Renal protection in cardiovascular surgery [version 1; referees: 2 approved]

F1000Research

卷:5

Nora Di Tomasso¹  Fabrizio Monaco¹  Giovanni Landoni² 

[1] Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy;

[2] Vita-Salute San Raffaele University, Milan, Italy;

关键词: Acute Cardiovascular Problems;    Acute Renal Failure;    Cardiovascular Pharmacology;    Coronary Artery Disease;    Immunological Biomarkers;    Pathophysiology of Chronic Kidney Disease (CKD);    Perioperative Critical Care;    Renal & Gastrointestinal Problems in Critical Care;    Renal Pharmacology;    Valvular Disease;   

DOI  :  10.12688/f1000research.7348.1

来源: DOAJ

【 摘 要 】

Acute kidney injury (AKI) is one of the most relevant complications after major surgery and is a predictor of mortality. In Western countries, patients at risk of developing AKI are mainly those undergoing cardiovascular surgical procedures. In this category of patients, AKI depends on a multifactorial etiology, including low ejection fraction, use of contrast media, hemodynamic instability, cardiopulmonary bypass, and bleeding. Despite a growing body of literature, the treatment of renal failure remains mainly supportive (e.g. hemodynamic stability, fluid management, and avoidance of further damage); therefore, the management of patients at risk of AKI should aim at prevention of renal damage. Thus, the present narrative review analyzes the pathophysiology underlying AKI (specifically in high-risk patients), the preoperative risk factors that predispose to renal damage, early biomarkers related to AKI, and the strategies employed for perioperative renal protection. The most recent scientific evidence has been considered, and whenever conflicting data were encountered possible suggestions are provided.

【 授权许可】

Unknown