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Low Intraoperative Cerebral Oxygen Saturation Is Associated with Acute Kidney Injury after Off-Pump Coronary Artery Bypass

Authors :
Seo Hee Ko
Jong-Wook Song
Jae-Kwang Shim
Sarah Soh
Young-Lan Kwak
Source :
Journal of Clinical Medicine; Volume 12; Issue 1; Pages: 359
Publication Year :
2023
Publisher :
Multidisciplinary Digital Publishing Institute, 2023.

Abstract

By monitoring the brain as the index organ of global oxygen supply–demand balance including major organs, regional cerebral oxygen saturation (rScO2) may indicate adequacy of renal perfusion. The aim of this study was to investigate the relationship between perioperative rScO2 and acute kidney injury (AKI) after off-pump coronary artery bypass (OPCAB). AKI was diagnosed according to the Kidney Disease: Improving Global Outcomes criteria. Collected rScO2 variables were baseline, mean, and lowest value during surgery, maximal percentage decrease from baseline, and areas under the threshold below an absolute value of 50% (AUT50) and of 80% of baseline (AUT80%base). Among 580 patients, AKI developed in 143 (24.7%) patients. Patients with AKI had lower baseline, mean, and lowest rScO2 and higher AUT50 and AUT80%base than those without AKI despite routine efforts to restore the rScO2 values within 20% of the baseline. Among the rScO2 variables, the area under the receiver operating characteristic curve of mean rScO2 was the highest (0.636), which was used for the multivariable logistic regression. Multivariable logistic regression revealed mean rScO2 as an independent predictor of AKI (odds ratio, 0.964; 95% confidence interval, 0.937–0.990; p = 0.008), along with chronic kidney disease and emergency surgery. Low intraoperative mean rScO2 was independently associated with AKI after OPCAB, which may serve as an early marker of renal injury.

Details

Language :
English
ISSN :
20770383
Database :
OpenAIRE
Journal :
Journal of Clinical Medicine; Volume 12; Issue 1; Pages: 359
Accession number :
edsair.doi.dedup.....8be6558930f758b25b143561a64d2eaa
Full Text :
https://doi.org/10.3390/jcm12010359