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Tissue Oxygen Saturation Combined With Serum Lactic Acid Can Predict Cardiac Surgery-Associated Acute Kidney Injury
Fangzhou Li1, Jinfeng Luo1, Lijuan Guo1
1Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
Journal of Cardiothoracic and Vascular Anesthesia
|November 2, 2025
Summary
Near-infrared spectroscopy (NIRS) and serum lactate levels can predict acute kidney injury after cardiac surgery. Tissue oxygenation during cardiopulmonary bypass and elevated lactate post-surgery are key indicators for early intervention.
Area of Science:
- Cardiovascular Surgery
- Nephrology
- Critical Care Medicine
Background:
- Cardiac surgery-associated acute kidney injury (CSA-AKI) is a significant complication.
- Early prediction of CSA-AKI is crucial for timely intervention and improved patient outcomes.
Purpose of the Study:
- To evaluate the predictive value of tissue oxygenation, measured by near-infrared spectroscopy (NIRS), and serum lactate levels for CSA-AKI.
- To identify early markers for predicting CSA-AKI in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Main Methods:
- Retrospective analysis of 391 patients undergoing cardiac surgery with CPB.
- NIRS was used to measure brain (SctO2) and skeletal muscle (StO2) tissue oxygen saturation.
- Perioperative serum lactate levels were analyzed via blood gas analysis.
Main Results:
- Specific cutoff values for SctO2 and StO2 during and after CPB demonstrated high predictive accuracy for CSA-AKI.
- Postoperative serum lactate levels ≥2.65 mg/L were independent predictors of CSA-AKI.
- A predictive model incorporating 5 variables achieved an AUC of 91.8%.
Conclusions:
- Tissue oxygen saturation during CPB and elevated postoperative serum lactate levels are valuable early predictors of CSA-AKI.
- These parameters offer clinical utility for guiding early intervention strategies in cardiac surgery patients.
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