Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a major adverse effect of cardiac surgery. The early detection of this complication can improve the quality of postoperative care and help prevent this phenomenon. Methods: In this prospective descriptive-analytical study, 148 patients were enrolled, 107 of whom were selected for analysis between February and September 2019 in the Cardiac Surgery Unit of Golestan Hospital, Ahvaz, Iran. Kidney tissue oxygen saturation was measured at multiple definite times during surgery. Hemoglobin, blood urea nitrogen, creatinine, and lactate were measured during and 48 hours after the surgery. Results: Forty-one patients were diagnosed with CSA-AKI according to the KDIGO criteria. Parametric and non-parametric analyses showed no significant difference between the CSA-AKI and non-CSA-AKI groups in the demographic parameters. Repeated measures ANOVA showed no significant difference in parameters, except for BUN. Repeated measures ANOVA showed a significant difference between both groups and time factors (P < 0.001, P = 0.0006, respectively). The ROC curve analyses showed that in a single point of time, the difference in the middle of CPB time from baseline had a high value in the prediction of AKI (AUC: 0.764; CI: 0.57 - 0.951). Conclusions: Kidney saturation monitoring could be considered in cardiac surgery for the rapid detection of CSA-AKI. Although kidney tissue saturation is not correlated directly to the arterial oxygen saturation, the physician and the surgery team can predict the chance of acute kidney injury.
Background. Cardiac surgery-associated acute kidney injury (CSA –AKI), is a major complication of cardiac surgery. Early detection of this complication can improve the quality of post-operative care and help to prevent this phenomenon.Materials and Methods: 148 patients were enrolled to study and 107 patients were selected for analysis between February and September 2019 in the cardiac surgery unit of Golestan Hospital. Ahvaz. Iran. Kidney tissue oxygen saturation was measured in multiple definite times during surgery. Hemoglobin, blood urea nitrogen, creatinine, and lactate were measured during and 48 hours after surgery.Results: Forty-one patients were diagnosed of CSA-AKI according to KDIGO criteria. Parametric and non-parametric analyzes significant difference was not detected between CSA-AKI and NON CSA-AKI group in the demographic parameter. Repeated measurement of ANOVA Analysis did not show any significant difference in parameters except for BUN. Repeated measurement of ANOVA showed a significant difference in both groups and time factors (p<0.001, p=0.0006 respectively). ROC curve analyzes showed in a single point of time, difference the middle of CPB time from baseline high-value in the prediction of AKI 0.764 (0.57 to 0.951) (AUC-CI). Conclusion; Kidney saturation monitoring could be considered as routine monitoring in cardiac surgery for the rapid detection of CSA -AKI. Although kidney tissue saturation is not correlated directly to the arterial saturation of oxygen, physician and surgery team could predict the chance of acute kidney injury exposure.
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