Renal perfusion during thoracoabdominal aortic operations: cold crystalloid is superior to normothermic blood

Assessment of hepatosplanchnic pathophysiology during thoracoabdominal aortic aneurysm repair using visceral perfusion and shunt☆

“…Our flow rate is also supported by the findings of decreased whole body oxygen consumption up to 30% at 32 8C [12]. On the other hand, Coselli's group, using a lower flow rate of 400 ml/min for four branches at normothermia, reported that intermittent cold crystalloid perfusion provides superior renal protection than selective perfusion [13]. Safi and Colleagues [14], using a lower flow rate of 200-600 ml/min for four branches at moderate hypothermia, also reported no beneficial effect of selective perfusion on renal function.…”

Intraoperative skeletal muscle ischemia contributes to risk of renal dysfunction following thoracoabdominal aortic repair☆☆☆

“…While no standard definition of post-TAAA renal dysfunction has become established in the literature, studies that define it in terms of increasing postoperative creatinine report rates of 10-40%, [1][2][3][4][5][6] while those that define it as requirement for new dialysis report rates in the 2-15% range [3,4,[6][7][8]. The only large multicenter report in the literature to date describes renal failure rates submitted by hospitals to Medicare as part of their billing data.…”

Guidelines for Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection (JCS 2011)

“…For reconstruction of the abdominal major arterial branches, selective perfusion of the celiac artery, the superior mesenteric artery, and the renal arteries should be performed, and cold Ringer's lactate solution can be applied for renal arteries reconstruction only. 156 …”