Minerva anestesiologica
-
Minerva anestesiologica · Nov 2020
Observational StudyThe predictive value of the intraoperative renal pulsatility index for acute kidney injury in patients undergoing cardiac surgery.
The incidence of cardiac surgery-associated acute kidney injury (CSA-AKI) is very high. The Renal Resistive Index (RRI) is measured by transesophageal echocardiography (TEE) and can be used to predict the occurrence of CSA-AKI, but few studies have examined the Renal Pulsatility Index (RPI). The objective of this study was to explore the predictive value of intraoperative RPI for CSA-AKI. ⋯ An RPI at T2>1.86 is correlated with a higher incidence of postoperative AKI. Treatment guided and personalized on the base of this parameter should be investigated by further dedicated studies.
-
Minerva anestesiologica · Nov 2020
Observational StudyProspective evaluation of preoperative lung ultrasound for prediction of perioperative outcome and myocardial injury in adult patients undergoing vascular surgery (LUPPO Study).
Myocardial injury after non-cardiac surgery (MINS) is a frequent perioperative event in vascular surgery, associated both with worse outcome and subsequent cardiovascular events. Current guidelines advocate troponin (hs-cTnT) and NT-proBNP measurements in selected patients before surgery, but accurate preoperative identification of patients at risk for MINS is an unmet clinical need. Focused lung ultrasound (LUS) might help to select patients at increased risk for MINS, because it can visualize B-line artifacts correlating to cardiopulmonary disease. Therefore, we investigated whether quantification of B-line artifacts improves perioperative risk predictive accuracy for MINS. ⋯ Lung ultrasound in combination with hs-cTnT showed a better test accuracy than hs-cTnT alone and might guide clinicians to identify vascular patients at increased risk for MINS.