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Renal, hepatic, and gastrointestinal complications of cardiac surgery 

Renal, hepatic, and gastrointestinal complications of cardiac surgery
Chapter:
Renal, hepatic, and gastrointestinal complications of cardiac surgery
Author(s):

Sara Jane Allen

and David Sidebotham

DOI:
10.1093/med/9780199653478.003.0031
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date: 20 October 2019

Acute kidney injury (AKI) is common after cardiac surgery and is associated with a high mortality. Risk factors and preoperative treatments are discussed. The benefit of some interventions is less certain. The metabolic consequences of AKI include hyperkalaemia, metabolic acidosis, fluid overload, hypophosphataemia, and uraemic encephalopathy. The main criteria for instituting renal replacement therapy are hyperkalemia, metabolic acidosis, and volume overload (not serum creatinine).Patients with dialysis-dependent renal failure present particular challenges to the anaesthetist. Special consideration must be given to the timing of haemodialysis.Gastrointestinal complications are uncommon following cardiac surgery but are associated with high mortality. The main risk factors and preventative strategies are discussed. Other preventative strategies are unproven. Severe hepatic dysfunction is very uncommon following cardiac surgery, and is mainly related to haemodynamic compromise. Treatment is supportive.

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