061 * Short- And Long-Term Outcomes (Including Quality of Life) After Cardiac Surgery in Patients With Postoperative Acute Kidney Injury

Nandi, Jay; Mishra, Prashant; Luckraz, Heyman; Nevill, Alan M.; Denyer, N.; Kitchlu, S.; Giri, Ramesh; Nicholas, Johann

doi:10.1093/icvts/ivu276.61

Cited by 2 publications

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“…Patient’s selection for being at risk of developing AKI was based on our unit’s own experience, 7 and previous report. 1 For the purpose of this pilot study, the RIFLE definition for AKI was used.…”

Section: Methodsmentioning

confidence: 99%

“…It is now customary to use the Risk, Injury , Failure , Loss of kidney function, and End-stage kidney disease (RIFLE), 2 3 or the Acute Kidney Injury Network (AKIN) consensus criteria. 4 The development of AKI in the postop cardiac surgery setting is associated with significant morbidity, 5 6 mortality, 5 prolonged intensive care unit (ICU) and inhospital stays, 7 increased treatment costs and poorer long-term survival and quality of life. 7–9 As yet, no satisfactory strategy has been successful in preventing AKI despite identifying patients who are at risk of developing AKI.…”

Section: Introductionmentioning

confidence: 99%

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The use of the RenalGuard system in cardiac surgery with cardiopulmonary bypass: a first in man prospective, observational, feasibility pilot study

Luckraz

Giri²,

Wrigley³

et al. 2017

Open Heart

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ObjectivesAs proof of concept, this prospective, observational study assessed the feasibility and early clinical outcomes of performing on-pump cardiac surgery with the RenalGuard system.BackgroundAcute kidney injury (AKI) is reported in up to 30% of patients undergoing cardiac surgery and is a recognised independent predictor of both morbidity and mortality. Forced diuresis with the RenalGuard system reduces the incidence of AKI during percutaneous coronary intervention procedures but its use in cardiac surgery has not been explored.MethodsTen consecutive patients who were at risk of developing AKI during cardiac surgery were selected. The RenalGuard system was used to facilitate forced diuresis using weight-adjusted intravenous furosemide while maintaining neutral fluid balance by matched intravenous fluid replacement. This regimen was initiated preoperatively in all patients and continued for 6–12 hours postoperatively. Serum creatinine, electrolytes and need for renal replacement were documented in all patients.ResultsThe RenalGuard system functioned successfully in all patients and facilitated high perioperative urine outputs, even when patients were placed on cardiopulmonary bypass (CPB). There were no incidences of significant (A) electrolyte imbalance, (B) changes in haemoglobin levels or (C) pulmonary oedema. No patients developed AKI within 36 hours of surgery despite one patient developing cardiac tamponade 8 hours postoperatively and one patient developing paralytic ileus. One patient, however, was ‘electively’ haemofiltered on day 2 after developing acute right ventricular failure. The median intensive care stay was 1.5 (1, 5) days.ConclusionThe RenalGuard system can be used successfully in patients undergoing cardiac surgery with CPB and may reduce the incidence of AKI in at-risk patients.Trial registrationNCT02974946; Pre-results.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The use of the RenalGuard system in cardiac surgery with cardiopulmonary bypass: a first in man prospective, observational, feasibility pilot study

Luckraz

Giri²,

Wrigley³

et al. 2017

Open Heart

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“…Daniel T. Engelman, MD, FACS, a,b and John A. Kellum, MD, FACP, MCCM c After cardiac surgery, acute kidney injury (AKI) develops in 15% to 30% of patients. 1 The development of AKI after cardiac surgery is associated with significant morbidity and mortality, 2,3 prolonged intensive care unit and in-hospital stays, 4 increased treatment costs, and decreased long-term survival and quality of life. Standard risk-assessment tools have been ineffective in reducing this incidence.…”

mentioning

confidence: 99%

Should urinary biomarkers be a standard component of evaluation after cardiac surgery?

Engelman

Kellum

2018

The Journal of Thoracic and Cardiovascular Surgery

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061 * Short- And Long-Term Outcomes (Including Quality of Life) After Cardiac Surgery in Patients With Postoperative Acute Kidney Injury

Cited by 2 publications

References 0 publications

The use of the RenalGuard system in cardiac surgery with cardiopulmonary bypass: a first in man prospective, observational, feasibility pilot study

The use of the RenalGuard system in cardiac surgery with cardiopulmonary bypass: a first in man prospective, observational, feasibility pilot study

Should urinary biomarkers be a standard component of evaluation after cardiac surgery?

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