Pacini et al performed a retrospective analysis of a prospectively collected research database of 641 consecutive patients undergoing thoracic aortic surgery with bilateral antegrade selective cerebral perfusion (ASCP) and moderate hypothermia.
Moderate hypothermia was defined as core body temperature 24-25 ºC. Acute kidney injury (AKI) was defined in accordance with the RIFLE criteria, as a rise in the creatinine of ≥100% rise in creatinine from baseline or the requirement for temporary or permanent renal replacement therapy (RRT).
AKI occurred in 122 patients (19.0%) with RRT required in 59 patients (9.2%). In hospital mortality was significantly higher in the patients with AKI, 41 of 122 (33.6%) mortality in patients with AKI versus 35 of 519 (6.7%) mortality in patients without AKI (p<0.001).
Operative factors significantly associated with increased rates of AKI include: Urgent or emergency procedure, type A dissection, chronic aneurysm, modified Bentall procedure and procedure concomitant on the aortic or mitral valve.
There was no statistical difference in the duration of cardiopulmonary bypass, aortic crossclamp time, ASCP time, visceral ischaemia time or extent of aortic procedure.
The full manuscript is available here
Pacini D, Pantaleo A, Di Marco L, Leone A, Barberio G, Parolari A, Jafrancesco G Di Bartolomeo R. Risk factors for acute kidney injury after surgery of the thoracic aorta using antegrade selective cerebral perfusion and moderate hypothermia. J Thorac Cardiovasc Surg. 2015 May 20. pii: S0022-5223(15)00524-3. doi: 10.1016/j.jtcvs.2015.04.008. [Epub ahead of print]