TY - JOUR
T1 - The Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society for Extracorporeal Technology Clinical Practice Guidelines for the Prevention of Adult Cardiac Surgery-Associated Acute Kidney Injury
AU - Brown, Jeremiah R.
AU - Baker, Robert A.
AU - Shore-Lesserson, Linda
AU - Fox, Amanda A.
AU - Mongero, Linda B.
AU - Lobdell, Kevin W.
AU - Lemaire, Scott A.
AU - De Somer, Filip M.J.J.
AU - Wyler Von Ballmoos, Moritz
AU - Barodka, Viachaslau
AU - Arora, Rakesh C.
AU - Firestone, Scott
AU - Solomon, Richard
AU - Parikh, Chirag R.
AU - Shann, Kenneth G.
AU - Hammon, John
PY - 2023/1
Y1 - 2023/1
N2 - EXECUTIVE SUMMARY1. In adult cardiac surgery with cardiopulmonary bypass (CPB), avoiding hyperthermic perfusion (>37 °C) is recommended to reduce the risk of cardiac surgery–associated acute kidney injury (CSA-AKI). (Class of Recommendation: I, Level of Evidence: B-R)2. In adult cardiac surgery with CPB, a goal-directed oxygen delivery strategy is recommended to reduce the risk of CSA-AKI. (Class of Recommendation: I, Level of Evidence: B-R)3. In adult cardiac surgery with CPB, it is reasonable to adopt the Kidney Disease Improving Global Outcomes (KDIGO) practice guidelines for patients at high risk of AKI to reduce the risk of CSA-AKI (Class of Recommendation IIA; Level of Evidence B-R).4. In adult cardiac surgery with CPB, fenoldopam may be reasonable to reduce the risk of CSA-AKI, as long as hypotension is avoided (Class of Recommendation: IIB, Level of Evidence: B-R).5. In adult cardiac surgery with CPB, it might be reasonable to use minimally invasive extracorporeal circulation (MiECC) techniques to reduce the risk of CSA-AKI. (Class of Recommendation: IIB, Level of Evidence: B-R)6. In adult cardiac surgery with CPB, dopamine infusion alone, during CPB and the perioperative period, is not recommended to reduce the risk of CSA-AKI. (Class of Recommendation III: No Benefit, Level of Evidence: A)7. In adult cardiac surgery with CPB, mannitol is not recommended to reduce the risk of CSA-AKI. (Class of Recommendation III: No Benefit, Level of Evidence: B-R)
AB - EXECUTIVE SUMMARY1. In adult cardiac surgery with cardiopulmonary bypass (CPB), avoiding hyperthermic perfusion (>37 °C) is recommended to reduce the risk of cardiac surgery–associated acute kidney injury (CSA-AKI). (Class of Recommendation: I, Level of Evidence: B-R)2. In adult cardiac surgery with CPB, a goal-directed oxygen delivery strategy is recommended to reduce the risk of CSA-AKI. (Class of Recommendation: I, Level of Evidence: B-R)3. In adult cardiac surgery with CPB, it is reasonable to adopt the Kidney Disease Improving Global Outcomes (KDIGO) practice guidelines for patients at high risk of AKI to reduce the risk of CSA-AKI (Class of Recommendation IIA; Level of Evidence B-R).4. In adult cardiac surgery with CPB, fenoldopam may be reasonable to reduce the risk of CSA-AKI, as long as hypotension is avoided (Class of Recommendation: IIB, Level of Evidence: B-R).5. In adult cardiac surgery with CPB, it might be reasonable to use minimally invasive extracorporeal circulation (MiECC) techniques to reduce the risk of CSA-AKI. (Class of Recommendation: IIB, Level of Evidence: B-R)6. In adult cardiac surgery with CPB, dopamine infusion alone, during CPB and the perioperative period, is not recommended to reduce the risk of CSA-AKI. (Class of Recommendation III: No Benefit, Level of Evidence: A)7. In adult cardiac surgery with CPB, mannitol is not recommended to reduce the risk of CSA-AKI. (Class of Recommendation III: No Benefit, Level of Evidence: B-R)
KW - cardiac surgery
KW - comorbidities
KW - kidney disease
KW - guidelines
UR - http://www.scopus.com/inward/record.url?scp=85144297078&partnerID=8YFLogxK
U2 - 10.1213/ANE.0000000000006286
DO - 10.1213/ANE.0000000000006286
M3 - Article
C2 - 36534719
AN - SCOPUS:85144297078
SN - 0003-2999
VL - 136
SP - 176
EP - 184
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 1
ER -