The Effect of Intraoperative Hypotension on Postoperative Renal Function.

IF 1.6 Q2 ANESTHESIOLOGY

Current Anesthesiology Reports Pub Date : 2023-09-01 Epub Date: 2023-06-14 DOI:10.1007/s40140-023-00564-2

Benjamin Kim, Gurleen Sangha, Amrik Singh, Christian Bohringer

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Abstract

Purpose of review: This review summarizes the most recent literature on the association between intraoperative hypotension (IOH) and the occurrence of postoperative acute kidney injury (AKI). It provides recommendations for the management of intraoperative blood pressure to reduce the incidence of postoperative AKI. Fluid management strategies, administration of vasopressor medications, and other methods for reducing the incidence of AKI are also briefly discussed.

Recent findings: Recent retrospective studies have demonstrated a solid association of IOH with postoperative AKI. IOH is associated not only with AKI but also with myocardial infarction, stroke, and death. Strict BP management to avoid a mean blood pressure less than 65mmHg is now recommended to reduce the incidence of postoperative AKI and other adverse outcomes.

Summary: IOH is robustly associated with AKI, and intraoperative mean BP should be maintained above 65 mmHg at all times. The etiology of postoperative AKI is however multifactorial, and factors other than BP therefore also need to be considered to prevent it.

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术中低血压对术后肾功能的影响

综述目的：本综述总结了关于术中低血压（IOH）与术后急性肾损伤（AKI）发生之间关系的最新文献。它为术中血压管理提供了建议，以减少术后AKI的发生率。本文还简要讨论了流体管理策略、血管加压药物的使用以及其他降低AKI发生率的方法。最近的发现：最近的回顾性研究已经证明IOH与术后AKI有密切的联系。IOH不仅与AKI有关，还与心肌梗死、卒中和死亡有关。现在建议严格控制血压以避免平均血压低于65mmHg，以减少术后AKI和其他不良后果的发生率。总结：IOH与AKI密切相关，术中平均血压应始终保持在65 mmHg以上。然而，术后AKI的病因是多因素的，因此也需要考虑BP以外的因素来预防它。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Anesthesiology Reports Medicine-Anesthesiology and Pain Medicine

CiteScore

2.80

自引率

0.00%

发文量

期刊介绍： This journal aims to offer expert review articles on the most significant recent developments in the field of anesthesiology. By providing clear, insightful, balanced contributions, the journal intends to serve those involved in the delivery of anesthesia for surgical and medical procedures, treatment of acute and chronic pain conditions, perioperative management for operative and intensive care unit patients, and associated basic science and clinical research efforts in their areas. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of more than 20 internationally diverse members reviews the annual table of contents, ensures that topics include emerging research, and suggests topics of special importance to their country/region. Topics covered may include ambulatory anesthesia; anesthesia and inflammation; anesthetic mechanisms; anesthetic pharmacology; cardiovascular anesthesia; critical care anesthesia; local anesthetic pharmacology; monitoring technology; neuroanesthesia; neuromuscular blockade; obstetrical anesthesia; pain mechanisms; pain therapy; patient safety; pediatric anesthesia; quality assessment; regional anesthesia; and transplantation anesthesia.