The Relevance of Renal Oxygen Saturation Over Other Markers in Cardiac Surgery–Associated Acute Kidney Injury

Objective Acute kidney injury (AKI) is a common complication after cardiac surgery and is associated with significant morbidity and mortality. Near infrared spectroscopy (NIRS) is a noninvasive technique for real-time measurement of cerebral tissue oxygenation. The purpose of the present study was to evaluate the correlation of AKI with hemoglobin and regional cerebral oxygen saturation (rScO2) measured intraoperatively and postoperatively in patients undergoing cardiac surgery. Methods We retrospectively analyzed the prospectively collected data of 45 adult patients with normal renal function who underwent isolated coronary artery bypass grafting (CABG) from January 2014 to May 2014. Kidney injury was assessed according to the Acute Kidney Injury Network criteria. rScO2 and hemoglobin were measured every hour intraoperatively and for the first 24 hours postoperatively. Results The hemoglobin concentration and rScO2 were significantly lower in patients with than without AKI, and no linear trends were observed. No exact cut-off values were obtained. Conclusion This retrospective study shows that a lower rScO2 and hemoglobin concentration are correlated with AKI after CABG in patients with no peripheral vascular disease or recent myocardial infarction. We suggest that cerebral oximetry alone may predict postoperative AKI well.

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Low Renal Oxygen Saturation at Near-Infrared Spectroscopy on the First Day of Life Is Associated with Developing Acute Kidney Injury in Very Preterm Infants

Neonatology ◽

10.1159/000494462 ◽

2019 ◽

Vol 115 (3) ◽

pp. 198-204 ◽

Cited By ~ 5

Author(s):

Francesco Bonsante ◽

Duksha Ramful ◽

Christine Binquet ◽

Sylvain Samperiz ◽

Sandrine Daniel ◽

...

Keyword(s):

Acute Kidney Injury ◽

Infrared Spectroscopy ◽

Oxygen Saturation ◽

Preterm Infants ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Kidney Injury ◽

Very Preterm Infants ◽

Very Preterm ◽

Renal Oxygen

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The Relation Of Intraoperative Renal Oxygen Saturation Change With Postoperative Acute Kidney Injury

Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society ◽

10.5222/gkdad.2021.82621 ◽

2021 ◽

Author(s):

Mustafa Emre Gürcü ◽

Atakan Erkılınç ◽

Pınar Karaca Baysal ◽

Fatih Yılmaz ◽

Tuncer Koçak

Keyword(s):

Acute Kidney Injury ◽

Cardiopulmonary Bypass ◽

Oxygen Saturation ◽

Heart Surgery ◽

Open Heart Surgery ◽

Kidney Injury ◽

Left Ventricular Ejection ◽

Open Heart ◽

The Relationship ◽

Renal Oxygen

Objective: Acute kidney injury seen in 25-30 % of the cases after open heart surgery where cardiopulmonary bypass was performed, is one of the most important factors that affect the success of the on- pump open heart surgery by increasing the rates of postoperative morbidity, and mortality. Near infrared spectroscopy (NIRS) is a noninvasive monitoring that frequently used method that allows correction of imbalances in oxygen supply to the brain and vital organs. We aimed to investigate the relationship between renal oxygen saturation values and postoperative acute kidney injury. Method: Fifty patients who underwent on- pump open heart surgery between July 2020 and January 2021 by using cardiopulmonary bypass were included in the study. Demographic data included age, gender, body mass index (BMI), hypertension, diabetes mellitus, chronic obstructive pulmonary disease, other chronic diseases and left ventricular ejection fraction. The definition of acute kidney injury was defined according to the criteria of KDIGO. At the end of the postoperative 48th hour the relationship between intraoperative renal rSO2 changes in patients with or without acute kidney injury was evaluated. Results: Fifty patients were included in the current study. The median (IQR) age of 50 patients was 62 (54.3-66.5), and mostly male patients constituted the study populatio,. When we evaluated the intraoperative data, there were statistically significant differences in changes in renal rSO2 values in patients who had and had not developed postoperative acute kidney injury (-12%, -3%, respectively) (p: 0.001). In the multivariate logistic regression analysis, the change in rSO2 values in the intraoperative period [(from - 10% to 0.5%), OR: 0.18 (0.04-0.76) p: 0.03] were found to be an independent predictor of postoperative acute kidney injury. Conclusion: We found that the decrease of renal rSO2 measurements during surgery may predict the development of acute kidney injury in the postoperative period. We think that renal oxygen saturation monitoring with NIRS is a very effective method for predicting postoperative renal dysfunction, because it is both noninvasive and reflects simultaneous data.

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Evaluation of renal oxygen saturation using photoacoustic imaging for the early prediction of chronic renal function in a model of ischemia-induced acute kidney injury

PLoS ONE ◽

10.1371/journal.pone.0206461 ◽

2018 ◽

Vol 13 (12) ◽

pp. e0206461 ◽

Cited By ~ 5

Author(s):

Kenichiro Okumura ◽

Junichi Matsumoto ◽

Yasunori Iwata ◽

Kotaro Yoshida ◽

Norihide Yoneda ◽

...

Keyword(s):

Acute Kidney Injury ◽

Renal Function ◽

Oxygen Saturation ◽

Photoacoustic Imaging ◽

Kidney Injury ◽

Early Prediction ◽

Renal Oxygen

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Brain and Muscle Oxygen Saturation Combined with Kidney Injury Biomarkers Predict Cardiac Surgery Related Acute Kidney Injury

Diagnostics ◽

10.3390/diagnostics11091591 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1591

Author(s):

Wiktor Szymanowicz ◽

Ludmiła Daniłowicz-Szymanowicz ◽

Wojtek Karolak ◽

Maciej Michał Kowalik ◽

Romuald Lango

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Oxygen Saturation ◽

Cystatin C ◽

Near Infrared ◽

Kidney Injury ◽

Tissue Oxygen Saturation ◽

Muscle Oxygen ◽

Patients At Risk ◽

Novel Biomarkers

Background: Early identification of patients at risk for cardiac surgery-associated acute kidney injury (CS-AKI) based on novel biomarkers and tissue oxygen saturation might enable intervention to reduce kidney injury. Aims: The study aimed to ascertain whether brain and muscle oxygenation measured by near-infrared spectroscopy (NIRS), in addition to cystatin C and NGAL concentrations, could help with CS-AKI prediction. Methods: This is a single-centre prospective observational study on adult patients undergoing cardiac surgery using cardiopulmonary bypass (CPB). Brain and muscle NIRS were recorded during surgery. Cystatin C was measured on the first postoperative day, while NGAL directly before and 3 h after surgery. Results: CS-AKI was diagnosed in 18 (16%) of 114 patients. NIRS values recorded 20 min after CPB (with cut-off value ≤ 54.5% for muscle and ≤ 62.5% for the brain) were revealed to be the most accurate predictors of CS-AKI. Preoperative NGAL ≥ 91.5 ng/mL, postoperative NGAL ≥ 140.5 ng/mL, and postoperative cystatin C ≥ 1.23 mg/L were identified as independent and significant CS-AKI predictors. Conclusions: Brain and muscle oxygen saturation 20 min after CPB could be considered early parameters possibly related to CS-AKI risk, especially in patients with increased cystatin C and NGAL levels.

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Regional thigh tissue oxygen saturation during cardiopulmonary bypass predicts acute kidney injury after cardiac surgery

Journal of Artificial Organs ◽

10.1007/s10047-020-01175-y ◽

2020 ◽

Vol 23 (4) ◽

pp. 315-320

Author(s):

Kenjiro Sakaki ◽

Tadashi Kitamura ◽

Satoshi Kohira ◽

Shinzo Torii ◽

Toshiaki Mishima ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Oxygen Saturation ◽

Kidney Injury ◽

Tissue Oxygen Saturation ◽

Tissue Oxygen

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Should kidney oxygen saturation be monitored to prevent acute kidney injury after adult cardiac surgery?

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2019.05.012 ◽

2019 ◽

Vol 158 (3) ◽

pp. e105-e106 ◽

Cited By ~ 2

Author(s):

Christian Ortega-Loubon ◽

Inmaculada Fierro ◽

Eduardo Tamayo

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Oxygen Saturation ◽

Kidney Injury ◽

Adult Cardiac Surgery

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Investigating the Effect of Near Infra-Red Spectroscopy (NIRS) on Early Diagnosis of Cardiac Surgery-Associated Acute Kidney Injury

Anesthesiology and Pain Medicine ◽

10.5812/aapm.109863 ◽

2020 ◽

Vol 10 (6) ◽

Author(s):

Fatemeh Javaherforooshzadeh ◽

Hojatolah Bhandori ◽

Sara Jarirahmadi ◽

Nima Bakhtiari

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Oxygen Saturation ◽

Repeated Measures ◽

Arterial Oxygen Saturation ◽

Kidney Tissue ◽

Kidney Injury ◽

Arterial Oxygen ◽

Repeated Measures Anova ◽

Significant Difference

Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a major adverse effect of cardiac surgery. The early detection of this complication can improve the quality of postoperative care and help prevent this phenomenon. Methods: In this prospective descriptive-analytical study, 148 patients were enrolled, 107 of whom were selected for analysis between February and September 2019 in the Cardiac Surgery Unit of Golestan Hospital, Ahvaz, Iran. Kidney tissue oxygen saturation was measured at multiple definite times during surgery. Hemoglobin, blood urea nitrogen, creatinine, and lactate were measured during and 48 hours after the surgery. Results: Forty-one patients were diagnosed with CSA-AKI according to the KDIGO criteria. Parametric and non-parametric analyses showed no significant difference between the CSA-AKI and non-CSA-AKI groups in the demographic parameters. Repeated measures ANOVA showed no significant difference in parameters, except for BUN. Repeated measures ANOVA showed a significant difference between both groups and time factors (P < 0.001, P = 0.0006, respectively). The ROC curve analyses showed that in a single point of time, the difference in the middle of CPB time from baseline had a high value in the prediction of AKI (AUC: 0.764; CI: 0.57 - 0.951). Conclusions: Kidney saturation monitoring could be considered in cardiac surgery for the rapid detection of CSA-AKI. Although kidney tissue saturation is not correlated directly to the arterial oxygen saturation, the physician and the surgery team can predict the chance of acute kidney injury.

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