Document Detail

Transfusion and risk of acute kidney injury in cardiac surgery.
MedLine Citation:
PMID:  23242748     Owner:  NLM     Status:  In-Data-Review    
Acute kidney injury (AKI) is a serious and common complication of major surgery. This narrative review focuses on the relationship between perioperative red blood cell transfusion and AKI after cardiac surgery with cardiopulmonary bypass (CPB). Numerous observational studies have shown that these two factors are independently associated with each other. Several lines of evidence suggest that the nature of this association is one of cause and effect. The pathophysiological mechanism by which transfusions might harm the kidney has not been fully elucidated, but it is known that erythrocytes undergo irreversible morphological and biochemical changes during storage. As a result, after transfusion, they can promote a pro-inflammatory state, impair tissue oxygen delivery, and exacerbate tissue oxidative stress. This in turn can cause AKI in susceptible patients undergoing cardiac surgery with CPB, such as those with pre-existing kidney dysfunction or anaemia. Interventions aimed at avoiding perioperative blood transfusion might, therefore, reduce the risk of AKI after cardiac and other types of surgery.
K Karkouti
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  109 Suppl 1     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  i29-i38     Citation Subset:  IM    
Department of Anesthesia and Pain Management, Institute of Health Policy, Management, and Evaluation, Toronto General Research Institute, Toronto General Hospital, University Health Network, University of Toronto, 200 Elizabeth Street, Toronto, ON, Canada M5G 2C4.
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