Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Fast-Track Failure After Cardiac Surgery: Risk Factors and Outcome With Long-Term Follow-Up.
An important cornerstone of the Enhanced Recovery After Cardiac Surgery initiative is a fast-track cardiac anesthesia management protocol. Fast-track failure has been described to have a detrimental impact on immediate postoperative outcomes. The authors here evaluated risk factors for short- and long-term effects of fast-track failure. ⋯ Fast-track failure is associated with increases in morbidity and long-term mortality, but remains difficult to predict.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Is an Acute Perioperative Increase in Creatinine Production Rate a Potential Mechanism for an Early Creatinine-Based Signal of Renal Injury After Cardiac Surgery?
Previous studies report a creatinine-based signal of injury within hours after cardiac surgery, which is sooner than expected based on creatinine kinetic modelling. A plausible mechanism for such an early signal has not been established, but might be explained by an acute perioperative increase in creatinine production rate (Crprod-rate). The authors sought to test the hypothesis that perioperative Crprod-rate increases from baseline in patients undergoing cardiac surgery. ⋯ Perioperative Crprod-rate increased from baseline in patients undergoing cardiac surgery. This may represent a mechanism for an earlier creatinine-based signal of renal injury than previously thought possible.