Absent renal blood flow diagnosed by transesophageal echocardiography during cardiopulmonary bypass

摘要

CARDIAC SURGERY-ASSOCIATED acute kidney injury (CSA-AKI) is reported to occur in up to 30% of cardiac surgical patients,1 with around 1% requiring hemodial-ysis.2 The severity of CSA-AKI can be described using the RIFLE criteria (risk, injury, failure, loss and end-stage renal failure)3 or AKIN (Acute Kidney Injury Network) criteria.It is widely recognized that patients with CSA-AKI have increased perioperative morbidity and mortality. Frustratingly, the incidence of CSA-AKI has remained unchanged over the last decade.1 One of the major potential causes of CSA-AKI is renal ischemia, but the incidence of absent renal blood flow (RBF) during cardiac surgery is unknown.