Perfusion · 2026
Innovative use of quality indicators during cardiopulmonary bypass: a goal directed perfusion strategy using real-time area under the threshold analysis.
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van Hoeven Marloes, Gensen Carmen, Overdevest Eddy, Gerritse Matthijs, Turco Simona, Bouwman Arthur
Аннотация
UNLABELLED: This study aims to assess current quality indicators and determine the added value of total area under the threshold (TAUT) and largest area under the threshold (LAUT) for risk factors associated with post-cardiosurgical acute kidney injury (AKI) in a large patient population. This approach may offer insights to further reduce the incidence of AKI.
METHODS: This is a retrospective single center study of procedures from January 1st 2019 to August 31st 2023. The final cohort included 3086 patients who underwent on-pump cardiothoracic surgery procedures at a temperature ≥ 34°C. This study particularly focused of three risk factors for AKI, namely, the oxygen delivery (DO2i), venous saturation (SvO2) and mean arterial pressure (MAP).
RESULTS: The TAUT-DO2i300 (threshold value 300 mL/min/m2), as well as the TAUT-SvO270 (threshold value 70%) were significantly larger in the group of patients who developed AKI (P < 0.001). The TAUT-MAP60 (threshold value 60 mmHg) was significantly different between AKI and non-AKI groups during CPB, but they were significantly larger for the AKI group during the first 6 h at the ICU (P < 0.001).
CONCLUSION: The findings indicate that increased cumulative AUT-DO2i300 exposure may be linked to a higher risk of AKI, supporting the potential role of AUT-based monitoring in guiding intraoperative management during on-pump cardiac surgery.
METHODS: This is a retrospective single center study of procedures from January 1st 2019 to August 31st 2023. The final cohort included 3086 patients who underwent on-pump cardiothoracic surgery procedures at a temperature ≥ 34°C. This study particularly focused of three risk factors for AKI, namely, the oxygen delivery (DO2i), venous saturation (SvO2) and mean arterial pressure (MAP).
RESULTS: The TAUT-DO2i300 (threshold value 300 mL/min/m2), as well as the TAUT-SvO270 (threshold value 70%) were significantly larger in the group of patients who developed AKI (P < 0.001). The TAUT-MAP60 (threshold value 60 mmHg) was significantly different between AKI and non-AKI groups during CPB, but they were significantly larger for the AKI group during the first 6 h at the ICU (P < 0.001).
CONCLUSION: The findings indicate that increased cumulative AUT-DO2i300 exposure may be linked to a higher risk of AKI, supporting the potential role of AUT-based monitoring in guiding intraoperative management during on-pump cardiac surgery.