ЛІКУВАННЯ ХВОРИХ ІЗ ГОСТРОЮ НИРКОВОЮ НЕДОСТАТНІСТЮ ПІСЛЯ КАРДІОХІРУРГІЧНИХ ОПЕРАЦІЙ В УМОВАХ ШТУЧНОГО КРОВООБІГУ ПРИ НИЗЬКІЙ ФРАКЦІЇ ВИКИДУ ЛІВОГО ШЛУНОЧКА
Keywords:
acute renal failure, chronic renal failure, low left ventricular ejection fraction, cardiopulmonary bypass, cardiac surgeryAbstract
Actuality. Despite the achievements in acute kidney injury diagnostics and management, the problem of acute renal failure is still of great importance. The objective of the study was to analyze risk factors for postoperative acute kidney failure, the possibilities of modifiable risk factors improvement and treatment optimization for the purpose of diminishing acute kidney failure occurrence in the postoperative period. Materials and methods. We present data of 485 patients with low left ventricular ejection fraction (LVEF) (less than 40%) after cardiac surgery. Acute kidney injury was diagnosed in 106 (21.8%). Results. The study demonstrated, that pump function optimizing, optimal blood pressure with avoidance of even transient hypotension episodes, diminishing of cardiopulmonary bypass time, optimal fluid balance, optimal hemoglobin level, adequate nutrition, minimizing nephrotoxic drugs are the most effective prophylactic measures. Conclusions. Acute renal failure is a challenge of cardiac surgery, that needs complex staged approach. Its treatment is costly and not always successful.
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