Intraoperative Renal Regional Oxygen Desaturation Can Be a Predictor for Acute Kidney Injury after Cardiac Surgery
Section snippets
Methods
After approval by the Institutional Ethics Committee and obtaining written informed consent, a total of 100 adult patients who underwent elective cardiac surgery with cardiopulmonary bypass (CPB) were enrolled between October 2010 and August 2011. Exclusion criteria were off-pump coronary artery bypass surgery (OPCAB), aortic surgery (total arch replacement and/or descending aorta replacement surgery), emergency surgery, left ventricular ejection fraction (LVEF)<30%, body mass index (BMI)≥30
Results
Between October 2010 and August 2011, 153 patients admitted to this hospital met the inclusion criteria (Fig 2). Of these, 38 were excluded because both renal depths were≥40 mm. An additional 15 patients refused to enroll in the study. Of 100 patients who were enrolled in this study, 5 were excluded because of incomplete renal rSO2 data. Thus, 95 patients were included in the final analysis; 66 patients received bilateral renal rSO2 monitoring and 29 patients received unilateral monitoring.
Discussion
In the current analysis the authors have found that intraoperative renal regional oxygen desaturation is associated significantly with postoperative AKI and that use of NIRS for continuous monitoring of the intraoperative renal rSO2 can predict the risk of AKI in adult patients undergoing cardiac surgery with CPB.
Postoperative AKI is associated with increased morbidity and mortality in patients undergoing cardiac surgery.2, 3 Therefore, early detection of deterioration in renal function and
Conclusion
In conclusion, the current prospective observational study indicated a predictive ability of intraoperative renal rSO2 monitoring for postoperative AKI in adult patients undergoing cardiac surgery. However, the use of an NIRS sensor that can monitor tissue areas deeper below the skin surface is warranted to generalize the use of this method to all patients undergoing cardiac surgery. In addition, further studies are needed to evaluate effective interventions to correct renal regional oxygen
Acknowledgments
This study was partly supported by an unrestricted grant by E-Wha Biomedics Co., Seoul, Korea. The authors thank Seungbong Han, PhD, Statistician, Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea, for valuable statistical advice and assistance.
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