Evidence
Clin Exp Pharmacol Physiol. 2023 Aug 7. doi: 10.1111/1440-1681.13812. Online ahead of print.
ABSTRACT
Targeting greater pump flow and mean arterial pressure (MAP) during cardiopulmonary bypass (CPB) could potentially alleviate renal hypoxia and reduce the risk of postoperative acute kidney injury (AKI). Therefore, in an observational study of 93 patients undergoing on-pump cardiac surgery, we tested whether intraoperative hemodynamic management differed between patients who did and did not develop AKI. Then, in 20 patients, we assessed the feasibility of a larger-scale trial in which patients would be randomized to greater than normal target pump flow and MAP, or usual care, during CPB. In the observational cohort, MAP during hypothermic CPB averaged 68.8 ± 8.0 mmHg (mean ± SD) in the 36 patients who developed AKI and 68.9 ± 6.3 mmHg in the 57 patients who did not (p = 0.98). Pump flow averaged 2.4 ± 0.2 L/min/m2 in both groups. In the feasibility clinical trial, compared with usual care, those randomized to increased target pump flow and MAP had greater mean pump flow (2.70 ± 0.23 vs. 2.42 ± 0.09 L/min/m2 during the period before rewarming) and systemic oxygen delivery (363 ± 60 vs. 281 ± 45 mL/min/m2 ). Target MAP ≥80 mmHg was achieved in 66.6% of patients in the intervention group but in only 27.3% of patients in the usual care group. Nevertheless, MAP during CPB did not differ significantly between the two groups. We conclude that little insight was gained from our observational study regarding the impact of variations in pump flow and MAP on the risk of AKI. However, a clinical trial to assess the effects of greater target pump flow and MAP on the risk of AKI appears feasible.
PMID:37549882 | DOI:10.1111/1440-1681.13812
Add to Google Keep
Estimated reading time: 5 minute(s)
Latest: Psychiatryai.com #RAISR4D
Real-Time Evidence Search [Psychiatry]
AI Research [Andisearch.com]
Intraoperative hemodynamics and risk of cardiac surgery-associated acute kidney injury: An observation study and a feasibility clinical trial
🌐 90 Days
VR Related Evidence Matrix
- APASL clinical practice guidelines on the management of acute kidney injury in acute-on-chronic liver failure
- Nephrological Detrimental Impacts Resulting From Novel Immunotherapy Drugs Used in the Treatment of Cancer: A Systematic Review
- Continuous vs intermittent Non-Invasive blood pressure MONitoring in preventing postoperative organ failure (niMON): study protocol for an open-label, multicenter randomized trial
- Controlled Mechanical Ventilation in Critically Ill Patients and the Potential Role of Venous Bagging in Acute Kidney Injury
- Interpretable machine learning-based individual analysis of acute kidney injury in immune checkpoint inhibitor therapy
- Metformin Use in Type 2 Diabetics and Delirium After Noncardiac Surgery: A Retrospective Cohort Analysis
- Community-acquired acute kidney injury in India: data from ISN-acute kidney injury registry
- High-flow nasal cannula therapy versus conventional oxygen therapy for adult patients after cardiac surgery: A systemic review and meta-analysis
- Short-term mild hyperventilation on intracranial pressure, cerebral autoregulation, and oxygenation in acute brain injury patients: a prospective observational study
- Cardiac output-mediated regulation of cerebral blood flow during exercise: Clinical perspectives on the indirect impact of muscle metaboreflex
- Significance Analysis of the Improvement in Postoperative Recovery of Cardiac Surgery Patients Based on the Graded Management Established Using the Delirium Prediction Model
- Relative band power in assessing temporary neurological dysfunction post- type A aortic dissection surgery: a prospective study
- Relative band power in assessing temporary neurological dysfunction post- type A aortic dissection surgery: a prospective study
- Tailored Yoga Intervention for Postlumbar Spine Surgical Pain Management: A Feasibility Study
- The Association of Preoperative Diabetes With Postoperative Delirium in Older Patients Undergoing Major Orthopedic Surgery: A Prospective Matched Cohort Study
- Use of a Combination Lavender/Peppermint Aromatherapy Patch During Port Catheter Placement Under Monitored Anesthesia Care Does Not Reduce Time to Discharge Readiness: A Randomized Controlled Trial
- Sub-anesthetic dose of esketamine decreases postoperative opioid self-administration after spine surgery: a retrospective cohort analysis
- Directional sensitivity of the cerebral pressure-flow relationship during forced oscillations induced by oscillatory lower body negative pressure
- Perioperative management of a double valve replacement and coronary artery bypass graft in a patient with carcinoid syndrome; a case report and literature review
- Effect of virtual reality hypnosis on intraoperative sedation needs and functional recovery in knee arthroplasty: a prospective randomized clinical trial
- Association between low values of mean arterial pressure and impaired cognitive performance in older patients with mild cognitive impairment: cross-sectional preliminary findings from the STRENGTH Project
- Randomized-controlled trial of anakinra plus zinc vs. prednisone for severe alcohol-associated hepatitis
- Compare the Combined Diagnostic Accuracy of Transient Elastography and Visual Liver Score in Assessing Non-Alcoholic Fatty Liver Disease (NAFLD) and Compare it with Liver Biopsy in Morbidly Obese Patients Undergoing Bariatric Surgery: An…
- Comparison of Remimazolam and Propofol on Postoperative Delirium in Elderly Patients Undergoing Radical Resection of Colon Cancer: A Single-Center Prospective Randomized Controlled Study
- Feasibility and Acceptability of Using Wireless Limited Polysomnography to Capture Sleep Before, During, and After Hospitalization for Patients With Planned Cardiothoracic Surgery
- Evaluation of management of CT scan proved solid organ injury in blunt injury abdomen-a prospective study
- Optimizing the use of ketamine to reduce chronic postsurgical pain in women undergoing mastectomy for oncologic indication: study protocol for the KALPAS multicenter randomized controlled trial
- Methadone for Emergence Delirium in Ambulatory Pediatric Strabismus Surgery
- Investigation of the effect of virtual reality distraction in patients undergoing mandibular periodontal surgery: A randomized controlled study
- Incidence Rate of Post Coronary Artery Shunt Complications; Age Dependent!
- Proton Pump Inhibitors and Cognitive Health: Review on Unraveling the Dementia Connection and Co-morbid Risks
- Opioid-Free Analgesia is Safe and Effective in Anterior Cervical Spine Surgery: A Randomized Controlled Trial
- Perioperative mental health intervention for depression and anxiety symptoms in older adults study protocol: design and methods for three linked randomised controlled trials
- Can stepped collaborative care interventions improve post-traumatic stress disorder symptoms for racial and ethnic minority injury survivors?
- Effects of a sphenopalatine ganglion block on postcraniotomy pain management: a randomized, double-blind, clinical trial
- Effectiveness and Safety of Intrathecal Morphine for Pediatric Patients Undergoing Scoliosis Surgery: A Systematic Review and Meta-Analysis
- The Flow State Scale for Rehabilitation Tasks: A New Flow Experience Questionnaire for Stroke Patients
- Preoperative mild cognitive impairment as a risk factor of postoperative cognitive dysfunction in elderly patients undergoing spine surgery
- Deep learning assists in acute leukemia detection and cell classification via flow cytometry using the acute leukemia orientation tube
- Long-Term Use of Proton-Pump Inhibitors: Unravelling the Safety Puzzle
- Trial of Early Minimally Invasive Removal of Intracerebral Hemorrhage
- A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients-A Review PART II-Pharmacological Approach for Management of Elderly Patients with Peripheral Atherosclerotic Lesions outside Coronary…
- Third-Degree Heart Block in COVID-19 Pneumonia Complicated by Methicillin-Resistant Staphylococcus Aureus (MRSA) Bacteremia. A Case Report and Review of Literature
- Third-Degree Heart Block in COVID-19 Pneumonia Complicated by Methicillin-Resistant Staphylococcus Aureus (MRSA) Bacteremia. A Case Report and Review of Literature
- Predictive factors of thoracic aortic calcification in patients candidate for cardiac surgery
- Utility of Remimazolam for Fast-Track Recovery Following Surgical Aortic Valve Replacement in an Elderly Patient With Severe Aortic Stenosis: A Case Report
- Circadian and Diurnal Regulation of Cerebral Blood Flow
- Can Baseline Patient Clinical and Demographic Characteristics Predict Response to Early Posttraumatic Stress Disorder Interventions After Physical Injury?
- Patterns of inappropriate prescribing and clinical characteristics in patients at admission to an acute care of the elderly unit
- Effectiveness of Peer-Based and Conventional Video Education in Reducing Perioperative Depression and Anxiety Among Coronary Artery Bypass Grafting Patients: A Randomized Controlled Trial
- Leukocyte- and platelet-rich fibrin in cranial surgery: a single-blinded, prospective, randomized controlled noninferiority trial
- Ultrasound-guided robotic surgical procedures: a systematic review
- Study on the risk factors of postoperative wound complications in patients with ankle fracture
- Feasibility of a breath robot intervention to reduce sleep problems in posttraumatic stress disorder: protocol for a randomized controlled study
- Cognitive and cerebrospinal fluid Alzheimer's disease-related biomarker trajectories in older surgical patients and matched nonsurgical controls
- WWP2 Regulates Kidney Fibrosis and the Metabolic Reprogramming of Profibrotic Myofibroblasts
- Effect of Target Temperature Management on Optic Nerve Sheath Diameter in Post-Cardiac Arrest Patients
- Perioperative point-of-care-testing of plasmacholinesterases identifies older patients at risk for postoperative delirium: an observational prospective cohort study
- Feasibility of online managing cancer and living meaningfully (CALM) in Chinese patients with metastatic breast cancer: a pilot randomized control trial
- Utility of cortical tissue analysis in normal pressure hydrocephalus
- The impact of postoperative agitated delirium on dementia in surgical patients
- Targeting metabolic-associated fatty liver disease in diabetic kidney disease: A call to action
- Surgical intervention for cerebral amyloid angiopathy-related lobar intracerebral hemorrhage: a systematic review
- Predictive factors for postoperative delirium in thoracic surgery
Evidence Blueprint
Intraoperative hemodynamics and risk of cardiac surgery-associated acute kidney injury: An observation study and a feasibility clinical trial
☊ AI-Driven Related Evidence Nodes
(recent articles with at least 5 words in title)
More Evidence
Intraoperative hemodynamics and risk of cardiac surgery-associated acute kidney injury: An observation study and a feasibility clinical trial
🌐 365 Days
VR Related Evidence Matrix
- Biochemical Changes in Cardiopulmonary Bypass in Cardiac Surgery: New Insights
- APASL clinical practice guidelines on the management of acute kidney injury in acute-on-chronic liver failure
- The Influence of Pre-operative Pain and Anxiety on Acute Postoperative Pain in Cardiac Surgery Patients Undergoing Enhanced Recovery after Surgery
- Nephrological Detrimental Impacts Resulting From Novel Immunotherapy Drugs Used in the Treatment of Cancer: A Systematic Review
- Continuous vs intermittent Non-Invasive blood pressure MONitoring in preventing postoperative organ failure (niMON): study protocol for an open-label, multicenter randomized trial
- Controlled Mechanical Ventilation in Critically Ill Patients and the Potential Role of Venous Bagging in Acute Kidney Injury
- The progression of hepatorenal syndrome-acute kidney injury in acute alcohol-associated hepatitis: renal outcomes after liver transplant
- Hypotension-Avoidance Versus Hypertension-Avoidance Strategies in Noncardiac Surgery : An International Randomized Controlled Trial
- Interpretable machine learning-based individual analysis of acute kidney injury in immune checkpoint inhibitor therapy
- Metformin Use in Type 2 Diabetics and Delirium After Noncardiac Surgery: A Retrospective Cohort Analysis
- Hypotension during transsphenoidal pituitary surgery associated with increase in plasma levels of brain injury markers
- Community-acquired acute kidney injury in India: data from ISN-acute kidney injury registry
- Regional versus general anesthesia in older patients for hip fracture surgery: a systematic review and meta-analysis of randomized controlled trials
- Proton Pump Inhibitors, Kidney Damage, and Mortality: An Updated Narrative Review
- Non-Alcoholic Fatty Liver Disease Predicts Acute Kidney Injury Readmission in Heart Failure Hospitalizations: A Nationwide Analysis
- Impact of early postoperative blood glucose variability on serum endocan level in cardiac surgery patients: a sub study of the ENDOLUNG observational study
- Dexmedetomidine Alleviates Ischemia/Reperfusion-Associated Acute Kidney Injury by Enhancing Autophagic Activity via the α2-AR/AMPK/mTOR Pathway
- Effect of Dexmedetomidine on Posttraumatic Stress Disorder in Patients Undergoing Emergency Trauma Surgery: A Randomized Clinical Trial
- The Effect of Visits by Operating Room Nurses Before Cardiac Surgery on Anxiety and Pain Management
- Comparison of Effects of Liuzijue Exercise and Conventional Respiratory Training on Patients after Cardiac Surgery: A Randomized Controlled Trial
- Clinical characteristics and prognosis of hospitalized patients with moderate alcohol-associated hepatitis
- High-flow nasal cannula therapy versus conventional oxygen therapy for adult patients after cardiac surgery: A systemic review and meta-analysis
- The effects of higher versus lower protein delivery in critically ill patients: an updated systematic review and meta-analysis of randomized controlled trials with trial sequential analysis
- Comments on: Nonalcoholic Fatty Liver Disease Predicts Acute Kidney Injury Readmission in Heart Failure Hospitalizations: A Nationwide Analysis
- Absolute and Relative Risks of Kidney Outcomes Associated With Lithium vs Valproate Use in Sweden
- Study of Renal Dysfunction in Alcoholic Liver Disease
- Short-term mild hyperventilation on intracranial pressure, cerebral autoregulation, and oxygenation in acute brain injury patients: a prospective observational study
- Risk Factors of Acute Pain in Elderly Patients After Laparoscopic Radical Resection of Colorectal Cancer
- Comparison of the effects of remimazolam tosylate and propofol on postoperative delirium among older adults undergoing major non-cardiac surgery: protocol for a randomised controlled trial
- Association Between Preoperative Long-Term Poor Sleep Quality and Postoperative Delirium in Elderly Patients Undergoing Cardiac Surgery: A Multi-Center Observational Study
- Cardiac output-mediated regulation of cerebral blood flow during exercise: Clinical perspectives on the indirect impact of muscle metaboreflex
- Effects of depth of neuromuscular block on surgical operating conditions in women undergoing gynecologic laparoscopic surgery: a randomized clinical trial
- Effect of maximal-intensity and high-intensity interval training on exercise capacity and Quality of Life in patients with acute myocardial infarction: a randomized controlled trial
- Significance Analysis of the Improvement in Postoperative Recovery of Cardiac Surgery Patients Based on the Graded Management Established Using the Delirium Prediction Model
- Relative band power in assessing temporary neurological dysfunction post- type A aortic dissection surgery: a prospective study
- Relative band power in assessing temporary neurological dysfunction post- type A aortic dissection surgery: a prospective study
- Tailored Yoga Intervention for Postlumbar Spine Surgical Pain Management: A Feasibility Study
- The Association of Preoperative Diabetes With Postoperative Delirium in Older Patients Undergoing Major Orthopedic Surgery: A Prospective Matched Cohort Study
- Use of a Combination Lavender/Peppermint Aromatherapy Patch During Port Catheter Placement Under Monitored Anesthesia Care Does Not Reduce Time to Discharge Readiness: A Randomized Controlled Trial
- Lower-grade gliomas surgery guided by GRPR-targeting PET/NIR dual-modality image probe: a prospective and single-arm clinical trial
- Sub-anesthetic dose of esketamine decreases postoperative opioid self-administration after spine surgery: a retrospective cohort analysis
- Mental health changes in elderly patients undergoing non-cardiac surgery during the COVID-19 pandemic in China
- Virtual Reality-Based Intervention to Reduce Preoperative Anxiety in Adults Undergoing Elective Surgery: A Randomized Clinical Trial
- Hemispheric Epilepsy Surgery for Hemimegalencephaly: The UCLA Experience
- Determinants of Early Mobilization in Post-Cardiac Surgery Patients
- Effects of acupressure on intestinal function in patients with coronary artery bypass graft surgery: a randomized clinical trial
- Directional sensitivity of the cerebral pressure-flow relationship during forced oscillations induced by oscillatory lower body negative pressure
- Electroencephalographic Biomarkers, Cerebral Oximetry, and Postoperative Cognitive Function in Adult Non-Cardiac Surgical Patients: a Prospective Cohort Study
- The BETTER Traumatic Brain Injury Transitional Care Intervention: A Feasibility Study
- A longitudinal multidimensional rehabilitation program for patients undergoing allogeneic blood and marrow transplantation (CaRE-4-alloBMT): Protocol for a phase II feasibility pilot randomized controlled trial
- Chronic post-thoracotomy pain after lung cancer surgery: a prospective study of preoperative risk factors
- A Feasibility Randomized Controlled Trial of Prehabilitation During Neoadjuvant Chemotherapy for Women with Breast Cancer: A Mixed Methods Study
- Perioperative management of a double valve replacement and coronary artery bypass graft in a patient with carcinoid syndrome; a case report and literature review
- Effect of virtual reality hypnosis on intraoperative sedation needs and functional recovery in knee arthroplasty: a prospective randomized clinical trial
- Patient perception and satisfaction in awake burr hole trepanation under local anesthesia for evacuation of chronic subdural hematoma
- Effect of an intraoperative periradicular application of platelet-rich fibrin (PRF) on residual post-surgical neuropathic pain after disc herniation surgery: study protocol for NeuroPRF, a randomized controlled trial
- Application progress of nursing intervention in cardiac surgery
- Thirty-Day readmissions among COVID-19 patients hospitalized during the early pandemic in the United States: Insights from the Nationwide Readmissions Database
- Association between low values of mean arterial pressure and impaired cognitive performance in older patients with mild cognitive impairment: cross-sectional preliminary findings from the STRENGTH Project
- Randomized-controlled trial of anakinra plus zinc vs. prednisone for severe alcohol-associated hepatitis
- Dexmedetomidine after deep brain stimulation for prevention of delirium in elderly patients with Parkinson's disease: protocol for a single-centre, randomised, double-blind, placebo-controlled trial in China
- Effect of Preoperative Carbohydrate Drink and Postoperative Chewing Gum on Postoperative Nausea and Vomiting in Patients Undergoing Day Care Laparoscopic Cholecystectomy: A Randomized Controlled Trial
- Preoperative Virtual Reality to Expose Patients With Breast Cancer to the Operating Room Environment: Feasibility and Pilot Case Series Study
- The Effect of Hand Reflexology Massage on Pain and Anxiety After Coronary Artery Bypass Graft Surgery: A Double-Blind, Randomized, Placebo-Controlled Trial