Reduction of AKI in Cardiothoracic Surgery

Authors

Dylan Ryan, University of LynchburgFollow

Specialty

Cardiothoracic Surgery

Advisor

Dr. Shuler

Abstract

Acute kidney injury (AKI) is a common preventable complication in the postoperative phase following cardiac surgery. Traditional sternotomy open heart surgery requires cardiopulmonary bypass, which leads to the risk of reduced blood flow to vital organs. Particularly the renal system is at elevated risk for ischemia if not optimally perfused. This article serves as a data analysis identifying biomarkers representative of AKI and methods to reduce the incidence of AKI. Optimal fluid management in the postoperative period is essential to further avoiding AKI. Prevention and early detection are vital in mitigating the risk of AKI. Strict fluid replacement is assessed upon reviewing hemodynamics, and set parameters of serum creatinine, nephrocheck, and urine output. AKI not only causes acute renal issues but can also have lasting negative impacts on renal function. On the hospital end, AKI leads to increased length of stay (LOS) and poor outcomes, thereby leading their rank to fall based on data collected by the Society of Thoracic Surgery (STS). Hospitals practicing cardiac surgery review quarterly or yearly AKI rates, making it one of the most prominent discussed complications in this field. Further research is continuously needed to improve guidelines surrounding optimal fluid management. However, enough research exists proving that properly monitored renal function with preventative measures in place leads to improved patient and hospital outcomes.

Recommended Citation

Ryan D. Reduction of AKI in Cardiothoracic Surgery. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2023; 5(2).