The Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society of Extracorporeal Technology Clinical Practice Guidelines for the Prevention of Adult Cardiac Surgery–Associated Acute Kidney Injury

Jeremiah R. Brown; Robert A. Baker; Linda Shore-Lesserson; Amanda A. Fox; Linda B. Mongero; Kevin W. Lobdell; Scott A. LeMaire; Filip M.J.J. De Somer; Moritz Wyler von Ballmoos; Viachaslau Barodka; Rakesh C. Arora; Scott Firestone; Richard Solomon; Chirag R. Parikh; Kenneth G. Shann; John Hammon

doi:10.1016/j.athoracsur.2022.06.054

The Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society of Extracorporeal Technology Clinical Practice Guidelines for the Prevention of Adult Cardiac Surgery–Associated Acute Kidney Injury

Jeremiah R. Brown, Robert A. Baker, Linda Shore-Lesserson, Amanda A. Fox, Linda B. Mongero, Kevin W. Lobdell, Scott A. LeMaire, Filip M.J.J. De Somer, Moritz Wyler von Ballmoos, Viachaslau Barodka, Rakesh C. Arora, Scott Firestone, Richard Solomon, Chirag R. Parikh, Kenneth G. Shann, John Hammon

College of Medicine and Public Health

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

Abstract

Executive Summary
1.
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)

Original language	English
Pages (from-to)	34-42
Number of pages	9
Journal	Annals of Thoracic Surgery
Volume	115
Issue number	1
Early online date	20 Dec 2022
DOIs	https://doi.org/10.1016/j.athoracsur.2022.06.054
Publication status	Published - Jan 2023

Keywords

cardiac disease
comorbidities
kidney disease
guidelines

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Brown, J. R., Baker, R. A., Shore-Lesserson, L., Fox, A. A., Mongero, L. B., Lobdell, K. W., LeMaire, S. A., De Somer, F. M. J. J., Wyler von Ballmoos, M., Barodka, V., Arora, R. C., Firestone, S., Solomon, R., Parikh, C. R., Shann, K. G., & Hammon, J. (2023). The Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society of Extracorporeal Technology Clinical Practice Guidelines for the Prevention of Adult Cardiac Surgery–Associated Acute Kidney Injury. Annals of Thoracic Surgery, 115(1), 34-42. https://doi.org/10.1016/j.athoracsur.2022.06.054

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title = "The Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society of Extracorporeal Technology Clinical Practice Guidelines for the Prevention of Adult Cardiac Surgery–Associated Acute Kidney Injury",

abstract = "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)",

keywords = "cardiac disease, comorbidities, kidney disease, guidelines",

author = "Brown, {Jeremiah R.} and Baker, {Robert A.} and Linda Shore-Lesserson and Fox, {Amanda A.} and Mongero, {Linda B.} and Lobdell, {Kevin W.} and LeMaire, {Scott A.} and {De Somer}, {Filip M.J.J.} and {Wyler von Ballmoos}, Moritz and Viachaslau Barodka and Arora, {Rakesh C.} and Scott Firestone and Richard Solomon and Parikh, {Chirag R.} and Shann, {Kenneth G.} and John Hammon",

year = "2023",

month = jan,

doi = "10.1016/j.athoracsur.2022.06.054",

language = "English",

volume = "115",

pages = "34--42",

journal = "Annals of Thoracic Surgery",

issn = "0003-4975",

publisher = "The Annals of Thoracic Surgery",

number = "1",

}

Brown, JR, Baker, RA, Shore-Lesserson, L, Fox, AA, Mongero, LB, Lobdell, KW, LeMaire, SA, De Somer, FMJJ, Wyler von Ballmoos, M, Barodka, V, Arora, RC, Firestone, S, Solomon, R, Parikh, CR, Shann, KG & Hammon, J 2023, 'The Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society of Extracorporeal Technology Clinical Practice Guidelines for the Prevention of Adult Cardiac Surgery–Associated Acute Kidney Injury', Annals of Thoracic Surgery, vol. 115, no. 1, pp. 34-42. https://doi.org/10.1016/j.athoracsur.2022.06.054

The Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society of Extracorporeal Technology Clinical Practice Guidelines for the Prevention of Adult Cardiac Surgery–Associated Acute Kidney Injury. / Brown, Jeremiah R.; Baker, Robert A.; Shore-Lesserson, Linda et al.
In: Annals of Thoracic Surgery, Vol. 115, No. 1, 01.2023, p. 34-42.

Research output: Contribution to journal › Article › peer-review

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AU - Fox, Amanda A.

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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

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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 disease

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Brown JR, Baker RA, Shore-Lesserson L, Fox AA, Mongero LB, Lobdell KW et al. The Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society of Extracorporeal Technology Clinical Practice Guidelines for the Prevention of Adult Cardiac Surgery–Associated Acute Kidney Injury. Annals of Thoracic Surgery. 2023 Jan;115(1):34-42. Epub 2022 Dec 20. doi: 10.1016/j.athoracsur.2022.06.054

The Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society of Extracorporeal Technology Clinical Practice Guidelines for the Prevention of Adult Cardiac Surgery–Associated Acute Kidney Injury

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