• Acta Anaesthesiol Scand · Nov 2019

    Duration of critically low oxygen delivery is associated with acute kidney injury after cardiac surgery.

    • Sebastian R Rasmussen, Kristian Kandler, Rikke V Nielsen, Peter Cornelius Jakobsen, Nikoline N Knudsen, Marco Ranucci, Christian Nilsson Jens J Department of Cardiothoracic Anaesthesiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark., and Hanne B Ravn.
    • Department of Cardiothoracic Anaesthesiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
    • Acta Anaesthesiol Scand. 2019 Nov 1; 63 (10): 1290-1297.

    BackgroundAcute kidney injury is a serious complication following cardiac surgery associated with mortality. Restricted oxygen delivery is a potential risk factor for acute kidney injury. The aim of this study was to investigate the impact of the duration of low oxygen delivery (<272 mL  min-1  m-2 ), during cardiopulmonary bypass on kidney function.MethodsPatients undergoing coronary artery bypass graft surgery ± valve repair were included n = 1968. Oxygen delivery was monitored during cardiopulmonary bypass. Data were explored using multiple regression analyses regarding association between low oxygen delivery and renal replacement therapy (RRT), acute kidney injury (AKI) and post-operative peak serum creatinine (PPSC).ResultsPost-operative peak serum creatinine, incidence of acute kidney injury, and need for dialysis increased in a dose-dependent manner in relation to duration of a mean oxygen delivery <272 mL  min-1  m-2 . Using multiple regression analyses, only exposure for at least 30 minutes was independently associated with increased PPSC and AKI. In contrast, both short (1-5 min, OR: 2.58 [1.20, 5.54]; P = .015) and at least 30-minute (OR: 2.85 [1.27-6.41]; P = .011) exposure to low DO2 were both independently associated with the need for RRT.ConclusionA low oxygen delivery during cardiopulmonary bypass was in a dose-dependent manner associated with an increased risk of renal injury.© 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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