy
BACKGROUND: Although the Ross procedure offers potential benefits in young adults, technical complexity represents a significant limitation. Therefore, the safety of expanding its use in more complex settings is uncertain. The aim of this study was to compare early outcomes of standard isolated Ross procedures vs expanding elgibility to higher-risk clinical settings. METHODS: From 2011 to 2016, 261 patients (46 ± 12 years) underwent Ross procedures in 2 centres...
January 31, 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29706810/novel-renal-biomarker-evaluation-for-early-detection-of-acute-kidney-injury-after-transcatheter-aortic-valve-implantation
#16
Mani Arsalan, Ethan Ungchusri, Robert Farkas, Melissa Johnson, Rebeca J Kim, Giovanni Filardo, Benjamin D Pollock, Molly Szerlip, Michael J Mack, Elizabeth M Holper
Acute kidney injury (AKI) following transcatheter aortic valve implantation (TAVI) is associated with increased morbidity and mortality. The biomarkers neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) are predictive of AKI after cardiac surgery, but there is little data regarding these biomarkers after TAVI. We evaluated the associations between NGAL, KIM-1, and IL-18 levels and the incidence and severity of AKI and changes in serum creatinine after TAVI...
April 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29701385/predictors-of-acute-kidney-injury-in-the-postoperative-period-of-cardiac-surgery-associated-with-cardiopulmonary-bypass
#17
Raquel Moreira, Tiago Jacinto, Paulo Neves, Luís Vouga, Cristina Baeta
INTRODUCTION: Acute kidney injury (AKI) in the postoperative period of cardiac surgery occurs in 1 to 30% of the patients, mainly caused by ischemia secondary to renal hypoperfusion. Cardiopulmonary bypass (CPB) has a deleterious effect on renal function, constituting an aggression to the patient's homeostasis. AIM: To evaluate the incidence of AKI in the postoperative period of cardiac surgery in patients without preoperative renal insufficiency who underwent cardiac surgery with CPB, and explore the association between incidence of AKI and predictors related to CPB...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701366/cardiac-surgery-with-synchronous-carotid-angioplasty-our-experience
#18
Carlos Pinto, Marco Costa, Hilario Oliveira, Manuel Antunes
INTRODUCTION: The identification of carotid stenosis in patients proposed for coronary artery bypass grafting, proves that atherosclerosis is a systemic disease. In patients with carotid disease and in need of cardiac surgery, there are still questions about the best method of treatment - medical, surgical or percutaneous, the degree of stenosis considered for intervention and the best time for treatment (pre, peri or postoperative heart surgery). The surgical treatment of the carotid stenosis is currently the gold standard...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29696581/potential-biomarkers-of-tissue-hypoxia-during-acute-hemodilutional-anemia-in-cardiac-surgery-a-prospective-study-to-assess-tissue-hypoxia-as-a-mechanism-of-organ-injury
#19
Gregory M T Hare, Kaho Han, Yevheniy Leshchyshyn, Nikhil Mistry, Tiffanie Kei, Si Yuan Dai, Albert K Y Tsui, Razak A Pirani, Jaideep Honavar, Rakesh P Patel, Sanjay Yagnik, Shelley L Welker, Tessa Tam, Alexander Romaschin, Philip W Connelly, W Scott Beattie, C David Mazer
PURPOSE: Hemodilutional anemia is associated with acute kidney injury (AKI) and mortality in patients undergoing cardiac surgery by mechanisms that may include tissue hypoxia. Our hypothesis was to assess if changes in the potential hypoxic biomarkers, including methemoglobin and erythropoietin, correlated with a decrease in hemoglobin (Hb) concentration following hemodilution on cardiopulmonary bypass (CPB). METHODS: Arterial blood samples were taken from patients (n = 64) undergoing heart surgery and CPB at baseline, during CPB, following CPB, and in the intensive care unit (ICU)...
April 25, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29696106/evaluation-of-the-effect-of-aminophylline-in-reducing-the-incidence-of-acute-kidney-injury-after-cardiac-surgery
#20
Shahrbanoo Shahbazi, Peyman Alishahi, Elham Asadpour
Objectives: Acute 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...
August 2017: Anesthesiology and Pain Medicine
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