Pneumoperitoneum and Acute Kidney Injury-An Integrative Clinical Concept Review
Copyright © ASAIO 2022..
An increased intraabdominal pressure, particularly when occurring during periods of hemodynamic instability or fluid overload, is regarded as a major contributor to acute kidney injury (AKI) in intensive care units. During abdominal laparoscopic procedures, intraoperative insufflation pressures up to 15 mmHg are applied, to enable visualization and surgical manipulation but with the potential to compromise net renal perfusion. Despite the widely acknowledged renal arterial autoregulation, net arterial perfusion pressure is known to be narrow, and the effective renal medullary perfusion is disproportionately impacted by venous and lymphatic congestion. At present, the potential risk factors, mitigators and risk-stratification of AKI during surgical pneumoperitoneum formation received relatively limited attention among nephrologists and represent an opportunity to look beyond mere blood pressure and intake-output balances. Careful charting and reporting duration and extent of surgical pneumoperitoneum represents an opportunity for anesthesia teams to better communicate intraoperative factors affecting renal outcomes for the postoperative clinical teams. In this current article, the authors are integrating preclinical data and clinical experience to provide a better understanding to optimize renal perfusion during surgeries. Future studies should carefully consider intrabdominal insufflation pressure as a key variable when assessing outcomes and blood pressure goals in these settings.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:69 |
|---|---|
| Enthalten in: |
ASAIO journal (American Society for Artificial Internal Organs : 1992) - 69(2023), 2 vom: 01. Feb., Seite e54-e65 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Kopitkó, Csaba [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 03.02.2023 Date Revised 17.02.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1097/MAT.0000000000001866 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM350330913 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM350330913 | ||
| 003 | DE-627 | ||
| 005 | 20231226044745.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/MAT.0000000000001866 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1167.xml |
| 035 | |a (DE-627)NLM350330913 | ||
| 035 | |a (NLM)36521162 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Kopitkó, Csaba |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Pneumoperitoneum and Acute Kidney Injury-An Integrative Clinical Concept Review |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 03.02.2023 | ||
| 500 | |a Date Revised 17.02.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © ASAIO 2022. | ||
| 520 | |a An increased intraabdominal pressure, particularly when occurring during periods of hemodynamic instability or fluid overload, is regarded as a major contributor to acute kidney injury (AKI) in intensive care units. During abdominal laparoscopic procedures, intraoperative insufflation pressures up to 15 mmHg are applied, to enable visualization and surgical manipulation but with the potential to compromise net renal perfusion. Despite the widely acknowledged renal arterial autoregulation, net arterial perfusion pressure is known to be narrow, and the effective renal medullary perfusion is disproportionately impacted by venous and lymphatic congestion. At present, the potential risk factors, mitigators and risk-stratification of AKI during surgical pneumoperitoneum formation received relatively limited attention among nephrologists and represent an opportunity to look beyond mere blood pressure and intake-output balances. Careful charting and reporting duration and extent of surgical pneumoperitoneum represents an opportunity for anesthesia teams to better communicate intraoperative factors affecting renal outcomes for the postoperative clinical teams. In this current article, the authors are integrating preclinical data and clinical experience to provide a better understanding to optimize renal perfusion during surgeries. Future studies should carefully consider intrabdominal insufflation pressure as a key variable when assessing outcomes and blood pressure goals in these settings | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 700 | 1 | |a Rosivall, László |e verfasserin |4 aut | |
| 700 | 1 | |a Medve, László |e verfasserin |4 aut | |
| 700 | 1 | |a Gondos, Tibor |e verfasserin |4 aut | |
| 700 | 1 | |a Soliman, Karim M |e verfasserin |4 aut | |
| 700 | 1 | |a Szabó, Zsuzsanna |e verfasserin |4 aut | |
| 700 | 1 | |a Pettendi, Éva |e verfasserin |4 aut | |
| 700 | 1 | |a Fülöp, Tibor |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t ASAIO journal (American Society for Artificial Internal Organs : 1992) |d 1997 |g 69(2023), 2 vom: 01. Feb., Seite e54-e65 |w (DE-627)NLM012606766 |x 1538-943X |7 nnns |
| 773 | 1 | 8 | |g volume:69 |g year:2023 |g number:2 |g day:01 |g month:02 |g pages:e54-e65 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/MAT.0000000000001866 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 69 |j 2023 |e 2 |b 01 |c 02 |h e54-e65 | ||