Potential Renoprotective Strategies in Adult Cardiac Surgery: A Survey of Society of Cardiovascular Anesthesiologists Members to Explore the Rationale and Beliefs Driving Current Clinical Decision-Making.
Potential Renoprotective Strategies in Adult Cardiac Surgery: A Survey of Society of Cardiovascular Anesthesiologists Members to Explore the Rationale and Beliefs Driving Current Clinical Decision-Making.
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DOI：
10.1053/j.jvca.2021.02.004
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发表时间：
2021-07
影响因子：
2.8
通讯作者：
中科院分区：
文献类型：
--
作者：
我们试图i)描述麻醉师使用各种围手术期策略的基本原理，假设这些策略会影响接受心脏手术的成年患者的肾功能，ii)描述现有的关于这些策略对肾脏影响的证据质量的信念，以及iii)确定麻醉师最重视详细的、基于证据的评估的潜在肾保护策略。成人心脏手术患者围手术期实践调查。在线调查。心血管麻醉师协会（SCA）成员。该调查被分发给2000多名SCA成员，由202名受访者全部或部分完成。术中目标血压的选择（和相对避免低血压）是最常报道的策略，反映了对其潜在肾脏影响的信念（79%;95% CI 72-85%）。大多数受访者认为，支持心脏手术中术中目标血压对肾损伤影响的证据质量为高或中等。其他因素，包括特定的非肾脏原因，外科医生的偏好，部门或机构层面的决定，传统或习惯也经常被报道影响决策。在随后的详细的、以证据为基础的回顾中，最常被要求纳入的潜在肾保护策略是术中目标血压和选择血管加压药物以达到目标血压。大量围手术期策略被认为对接受心脏手术的成年患者的肾损伤有不同的影响，这些策略对肾脏影响的证据质量差异很大。
We sought to i) characterize the rationale underpinning anesthesiologists use of various perioperative strategies hypothesized to impact renal function in adult patients undergoing cardiac surgery, ii) characterize existing belief about the quality of evidence addressing the renal impact of these strategies, and iii) identify potentially reno-protective strategies for which anesthesiologists would most value a detailed, evidence-based review. Survey of perioperative practice in adult patients undergoing cardiac surgery. On-line survey. Members of the Society of Cardiovascular Anesthesiologists (SCA). None The survey was distributed to more than 2000 SCA members and completed in whole or in part by 202 respondents. Selection of target intraoperative blood pressure (and relative hypotension avoidance) was the strategy most frequently reported to reflect belief about its potential renal effect (79%; 95% CI 72–85%). Most respondents believed the evidence supporting an effect on renal injury of intraoperative target blood pressure during cardiac surgery was of high or moderate quality. Other factors, including a specific non-renal rationale, surgeon preference, department- or institution-level decisions, tradition or habit were also frequently reported to impact decision making across queried strategies. Potentially reno-protective strategies most frequently requested for inclusion in a subsequent detailed, evidence-based review were intraoperative target blood pressure and choice of vasopressor agent to achieve target pressure. A large number of perioperative strategies are variably believed to impact renal injury in adult patients undergoing cardiac surgery, with wide variation in perceived quality of evidence for a renal effect of these strategies.
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DOI：
10.1186/s13054-016-1352-z
发表时间：
2016-07-04
期刊：
Critical care (London, England)
影响因子：
--
作者：
O'Neal JB;Shaw AD;Billings FT 4th
通讯作者：
Billings FT 4th
影响因子：
6.1
作者：
Dasta, Joseph F.;Kane-Gill, Sandra L.;Kellum, John A.
通讯作者：
Kellum, John A.
影响因子：
5.7
作者：
Sniecinski, Roman M.;Bennett-Guerrero, Elliott;Shore-Lesserson, Linda
通讯作者：
Shore-Lesserson, Linda
影响因子：
4.6
作者：
Robert, Alina M.;Kramer, Robert S.;Brown, Jeremiah R.
通讯作者：
Brown, Jeremiah R.
DOI：
10.1016/j.jtcvs.2018.04.045
发表时间：
2018-11-01
影响因子：
6
作者：
Ranucci, Marco;Johnson, Ian;Pistuddi, Valeria
通讯作者：
Pistuddi, Valeria