Defining an Intraoperative Hypotension Threshold in Association with De Novo Renal Replacement Therapy after Cardiac Surgery

Conclusions MAP less than 65 mmHg for 10  min or more post-CPB is associated with an increased risk ofde novo postoperative renal replacement therapy. The association between intraoperative hypotension and AKI was weaker in comparison to factors such as renal insufficiency, heart failure, obesity, anemia, complex or emergent surgery, and new-onset postoperative atrial fibrillation. Nonetheless, post-CPB hypotension is a potentially easier modifiable risk factor that warrants further investigation.Editor ’s PerspectiveWhat We Already Know about This TopicPatients undergoing cardiac surgery with cardiopulmonary bypass are at risk for acute kidney injury requiringde novo renal replacement therapyThe specific association between pre –, during, and post–cardiopulmonary bypass hypotension andde novo renal replacement therapy remains unclearWhat This Article Tells Us That Is NewVarying definitions of hypotension before and during cardiopulmonary bypass are not associated with renal replacement therapyMean arterial pressure less than 55 or between 55 and 64 mmHg for 10 or more minutes after cardiopulmonary bypass is associated with renal replacement therapyThe association of post –cardiopulmonary bypass hypotension with renal replacement therapy is weaker than nonmodifiable procedure and patient risk factors
Source: Anesthesiology - Category: Anesthesiology Source Type: research