Abstract:
Post-operative acute kidney injury is a devastating complication with significant morbidity and mortality associated with it. The perioperative anesthesiologist is in a unique position to potentially mitigate the risk of postoperative AKI, however, understanding the pathophysiology, risk factors and preventative strategies is paramount. There are also certain clinical scenarios, where renal replacement therapy may be indicated intraoperatively including severe electrolyte abnormalities, metabolic acidosis and massive volume overload. A multidisciplinary approach including the nephrologist, critical care physician, surgeon and anesthesiologist is necessary to determine the optimal management of these critically ill patients.
摘要:
术后急性肾损伤是一种毁灭性的并发症,具有显著的发病率和死亡率。围手术期麻醉师处于独特的位置,可以潜在地减轻术后AKI的风险,然而,了解病理生理学,风险因素和预防策略至关重要。也有某些临床情况,术中可能需要肾脏替代疗法,包括严重的电解质异常,代谢性酸中毒和大量容量超负荷。多学科的方法,包括肾脏病学家,重症监护医生,外科医生和麻醉师是必要的,以确定这些危重病人的最佳管理。