Perioperative intravascular volume replacement and kidney insufficiency.
Perioperative acute kidney injury (AKI) occurrence is probably increased in recent years due to the increased level of complexity of surgical procedures and severity of illness of surgical patients. Perioperative AKI has a multifactorial aetiology (preoperative co-morbidities such as diabetes, heart failure and chronic kidney disease, emergent surgery, exposure to nephrotoxic drugs, haemodynamic instability, hypothermia, inflammatory response to surgery, hospital-acquired infections and abdominal compartment syndrome). However, fluid choice for perioperative volume replacement might have a major role in perioperative AKI, as administration of crystalloid solutions, colloids or haemoderivates has the potential for kidney injury. This review focusses on the issue of fluid replacement quality and quantity and their association with renal dysfunction.
Department of Cardiology and Cardiac Surgery, Pediatric Cardiac Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. z.ricci@libero.it
Zaccaria
Z
Ricci
Stefano
S
Romagnoli
Claudio
C
Ronco
D001810:Blood Volume / Q000502:physiology*; D000077324:Crystalloid Solutions; D005440:Fluid Therapy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage; D019990:Perioperative Care / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology* / Q000628:therapy; D051437:Renal Insufficiency / Q000453:epidemiology* / Q000628:therapy*
D000077324:Crystalloid Solutions; D007552:Isotonic Solutions