Acute kidney injury is a common complication after cardiac surgery with cardiopulmonary bypass. The authors evaluated the effects of normothermic bypass on renal blood flow, glomerular filtration rate, oxygen consumption, and supply/demand relationship, i.e., oxygenation (primary outcome) in patients undergoing surgery.Eighteen normal preoperative serum creatinine procedures (2.5 l · min m) were included informed consent. Systemic hemodynamic variables measured by pulmonary artery vein...

Estimation of kidney function in critically ill patients with acute injury (AKI), is important for appropriate dosing drugs and adjustment therapeutic strategies, but challenging due to fluctuations function, creatinine metabolism fluid balance. Data on the agreement between estimating gold standard methods assess glomerular filtration rate (GFR) early AKI are lacking. We evaluated urinary clearance (CrCl) three commonly used equations, Cockcroft Gault (CG), Modification Diet Renal Disease...

Acute kidney injury occurs frequently after cardiac or major vascular surgery and is believed to be predominantly a consequence of impaired renal oxygenation. However, in patients with acute injury, data on oxygen consumption (RVO2), blood flow, glomerular filtration, oxygenation, i.e., the supply/demand relationship, are lacking current views oxygenation clinical situation presumptive largely based experimental studies.Prospective, two-group comparative study.Cardiothoracic intensive care...

Objectives: Acute kidney injury develops in a large proportion of patients after cardiac surgery because the low output syndrome. The inodilator levosimendan increases with cardiopulmonary bypass, but detailed analysis its effects on renal perfusion, glomerular filtration, and oxygenation this group is lacking. We therefore evaluated blood flow, filtration rate, oxygen consumption, demand/supply relationship, i.e., extraction, early bypass. Design: Prospective, placebo-controlled, randomized...

Acute kidney injury (AKI), which is a major complication after cardiovascular surgery, associated with significant morbidity and mortality. Diuretic agents are frequently used to improve urine output facilitate fluid management in these patients. Mannitol, an osmotic diuretic, the perioperative setting belief that it exerts reno-protective properties. In recent study on uncomplicated postcardiac-surgery patients normal renal function, mannitol increased glomerular filtration rate (GFR),...

The beneficial effects of vasopressin on diuresis and creatinine clearance have been demonstrated when used as an additional/alternative therapy in catecholamine-dependent vasodilatory shock. A detailed analysis the renal perfusion, glomerular filtration, excretory function oxygenation man is, however, lacking. objective this pharmacodynamic study was to evaluate low moderate doses blood flow (RBF), filtration rate (GFR), oxygen consumption (RVO2) extraction (RO2Ex) post-cardiac surgery...

Objectives Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used to provide cardiorespiratory support in cardiogenic shock, but selection of patients and timing ECMO-start remains a challenge. This study aims describe the 1 year outcome VA-ECMO for shock with focus on etiology severity shock.

Imbalance of the renal medullary oxygen supply/demand relationship can cause ischaemic acute failure (ARF). The use dopamine for prevention/treatment ARF has been questioned. It suggested that may increase consumption (RVO(2)) due to increased solute delivery tubular cells, which jeopardize oxygenation. Information on effects perfusion, filtration and oxygenation in man is, however, lacking. We evaluated blood flow (RBF), glomerular rate (GFR), RVO(2) O(2) demand/supply relationship, i.e....

Recent experimental studies have shown that a norepinephrine-induced increase in blood pressure induces loss of plasma volume, particularly under increased microvascular permeability. We studied the effects variations mean arterial (MAP) on volume changes and systemic haemodynamics patients with vasodilatory shock.Twenty-one mechanically ventilated who required norepinephrine to maintain MAP > or =70 mmHg because septic/postcardiotomy shock were included. The dose was randomly titrated...

Extracorporeal cardiopulmonary resuscitation (ECPR) can save patients with refractory cardiac arrest; however, according to recent meta-analyses, only 20% of achieve favorable outcomes (Modified Rankin Scale 0-3). We aimed develop and validate an ECPR prediction model improve patient selection.

Acute kidney injury (AKI) occurs frequently after liver transplantation and is associated with the development of chronic disease increased mortality. There a lack data on renal blood flow (RBF), oxygen consumption, glomerular filtration rate (GFR) oxygenation, i.e. supply/demand relationship, early transplantation. Increased insight into pathophysiology needed to improve prevention treatment postoperative AKI. We have therefore studied hemodynamics, function oxygenation in humans.Systemic...

Acute kidney injury (AKI) is a common complication with major impact on morbidity and mortality after cardiac surgery cardiopulmonary bypass (CPB). The aim of the present study was to perform detailed analysis release tubular biomarker N-acetyl-b-D-glucosaminidase (NAG) during early CPB describe independent predictors maximal injury. We hypothesized that renal occurs onset CPB.In this prospective observational study, we included 61 patients undergoing open an expected duration exceeding 60...

Data on renal hemodynamics, function, and oxygenation in early clinical septic shock are lacking. We therefore measured blood flow, glomerular filtration rate, oxygen consumption, patients with shock.Prospective comparative study.General cardiothoracic ICUs.Patients norepinephrine-dependent (n = 8) were studied within 24 hours after arrival the ICU compared postcardiac surgery without acute kidney injury (comparator group, n 58).None.Data systemic hemodynamics variables obtained during two...

Background Acute kidney injury is commonly seen after liver transplantation. The optimal perioperative target mean arterial pressure ( MAP ) for renal filtration, perfusion and oxygenation in recipients not known. effects of norepinephrine‐induced changes on blood flow RBF ), oxygen delivery RDO 2 glomerular filtration rate GFR (=renal extraction, RO Ex) were therefore studied early Methods Ten patients with an intra‐ post‐operative vasopressor‐dependent systemic vasodilation transplantation...

Background Induction of general anaesthesia has been shown to cause haemodilution and an increase in plasma volume. The aim this study was evaluate whether prevention hypotension during induction could avoid haemodilution. Methods Twenty‐four cardiac surgery patients, 66 ± 10 years, were randomised receive either norepinephrine a dose needed maintain mean arterial blood pressure ( MAP ) at pre‐anaesthesia levels after or control group that received vasopressor if decreased below 60 mmHg. No...

Minimizing cardiac arrest times is critical in extracorporeal cardiopulmonary resuscitation (ECPR). Pre-primed extra corporeal membrane oxygenator (ECMO) used for this, but knowledge limited to experimental studies. We prospectively investigated function and sterility dry plus wet pre-priming a clinical setting.