End-of-Procedure Volume Responsiveness Defined by the Passive Leg Raise Test Is Not Associated With Acute Kidney Injury After Cardiopulmonary Bypass
| Autor: | Ryan L. Melvin, Ahmed Zaky, Sara J. Pereira, Ashita Tolwani, Jean-Francois Pittet, Duraid Younan, Charity J. Morgan, Bradley Meers, James E. Davies, Brent Kidd |
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| Rok vydání: | 2020 |
| Předmět: |
Resuscitation
medicine.medical_specialty 030204 cardiovascular system & hematology urologic and male genital diseases law.invention 03 medical and health sciences 0302 clinical medicine Postoperative Complications 030202 anesthesiology law Risk Factors Internal medicine Cardiopulmonary bypass medicine Humans Prospective Studies Cardiac Surgical Procedures Leg Cardiopulmonary Bypass business.industry Acute kidney injury Stroke volume Acute Kidney Injury medicine.disease Intensive care unit Cardiac surgery Anesthesiology and Pain Medicine Blood pressure Cardiology Cardiology and Cardiovascular Medicine business Kidney disease |
| Zdroj: | Journal of cardiothoracic and vascular anesthesia. 35(5) |
| ISSN: | 1532-8422 |
| Popis: | Objectives Renal hypoperfusion is a common mechanism of cardiac surgery–related acute kidney injury (CS-AKI). However, the optimal amount of volume resuscitation to correct systemic hypoperfusion and prevent the postoperative development of CS-AKI has been a subject of debate. The goal of this study was to assess the association of volume responsiveness determined by stroke volume variation using the passive leg raise test (PLRT) at chest closure, with the development of CS-AKI according to the Kidney Disease Improving Global Outcomes criteria. Design Single-center, prospective observational study. Setting Tertiary hospital. Interventions None. Measurements and Main Results A total of 131 patients were studied from January 2015 until May 2017. All patients underwent cardiac surgery that required cardiopulmonary bypass. Volume responsiveness was assessed at chest closure using the PRLT. Stroke volume variation from the sitting to the recumbent positions was measured by transesophageal echocardiography. Fluid responsiveness was defined as an increase of >12% of stroke volume from sitting to recumbent positions. A total of 82 (68.3%) patients were fluid-responsive versus 38 (31.6%) who were fluid-unresponsive. CS-AKI occurred in 30% of patients. There was no difference in CS-AKI between fluid-responsive and fluid-nonresponsive groups. However, CS-AKI was associated independently with an increases in body mass index and preoperative diastolic blood pressure. CS-AKI also was associated with prolonged intensive care unit length of stay. Conclusion End-of-procedure volume responsiveness is not associated with a high risk for postoperative CS-AKI. |
| Databáze: | OpenAIRE |
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