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Research Article
Analgesic and Opioid Sparing Effects of Tramadol, Ketamine, and Bupivacaine Following Wound Infiltration After Caesarean Section
Olayinka Olumide Ajiboye,
Adeyemi William Osebequin,
Agu Edith,
Olateju Simeon Olugbade,
Achi Joseph,
Oyewole Ezekiel
Issue:
Volume 12, Issue 1, June 2024
Pages:
1-6
Received:
16 December 2023
Accepted:
2 January 2024
Published:
18 January 2024
Abstract: Background: Adequate management of pain is considered a fundamental human right and social justice and this may be achieved for women who had caesarean section under subarachnoid block with multi modal means of analgesia. Wound infiltration with different agents may be part of the multi modal means of providing adequate analgesia. The study aimed to determine which of plain bupivacaine, ketamine or tramadol will give the best pain control post-operatively in terms of quality and duration of pain relief when used for wound infiltration following caesarean section under subarachnoid block. Methods: A prospective double blind randomized study of 132 patients, divided into three groups of A, B, and C with 44 patients in each group. Each group had wound infiltration with either 0.125% plain bupivacaine (Group A), 0.25% ketamine (Group B), or 0.25% tramadol (Group C) after caesarean section under subarachnoid block. Pain was assessed hourly in the first 4 hours then 4 hourly for 20hours. The duration of pain relief after subcutaneous infiltration, morphine consumption, and side effects were noted for all the three groups. Results: Time to first rescue analgesic was similar in all three groups, however duration of analgesia was longest in Group A (4 hours). ANOVA analysis of the time to first analgesic request across the three groups was not statistically significant (p=0.0862). Morphine consumption was highest in Group C with an average of 7mg in 24 hours, but was lower in Groups A and B which were 5.09mg and 5.63mg respectively in 24 hours. Using the 5 point Likert to test for patient satisfaction; group A recorded highest percentage of patients who strongly agreed to being satisfied, while the least percentage to satisfaction was found in Group C. Conclusion: This study demonstrated that of the three drugs tested, bupivacaine was the most effective analgesic with consequent reduction in opioid consumption and offered prolonged patient satisfaction.
Abstract: Background: Adequate management of pain is considered a fundamental human right and social justice and this may be achieved for women who had caesarean section under subarachnoid block with multi modal means of analgesia. Wound infiltration with different agents may be part of the multi modal means of providing adequate analgesia. The study aimed t...
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Case Report
Ultrasound-Guided Quadratus Lumborum Block as a Sole Anesthetic Method for Giant Inguinal Herniorrhaphy in an Elderly Patient with High Risk
Guangchao Zhang,
Min Xu,
Xiao Wang*
Issue:
Volume 12, Issue 1, June 2024
Pages:
7-10
Received:
14 January 2024
Accepted:
29 January 2024
Published:
5 February 2024
Abstract: Background: Quadratus lumborum (QL) block is a fascial plane block where local anesthetic is injected adjacent to the quadratus lumborum muscle to provide effective analgesia for abdominal procedures. We presented the feasibility of using this technique as the sole anesthetic technique for giant inguinal herniorrhaphy repair by observing intraoperative and postoperative analgesic effects in patients. Case: We present an elderly patient with complex comorbidities who was hospitalized for a left inguinal hernia that fell into the scrotum and formed a huge hernial sac. Comorbidities include hypertension, atrial fibrillation, and chronic obstructive pulmonary disease. After adequate preoperative evaluation, the anesthesiologist scheduled to perform QL block as the sole anesthetic technique to complete a giant inguinal herniorrhaphy with 30 mL of ropivacaine (0.33%). Intraoperative hemodynamics was stable, the patient did not complain discomfort and pain. And no additional analgesics or local infiltration anesthesia was required. The patient was able to move 6 hours after surgery and received the first analgesia 14 hours later. He was discharged one day later, without recurrence after one year of follow-up. Conclusions: Our experience suggests that QL block with 30 mL of ropivacaine (0.33%) may be an effective intraoperative anesthesia technique suitable for elderly patients with complex complications undergoing giant inguinal hernia repair surgery, and a represents a viable alternative approach to general and neuraxial anesthesia.
Abstract: Background: Quadratus lumborum (QL) block is a fascial plane block where local anesthetic is injected adjacent to the quadratus lumborum muscle to provide effective analgesia for abdominal procedures. We presented the feasibility of using this technique as the sole anesthetic technique for giant inguinal herniorrhaphy repair by observing intraopera...
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Case Report
Thrombosis of Prosthetic Tricuspid Valve During Veno-Arterial Extracorporeal Membrane Oxygenation Support: A Case Report
Issue:
Volume 12, Issue 1, June 2024
Pages:
11-14
Received:
17 January 2024
Accepted:
31 January 2024
Published:
20 February 2024
Abstract: Extracorporeal membrane oxygenation (ECMO) is frequently used for severe postcardiotomy cardiogenic shock in patients with bioprosthetic valves. Acute prosthetic valve thrombosis (PVT) is a rare complication after valve replacement surgery and significantly increases morbidity and mortality. Patients who develop PVT on ECMO could significantly influence the long-term durability of the bioprosthetic valves. However, previous studies only analyzed risk factor and treatment of the mitral valve thrombosis during ECMO support. The mechanism of thrombosis on the tricuspid valve was still unknown. Here we describe the symptoms and treatment of a valve replacement patient who developed bioprosthetic tricuspid valve thrombosis during veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Meanwhile, the patient’s mechanical prosthetic mitral valve functioned normally. An emergency re-do tricuspid prosthesis replacement was performed, and the patient finally developed the successful decannulation. At 6 months follow-up, the patient showed asymptomatic and had a reasonable quality of life. The pathophysiology of tricuspid valve thrombosis may be different from the left heart. Our case highlights that the risk of thrombosis associated with a prosthesis in the tricuspid position can be even higher in the setting of VA-ECMO support. In such patients, promoting forward blood flow across the prosthesis and improving levels of anticoagulation may be particularly important.
Abstract: Extracorporeal membrane oxygenation (ECMO) is frequently used for severe postcardiotomy cardiogenic shock in patients with bioprosthetic valves. Acute prosthetic valve thrombosis (PVT) is a rare complication after valve replacement surgery and significantly increases morbidity and mortality. Patients who develop PVT on ECMO could significantly infl...
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Case Report
Timely Surgical Intervention for Absent Pulmonary Valve Syndrome with an Intact Ventricular Septum in a Patient with a Long-Term Survival: A Case Report
Yunyi Zhang,
Shuhua Luo*,
Enping Wang
Issue:
Volume 12, Issue 1, June 2024
Pages:
15-19
Received:
31 January 2024
Accepted:
21 February 2024
Published:
29 February 2024
Abstract: Absent pulmonary valve syndrome with an intact ventricular septum (APVS with IVS) is a rare congenital heart defect that is associated with a high perinatal mortality. Most fetuses can hard to survive without inotropic support or heart transplantation due to the severe respiratory dysfunction, heart failure and serious infections resulting from tracheobronchial compression and right ventricular dilation. Almost one-third of the patients opted for a termination of pregnancy. The etiology of APVS patients is still unknown. Previous research only noted an enhancement in the long-term survival of APVS with tetralogy of Fallot patients over the past decade. However, the timeliness of surgical intervention and survival status in APVS with IVS patients remains unclear. In our case, we described a 27-year-old patient with a rare combination of the rudimentary pulmonary valve, intact ventricular septum and absent superior vena cava who successfully developed biventricular physiology without any medical intervene. And he received a timely pulmonary valve implantation in our centre to prevent further right ventricular dysfunction. Thus, we highlighted that biventricular circulation can be successfully achieved in this rare subtype of APVS with IVS patients. However, more multicentre studies and lifelong follow-up are required to determine the timeliness for pulmonary valve surgery to avoid over-dilatation of the right ventricle in APVS with IVS patients.
Abstract: Absent pulmonary valve syndrome with an intact ventricular septum (APVS with IVS) is a rare congenital heart defect that is associated with a high perinatal mortality. Most fetuses can hard to survive without inotropic support or heart transplantation due to the severe respiratory dysfunction, heart failure and serious infections resulting from tra...
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Research Article
A Study on Pre-clinical Anaesthesia Elective in Shaping Medical Students' Knowledge and Career Perspectives
Jeffrey Hauck*,
Ivan Angelov,
Kelli Silcox,
Ali Khalifa
Issue:
Volume 12, Issue 1, June 2024
Pages:
20-25
Received:
24 February 2024
Accepted:
7 March 2024
Published:
19 March 2024
DOI:
10.11648/j.ijacm.20241201.15
Downloads:
Views:
Abstract: Anesthesiology stands out as one of the rapidly growing and highly competitive medical specialties, necessitating students to cultivate an interest in anesthesia early and prepare extensively for clinical electives. Pre-clinical electives that introduce students to anesthesia and ready them for clinical settings in the early stages of their academic journey may confer benefits and enhance their competitiveness as residency applicants. This study implemented an eight-week pre-clinical elective titled "The History of Anesthesia" for first- and second-year students at Baylor College of Medicine. Eighty-eight students participated in the elective, with thirteen completing both pre-course and post-course surveys. The survey, consisting of thirteen questions related to anesthesia interest and relevant clinical knowledge, was analyzed, and statistical significance was calculated. The survey results demonstrated significantly elevated levels of self-assessed knowledge in the post-course survey compared to the pre-course survey (p < .05). Notably, topics considered more clinically relevant, such as modern anesthetic techniques, regional anesthesia, and obstetric anesthesia, exhibited significantly higher average survey results in the post-course compared to the pre-course results. The implementation of pre-clinical electives focusing on success in clinical settings appears beneficial for students aspiring to apply to an anesthesiology residency. Institutions should consider exposing students to anesthetic topics earlier in their academic journey to adequately prepare them for the competitive residency application process.
Abstract: Anesthesiology stands out as one of the rapidly growing and highly competitive medical specialties, necessitating students to cultivate an interest in anesthesia early and prepare extensively for clinical electives. Pre-clinical electives that introduce students to anesthesia and ready them for clinical settings in the early stages of their academi...
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Research Article
Effects of Dexmedetomidine on Oxidative Stress, Inflammatory Response, Coagulation Function and Hemodynamics in Patients Undergoing Hysterectomy
Issue:
Volume 12, Issue 1, June 2024
Pages:
26-32
Received:
11 March 2024
Accepted:
2 April 2024
Published:
28 April 2024
Abstract: Objective To investigate the effects of dexmedetomidine on oxidative stress, inflammatory response, coagulation function and hemodynamics in patients undergoing hysterectomy. Methods 92 patients who underwent hysterectomy in our hospital from January to September 2023 were selected as subjects. According to the difference in anesthesia, 46 patients were in the control group and 46 in the dexmedetomidine group. Patients in the control group received midazolam anesthesia, and patients in the dexmedetomidine group received dexmedetomidine anesthesia. The changes of oxidative stress, inflammatory response, coagulation function and hemodynamics were compared between T0 (before anesthesia), T1 (10 min after anesthesia), T2 (after extubation) and T3 (24 h after surgery). Results At T0, there was no significant difference in T-AOC, GSH-Px, MBP, MCP-1, AT III, FDP, MAP and SpO2 between the two groups (P>0.05). At the time of T1, T2 and T3, the two groups of patients T-AOC, GSH-Px were all lower than T0 (P<0.05), MBP and MCP-1 were all higher than T0 (P<0.05). The levels of T-AOC and GSH-Px in the dexmedetomidine group were significantly higher than those in the control group (P<0.05). The levels of MCP-1 was significantly lower than that of the control group (P<0.05). At the T1 and T2, ATIII levels was lower than T0 (P<0.05), and FDP levels was higher than T0 (P<0.05). At the time of T3, the levels of ATIII and FDP in the dexmedetomidine group recovered to the normal level of T0. There was no significant change in MAP and SpO2 at each time in the dexmedetomidine group (P>0.05). Conclusion Dexmedetomidine can more effectively alleviate the oxidative stress response in patients with hysterectomy, reduce the symptoms of inflammation in patients, improve the coagulation status of patients and have less influence on hemodynamics, and have high clinical value.
Abstract: Objective To investigate the effects of dexmedetomidine on oxidative stress, inflammatory response, coagulation function and hemodynamics in patients undergoing hysterectomy. Methods 92 patients who underwent hysterectomy in our hospital from January to September 2023 were selected as subjects. According to the difference in anesthesia, 46 patients...
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Case Report
Intraoperative Hypoxemia in the Right Lateral Decubitus Position: A Case Report
Guowei Wu
,
Hongwei Xu*
Issue:
Volume 12, Issue 1, June 2024
Pages:
33-37
Received:
28 March 2024
Accepted:
11 April 2024
Published:
28 April 2024
Abstract: Platypnea-Orthodeoxia syndrome (POS), an exceptionally uncommon condition, is characterized by decreased oxygen saturation in an upright posture with corresponding improvement in the supine position. Recently, an 85-year-old female patient presented for surgery due to a left femoral neck fracture. Following successful tracheal intubation and anesthesia induction, the ventilator indicated an airway pressure of 15mmHg. While in the right lateral decubitus position, the patient developed hypoxia despite normal arterial blood pressure and symmetrical breath sounds. Attempts to alleviate the hypoxia through pure oxygen ventilation, tympanic lung ventilation, and high-frequency ventilation were unsuccessful. Subsequently, there was a notable decrease in both blood pressure and heart rate, prompting an immediate halt to the surgery and repositioning the patient to the supine position. This resulted in the normalization of the patient's heart rate, oxygen saturation, and blood pressure. To investigate the etiology, a TEE probe was inserted, revealing the presence of a patent foramen ovale (PFO) and a significant right-to-left shunt while the patient was in the lateral position. The procedure was performed in a specific right lateral decubitus position. This case may represent a unique manifestation of POS syndrome, expanding the differential diagnosis for intraoperative position-related hypoxemia. Given the severe hypoxemia observed with intraoperative positional changes, a strong suspicion of POS syndrome is warranted.
Abstract: Platypnea-Orthodeoxia syndrome (POS), an exceptionally uncommon condition, is characterized by decreased oxygen saturation in an upright posture with corresponding improvement in the supine position. Recently, an 85-year-old female patient presented for surgery due to a left femoral neck fracture. Following successful tracheal intubation and anesth...
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Research Article
Comparison the Cerebroprotective Effect of Sevoflurane and Propofol in Patients with Carotid Artery Stenosis Undergoing Coronary Artery Bypass Grafting: A Randomized Clinical Study
Rabie Nasr*,
Ahmed Soliman
Issue:
Volume 12, Issue 1, June 2024
Pages:
38-46
Received:
29 February 2024
Accepted:
21 March 2024
Published:
10 May 2024
DOI:
10.11648/j.ijacm.20241201.18
Downloads:
Views:
Abstract: Objective: The Objective of the study was to evaluate the perioperative cerebral protective effect of sevoflurane and propofol in patients with carotid artery stenosis undergoing coronary artery bypass grafting. Materials and Methods: A randomized clinical study included 200 patients with preoperative carotid artery stenosis <50% scheduled for cardiac surgery with cardiopulmonary bypass. The patients were classified into 2 groups (each=100), Sevoflurane group: The patients received sevoflurane (concentration 1% to 4%) as an inhalational agent. Propofol group: The patients received propofol infusion (4-6 mg/kg/hr). The sevoflurane and propofol were given during the whole procedure (before, during, and after cardiopulmonary bypass). The monitors included heart rate, mean arterial blood pressure (MAP), central venous pressure and cerebral near-infrared spectroscopy (NIRS), the incidence of postoperative cognitive dysfunction and stroke. Results: There was no significant difference in the perioperative heart rate, mean arterial blood pressure, central venous pressure, and the right or left regional cerebral oxygen saturation between the two groups (P>0.05). The incidence of postoperative neurological complication was significantly lower with sevoflurane than propofol (P=0.012). The incidence of delirium was significantly lower with sevoflurane than propofol (P=0.023). The incidence of stroke was lower with sevoflurane than propofol, but the difference was insignificant (P=0.682). The ICU and hospital length of stay were shorter with sevoflurane than propofol (P=0.013, P=0.033 respectively). Conclusions: The sevoflurane was associated with a lower incidence of postoperative cognitive dysfunction than propofol in patients with carotid artery stenosis undergoing coronary artery bypass grafting.
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Research Article
Assessing the Safety and Efficacy of Spinal Anesthesia in Preterm and Term Neonates: A Multicenter Experience
Adamu Yusuf Baffah,
Abubakar Muhammad Ballah*,
Yahaya Halima Bidemi,
Jika Mohammed Mohammed,
Gyadale Abdulhamid Njidda,
Nwokorie Rosemary Mabong,
Galadima Hajara Aminu,
Hassan Maina Ali,
Ibrahim Naziru Joda,
Abdullahi Muhammad Maryam,
Adam Ibrahim Abdullahi,
Andibanbang Franklin
Issue:
Volume 12, Issue 1, June 2024
Pages:
47-52
Received:
20 May 2024
Accepted:
30 May 2024
Published:
14 June 2024
Abstract: Background: Worldwide, the incidence of premature birth is increasing with its attending congenital anomalies, so complex surgical interventions to manage these congenital anomalies or complications are usually performed at early days of life. Neonates are vulnerable to apnea, and congenital cardiopulmonary problems and they have higher morbidity and mortality compared to older children and adults etc. In the preterm neonate, the risk of bronchopulmonary dysplasia and apnoea make their management complex and this is further compounded by their smaller size. Objective of study: The aim of the study was to determine the safety and efficacy of spinal anesthesia among neonates. Methodology: The study is a prospective study conducted in three tertiary health Institutions in northeast Nigeria. It includes all neonates scheduled for surgery amenable under SA. Sociodemographic variables, Haemodynamic variables, duration of surgery, and complications observed were all recorded. Results: Spinal anaesthesia SA was done in 230 patients, 90% of the patients were term, and only 10% were preterm. The majority were male with a mean weight of 3002 ± 660 grams and a mean age of 14.51±7.28 days. SA was successful in 93% of the patients in the first attempt. Heart rate, mean arterial pressure and oxygen saturation remained stable all through the duration of surgery. About 6% of the patients were converted to General Anaesthesia GA on account of prolonged surgery. The highest level of sympathetic block was recorded at the level of T4 while the lowest was at T6. Herniotomy was the most common surgery performed. The surgery lasted an average of 72 ± 28 minutes. No complication was recorded. Conclusion: Spinal anaesthesia provides a safe and reliable option for neonates who may require surgery early in life to improve their chances of survival. It serves as an alternative to GA with enhanced haemodynamic stability in this fragile population.
Abstract: Background: Worldwide, the incidence of premature birth is increasing with its attending congenital anomalies, so complex surgical interventions to manage these congenital anomalies or complications are usually performed at early days of life. Neonates are vulnerable to apnea, and congenital cardiopulmonary problems and they have higher morbidity a...
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Case Report
Airway Management of Intracranial Aneurysms Associated with Nasopharyngolaryngeal Hemangioma: A Case Report
Guowei Wu,
Hongwei Xu*
Issue:
Volume 12, Issue 1, June 2024
Pages:
53-56
Received:
10 May 2024
Accepted:
3 June 2024
Published:
19 June 2024
Abstract: Intracranial aneurysm is a very common disease, which is an abnormal bulge on the wall of intracranial artery. It is the first cause of subarachnoid hemorrhage. With the development of imaging, the disease is easily diagnosed. A 60-year-old man was diagnosed with anterior communicating artery aneurysm and underwent aneurysm clipping. During routine induction of anesthesia, a nasopharyngolaryngeal hemangioma was visualized under a video laryngoscope. This poses a serious challenge for tracheal intubation. With the assistance of a video laryngoscope and local anesthesia with lidocaine, a 6.5# reinforced endotracheal tube was inserted. Nasopharyngolaryngeal hemangioma is a congenital vascular anomaly characterized by proliferation of endothelial cells. The incidence of infantile and childhood hemangiomas is low, and most spontaneously resolve by the age of 4 to 6 years. Adult nasopharyngolaryngeal hemangioma are extremely rare and are residual lesions from infancy and childhood. Although nasopharyngolaryngeal hemangioma does not clearly affect the quality of life of patients, intracranial hemangioma has caused blurred vision and decreased vision. Therefore, surgery for intracranial aneurysm was necessary for this patient. This case emphasizes the management of unplanned difficult airway of pharyngeal hemangioma and the emergency plan for hemangioma rupture and bleeding. Provide guidance and risk management procedures for nasopharyngotracheal intubation.
Abstract: Intracranial aneurysm is a very common disease, which is an abnormal bulge on the wall of intracranial artery. It is the first cause of subarachnoid hemorrhage. With the development of imaging, the disease is easily diagnosed. A 60-year-old man was diagnosed with anterior communicating artery aneurysm and underwent aneurysm clipping. During routine...
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Research Article
The Relationship Between Postoperative Drainage Volume and the Incidence of Postoperative Renal Injury in Infants Undergoing Cardiac Surgery
Yuan Yuan*
Issue:
Volume 12, Issue 1, June 2024
Pages:
57-61
Received:
19 May 2024
Accepted:
5 June 2024
Published:
19 June 2024
Abstract: Cardiac surgery-related acute kidney injury (CS-AKI) is a serious and frequently encountered complication that occurs in children undergoing cardiac surgery. It is particularly prevalent among those who undergo complex and prolonged surgical procedures. CS-AKI is a complex condition that can lead to significant morbidity and even mortality, and thus, understanding its pathogenesis and identifying potential risk factors is crucial for improving patient outcomes. One of the most consistent contributing factors to the development of CS-AKI is intraoperative bleeding. Bleeding during surgery can lead to hemodynamic instability, which in turn can affect renal perfusion and oxygen supply, ultimately leading to kidney injury. Intraoperative renal hypoperfusion and oxygen supply and demand imbalances are recognized as important pathogenic mechanisms underlying CS-AKI. To further investigate the relationship between intraoperative bleeding and postoperative kidney damage, researchers have conducted prospective observational studies. These studies focus on infants and young children undergoing cardiac surgery, as they are particularly vulnerable to the complications of such surgeries. By carefully observing and documenting the postoperative drainage volume, researchers aim to evaluate the correlation between postoperative blood loss and the incidence of postoperative renal injury. The results of these studies have provided valuable insights into the pathophysiology of CS-AKI. However, it is important to note that the correlation between postoperative eCrCl (estimated creatinine clearance) and postoperative drainage volume has not been found to be significant. This suggests that while intraoperative bleeding may contribute to the development of kidney injury, it may not be the sole determinant of renal outcome.
Abstract: Cardiac surgery-related acute kidney injury (CS-AKI) is a serious and frequently encountered complication that occurs in children undergoing cardiac surgery. It is particularly prevalent among those who undergo complex and prolonged surgical procedures. CS-AKI is a complex condition that can lead to significant morbidity and even mortality, and thu...
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Case Report
Catastrophic Cardiac Arrest Caused by Acute Pulmonary Hypertension After Removal of Giant Left Atrial Thrombus
Issue:
Volume 12, Issue 1, June 2024
Pages:
62-65
Received:
20 April 2024
Accepted:
8 May 2024
Published:
21 June 2024
Abstract: Background: Pulmonary hypertension (PH) is defined as a resting mean pulmonary arterial pressure (mPAP) >20 mmHg on right heart catheterization, as described in the proceedings of the 6th World Symposium on Pulmonary Hypertension. Left-sided heart failure (left heart disease) is the most common cause of pulmonary hypertension (PH). Transesophageal echocardiography (TEE) plays an important role in the monitoring of PH. But the disadvantage of TEE is the lack of continuity of monitoring. For patients with severe mitral stenosis and severe PH, should the Swan-Ganz catheter be placed routinely? The monitoring of pulmonary artery pressure and pulmonary venous pressure by Swan-Ganz catheter can guide the management of perioperative circulation and respiration, especially for early detection of PH. Case presentation: This case report introduce a severe mitral valve stenosis with giant left atrium thrombosis performing cardiac surgery. After the removal of giant left atrial mass and mitral valve replacement under cardiopulmonary bypass (CPB), the patient gradually experienced difficulty in ventilation and persistent refractory hypotension, followed by ventricular fibrillation during the process of chest closure. Conclusions: TEE helps diagnose acute pulmonary hypertension. Although TEE plays an important role in the diagnosis and the decision to use mechanical devices, a Swan-Ganz catheter would be an effective hemodynamic monitoring device and can be used in conjunction with TEE in cardiac surgery.
Abstract: Background: Pulmonary hypertension (PH) is defined as a resting mean pulmonary arterial pressure (mPAP) >20 mmHg on right heart catheterization, as described in the proceedings of the 6th World Symposium on Pulmonary Hypertension. Left-sided heart failure (left heart disease) is the most common cause of pulmonary hypertension (PH). Transesophageal ...
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Case Report
A Case of Cardiac Surgery-Associated Acute Kidney Injury
Issue:
Volume 12, Issue 1, June 2024
Pages:
66-69
Received:
22 May 2024
Accepted:
11 June 2024
Published:
21 June 2024
Abstract: Approximately 2 million patients undergo cardiac surgery annually with 20% to 30% developing the cardiac surgery-associated acute kidney injury. Patient who has undergone cardiac surgery in the past week and meets the criteria for acute kidney injury can be classified as a cardiac surgery-associated acute kidney injury. The cardiac surgery-associated acute kidney injury may be caused by various factors during perioperative period. Preoperative risk factors include advanced age, female gender, pre-existing renal insufficiency, heart failure, left main coronary artery disease, diabetes, chronic obstructive pulmonary disease, peripheral vascular disease, liver disease, low cardiac output and hypotension. Intraoperative risk factors include the type of surgery (valve surgery, combined valve and coronary artery surgery, emergency and reoperations), low-flow cardiopulmonary bypass, hypothermic cardiopulmonary bypass, deep hypothermic circulatory arrest, cardiopulmonary bypass duration >100-120 minutes, hemodilution, hemolysis and hemoglobinuria due to prolonged cardiopulmonary bypass duration. We present the case of a 53-year-old female with severe valvular heart disease complicated by infecting human immunodeficiency virus. She experienced an acute kidney injury after cardiac surgery. The rationale for this case report is to learn about the risk factors of cardiac surgery-associated acute kidney injury and take measures to prevent it.
Abstract: Approximately 2 million patients undergo cardiac surgery annually with 20% to 30% developing the cardiac surgery-associated acute kidney injury. Patient who has undergone cardiac surgery in the past week and meets the criteria for acute kidney injury can be classified as a cardiac surgery-associated acute kidney injury. The cardiac surgery-associat...
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