Cardiopulmonary bypass associated acute kidney injury: better understanding and better prevention

被引:7
作者
Yang, Xutao [1 ,2 ]
Zhu, Li [1 ,2 ,3 ]
Pan, Hong [1 ,2 ]
Yang, Yi [1 ,2 ,4 ]
机构
[1] Zhejiang Univ, Affiliated Hosp 4, Sch Med, Int Inst Med, Yiwu, Peoples R China
[2] Zhejiang Univ, Int Inst Med, Int Sch Med, Yiwu, Peoples R China
[3] Zhejiang Univ, Jinhua Affiliated Hosp, Sch Med, Yiwu, Peoples R China
[4] Zhejiang Univ, Dept Nephrol, Affiliated Hosp 4, Sch Med, Yiwu 322000, Peoples R China
关键词
Cardiopulmonary bypass; acute kidney injury; pathogenesis; prevention; ACUTE-RENAL-FAILURE; PUMP CORONARY SURGERY; SYSTEMIC INFLAMMATORY RESPONSE; RANDOMIZED CONTROLLED-TRIAL; BLOOD-CELL TRANSFUSION; GOAL-DIRECTED THERAPY; ADULT CARDIAC-SURGERY; OFF-PUMP; ON-PUMP; NITRIC-OXIDE;
D O I
10.1080/0886022X.2024.2331062
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Cardiopulmonary bypass (CPB) is a common technique in cardiac surgery but is associated with acute kidney injury (AKI), which carries considerable morbidity and mortality. In this review, we explore the range and definition of CPB-associated AKI and discuss the possible impact of different disease recognition methods on research outcomes. Furthermore, we introduce the specialized equipment and procedural intricacies associated with CPB surgeries. Based on recent research, we discuss the potential pathogenesis of AKI that may result from CPB, including compromised perfusion and oxygenation, inflammatory activation, oxidative stress, coagulopathy, hemolysis, and endothelial damage. Finally, we explore current interventions aimed at preventing and attenuating renal impairment related to CPB, and presenting these measures from three perspectives: (1) avoiding CPB to eliminate the fundamental impact on renal function; (2) optimizing CPB by adjusting equipment parameters, optimizing surgical procedures, or using improved materials to mitigate kidney damage; (3) employing pharmacological or interventional measures targeting pathogenic factors.
引用
收藏
页数:20
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