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https://www.readbyqxmd.com/read/28098429/natural-history-of-nonimmune-mediated-thrombocytopenia-and-acute-kidney-injury-in-pediatric-open-heart-surgery
#1
Shannon Tew, Manuel L Fontes, Nathaniel H Greene, Miklos D Kertai, George Ofori-Amanfo, Robert D B Jaquiss, Andrew J Lodge, Warwick A Ames, Hercilia Mayumi Homi, Kelly A Machovec, Edmund H Jooste
OBJECTIVE: Thrombocytopenia and acute kidney injury (AKI) are common following pediatric cardiac surgery with cardiopulmonary bypass (CPB). However, the relationship between postoperative nadir platelet counts and AKI has not been investigated in the pediatric population. Our objective was to investigate this relationship and examine independent predictors of AKI. DESIGN: After IRB approval, we performed a retrospective review of the institution's medical records and database...
January 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28095822/hyperuricemia-increases-the-risk-of-acute-kidney-injury-a-systematic-review-and-meta-analysis
#2
Xialian Xu, Jiachang Hu, Nana Song, Rongyi Chen, Ting Zhang, Xiaoqiang Ding
BACKGROUND: Mounting evidence indicated that the elevated serum uric acid level was associated with an increased risk of acute kidney injury (AKI). Our goal was to systematically evaluate the correlation of serum uric acid (SUA) level and incidence of AKI by longitudinal cohort studies. METHODS: We searched electronic databases and the reference lists of relevant articles. 18 cohort studies with 75,200 patients were analyzed in this random-effect meta-analysis. Hyperuricemia was defined as SUA levels greater than 360-420 μmol/L (6-7 mg/dl), which was various according to different studies...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28077532/modern-hydroxyethyl-starch-and-acute-kidney-injury-after-cardiac-surgery-a-prospective-multicentre-cohort
#3
M Vives, R Callejas, P Duque, G Echarri, D N Wijeysundera, A Hernandez, A Sabate, M Bes-Rastrollo, P Monedero
BACKGROUND: Recent trials have shown hydroxyethyl starch (HES) solutions increase the risk of acute kidney injury (AKI) in critically ill patients. It is uncertain whether these adverse effects also affect surgical patients. We sought to determine the renal safety of modern tetrastarch (6% HES 130/0.4) use in cardiac surgical patients. METHODS: In this multicentre prospective cohort study, 1058 consecutive patients who underwent cardiac surgery from 15th September 2012 to 15th December 2012 were recruited in 23 Spanish hospitals...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077530/impact-of-balanced-tetrastarch-raw-material-on-perioperative-blood-loss-a-randomized-double-blind-controlled-trial
#4
A Joosten, R Tircoveanu, S Arend, P Wauthy, P Gottignies, P Van der Linden
BACKGROUND: As 6% hydroxyethyl starch (HES) 130/0.40 or 130/0.42 can originate from different vegetable sources, they might have different clinical effects. The purpose of this prospective, randomized, double-blind controlled trial was to compare two balanced tetrastarch solutions, one maize-derived and one potato-derived, on perioperative blood loss in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). METHODS: We randomly assigned 118 patients undergoing elective cardiac surgery into two groups, to receive either a maize- or a potato-derived HES solution...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28074790/incidence-and-progression-of-cardiac-surgery-associated-acute-kidney-injury-and-its-relationship-with-bypass-and-cross-clamp-time
#5
Habib Md Reazaul Karim, Mohd Yunus, Manuj Kumar Saikia, Jyoti Prasad Kalita, Mrinal Mandal
INTRODUCTION: Cardiac surgery-associated kidney injury (CSA-AKI) is common but relatively less is known about its progression. The present study is aimed at evaluating the incidence and course of CSA-AKI and its relationship with the different durations of cardiopulmonary bypass (CPB) and cross clamp times. MATERIALS AND METHODS: Occurrences of CSA-AKI are evaluated as per the Akin Kidney Injury Network (AKIN) criteria over the course of 5 postoperative day (POD) in 100 patients...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28072936/haptoglobin-and-free-haemoglobin-during-cardiac-surgery-is-there-a-link-to-acute-kidney-injury
#6
A J Wetz, E M Richardt, H Schotola, M Bauer, A Bräuer
Acute kidney injury (AKI) is frequently observed after cardiac surgery (CS) with cardiopulmonary bypass (CPB). Multiple mechanisms underlie this phenomenon, including CPB-dependent haemolysis. Haemoglobin is released during haemolysis, and free haemoglobin (frHb) causes tubular cell injury after exceeding the binding capacity of haptoglobin (Hp). The objective of this study was to investigate the influence of perioperative changes in frHb and Hp levels on the incidence of CS-associated (CSA) AKI. After receiving local ethics committee approval and obtaining informed consent from our patients, we analysed the data pertaining to 154 patients undergoing CPB surgery...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28060555/efficacy-of-n-acetylcysteine-in-preventing-acute-kidney-injury-after-cardiac-surgery-a-meta-analysis-study
#7
Mei Mei, Hong-Wen Zhao, Qian-Guang Pan, You-Min Pu, Mao-Zhi Tang, Bing-Bing Shen
PURPOSE: To evaluate whether perioperative N-acetylcysteine (NAC) administration reduces the risk of cardiac surgery associated acute kidney injury (CSA-AKI). MATERIALS AND METHODS: A systematic literature review (Medline, PubMed, Cochrane, Biomedical central, Google Scholar) identified 10 studies (1391 patients; 695 NAC and 696 placebo) that compared the efficacy and adverse effects of perioperative NAC administration for CSA-AKI prevention in adults undergoing elective cardiac surgery...
January 6, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28035621/implications-of-dynamic-changes-in-mir-192-expression-in-ischemic-acute-kidney-injury
#8
Lulu Zhang, Yuan Xu, Song Xue, Xudong Wang, Huili Dai, Jiaqi Qian, Zhaohui Ni, Yucheng Yan
PURPOSE: Ischemia-reperfusion injury (IRI) is a major cause of acute kidney injury (AKI) with poor outcomes. While many important functions of microRNAs (miRNAs) have been identified in various diseases, few studies reported miRNAs in acute kidney IRI, especially the dynamic changes in their expression and their implications during disease progression. METHODS: The expression of miR-192, a specific kidney-enriched miRNA, was assessed in both the plasma and kidney of IRI rats at different time points after kidney injury and compared to renal function and kidney histological changes...
December 29, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/28024933/a-preoperative-multimarker-approach-to-evaluate-acute-kidney-injury-after-cardiac-surgery
#9
Tone B Enger, Hilde Pleym, Roar Stenseth, Guri Greiff, Alexander Wahba, Vibeke Videm
OBJECTIVE: To investigate whether a multimarker strategy combining preoperative biomarkers representing distinct pathophysiologic pathways enhances preoperative risk assessment of acute kidney injury after cardiac surgery (CSA-AKI) and increases knowledge of underlying pathogenesis. DESIGN: Prospective, cohort study. SETTING: Single-center tertiary referral hospital. PARTICIPANTS: The study comprised 1,015 adults undergoing cardiac surgery with cardiopulmonary bypass...
October 11, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28017677/preoperative-renal-resistive-index-predicts-risk-of-acute-kidney-injury-in-patients-undergoing-cardiac-surgery
#10
Daniel Hertzberg, Simon L Ceder, Ulrik Sartipy, Kent Lund, Martin J Holzmann
OBJECTIVE: To investigate whether an elevated preoperative renal resistive index (RRI) predicts acute kidney injury (AKI) in patients undergoing cardiac surgery. DESIGN: Prospective cohort study. SETTING: University hospital. PARTICIPANTS: Cohort of 96 adult cardiac surgical patients. INTERVENTIONS: Resistive index was measurement the day before surgery. MEASUREMENTS AND MAIN RESULTS: Renal Doppler was used to measure the resistive index in renal cortical or arcuate arteries the day before surgery...
October 11, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27997877/effects-of-low-dose-atrial-natriuretic-peptide-infusion-on-cardiac-surgery-associated-acute-kidney-injury-a-multicenter-randomized-controlled-trial
#11
Chieko Mitaka, Tetsu Ohnuma, Takanori Murayama, Fumio Kunimoto, Michio Nagashima, Tetsuhiro Takei, Naoya Iguchi, Makoto Tomita
PURPOSE: To evaluate the effects of atrial natriuretic peptide (ANP) on renal function and medical costs in patients with acute kidney injury (AKI) associated with cardiac surgery. MATERIALS AND METHODS: The Japanese trial for AKI in Post-cardiovascular surgery patients by ANP (JAPAN) was a prospective, multicenter, randomized, double-blind, placebo-controlled study conducted in 11 hospitals in Japan. Acute kidney injury was defined as an increase in serum creatinine of at least 0...
December 11, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27979834/ciclosporin-to-protect-renal-function-in-cardiac-surgery-ciprics-a-study-protocol-for-a-double-blind-randomised-placebo-controlled-proof-of-concept-study
#12
Per Ederoth, Edgars Grins, Alain Dardashti, Björn Brondén, Carsten Metzsch, André Erdling, Shahab Nozohoor, Arash Mokhtari, Magnus J Hansson, Eskil Elmér, Lars Algotsson, Stefan Jovinge, Henrik Bjursten
INTRODUCTION: Acute kidney injury (AKI) after cardiac surgery is common and results in increased morbidity and mortality. One possible mechanism for AKI is ischaemia-reperfusion injury caused by the extracorporeal circulation (ECC), resulting in an opening of the mitochondrial permeability transition pore (mPTP) in the kidneys, which can lead to cell injury or cell death. Ciclosporin may block the opening of mPTP if administered before the ischaemia-reperfusion injury. We hypothesised that ciclosporin given before the start of ECC in cardiac surgery can decrease the degree of AKI...
December 15, 2016: BMJ Open
https://www.readbyqxmd.com/read/27956671/defining-oliguria-during-cardiopulmonary-bypass-and-its-relationship-with-cardiac-surgery-associated-acute-kidney-injury
#13
D Hori, N M Katz, D M Fine, M Ono, V M Barodka, L C Lester, G Yenokyan, C W Hogue
BACKGROUND: While urine flow rate ≤0.5 ml kg(-1) h(-1) is believed to define oliguria during cardiopulmonary bypass (CPB), it is unclear whether this definition identifies risk for acute kidney injury (AKI) . The purpose of this retrospective study was to evaluate if urine flow rate during CPB is associated with AKI. METHODS: Urine flow rate was calculated in 503 patients during CPB. AKI in the first 48 h after surgery was defined by the Kidney Disease: Improving Global Outcomes classification...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27941063/prognostic-implications-of-adding-urine-output-to-serum-creatinine-measurements-for-staging-of-acute-kidney-injury-after-major-surgery-a-cohort-study
#14
Samuel Quan, Neesh Pannu, Todd Wilson, Chad Ball, Zhi Tan, Marcello Tonelli, Brenda R Hemmelgarn, Elijah Dixon, Matthew T James
BACKGROUND: Current guidelines recommend staging acute kidney injury (AKI) according to the serum creatinine (SCr) or urine output (UO) criteria that achieve the highest stage. There is little information about the implications of adding UO to SCr measurements for staging AKI outside intensive care units and after cardiac surgery. METHODS: We performed a cohort study of all adults without end-stage renal disease who underwent major noncardiac surgery between January 2005 and March 2011 in Calgary, AB, Canada...
December 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27930561/meta-analysis-for-outcomes-of-acute-kidney-injury-after-cardiac-surgery
#15
Qiankun Shi, Liang Hong, Xinwei Mu, Cui Zhang, Xin Chen
This study aimed to investigate the outcomes of acute kidney injury (AKI) after cardiac surgery by the meta-analysis.Electronic databases PubMed and Embase were searched for relative studies from December 2008 to June 2015. For eligible studies, the R software was conducted to meta-analyze outcomes of AKI patients (AKI group) and none-AKI patients after cardiac surgery (NO AKI group). The chi-square-based Q test and I statistic were used for heterogeneity analysis. P < 0.1 or I > 50% revealed significant heterogeneity among studies, and then a random effects model was used; otherwise a fixed effect model was performed...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27906719/diagnosis-of-cardiac-surgery-associated-acute-kidney-injury-from-functional-to-damage-biomarkers
#16
Wim Vandenberghe, Jorien De Loor, Eric A J Hoste
PURPOSE OF REVIEW: Acute kidney injury (AKI) occurs in up to 30% after cardiac surgery and is associated with adverse outcome. Currently, cardiac surgery-associated acute kidney injury (CSA-AKI) is diagnosed by Kidney Disease: Improving Global Outcomes criteria based on creatinine and urine output. To detect and treat AKI earlier, various biomarkers have been evaluated. This review addresses the current position of the two damage biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and [TIMP-2] [IGFBP7] in clinical practice...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27888759/prevention-of-statins-against-aki-and-mortality-following-cardiac-surgery-do-we-know-enough-a-trial-sequential-analysis
#17
Hong Weng, Sheng Li, Xian-Tao Zeng
No abstract text is available yet for this article.
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27871513/disagreement-between-fourth-generation-flotrac-and-lidcorapid-measurements-of-cardiac-output-and-stroke-volume-variation-during-laparoscopic-colectomy
#18
Masato Nakasuji, Aki Okutani, Taeko Miyata, Norie Imanaka, Masuji Tanaka, Kae Nakasuji, Miwako Nagai
STUDY OBJECTIVE: To determine the agreement between cardiac output (CO) and stroke volume variation (SVV) measured simultaneously by the fourth generation FloTrac/Vigileo system and LiDCOrapid system during pneumoperitoneum in patients undergoing laparoscopic colectomy. DESIGN: Retrospective observational study. SETTINGS: Operating room in a general hospital. PATIENTS: Ten patients (American Society of Anesthesiologist 1 or 2) without preoperative anemia...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27862029/creatinine-neutrophil-gelatinase-associated-lipocalin-and-cystatin-c-in-determining-acute-kidney-injury-after-heart-operations-using-cardiopulmonary-bypass
#19
Jurij Matija Kališnik, Eva Hrovat, Alenka Hrastovec, Janez Žibert, Aleš Jerin, Milan Skitek, Giuseppe Santarpino, Tomislav Klokocovnik
Acute kidney injury (AKI) represents frequent complication after cardiac surgery using cardiopulmonary bypass (CPB). In the hope to enhance earlier more reliable characterization of AKI, we tested the utility of neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (CysC) in addition to standard creatinine for early determination of AKI after cardiac surgery using CPB. Forty-one patients met the inclusion criteria. Arterial blood samples collected after induction of general anesthesia were used as baseline, further sampling occurred at CPB termination, 2 h after CPB, on the first and second day after surgery...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27856153/acute-kidney-injury-after-cardiac-surgery-by-complete-kdigo-criteria-predicts-increased-mortality
#20
Liisa Petäjä, Suvi Vaara, Sasu Liuhanen, Raili Suojaranta-Ylinen, Leena Mildh, Sara Nisula, Anna-Maija Korhonen, Kirsi-Maija Kaukonen, Markku Salmenperä, Ville Pettilä
OBJECTIVES: Acute kidney injury (AKI) occurs frequently after cardiac surgery and is associated with increased mortality. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria for diagnosing AKI include creatinine and urine output values. However, the value of the latter is debated. The authors aimed to evaluate the incidence of AKI after cardiac surgery and the independent association of KDIGO criteria, especially the urine output criterion, and 2.5-year mortality. DESIGN: Prospective, observational, cohort study...
August 26, 2016: Journal of Cardiothoracic and Vascular Anesthesia
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