Department of Anaesthesiology, Singapore General Hospital, Singapore; Department of Cardiothoracic Anaesthesia, National Heart Centre, Singapore.
Department of Anaesthesiology, Singapore General Hospital, Singapore; Department of Cardiothoracic Anaesthesia, National Heart Centre, Singapore.
J Cardiothorac Vasc Anesth. 2021 Dec;35(12):3774-3788. doi: 10.1053/j.jvca.2020.10.014. Epub 2020 Oct 16.
Red-colored urine occurring in the intraoperative and early postoperative periods after cardiac surgery is often a cause for concern. This observation may be a result of hematuria from pathology within the urinary tract, anticoagulant-related nephropathy, drug-induced acute interstitial nephropathy, excretion of heme pigment-containing proteins, such as myoglobin and hemoglobin, and hemolysis occurring during extracorporeal circulation. Within the kidneys, heme-containing compounds result in pigment nephropathy, which is a significant contributory factor to cardiac surgery-associated acute kidney injury. Concerted efforts to reduce red blood cell damage during cardiopulmonary bypass, together with early recognition of the at-risk patient and the institution of prompt therapeutic intervention, may improve outcomes. This review addresses the diagnosis, causes, and management of red-discolored urine occurring during and after cardiac surgery.
心脏手术后手术中和术后早期出现红色尿液通常令人担忧。这种观察结果可能是由于泌尿道疾病引起的血尿、抗凝相关肾病、药物引起的急性间质性肾炎、含血红素色素蛋白（如肌红蛋白和血红蛋白）的排泄以及体外循环过程中的溶血所致。在肾脏中，含血红素的化合物会导致色素性肾病，这是导致心脏手术相关急性肾损伤的重要因素。在体外循环过程中，通过减少红细胞损伤并早期识别高危患者并及时进行治疗干预，可能会改善预后。本文综述了心脏手术后手术中和术后出现红色尿液的诊断、病因和处理方法。
