Division of Nephrology, Centre Hospitalier de l'Université de Montréal, Montréal, Canada; Department of Anesthesiology, Montreal Heart Institute, Montréal, Canada.
Department of Anesthesiology, Montreal Heart Institute, Montréal, Canada; Division of Intensive Care, Centre Hospitalier de l'Université de Montréal, Montréal, Canada.
J Cardiothorac Vasc Anesth. 2019 Oct;33(10):2781-2796. doi: 10.1053/j.jvca.2018.11.002. Epub 2018 Nov 3.
The approach to the patient with acute kidney injury (AKI) after cardiac surgery involves multiple aspects. These include the rapid recognition of reversible causes, the accurate identification of patients who will progress to severe stages of AKI, and the subsequent management of complications resulting from severe renal dysfunction. Unfortunately, the inherent limitations of physical examination and laboratory parameter results are often responsible for suboptimal clinical management. In this review article, the authors explore how point-of-care ultrasound, including renal and extrarenal ultrasound, can be used to complement all aspects of the care of cardiac surgery patients with AKI, from the initial approach of early AKI to fluid balance management during renal replacement therapy. The current evidence is reviewed, including knowledge gaps and future areas of research.
心脏手术后急性肾损伤（AKI）患者的处理方法涉及多个方面。这些方面包括快速识别可逆性病因、准确识别将进展为 AKI 严重阶段的患者，以及随后处理严重肾功能障碍引起的并发症。不幸的是，体格检查和实验室参数结果的固有局限性常常导致临床处理效果欠佳。在这篇综述文章中，作者探讨了即时护理超声（包括肾脏和肾脏外超声）如何能够补充心脏手术后 AKI 患者护理的各个方面，从早期 AKI 的初始处理到肾脏替代治疗期间的液体平衡管理。文章还回顾了当前的证据，包括知识空白和未来的研究领域。
