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Early detection of postoperative acute kidney injury by Doppler renal resistive index in cardiac surgery with cardiopulmonary bypass  G. Bossard, P. Bourgoin,

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Presentation on theme: "Early detection of postoperative acute kidney injury by Doppler renal resistive index in cardiac surgery with cardiopulmonary bypass  G. Bossard, P. Bourgoin,"— Presentation transcript:

1 Early detection of postoperative acute kidney injury by Doppler renal resistive index in cardiac surgery with cardiopulmonary bypass  G. Bossard, P. Bourgoin, J.J. Corbeau, J. Huntzinger, L. Beydon  British Journal of Anaesthesia  Volume 107, Issue 6, Pages (December 2011) DOI: /bja/aer289 Copyright © 2011 The Author(s) Terms and Conditions

2 Fig 1 Example of RRI measurement (RRI=0.55). The Doppler beam is angled to match the artery long axis. British Journal of Anaesthesia  , DOI: ( /bja/aer289) Copyright © 2011 The Author(s) Terms and Conditions

3 Fig 2 Resistance index before and after the operation in subjects who underwent preoperative RRI assessment. Horizontal marks represent the mean of the nearby data points. British Journal of Anaesthesia  , DOI: ( /bja/aer289) Copyright © 2011 The Author(s) Terms and Conditions

4 Fig 3 (a) Resistance index in subjects on day 0 (upon arrival in the ITU). AKI subjects have been split into two groups (without and with RRT). Horizontal dotted line (RRI=0.74) represents the best threshold value to predict AKI. (b) Contingency table of AKI according to RIFLE and our study (AKI=sCr increase >30% from baseline, after operation). Discrepancies between classifications reflect the need for RRT in some subjects for acute hyperkalaemia and severe oliguria, which does not lead to an immediate increase in sCr. British Journal of Anaesthesia  , DOI: ( /bja/aer289) Copyright © 2011 The Author(s) Terms and Conditions

5 Fig 4 Plot of RRI vs MAP on day 0, that is, during the first 40 min, after operation (r=0.39, P<0.001). British Journal of Anaesthesia  , DOI: ( /bja/aer289) Copyright © 2011 The Author(s) Terms and Conditions

6 Fig 5 Prediction of postoperative renal failure with ROC curves using five variables: preoperative sCr [sCr (preop.)], preoperative sCr indexed clearance [sCr Cl (preop.)], postoperative peak sCr [peak sCr (postop.)], and resistance index (RRI) on day 0 and weight indexed hourly diuresis on day 1. AUC appears in cartouche with confidence interval (CI). On the ROC curve, 0.74 represents the RRI value achieving the best sensitivity and specificity. British Journal of Anaesthesia  , DOI: ( /bja/aer289) Copyright © 2011 The Author(s) Terms and Conditions

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