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[Exploration of Renal Microcirculation Perfusion During Cardiopulmonary Bypass with Contrast-enhanced Ultrasound]
Insights
Contrast-enhanced ultrasound revealed significantly reduced renal microcirculation perfusion during cardiopulmonary bypass (CPB). This technique effectively monitors kidney perfusion in cardiac surgery patients.
Area of Science:
- Nephrology
- Cardiovascular Surgery
- Medical Imaging
Background:
- Cardiopulmonary bypass (CPB) is associated with potential renal complications.
- Assessing renal microcirculation during CPB is crucial for patient outcomes.
- Contrast-enhanced ultrasound (CEU) offers a non-invasive method for evaluating organ perfusion.
Purpose of the Study:
- To investigate alterations in renal microcirculation perfusion during CPB using CEU.
- To assess the feasibility of CEU for monitoring kidney perfusion in adult cardiac surgery patients.
Main Methods:
- Six adult patients undergoing cardiac surgery with CPB and twelve controls were enrolled.
- CEU of the kidneys was performed during CPB or after anesthesia induction.
- Quantitative parameters (wash-in slope, AUC, PI, TTP) were derived from time-intensity curves in different kidney regions.
Main Results:
- A significant reduction in the area under the curve (AUC) was observed in all renal regions (superficial cortex, deep cortex, medulla) during CPB compared to the control group.
- No adverse reactions related to the ultrasound contrast agent were reported.
- The medulla showed the most pronounced reduction in perfusion.
Conclusions:
- Renal microcirculation perfusion is significantly impaired during CPB, particularly in the medullary region.
- CEU is a viable tool for detecting changes in renal microcirculation perfusion during the perioperative period of cardiac surgery.
Objective:
To investigate the alteration of renal microcirculation perfusion during cardiopulmonary bypass (CPB) in adult patients with contrast-enhanced ultrasound (CEU).
Methods:
Six patients undergoing cardiac surgery with CPB and twelve patients undergoing non-cardiac surgery were enrolled and classified into CPB group and control group. CEU images of kidney were collected at the point of 30 min after CPB or 5 min after anesthesia induction respectively. Time intensity curve (TIC) was derived from three regions of interest (ROD. superficial cortex, deep cortex and medulla. Parameters including wash in slope (a), area under curve (AUC), peak intensity (PI) and time to peak (TTP) were calculated based on gamma-variant function.
Results:
CEU showed a significant reduction of AUC in all three regions (superficial cortex, deep cortex and medulla) during CPB, compared with anesthetic condition. Ultrasound contrast agent-related adverse reactions were not occurred in all enrolled patients.
Conclusion:
Renal microcirculation perfusion was dramatically reduced during CPB, especially in the medulla. CEU could be detected the renal microcirculation perfusion in the perioperative period of cardiac surgery.
