Role of perfusion pressure and flow in major organ dysfunction after cardiopulmonary bypass

Acute Kidney Injury (AKI) After Cardiac Surgery: Incidence, Risk Factors and Outcome

“…This last factor is perhaps the most predictive, with the risk for AKI-D approaching 10 to 20% in patients with a baseline preoperative creatinine 2.0 to 4.0 mg/dl. [13][14][15][16][17][18][19] In patients with a preoperative creatinine >4.0 mg/dl, the risk for AKI-D rises to 25 to 28%. [13][14][15] Several other risk factors have been identified but are more controversial and, thus, individually they do not play as prominent a role in determining the risk for AKI.…”

“…In aggregate, however, these factors may be important and potentially modifiable. These include factors specifically related to the bypass procedure itself, such as duration of CPB [16][17][18] and on-versus offpump coronary artery bypass surgery [19][20][21][22][23][24] .…”

Hepatic and renal effects of cardiopulmonary bypass

“…In summary, the major risk factors for AKI during cardiac surgery are the duration of CPB and the cross-clamp time [62,63]. Further studies are necessary to investigate a more reliable method for risk stratification and perioperative haemodynamic optimisation.…”

Entanglement of Sepsis, Chronic Kidney Disease, and Other Comorbidities in Patients Who Develop Acute Kidney Injury

“…[98][99][100] Intraoperative risk factors also are associated with postoperative CSA-AKI, including the use of intra-aortic balloon pumps, hypothermic circulatory arrest, the use of vasopressors, and the number of blood transfusions needed. 96,101,102 Based on these risk factors, a variety of clinical tools have been developed and validated to improve the AKI risk stratification of individual patients undergoing cardiac surgery (Table 3). Importantly, the role of cardiopulmonary bypass pump as a risk factor for CSA has been investigated intensively.…”