Department of Internal Medicine, Division of Cardiology, Medical Branch, University of Texas, 301 University Blvd, Galveston, TX, 77550, USA.
Curr Cardiol Rep. 2022 Oct;24(10):1299-1307. doi: 10.1007/s11886-022-01742-0. Epub 2022 Aug 4.
Management of patients presenting with acute coronary syndrome (ACS) includes invasive procedures that may increase the risk of acute kidney injury (AKI). AKI adversely affects the outcomes of such procedures and complicates the management of ACS. We have summarized several strategies for the prevention and management of AKI in this critical patient group including in the pre-procedural, intraprocedural, and post-procedural settings.
Definitive prevention and management strategies for AKI in patients presenting with ACS requiring invasive management can be confounded by the variation in data outcomes. Pre-procedural hydration with normal saline when accounting for time to catheterization, radial artery access, contrast stewardship, and close monitoring of renal function after catheterization should be implemented.
急性冠状动脉综合征(ACS)患者的治疗包括可能增加急性肾损伤(AKI)风险的有创性操作。AKI 会对这些操作的结果产生不良影响,并使 ACS 的治疗复杂化。我们总结了该类高危患者群体的 AKI 预防和处理策略,包括术前、术中和术后。
由于数据结果的差异,需要进行有创性治疗的 ACS 患者 AKI 的明确预防和处理策略可能会变得复杂。术前应考虑到置管时间、桡动脉入路、对比剂管理以及置管后肾功能的密切监测,用生理盐水进行水化治疗。