Cooper David S, Basu Rajit K, Price Jack F, Goldstein Stuart L, Krawczeski Catherine D
The Heart Institute and the Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Division of Critical Care and the Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
World J Pediatr Congenit Heart Surg. 2016 Mar;7(2):152-63. doi: 10.1177/2150135115623289.
The field of cardiac intensive care continues to advance in tandem with congenital heart surgery. The focus of intensive care unit care has now shifted to that of morbidity reduction and eventual elimination. Acute kidney injury (AKI) after cardiac surgery is associated with adverse outcomes, including prolonged intensive care and hospital stays, diminished quality of life, and increased long-term mortality. Acute kidney injury occurs frequently, complicating the care of both postoperative patients and those with heart failure. Patients who become fluid overloaded and/or require dialysis are at high risk of mortality, but even minor degrees of AKI portend a significant increase in mortality and morbidity. Clinicians continue to seek methods of early diagnosis and risk stratification of AKI to prevent its adverse sequelae. Previous conventional wisdom that survivors of AKI fully recover renal function without subsequent consequences may be flawed.
心脏重症监护领域继续与先天性心脏手术同步发展。重症监护病房护理的重点现已转向降低发病率并最终消除发病率。心脏手术后的急性肾损伤（AKI）与不良后果相关，包括重症监护和住院时间延长、生活质量下降以及长期死亡率增加。急性肾损伤经常发生，使术后患者和心力衰竭患者的护理变得复杂。出现液体过载和/或需要透析的患者死亡风险很高，但即使是轻度的急性肾损伤也预示着死亡率和发病率会显著增加。临床医生继续寻求急性肾损伤的早期诊断和风险分层方法，以预防其不良后果。以前的传统观念认为急性肾损伤幸存者能完全恢复肾功能且无后续影响，这可能是错误的。
