International Perfusion Association

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Category: Renal

Exploding Kidney

Is Ultrafiltration Volume a Predictor of Postoperative Acute Kidney Injury in Patients Undergoing Cardiopulmonary Bypass?

This study investigates the relationship between intraoperative ultrafiltration (UF) volume during cardiopulmonary bypass (CPB) and the incidence of acute kidney injury (AKI) post-coronary artery bypass graft (CABG) surgery. Analyzing data from 641 patients, it found that higher UF volumes are significantly associated with an increased risk of AKI. Other identified predictors of AKI include patient age, the lowest mean arterial pressure during surgery, and red blood cell transfusions. These results underscore the importance of careful UF management during CPB to mitigate the risk of postoperative AKI.

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Plasma Hyperosmolality as a Risk Factor for Postoperative Acute Kidney Injury in Cardiopulmonary Bypass Patients

This double-blind, randomized controlled trial from a tertiary teaching hospital in Sweden aimed to evaluate the impact of hyperosmolar priming solutions on cardiac surgery-associated acute kidney injury (CSA-AKI). Including patients aged ≥65 years undergoing routine cardiac surgery with cardiopulmonary bypass, the study compared the effects of a Ringer’s acetate based solution with Mannitol and sodium concentrate to a control group. Results indicated that while the hyperosmolar prime solution itself did not increase postoperative CSA-AKI incidence, high plasma osmolality was identified as an independent risk factor, increasing CSA-AKI risk by 30%. The findings underscore the need for further investigation into plasma hyperosmolality’s role in CSA-AKI risk.

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AKI Pressure

Higher Perfusion Pressure and Pump Flow During Cardiopulmonary Bypass Are Beneficial for Kidney Function-A Single-Centre Prospective Study

This study investigates the impact of higher mean arterial pressure (MAP) and pump flow during cardiopulmonary bypass (CPB) on kidney function. One hundred nine patients were divided into groups with standard and increased CPB pump flow to maintain MAP > 90 mmHg. Results showed that a higher MAP did not affect the incidence of acute kidney injury but improved intraoperative and postoperative diuresis and reduced renin release. Additionally, higher MAP did not increase cerebrovascular complications and may reduce postoperative delirium incidence, suggesting that maintaining MAP > 90 mmHg during CPB is beneficial for kidney function and potentially for the central nervous system.

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Dialysis 123

Outcomes of Prophylactic Peritoneal Dialysis Catheter Insertion in Children Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis evaluated the association between prophylactic peritoneal dialysis (PD) catheter insertion during pediatric cardiac surgery and improved short-term outcomes. Analyzing seventeen studies, including four randomized controlled trials, the study found no significant link between prophylactic PD catheter insertion and reduced in-hospital mortality. Results for ICU stay length and time to achieve negative fluid balance were inconclusive, with some studies indicating benefits and others showing no difference. The analysis highlights the need for further research on short-term outcomes and fluid overload markers in this context, acknowledging the high risk of bias in the included studies.

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AKI 2

The Multifactorial Dynamic Perfusion Index: A Predictive Tool of Cardiac Surgery Associated Acute Kidney Injury

This study aimed to develop a dynamic predictive model for cardiac surgery associated acute kidney injury (CSA-AKI) by combining preoperative and intraoperative risk factors, including cardiopulmonary bypass (CPB) related data. The resulting Multifactorial Dynamic Perfusion Index (MDPI) demonstrated better predictive ability than static risk models, showing that inclusion of dynamic CPB quality indices significantly improves risk assessment for CSA-AKI.

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Mohamed Mohamed

GPT Serum CIRP Increases the Risk of Acute Kidney Injury After Cardiac Surgery

This study explored the connection between elevated Cold-induced RNA-binding protein (CIRP) levels and the incidence of acute kidney injury (AKI) following cardiac surgery, focusing on surgeries involving cardiopulmonary bypass (CPB). It was discovered that higher CIRP levels, especially in surgeries with CPB, are independently associated with a higher risk of developing AKI, leading to worse postoperative outcomes, including a lower survival rate over two years.

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Machine Learning AKI

Serum CIRP Increases the Risk of Acute Kidney Injury After Cardiac Surgery

The study aimed to investigate the role of cold-induced RNA-binding protein (CIRP) in the development of acute kidney injury (AKI) following cardiac surgery. Elevated extracellular CIRP levels, particularly associated with prolonged cardiopulmonary bypass (CPB) time, were identified as independent risk factors for postoperative AKI, especially severe cases, highlighting its correlation with adverse in-hospital outcomes.

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Exploding Kidney

Relationship Between Difference of Preoperative and Cardiopulmonary Bypass Mean Arterial Pressure, and Acute Kidney Injury in Cardiac Surgical Patients Undergoing Valve Surgery

In a study of 112 high-risk cardiac surgery patients, it was found that the difference in pre-operative and on-bypass mean arterial pressure (MAP) and cardiopulmonary bypass (CPB) flows did not significantly predict early post-surgical acute kidney injury (CSA-AKI). However, baseline serum levels of Neutrophil gelatinase-associated lipocalin (NGAL) and its early post-surgical percent change were strong independent predictors of CSA-AKI development, suggesting its potential as a useful biomarker in identifying patients at risk.

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Collectrin

Urinary Collectrin as Promising Biomarker for Acute Kidney Injury in Patients Undergoing Cardiac Surgery

This study explores urinary collectrin as a potential biomarker for early detection of acute kidney injury (AKI) in patients undergoing cardiac surgery with cardiopulmonary bypass. It found significant perioperative changes in collectrin levels, particularly on postoperative day 1, indicating its promise for timely AKI diagnosis and intervention, though further research is needed for clinical validation.

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