Renal blood flow and acute kidney injury in septic shock: an arduous conflict that smolders intrarenally?
Sepsis-induced acute kidney injury (SAKI) is traditionally viewed as a process driven by a reduced blood flow and prone to benefit from vasopressive support. In ovine hyperdynamic septic shock, Lankadeva et al. report a significant and flow-independent intrarenal perfusion and oxygenation "mismatch" jeopardizing the renal medulla that was aggravated by norepinephrine. Medullary and urinary oxygenation changed in parallel, suggesting that urinary oxygenation may act as a biomarker to predict SAKI.
Intensive Care Unit Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: Patrick.Honore@az.vub.ac.be.
Patrick M
PM
Honore
Intensive Care Unit Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Rita
R
Jacobs
Intensive Care Unit Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Elisabeth
E
De Waele
Intensive Care Unit Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Marc
M
Diltoer
Intensive Care Unit Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Herbert D
HD
Spapen
D058186:Acute Kidney Injury; D000818:Animals; D006801:Humans; D009638:Norepinephrine; D012079:Renal Circulation / Q000187:drug effects*; D018805:Sepsis; D012756:Sheep; D012772:Shock, Septic
D009638:Norepinephrine