术中低血压对术后肾功能的影响。
The Effect of Intraoperative Hypotension on Postoperative Renal Function.
作者信息
Kim Benjamin, Sangha Gurleen, Singh Amrik, Bohringer Christian
机构信息
Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA, USA.
Dayanand medical College and Hospital, Ludhiana, India.
出版信息
Curr Anesthesiol Rep. 2023 Sep;13(3):181-186. doi: 10.1007/s40140-023-00564-2. Epub 2023 Jun 14.
PURPOSE OF REVIEW
This review summarizes the most recent literature on the association between intraoperative hypotension (IOH) and the occurrence of postoperative acute kidney injury (AKI). It provides recommendations for the management of intraoperative blood pressure to reduce the incidence of postoperative AKI. Fluid management strategies, administration of vasopressor medications, and other methods for reducing the incidence of AKI are also briefly discussed.
RECENT FINDINGS
Recent retrospective studies have demonstrated a solid association of IOH with postoperative AKI. IOH is associated not only with AKI but also with myocardial infarction, stroke, and death. Strict BP management to avoid a mean blood pressure less than 65mmHg is now recommended to reduce the incidence of postoperative AKI and other adverse outcomes.
SUMMARY
IOH is robustly associated with AKI, and intraoperative mean BP should be maintained above 65 mmHg at all times. The etiology of postoperative AKI is however multifactorial, and factors other than BP therefore also need to be considered to prevent it.
综述目的
本综述总结了关于术中低血压（IOH）与术后急性肾损伤（AKI）发生之间关联的最新文献。它为术中血压管理提供建议，以降低术后AKI的发生率。还简要讨论了液体管理策略、血管升压药物的使用以及其他降低AKI发生率的方法。
最新发现
近期的回顾性研究已证实IOH与术后AKI之间存在密切关联。IOH不仅与AKI相关，还与心肌梗死、中风和死亡相关。现在建议进行严格的血压管理，以避免平均血压低于65mmHg，从而降低术后AKI和其他不良结局的发生率。
总结
IOH与AKI密切相关，术中平均血压应始终维持在65mmHg以上。然而，术后AKI的病因是多因素的，因此为预防AKI还需要考虑血压以外的其他因素。
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