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5 results

  • Evaluation of postoperative renal functions and its effect on body perfusion in patients with double aortic cannulation

  • Berra Zumrut Tan Recep, Aybala Tongut, Ali Can Hatemi, Eylem Tuncer, Abdullah Arif Yilmaz, Hakan Ceyran
  • Journal:
    Cardiology in the Young / Volume 33 / Issue 5 / May 2023
    Published online by Cambridge University Press:
    30 May 2022, pp. 733-740
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  • Background:

    The optimal visceral preservation method during aortic arch reconstruction is still controversial. It has been thought that double aortic cannulation is effective. Herein, it was aimed to evaluate this technique in providing distal perfusion.

    Methods:

    A total of 74 patients who underwent arch reconstruction between 2011 and 2019 were included. Patients were grouped according to ventricular physiology and cannulation strategies. Group 1 were univentricle patients, and all had double aortic cannulation. Group 2 were biventricular patients. Group 2A double aortic cannulation-done and Group 2B non-double aortic cannulation were included. Lactate, urea, creatinine values, renal functions, and need for peritoneal dialysis of patients were evaluated.

    Results:

    There were no complications observed due to descending aortic cannulation in any of the patients. A delayed sternal closure and the need for peritoneal dialysis were more common in the Group 1 (p < 0.01). The preoperative and postoperative 1st- and 2nd-day lactate, urea, and creatinine values in the Group 1 were higher (p < 0.05) when compared with the Group 2A and 2B. The same values were higher in Group 2A than the Group 2B (p < 0.05).

    Conclusion:

    The positive effect of double aortic cannulation on renal dysfunction could not be demonstrated. This may be associated with a <1 month of age, low weight, complex surgical procedure, and high preoperative lactate, urea, and creatinine values in patients with double aortic cannulation.

  • 66 - Overdoses

  • from Section 11 - Environmental emergencies
  • Edited by Kaushal Shah, Jarone Lee, Kamal Medlej, American University of Beirut, Scott D. Weingart
  • Book:
    Practical Emergency Resuscitation and Critical Care
    Published online:
    05 November 2013
    Print publication:
    24 October 2013, pp 431-450

  • Summary

    This chapter discusses the diagnosis, evaluation and management of disseminated intravascular coagulation and thrombotic thrombocytopenic purpura (TTP)/hemolytic uremic syndrome (HUS). The classic presentation of TTP involves a pentad of symptoms that include fever, neurological signs, anemia, thrombocytopenia, and renal dysfunction. This collection of symptoms is only seen in 20-30% of cases and it is strongly recommended to suspect the condition and manage it as such if a patient exhibits three or more of those features. HUS is most commonly seen in children and often follows an infectious illness, usually diarrhea. Morbidity and mortality in patients with TTP/HUS are usually attributed to thrombosis rather than anemia and bleeding. Patients with TTP can present with neurological symptoms that can be life threatening themselves or complicated by a life-threatening event. Patients (usually children) presenting with HUS may have significant renal dysfunction requiring dialysis.

  • Chapter 21 - Recipient selection

  • from Section 4 - Liver
  • Edited by Andrew A. Klein, Clive J. Lewis, Joren C. Madsen
  • Book:
    Organ Transplantation
    Published online:
    07 September 2011
    Print publication:
    11 August 2011, pp 173-181

  • Summary

    Heart transplantation has excellent long-term survival, with 50% of patients living 10 years, and significant improvement in quality of life. Various factors contribute to increased early graft failure and morality, including changing donor and recipient profiles in recent years. Changes in recent years that have improved very long-term survival include modern immunosuppression, statin use, systematic post-transplant care/surveillance, and better management of renal dysfunction. The long-term complications following heart transplantation are similar to those of other organ transplants and include vasculopathy and complications of immunosuppressants. Coronary artery vasculopathy (CAV) is a leading cause of graft failure. The incidences of various metabolic syndrome risk factors including hypertension, obesity, diabetes mellitus, and hyperlipidemia are increasingly seen after heart transplantation. Acute and chronic renal failures are common after heart transplantation. Malignancy is a major cause of late morbidity and mortality after heart transplantation. Involvement of psychological and psychiatric support is important following heart transplantation.

  • Renal impairment and moderate alcohol consumption in the elderly. Results from the Italian Longitudinal Study on Aging (ILSA)

  • Alessandra Buja, Emanuele Scafato, Bruno Baggio, Giuseppe Sergi, Stefania Maggi, Giuseppe Rausa, Angela Basile, Enzo Manzato, Silvia Ghirini, Egle Perissinotto
  • Journal:
    Public Health Nutrition / Volume 14 / Issue 11 / November 2011
    Published online by Cambridge University Press:
    01 June 2011, pp. 1907-1918
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  • Objective

    The influence of moderate alcohol consumption on renal function is not clear in elderly people. The aim of the present study was to investigate the relationship between alcohol consumption and renal function, expressed as serum creatinine levels and glomerular filtration rates (GFR), in an elderly population.

    Design

    Perspective cohort study.

    Setting

    Population-based study on an elderly Italian population.

    Subjects

    A sample of 3404 Italian people (1619 women and 1785 men), aged 65–84 years, from the Italian Longitudinal Study on Aging (ILSA).

    Results

    Prevalence and cumulative risk of impaired renal function (defined as GFR ≤ 60 ml/min) were estimated by sex and alcohol consumption groups. Logistic regression analysis adjusting for confounders (age, education, smoking, BMI and medications) and intermediate factors (blood cholesterol and fibrinogen, systolic hypertension and diabetes) showed that alcohol consumption level was not significantly related to the prevalence of mild renal impairment in elderly women. In men, both prevalence and incidence results seemed to suggest an inverse linear relationship between moderate alcohol consumption and the risk of mild renal impairment. A U-shaped association was shown for women at the incidence phase, suggesting a higher risk of developing renal impairment for women who drink more than 24 g alcohol/d.

    Conclusions

    Our results suggest that, in accordance with the recommendations on alcohol consumption in the elderly, moderate quantities of alcohol are not injurious to renal function in elderly men.

  • Renal complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease

  • Part of
  • Karl F. Welke, Joseph A. Dearani, Nancy S. Ghanayem, Marie J Beland, Irving Shen, Tjark Ebels
  • Journal:
    Cardiology in the Young / Volume 18 / Issue S2 / December 2008
    Published online by Cambridge University Press:
    01 December 2008, pp. 222-225

  • A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval.

    The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to the renal system. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases.

    Although renal dysfunction and renal failure are known risks of congenital heart surgery, accurate estimates of the incidences of these complications are limited. This lack of knowledge is in part due to the lack of uniform definitions of these postoperative complications. The purpose of this effort is to propose consensus definitions for renal complications following congenital cardiac surgery so that collection of such data can be standardized. Clinicians caring for patients with congenital heart disease will be able to use this list for databases, quality improvement initiatives, reporting of complications, and comparing strategies for treatment.