International Perfusion Association

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IPA

Category: Renal

Pedi Kidney

Association of Hyperoxia During Cardiopulmonary Bypass and Postoperative Delirium in the Pediatric Cardiac ICU

This study examines the relationship between hyperoxia during cardiopulmonary bypass (CPB) and postoperative delirium in pediatric patients in a cardiac ICU. Analyzing data from 148 patients, researchers found that 24% experienced delirium within 72 hours post-CPB. However, no significant association was found between hyperoxia and delirium. Exploratory analysis suggested that nutritional status, specifically weight z scores, might influence delirium risk, indicating a need for further research on risk factors.

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July 12, 2024
Haemoadsorption

Impact of Extracorporeal Haemoadsorption During Prolonged Cardiopulmonary Bypass on the Incidence of Acute Kidney Injury

This study investigates the effects of haemoadsorption (HA) therapy on inflammatory markers and renal damage indices during cardiopulmonary bypass (CPB) and the early postoperative period. Conducted at a single tertiary care center, the retrospective analysis compared three groups of patients who underwent CPB for over 120 minutes. The results showed that haemoadsorption therapy did not significantly reduce the incidence of acute kidney injury (AKI) but decreased the need for renal replacement therapy.

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June 26, 2024
Kidney Protection

A Randomized Trial of Intravenous Amino Acids for Kidney Protection

This study investigated the efficacy of intravenous amino acids in reducing acute kidney injury (AKI) in patients undergoing cardiac surgery. A total of 3511 patients were randomized to receive either amino acids or a placebo. Results showed a significant reduction in AKI occurrence in the amino acid group (26.9%) compared to the placebo group (31.7%), with a relative risk of 0.85. The severity of AKI and the need for kidney-replacement therapy were also lower in the amino acid group. No major differences in other secondary outcomes or adverse events were observed.

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June 12, 2024
ECMO Kidney

Long-Term Clinical Outcomes of Acute Kidney Disease in Patients Receiving Extracorporeal Membrane Oxygenation

This study investigates the long-term outcomes of acute kidney disease (AKD) in patients undergoing extracorporeal membrane oxygenation (ECMO). From a dataset of 395 patients, 40.5% developed AKD. Those with AKD had a higher risk of major adverse kidney events (MAKEs) and cardiovascular events (MACEs). The risk of readmissions due to infections or sepsis was also elevated in AKD survivors, emphasizing the long-term impact of AKD in ECMO patients.

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May 6, 2024
Mad Kidney

Risk Prediction Models for Renal Function Decline After Cardiac Surgery Within Different Preoperative Glomerular Filtration Rate Strata

This study focuses on developing risk prediction models to identify patients at risk of renal function decline post-cardiac surgery. Using data from 24,904 patients at Fuwai Hospital, the study found significant variances in renal decline risks across different preoperative glomerular filtration rate (eGFR) strata. Notably, patients with higher eGFR levels pre-surgery showed increased risk. The research produced distinct nomograms for each eGFR category, demonstrating good predictive accuracy and providing a practical tool for postoperative renal monitoring.

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April 21, 2024
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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April 9, 2024
Photo Text

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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March 25, 2024
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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March 3, 2024
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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February 12, 2024
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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January 27, 2024
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