• Ahmed Zaky, Duraid S Younan, Bradley Meers, James Davies, Sara Pereira, Ryan L Melvin, Brent Kidd, Charity Morgan, Ashita Tolwani, and Jean Francois Pittet.
• Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL. Electronic address: azaky@uabmc.edu.
• J. Cardiothorac. Vasc. Anesth. 2021 May 1; 35 (5): 1299-1306.

ObjectivesRenal hypoperfusion is a common mechanism of cardiac surgery-related acute kidney injury (CS-AKI). However, the optimal amount of volume resuscitation to correct systemic hypoperfusion and prevent the postoperative development of CS-AKI has been a subject of debate. The goal of this study was to assess the association of volume responsiveness determined by stroke volume variation using the passive leg raise test (PLRT) at chest closure, with the development of CS-AKI according to the Kidney Disease Improving Global Outcomes criteria.DesignSingle-center, prospective observational study.SettingTertiary hospital.InterventionsNone.Measurements And Main ResultsA total of 131 patients were studied from January 2015 until May 2017. All patients underwent cardiac surgery that required cardiopulmonary bypass. Volume responsiveness was assessed at chest closure using the PRLT. Stroke volume variation from the sitting to the recumbent positions was measured by transesophageal echocardiography. Fluid responsiveness was defined as an increase of >12% of stroke volume from sitting to recumbent positions. A total of 82 (68.3%) patients were fluid-responsive versus 38 (31.6%) who were fluid-unresponsive. CS-AKI occurred in 30% of patients. There was no difference in CS-AKI between fluid-responsive and fluid-nonresponsive groups. However, CS-AKI was associated independently with an increases in body mass index and preoperative diastolic blood pressure. CS-AKI also was associated with prolonged intensive care unit length of stay.ConclusionEnd-of-procedure volume responsiveness is not associated with a high risk for postoperative CS-AKI.Copyright © 2020 Elsevier Inc. All rights reserved.

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