Post-operative renal failure management in mechanical circulatory support patients

Danielle Austin*, Peter McCanny, Anders Aneman

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

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    Abstract

    Acute kidney injury (AKI) occurs commonly in patients requiring mechanical circulatory support (MCS) after cardiothoracic surgery. The prognostic implications of AKI in this patient group relate closely to the pathophysiology and risk factors associated with the underlying disease; pre-operative, intra-operative, and post-operative variables; hemodynamic factors; and type of support device used. General approaches to AKI management, including prevention strategies, medical management, and hemodynamic support, are also applicable in patients requiring MCS. Approaches to renal replacement therapy vary depend on patient factors, device-specific factors, and local preferences and experience. In this invited narrative review, we discuss the pathophysiology, risk factors, and prognostic implications of AKI in post-operative adult patients following institution of MCS. Management strategies for AKI are presented with a focus on those supported with either extracorporeal membrane oxygenation or a ventricular assist device.

    Original languageEnglish
    Article number833
    Pages (from-to)1-15
    Number of pages16
    JournalAnnals of Translational Medicine
    Volume8
    Issue number13
    DOIs
    Publication statusPublished - Jul 2020

    Bibliographical note

    Copyright the Publisher. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

    Keywords

    • Mechanical circulatory support (MCS)
    • acute kidney injury (AKI)
    • extracorporeal membrane oxygenation (ECMO)
    • left ventricular assist device (LVAD)

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