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Perioperative Renal Failure: Hypoperfusion During Cardiopulmonary Bypass?

Department of Anestesia and Intensive Care, IRCCS Policlinico S. Donato, San Donato Milanese, Milan, Italy, cardioanestesia{at}virgilio.it

Acute renal failure is one of the most frequent and life-threatening complications after cardiac surgery. There is a recent growing deal of information suggesting that during the time of cardiopulmonary bypass kidneys may suffer from an imbalance between oxygen supply and oxygen needs. A low hematocrit during cardiopulmonary bypass is associated with an increase risk of acute renal failure, mainly due to a low oxygen delivery. An inadequate oxygen delivery during cardiopulmonary bypass is associated with lactate production, and under normothermic conditions, hyperlactatemia appears for an oxygen delivery below 260 mL min^{– 1} m^–2. The risk of acute renal failure significantly increases for an oxygen delivery approximately at the same value (272 mL min^–1 m^{– 2}). During cardiopulmonary bypass, the pump flow should be coupled with the hematocrit to avoid falling below this critical oxygen delivery.

Key Words: cardiopulmonary bypass • acute renal failure • oxygen delivery

References

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Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 11, No. 4, 265-268 (2007)
DOI: 10.1177/1089253207311141


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Ranucci, M. Search for Related Content PubMed PubMed Citation Articles by Ranucci, M. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB LACTIC ACID OXYGEN Social Bookmarking                         What's this?