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Low Intraoperative Cerebral Oxygen Saturation Is Associated with Acute kidney Injury after Off-Pump Coronary Artery Bypass

 Seo Hee Ko  ;  Jong-Wook Song  ;  Jae-Kwang Shim  ;  Sarah Soh  ;  Young-Lan Kwak 
 JOURNAL OF CLINICAL MEDICINE, Vol.12(1) : 359, 2023-01 
Journal Title
Issue Date
acute kidney injury ; cerebral oximetry ; near-infrared spectroscopy ; off-pump coronary artery bypass ; regional cerebral oxygen saturation
By monitoring the brain as the index organ of global oxygen supply-demand balance including major organs, regional cerebral oxygen saturation (rScO2) may indicate adequacy of renal perfusion. The aim of this study was to investigate the relationship between perioperative rScO2 and acute kidney injury (AKI) after off-pump coronary artery bypass (OPCAB). AKI was diagnosed according to the Kidney Disease: Improving Global Outcomes criteria. Collected rScO2 variables were baseline, mean, and lowest value during surgery, maximal percentage decrease from baseline, and areas under the threshold below an absolute value of 50% (AUT50) and of 80% of baseline (AUT80%base). Among 580 patients, AKI developed in 143 (24.7%) patients. Patients with AKI had lower baseline, mean, and lowest rScO2 and higher AUT50 and AUT80%base than those without AKI despite routine efforts to restore the rScO2 values within 20% of the baseline. Among the rScO2 variables, the area under the receiver operating characteristic curve of mean rScO2 was the highest (0.636), which was used for the multivariable logistic regression. Multivariable logistic regression revealed mean rScO2 as an independent predictor of AKI (odds ratio, 0.964; 95% confidence interval, 0.937-0.990; p = 0.008), along with chronic kidney disease and emergency surgery. Low intraoperative mean rScO2 was independently associated with AKI after OPCAB, which may serve as an early marker of renal injury.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Ko, Seo Hee(고서희) ORCID logo https://orcid.org/0000-0001-8402-5624
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Soh, Sa Rah(소사라) ORCID logo https://orcid.org/0000-0001-5022-4617
Song, Jong Wook(송종욱) ORCID logo https://orcid.org/0000-0001-7518-2070
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
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