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Tabak'ian E.A.
FGBU "Rossiĭskiĭ kardiologicheskiĭ nauchno-proizvodstvennyĭ kompleks" Minzdrava Rossii, Moskva
Mershin K.V.
Department of Cardiovascular Surgery, A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Russian Ministry of Health, Moscow, Russia
Margolina A.A.
FGBU "Rossiĭskiĭ kardiologicheskiĭ nauchno-proizvodstvennyĭ kompleks" Minzdrava Rossii, Moskva
Burmistrova I.V.
Department of Cardiovascular Surgery, A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Russian Ministry of Health, Moscow, Russia
Buldakova N.A.
National Medical Research Center of Cardiology of Healthcare Ministry of the Russia, Moscow, Russia
Lepilin M.G.
Institute of cardiology named after A.L. Myasnikov of National medical research center of cardiology of the Ministry of healthcare of the Russian Federation
Partigulov S.A.
Institute of cardiology named after A.L. Myasnikov of National medical research center of cardiology of the Ministry of healthcare of the Russian Federation
Renal replacement therapy for acute kidney injury and multiple organ failure after surgery under cardiopulmonary bypass
Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2018;11(5): 76‑81
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To cite this article:
Tabak'ian EA, Mershin KV, Margolina AA, Burmistrova IV, Buldakova NA, Lepilin MG, Partigulov SA. Renal replacement therapy for acute kidney injury and multiple organ failure after surgery under cardiopulmonary bypass. Russian Journal of Cardiology and Cardiovascular Surgery.
2018;11(5):76‑81. (In Russ.)
https://doi.org/10.17116/kardio20181105176
Aim — to analyze the causes of acute kidney injury (AKI) and multiple organ failure (MOF) followed by replacement renal therapy (RRT) after surgery under cardiopulmonary bypass (CPB). Material and methods. Inclusion criteria were AKI and/or MOF followed by RRT or absence of AKI according to RIFLE-2004. There were 3 groups of patients: group 1 — without AKI, group 2 — AKI without RRT, group 3 — AKI followed by RRT. Data are presented as median, lower and upper quartiles. Differences were significant at p<0.05. Results. AKI followed by RRT occurred in 37 (0.97%) out of 3779 patients who underwent surgery under CPB. Liver failure was observed in 20 cases, MOF — in 30 cases. AKI followed by RRT group was characterized by lower preoperative GFR, higher percentage of combined procedures, advanced blood transfusion, greater CPB and aortic cross-clamping time. The main causes of AKI followed by RRT were bleeding, hemolysis, atrial fibrillation and low cardiac output, sympathomimetics administration. RRT courses for AKI stage II—III were started in 1—3 days after surgery. Kidney function recovery was observed in 40.6% of patients. Mortality rate was 59.4%. Conclusion. AKI in patients undergoing cardiac surgery is caused by circulatory ischemia and inflammatory factors. AKI followed by RRT is associated with advanced in-hospital mortality. Preoperative AKI risk stratification, no contrast agents’ administration on the day of surgery, adequate preoperative hydration, adequate oxygenation and/or optimal perfusion pressure during CPB and early RRT are essential.
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Tabak'ian E.A.
FGBU "Rossiĭskiĭ kardiologicheskiĭ nauchno-proizvodstvennyĭ kompleks" Minzdrava Rossii, Moskva
Mershin K.V.
Department of Cardiovascular Surgery, A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Russian Ministry of Health, Moscow, Russia
Margolina A.A.
FGBU "Rossiĭskiĭ kardiologicheskiĭ nauchno-proizvodstvennyĭ kompleks" Minzdrava Rossii, Moskva
Burmistrova I.V.
Department of Cardiovascular Surgery, A.L. Myasnikov Institute of Clinical Cardiology, Russian Cardiology Research and Production Complex, Russian Ministry of Health, Moscow, Russia
Buldakova N.A.
National Medical Research Center of Cardiology of Healthcare Ministry of the Russia, Moscow, Russia
Lepilin M.G.
Institute of cardiology named after A.L. Myasnikov of National medical research center of cardiology of the Ministry of healthcare of the Russian Federation
Partigulov S.A.
Institute of cardiology named after A.L. Myasnikov of National medical research center of cardiology of the Ministry of healthcare of the Russian Federation
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