Vanessa Moll, Ashish K Khanna, Andrea Kurz, Jiapeng Huang, Marije Smit, Madhav Swaminathan, Steven Minear, K Gage Parr, Amit Prabhakar, Manxu Zhao, Manu L N G Malbrain
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引用次数: 0
摘要
心脏手术相关急性肾损伤（CSA-AKI）影响高达 42% 的心脏手术患者。CSA-AKI 是多因素造成的，而低腹腔灌注压常常被忽视。腹腔灌注压的计算方法是平均动脉压减去腹腔内压力（IAP）。IAH 会降低心输出量，压迫肾血管和肾实质。最近的研究强调了心脏手术患者经常出现 IAH 的情况，并将低灌注压与发生 AKI 联系起来。这篇综述和专家意见阐述了在 AKI 背景下 IAH 和 ACS 的病理生理学、诊断和治疗方面的现有证据。
Optimization of kidney function in cardiac surgery patients with intra-abdominal hypertension: expert opinion.
Cardiac surgery-associated acute kidney injury (CSA-AKI) affects up to 42% of cardiac surgery patients. CSA-AKI is multifactorial, with low abdominal perfusion pressure often overlooked. Abdominal perfusion pressure is calculated as mean arterial pressure minus intra-abdominal pressure (IAP). IAH decreases cardiac output and compresses the renal vasculature and renal parenchyma. Recent studies have highlighted the frequent occurrence of IAH in cardiac surgery patients and have linked the role of low perfusion pressure to the occurrence of AKI. This review and expert opinion illustrate current evidence on the pathophysiology, diagnosis, and therapy of IAH and ACS in the context of AKI.
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