Optimization of kidney function in cardiac surgery patients with intra-abdominal hypertension: expert opinion

Authors

Vanessa Moll, Department of Anesthesiology, Division of Critical Care Medicine, University of Minnesota, Minneapolis, MN, USA.
Ashish K. Khanna, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
Andrea Kurz, Departments of General Anesthesiology and Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA.
Jiapeng Huang, Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA.
Marije Smit, Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Madhav Swaminathan, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.
Steven Minear, Department of Anesthesiology, Cleveland Clinic Florida, Weston Hospital, Weston, FL, USA.
K Gage Parr, Department of Anesthesiology and Critical Care Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Amit Prabhakar, Department of Anesthesiology, Division of Critical Care Medicine, Emory School of Medicine, Atlanta, GA, USA.
Manxu Zhao, Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Manu L. Malbrain, First Department of Anaesthesiology and Intensive Therapy, Medical University Lublin, Lublin, Poland. manu.malbrain@umlub.pl.

Document Type

Journal Article

Publication Date

7-12-2024

Journal

Perioperative medicine (London, England)

Volume

13

Issue

1

DOI

10.1186/s13741-024-00416-5

Keywords

Abdominal-perfusion pressure; Acute kidney injury; Cardiac surgery; Continuous intra-abdominal pressure; Intra-abdominal pressure; Management; Monitoring; Prevention

Abstract

Cardiac surgery-associated acute kidney injury (CSA-AKI) affects up to 42% of cardiac surgery patients. CSA-AKI is multifactorial, with low abdominal perfusion pressure often overlooked. Abdominal perfusion pressure is calculated as mean arterial pressure minus intra-abdominal pressure (IAP). IAH decreases cardiac output and compresses the renal vasculature and renal parenchyma. Recent studies have highlighted the frequent occurrence of IAH in cardiac surgery patients and have linked the role of low perfusion pressure to the occurrence of AKI. This review and expert opinion illustrate current evidence on the pathophysiology, diagnosis, and therapy of IAH and ACS in the context of AKI.

APA Citation

Moll, Vanessa; Khanna, Ashish K.; Kurz, Andrea; Huang, Jiapeng; Smit, Marije; Swaminathan, Madhav; Minear, Steven; Parr, K Gage; Prabhakar, Amit; Zhao, Manxu; and Malbrain, Manu L., "Optimization of kidney function in cardiac surgery patients with intra-abdominal hypertension: expert opinion" (2024). GW Authored Works. Paper 5288.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5288

Department

Anesthesiology and Critical Care Medicine