Cardiac Surgery–Associated Acute Kidney Injury Clinical Practice Guidelines (STS/SCA/AmSECT, 2023)

Society of Thoracic Surgeons (STS)/Society of Cardiovascular Anesthesiologists (SCA)/American Society of Extracorporeal Technology (AmSECT)

These are some of the highlights of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

March 02, 2023

Guidelines for prevention of cardiac surgery–associated acute kidney injury (CSA-AKI) were published in January 2023 by the Society of Thoracic Surgeons (STS), the Society of Cardiovascular Anesthesiologists (SCA), and the American Society of Extracorporeal Technology (AmSECT) in Anesthesia & Analgesia.[1]

In adults undergoing cardiac surgery with cardiopulmonary bypass (CPB), avoidance of hyperthermic perfusion (>37°C) is recommended for reduction of CSA-AKI risk.

A goal-directed oxygen delivery strategy is recommended for reduction of CSA-AKI risk in adult cardiac surgery with CPB.

Adoption of the Kidney Disease Improving Global Outcomes (KDIGO) practice guidelines is reasonable for reduction of CSA-AKI risk in adults undergoing cardiac surgery with CPB who are at high risk for AKI.

Use of fenoldopam may be reasonable for reduction of CSA-AKI risk in adults undergoing cardiac surgery with CPB, provided that hypotension is avoided.

Use of minimally invasive extracorporeal circulation (MiECC) techniques might be reasonable for reduction of CSA-AKI risk in adults undergoing cardiac surgery with CPB.

Dopamine infusion alone during CPB and the perioperative period is not recommended for reduction of CSA-AKI risk in adults undergoing cardiac surgery with CPB.

Mannitol is not recommended for reduction of CSA-AKI risk in adults undergoing cardiac surgery with CPB.

For more information, please go to Acute Kidney Injury and Circulatory Arrest and Cardiopulmonary Bypass Hypothermia.

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