Acute Kidney Injury in Cardiac Surgery and Cardiac Intensive Care

Lau, Gary; Wald, Ron; Sladen, Robert N.; Mazer, C. David

doi:10.1177/1089253215593177

Cited by 13 publications

(23 citation statements)

References 196 publications

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“…AKI is a common complication with an estimated incidence about 7% to 45% in adult cardiac surgery [ 24 ]. Small increases in postoperative serum creatinine levels after cardiac surgery have been reported to be associated with increased morbidity and mortality even if the renal function has returned to normal at discharge [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine prevents acute kidney injury after adult cardiac surgery: a meta-analysis of randomized controlled trials

et al. 2018

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BackgroundDexmedetomidine has been shown to confer direct renoprotection by stabilizing the sympathetic system, exerting anti-inflammatory effects and attenuating ischemia/reperfusion (I/R) injury in preclinical studies. Results from clinical trials of dexmedetomidine on acute kidney injury (AKI) following adult cardiac surgery are controversial.MethodsWe searched EMBASE, PubMed, and Cochrane CENTRAL databases for randomized controlled trials (RCTs) comparing the renal effect of dexmedetomidine versus placebo or other anesthetic drugs in adult patients undergoing cardiac surgery. The primary outcome was the incidence of AKI. The secondary outcomes were mechanical ventilation (MV) duration, intensive care unit (ICU) stay and hospital length of stay(LOS), and postoperative mortality (in-hospital or within 30 days).ResultsTen trials with a total of 1575 study patients were selected. Compared with controls, dexmedetomidine significantly reduced the incidence of postoperative AKI [68/788 vs 97/787; odds ratio(OR), 0.65; 95% confidence interval (CI), 0.45–0.92; P = 0.02; I2 = 0.0%], and there was no difference between groups in postoperative mortality (4/487 vs 11/483; OR, 0.43; 95% CI, 0.14–1.28; P = 0.13; I2 = 0.0%), MV duration [in days; n = 1229; weighted mean difference(WMD), −0.22; 95% CI, −2.04 to 1.70; P = 0.81], ICU stay (in days; n = 1363; WMD, −0.85; 95% CI, −2.14 to 0.45; P = 0.20), and hospital LOS (in days; n = 878; WMD, −0.24; 95% CI, −0.71 to 0.23; P = 0.32).ConclusionsPerioperative administration of dexmedetomidine in adult patients undergoing cardiac surgery may reduce the incidence of postoperative AKI. Future trials are needed to determine the dose and timing of dexmedetomidine in improving outcomes, especially in patients with decreased baseline kidney function.

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Section: Discussionmentioning

confidence: 99%

Dexmedetomidine prevents acute kidney injury after adult cardiac surgery: a meta-analysis of randomized controlled trials

et al. 2018

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“…The mortality rate can reach up to 60%. In retrospective studies, a 30% decrease in GFR increased mortality by 4-6% in patients after cardiac surgery [11][12][13][14]. In a prospective cohort study of 43,642 patients after CABG and valvular surgery, the 30-day mortality was 64 % in patients needing hemodialysis after surgery, and 4% in patients without renal injury [15].…”

Section: Discussionmentioning

confidence: 99%

Frequency and factors affecting the development of acute kidney injury following open heart surgery

Özçelik¹,

Aşkar²

2020

Journal of Surgery and Medicine

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“…de temperatura e placa Peltier para teste de programação, conforme figura 8. LiquidCrystal lcd (12,11,9,8,7,6);…”

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O Conhecimento De Práticas Sanitárias Na Prevenção De Doenças Infecciosas Em Bairros Do Município De Patos, Estado Da Paraíba, Brasil

Souza¹,

Sales²,

Lacerda³

et al. 2020

Propostas, Recursos E Resultados Nas Ciências Da Saúde 8

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selecionados para participar de entrevista semiestruturada. Resultados: 45,6% dos pais e cuidadores possuíam o ensino médio, 54% ganhavam até um salário mínimo e 42% tinham um filho. 70% possuíam termômetro, 48,4% não observaram o tempo adequado para retirálo. 29,4% verificavam pela palpação. 34,3% conceituaram febre a partir de 37,5°C. 96,3% administravam antitérmicos e 83,3% desconheciam os efeitos adversos. 14% administravam antibióticos. 70% consideravam que a febre trazia malefícios e que o pior dano é a convulsão.Os discursos sugeriram forte influência cultural e do saber comum. Conclusão: Considerase, portanto, que os participantes possuíam medos, crenças e práticas de manejo da febre similares. Em algumas situações demonstraram conhecimento e percepções limitados, ocasionando em atitudes errôneas frente à febre. A febre fobia persiste, pais ou cuidadores demonstram insegurança para cuidar da criança febril.

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Acute Kidney Injury in Cardiac Surgery and Cardiac Intensive Care

Cited by 13 publications

References 196 publications

Dexmedetomidine prevents acute kidney injury after adult cardiac surgery: a meta-analysis of randomized controlled trials

Dexmedetomidine prevents acute kidney injury after adult cardiac surgery: a meta-analysis of randomized controlled trials

Frequency and factors affecting the development of acute kidney injury following open heart surgery

O Conhecimento De Práticas Sanitárias Na Prevenção De Doenças Infecciosas Em Bairros Do Município De Patos, Estado Da Paraíba, Brasil

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