The association of postcardiac surgery acute kidney injury with intraoperative systolic blood pressure hypotension.
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Background. Postoperative acute kidney injury (AKI) is associated with high mortality and substantial cost after aortocoronary bypass graft (CABG) surgery. We tested the hypothesis that intraoperative systolic blood pressure variation is associated with postoperative AKI. Methods. We gathered demographic, procedural, blood pressure, and renal outcome data for 7,247 CABG surgeries at a single institution between 1996 and 2005. A development/validation cohort methodology was randomly divided (66% and 33%, resp.). Peak postoperative serum creatinine rise relative to baseline (%ΔCr) was the primary AKI outcome variable. Markers reflective of intraoperative systolic blood pressure variation were derived for each patient including (1) peak and nadir values (absolute and relative to baseline) and (2) excursion episodes beyond selected thresholds (by duration, frequency, and duration × degree). Each marker of systolic blood pressure variation was then separately evaluated for association with AKI using linear regression models with adjustment for several known risk factors (age, aprotinin use, congestive heart failure, previous myocardial infarction, baseline creatinine, bypass time, diabetes, weight, concomitant valve surgery, gender, and preoperative pulse pressure). Results. An association was identified between systolic blood pressure relative to baseline and postoperative AKI (P < 0.006). Conclusions. In CABG surgery patients, intraoperative systolic blood pressure decrease relative to baseline systolic blood pressure is independently associated with postoperative AKI.
Published Version (Please cite this version)10.1155/2013/174091
Publication InfoAronson, Solomon; Fontes, Manuel Lopes; Gaca, Jeffrey G; Mathew, Joseph P; Newman, Mark Franklin; Phillips-Bute, Barbara Gottfried; & Stafford-Smith, Mark (2013). The association of postcardiac surgery acute kidney injury with intraoperative systolic blood pressure hypotension. Anesthesiol Res Pract, 2013. pp. 174091. 10.1155/2013/174091. Retrieved from https://hdl.handle.net/10161/11133.
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Professor of Anesthesiology
Solomon Aronson, MD, MBA, FACC, FACCP, FAHA, FASE Solomon Aronson is a tenured professor at Duke University and Executive Vice Chairman in the Department of Anesthesiology. Dr. Aronson earned his BS in molecular biology with distinction at the University of Wisconsin in Madison, and his MD with honors in research at the Medical College of Wisconsin in Milwaukee. After completing an anesthesiology residency including a year as chief resident at the Univer
Associate Professor of Surgery
Jerry Reves, M.D. Professor of Cardiac Anesthesiology
Current research interests include:1. The relationship between white matter patency, functional connectivity (fMRI) and neurocognitive function following cardiac surgery.2. The relationship between global and regional cortical beta-amyloid deposition and postoperative cognitive decline.3. The effect of lidocaine infusion upon neurocognitive function following cardiac surgery.4. The association between genotype and outcome after cardiac surgery.5. Atrial fibrillation
Professor Emeritus of Anesthesiology
Best known for his work in assessing and improving clinical outcomes and quality of life following cardiac surgery, Dr. Mark Newman is President of the Duke Private Diagnostic Clinic (The Duke Faculty Practice Organization) and the Merel H. Harmel Professor of Anesthesiology at Duke University Medical Center. In addition, Dr. Newman developed the Multicenter Perioperative Outcomes Research Group of the Duke Clinical Research Institute established at Duke in 2001 to further the study of strategie
Professor of Anesthesiology
My research interests are in the area of Cardiothoracic Anesthesiology. The main focus of my research is towards the understanding and prevention of acute kidney injury after cardiac and other major surgeries. Secondary interests include the study of analgesic strategies after cardiothoracic surgical procedures, performance of clinical trials, and perioperative transfusion and hemostasis.
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