Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Elevated Renal Oxygen Extraction During Open Abdominal Aortic Aneurysm Repair Is Related to Postoperative Renal Dysfunction

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Methodological issues of postoperative cognitive dysfunction research

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Mesenteric traction syndrome in pigs: A single-blinded, randomized controlled trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Endovascular Treatment of Chronic and Acute on Chronic Mesenteric Ischaemia: Results From a National Cohort of 245 Cases

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Learning Curves and Competences of Vascular Trainees Performing Open Aortic Repair in a Simulation-Based Environment

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Three and two dimensional ultrasound is as accurate as computed tomography in aortic sac assessment after endovascular aortic repair

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Cardiorespiratory responses to high intensity skeletal muscle metaboreflex activation in chronic obstructive pulmonary disease

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

BACKGROUND: Open abdominal aortic aneurysm repair is often followed by elevated plasma creatinine, likely due to impaired renal blood flow. We evaluated whether postoperative elevation in creatinine relates to renal oxygen extraction during surgery as an index of renal blood flow and also monitored frontal lobe oxygenation.

METHODS: For 19 patients (66 ± 10 years; mean ± SD) undergoing open infrarenal abdominal aortic aneurysm repair, renal oxygen extraction was determined by arterial and renal vein catheterization. Near-infrared spectroscopy determined frontal lobe oxygenation.

RESULTS: During surgery mean arterial pressure (from 102 ± 14 to 65 ± 11 mm Hg; P < .0001), arterial hemoglobin (from 7.7 ± 0.7 to 6.6 ± 0.8 mmol/L; P < 0.0001), and frontal lobe oxygenation (from 74 ± 6% to 70 ± 6%; P = .0414) decreased, while renal oxygen extraction increased (from 5.3% [4.3-8.1]; median [interquartile range] to 10.8% [5.8-17.5]; P = .0405). Plasma creatinine became significantly elevated on the second day after the operation (from 83 [73-101] to 105 µmol/L [79-143]; P = .0062) with a peak increase observed after 2 days (1-2). The peak increase in creatinine correlated to intraoperative renal oxygen extraction ( r = 0.51; P = .026).

CONCLUSION: Kidney function was affected after open abdominal aortic aneurysm repair likely related to limited renal blood flow. We take the increase in renal oxygen extraction and reduction in frontal lobe oxygenation to suggest that mean arterial pressure and hemoglobin were too low to maintain renal and cerebral circulation in vascular surgical patients.

Original languageEnglish
JournalSeminars in Cardiothoracic and Vascular Anesthesia
Volume22
Issue number4
Pages (from-to)369-375
Number of pages7
ISSN1089-2532
DOIs
Publication statusPublished - Dec 2018

ID: 56584437