Acute Kidney Injury (AKI) is a well-known complication following surgical procedures. So says the weight of clinical evidence. AKI has negative consequences for patient and healthcare provider, leading to worsened long term prospects and heightened costs of care.
Randomized Controlled Trials agree that anaesthetists can best avoid AKI if they manage the patient’s fluid balance. This means preventing hypoperfusion while also avoiding fluid overload. Furthermore it requires management of dosing and timing of fluid, inotropes and vasopressors.
Esophageal Doppler is the leading hemodynamic management technology. It features strongly in the main clinical studies. The system’s sophisticated algorithm delivers real-time, accurate flow and pressure data direct from the aorta. As a result, it provides the anaesthesiologist with a degree of control that helps drive clinical decisions. Moreover it enables them to keep the patient in their hemodynamic “sweet spot”. In so doing it avoids stress to the vital organs and helps to minimise AKI.
The independent body of clinical evidence confirms the role of hemodynamic management in achieving significant reductions in peri-operative AKI, even in patients considered to be low risk.
A narrative review of the impact of surgery and anaesthesia
on acute kidney injury: Ostermann et al; Anaesthesia, 2020
Multi-parametric functional hemodynamic optimization improves postsurgical outcome after intermediate risk open gastrointestinal surgery, a randomized controlled trial: Szturz et al; Edizione Minerva Medical, 2018
Effect of goal-directed haemodynamic therapy on postoperative complications in low to moderate risk surgical patients: a multicentre randomised controlled trial (FEDORA trial): Calvo-vecino et al; BJA 2018