Department of Anesthesiology, Intensive Care, and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, A1, Münster 48149, Germany.
Department of Anesthesiology, Intensive Care, and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, A1, Münster 48149, Germany.
Crit Care Clin. 2021 Apr;37(2):267-278. doi: 10.1016/j.ccc.2020.11.009. Epub 2021 Feb 13.
Acute kidney injury (AKI) occurs frequently after cardiac surgery and is associated with high morbidity and mortality. Although the number of cardiac surgical procedures is constantly growing worldwide, incidence of cardiac surgery-associated AKI is still around 40% and has a significant impact on global health care costs. Numerous trials attempted to identify strategies to prevent AKI and attenuate its detrimental consequences. Effective options remained elusive. Current evidence supports a multimodal risk-stratification approach with biomarker-guided management of high-risk patients, perioperative administration of dexmedetomidine, and implementation of a care bundle as recommended by the Kidney Disease: Improving Global Outcomes group.
心脏手术后经常会发生急性肾损伤(AKI),并且与高发病率和死亡率相关。尽管全球心脏外科手术的数量不断增加,但心脏手术相关 AKI 的发生率仍约为 40%,对全球医疗保健成本有重大影响。许多试验试图确定预防 AKI 和减轻其不良后果的策略,但有效的选择仍难以捉摸。目前的证据支持采用多模式风险分层方法,对高危患者进行生物标志物指导管理,围手术期给予右美托咪定,并按照改善全球肾脏病预后组织的建议实施护理套餐。