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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Cite this: Cardiac Surgery–Associated Acute Kidney Injury Clinical Practice Guidelines (STS/SCA/AmSECT, 2023) - Medscape - Mar 02, 2023.
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