Intensive Care Medicine

, Volume 44, Issue 6, pp 799–810 | Cite as

Advances in critical care management of patients undergoing cardiac surgery

  • Anders AnemanEmail author
  • Nicholas Brechot
  • Daniel Brodie
  • Frances Colreavy
  • John Fraser
  • Charles Gomersall
  • Peter McCanny
  • Peter Hasse Moller-Sorensen
  • Jukka Takala
  • Kamen Valchanov
  • Michael Vallely


Cardiac surgery has been evolving to include minimally invasive, hybrid and transcatheter techniques. Increasing patient age and medical complexity means that critical care management needs to adapt and evolve. Recent advances have occurred in several areas, including ventilation, haemodynamics and mechanical circulatory support, bleeding and coagulation, acute kidney injury, and neurological management. This narrative review describes standard care, recent advances, and future areas of research in the critical care management of patients undergoing cardiac surgery.


Cardiac surgery Intensive care 


Compliance with ethical standards

Conflicts of interest

Drs Anders Aneman, Peter McCanny, Frances Colreavy, Peter Hasse Moller-Sorensen do not have any relevant conflicts of interest to declare. Dr Brodie is currently the co-chair of the Trial Steering Committee for the VENT-AVOID trial sponsored by ALung Technologies and Kadence (Johnson & Johnson). All compensation for these activities is paid to Columbia University. Dr Vallely is a proctor for Abbott and serves on an Advisory Board for Medtronic.


  1. 1.
    Friedrich I, Simm A, Kotting J, Tholen F, Fischer B, Silber RE (2009) Cardiac surgery in the elderly patient. Dtsch Arzteblatt Int 106:416–422Google Scholar
  2. 2.
    Downs E, Lim S, Ragosta M, Yount K, Yarboro L, Ghanta R, Kern J, Kron I, Ailawadi G (2015) The influence of a percutaneous mitral repair program on surgical mitral valve volume. J Thorac Cardiovasc Surg 150:1093–1097CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Mack MJ (2013) Predicting risk in procedures for aortic stenosis: the next step forward. Eur J Cardio Thorac Surg 43:883–885CrossRefGoogle Scholar
  4. 4.
    Vallely MP, Wilson MK, Adams M, Ng MK (2012) How to set up a successful TAVI program. Ann Cardiothorac Surg 1:185–189PubMedPubMedCentralGoogle Scholar
  5. 5.
    Dhurandhar V, Saxena A, Parikh R, Vallely MP, Wilson MK, Butcher JK, Black DA, Tran L, Reid CM, Bannon PG (2015) Comparison of the safety and efficacy of on-pump (ONCAB) versus off-pump (OPCAB) coronary artery bypass graft surgery in the elderly: a review of the ANZSCTS database. Heart Lung Circ 24:1225–1232CrossRefPubMedGoogle Scholar
  6. 6.
    Zhao DF, Edelman JJ, Seco M, Bannon PG, Wilson MK, Byrom MJ, Thourani V, Lamy A, Taggart DP, Puskas JD, Vallely MP (2017) Coronary artery bypass grafting with and without manipulation of the ascending aorta: a network meta-analysis. J Am Coll Cardiol 69:924–936CrossRefPubMedGoogle Scholar
  7. 7.
    Seco M, Martinez GJ, Edelman JJ, Ng HK, Vallely MP, Wilson MK, Ng MK (2015) Combined total-arterial, off-pump coronary artery bypass grafting and transaortic transcatheter aortic valve implantation. Int J Cardiol 201:587–589CrossRefPubMedGoogle Scholar
  8. 8.
    Doenst T, Diab M, Sponholz C, Bauer M, Farber G (2017) The opportunities and limitations of minimally invasive cardiac surgery. Dtsch Arzteblatt Int 114:777–784Google Scholar
  9. 9.
    Nearman H, Klick JC, Eisenberg P, Pesa N (2014) Perioperative complications of cardiac surgery and postoperative care. Crit Care Clin 30:527–555CrossRefPubMedGoogle Scholar
  10. 10.
    Zochios V, Klein AA, Gao F, (2017) Protective invasive ventilation in cardiac surgery: a systematic review with a focus on acute lung injury in adult cardiac surgical patients. J Cardiothorac Vasc Anesth.
  11. 11.
    Zhu F, Gomersall CD, Ng SK, Underwood MJ, Lee A (2015) A randomized controlled trial of adaptive support ventilation mode to wean patients after fast-track cardiac valvular surgery. Anesthesiology 122:832–840CrossRefPubMedGoogle Scholar
  12. 12.
    Parke R, McGuinness S, Dixon R, Jull A (2013) Open-label, phase II study of routine high-flow nasal oxygen therapy in cardiac surgical patients. Br J Anaesth 111:925–931CrossRefPubMedGoogle Scholar
  13. 13.
    Stephan F, Barrucand B, Petit P, Rezaiguia-Delclaux S, Medard A, Delannoy B, Cosserant B, Flicoteaux G, Imbert A, Pilorge C, Berard L (2015) High-flow nasal oxygen vs noninvasive positive airway pressure in hypoxemic patients after cardiothoracic surgery: a randomized clinical trial. JAMA 313:2331–2339CrossRefPubMedGoogle Scholar
  14. 14.
    Jakob SM, Ruokonen E, Takala J (2000) Assessment of the adequacy of systemic and regional perfusion after cardiac surgery. Br J Anaesth 84:571–577CrossRefPubMedGoogle Scholar
  15. 15.
    Lannemyr L, Bragadottir G, Krumbholz V, Redfors B, Sellgren J, Ricksten SE (2017) Effects of cardiopulmonary bypass on renal perfusion, filtration, and oxygenation in patients undergoing cardiac surgery. Anesthesiology 126:205–213CrossRefPubMedGoogle Scholar
  16. 16.
    Holm J, Hakanson E, Vanky F, Svedjeholm R (2011) Mixed venous oxygen saturation predicts short- and long-term outcome after coronary artery bypass grafting surgery: a retrospective cohort analysis. Br J Anaesth 107:344–350CrossRefPubMedGoogle Scholar
  17. 17.
    Majure DT, Greco T, Greco M, Ponschab M, Biondi-Zoccai G, Zangrillo A, Landoni G (2013) Meta-analysis of randomized trials of effect of milrinone on mortality in cardiac surgery: an update. J Cardiothorac Vasc Anesth 27:220–229CrossRefPubMedGoogle Scholar
  18. 18.
    Li P, Qu LP, Qi D, Shen B, Wang YM, Xu JR, Jiang WH, Zhang H, Ding XQ, Teng J (2017) Significance of perioperative goal-directed hemodynamic approach in preventing postoperative complications in patients after cardiac surgery: a meta-analysis and systematic review. Ann Med 49:343–351CrossRefPubMedGoogle Scholar
  19. 19.
    Bignami E, Guarnieri M, Gemma M (2017) Fluid management in cardiac surgery patients: pitfalls, challenges and solutions. Minerva Anestesiol 83:638–651PubMedGoogle Scholar
  20. 20.
    Mehta RH, Leimberger JD, van Diepen S, Meza J, Wang A, Jankowich R, Harrison RW, Hay D, Fremes S, Duncan A, Soltesz EG, Luber J, Park S, Argenziano M, Murphy E, Marcel R, Kalavrouziotis D, Nagpal D, Bozinovski J, Toller W, Heringlake M, Goodman SG, Levy JH, Harrington RA, Anstrom KJ, Alexander JH, Investigators L-C (2017) Levosimendan in patients with left ventricular dysfunction undergoing cardiac surgery. N Engl J Med 376:2032–2042CrossRefPubMedGoogle Scholar
  21. 21.
    Cholley B, Caruba T, Grosjean S, Amour J, Ouattara A, Villacorta J, Miguet B, Guinet P, Levy F, Squara P, Ait Hamou N, Carillion A, Boyer J, Boughenou MF, Rosier S, Robin E, Radutoiu M, Durand M, Guidon C, Desebbe O, Charles-Nelson A, Menasche P, Rozec B, Girard C, Fellahi JL, Pirracchio R, Chatellier G (2017) Effect of levosimendan on low cardiac output syndrome in patients with low ejection fraction undergoing coronary artery bypass grafting with cardiopulmonary bypass: the LICORN randomized clinical trial. JAMA 318:548–556CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Landoni G, Lomivorotov VV, Alvaro G, Lobreglio R, Pisano A, Guarracino F, Calabro MG, Grigoryev EV, Likhvantsev VV, Salgado-Filho MF, Bianchi A, Pasyuga VV, Baiocchi M, Pappalardo F, Monaco F, Boboshko VA, Abubakirov MN, Amantea B, Lembo R, Brazzi L, Verniero L, Bertini P, Scandroglio AM, Bove T, Belletti A, Michienzi MG, Shukevich DL, Zabelina TS, Bellomo R, Zangrillo A (2017) Levosimendan for hemodynamic support after cardiac surgery. N Engl J Med 376:2021–2031CrossRefPubMedGoogle Scholar
  23. 23.
    Putzu A, Clivio S, Belletti A, Cassina T (2018) Perioperative levosimendan in cardiac surgery: a systematic review with meta-analysis and trial sequential analysis. Int J Cardiol 251:22–31CrossRefPubMedGoogle Scholar
  24. 24.
    Landoni G, Pasin L, Di Prima AL, Dossi R, Taddeo D, Zangrillo A (2014) Methylene blue: between scylla (meta-analysis) and charybdis (propensity). J Cardiothorac Vasc Anesth 28:e12–e13CrossRefPubMedGoogle Scholar
  25. 25.
    Benstoem C, Stoppe C, Liakopoulos OJ, Ney J, Hasenclever D, Meybohm P, Goetzenich A (2017) Remote ischaemic preconditioning for coronary artery bypass grafting (with or without valve surgery). Cochrane Database Syst Rev 5:CD011719PubMedGoogle Scholar
  26. 26.
    van Diepen S, Katz JN, Albert NM, Henry TD, Jacobs AK, Kapur NK, Kilic A, Menon V, Ohman EM, Sweitzer NK, Thiele H, Washam JB, Cohen MG, American Heart Association Council on Clinical C, Council on C, Stroke N, Council on Quality of C, Outcomes R, Mission L (2017) Contemporary management of cardiogenic shock: a scientific statement from the American Heart Association. Circulation 136:e232–e268CrossRefPubMedGoogle Scholar
  27. 27.
    Schmidt M, Burrell A, Roberts L, Bailey M, Sheldrake J, Rycus PT, Hodgson C, Scheinkestel C, Cooper DJ, Thiagarajan RR, Brodie D, Pellegrino V, Pilcher D (2015) Predicting survival after ECMO for refractory cardiogenic shock: the survival after veno-arterial-ECMO (SAVE)-score. Eur Heart J 36:2246–2256CrossRefPubMedGoogle Scholar
  28. 28.
    Thiele H, Zeymer U, Neumann FJ, Ferenc M, Olbrich HG, Hausleiter J, Richardt G, Hennersdorf M, Empen K, Fuernau G, Desch S, Eitel I, Hambrecht R, Fuhrmann J, Bohm M, Ebelt H, Schneider S, Schuler G, Werdan K (2012) Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med 367:1287–1296CrossRefPubMedGoogle Scholar
  29. 29.
    Miller PE, Solomon MA, McAreavey D (2017) Advanced percutaneous mechanical circulatory support devices for cardiogenic shock. Crit Care Med 45:1922–1929CrossRefPubMedGoogle Scholar
  30. 30.
    Rihal CS, Naidu SS, Givertz MM, Szeto WY, Burke JA, Kapur NK, Kern M, Garratt KN, Goldstein JA, Dimas V, Tu T (2015) 2015 SCAI/ACC/HFSA/STS clinical expert consensus statement on the use of percutaneous mechanical circulatory support devices in cardiovascular care: endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencionista; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d’intervention. J Am Coll Cardiol 65:2140–2141CrossRefPubMedGoogle Scholar
  31. 31.
    Abrams D, Combes A, Brodie D (2014) Extracorporeal membrane oxygenation in cardiopulmonary disease in adults. J Am Coll Cardiol 63:2769–2778CrossRefPubMedGoogle Scholar
  32. 32.
    Rosenzweig EB, Brodie D, Abrams DC, Agerstrand CL, Bacchetta M (2014) Extracorporeal membrane oxygenation as a novel bridging strategy for acute right heart failure in group 1 pulmonary arterial hypertension (American Society for Artificial Internal Organs: 1992). ASAIO J 60:129–133CrossRefPubMedGoogle Scholar
  33. 33.
    Paden ML, Conrad SA, Rycus PT, Thiagarajan RR (2013) Extracorporeal life support organization registry report 2012 (American Society for Artificial Internal Organs: 1992). ASAIO J 59:202–210CrossRefPubMedGoogle Scholar
  34. 34.
    Karagiannidis C, Brodie D, Strassmann S, Stoelben E, Philipp A, Bein T, Muller T, Windisch W (2016) Extracorporeal membrane oxygenation: evolving epidemiology and mortality. Intensive Care Med 42:889–896CrossRefPubMedGoogle Scholar
  35. 35.
    Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, Falk V, Gonzalez-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GM, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 18:891–975CrossRefPubMedGoogle Scholar
  36. 36.
    Anderson M, Morris L, Tang D, Batsides G, Kirtane A, Hanson I, Meraj P, Kapur N, O’Neill W (2017) Impella RP post approval study: first multi-center, prospective post market approval results for the impella RP in patients with right ventricular failure. J Heart Lung Transplant 36:S64–S65CrossRefGoogle Scholar
  37. 37.
    Schmack B, Weymann A, Popov AF, Patil NP, Sabashnikov A, Kremer J, Farag M, Brcic A, Lichtenstern C, Karck M, Ruhparwar A (2016) Concurrent Left ventricular assist device (LVAD) implantation and percutaneous temporary RVAD support via cardiacassist protek-duo tandemheart to preempt right heart failure. Med Sci Monit Basic Res 22:53–57CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Canty DJ, Heiberg J, Tan JA, Yang Y, Royse AG, Royse CF, Mobeirek A, Shaer FE, Albacker T, Nazer RI, Fouda M, Bakir BM, Alsaddique AA (2017) Assessment of image quality of repeated limited transthoracic echocardiography after cardiac surgery. J Cardiothorac Vasc Anesth 31:965–972CrossRefPubMedGoogle Scholar
  39. 39.
    Fletcher N, Geisen M, Meeran H, Spray D, Cecconi M (2015) Initial clinical experience with a miniaturized transesophageal echocardiography probe in a cardiac intensive care unit. J Cardiothorac Vasc Anesth 29:582–587CrossRefPubMedGoogle Scholar
  40. 40.
    Cavarocchi NC, Pitcher HT, Yang Q, Karbowski P, Miessau J, Hastings HM, Hirose H (2013) Weaning of extracorporeal membrane oxygenation using continuous hemodynamic transesophageal echocardiography. J Thorac Cardiovasc Surg 146:1474–1479CrossRefPubMedGoogle Scholar
  41. 41.
    Kumar A, Puri GD, Bahl A (2017) Transesophageal echocardiography, 3-dimensional and speckle tracking together as sensitive markers for early outcome in patients with left ventricular dysfunction undergoing cardiac surgery. J Cardiothorac Vasc Anesth 31:1695–1701CrossRefPubMedGoogle Scholar
  42. 42.
    Cinotti R, Delater A, Fortuit C, Roquilly A, Mahe PJ, Demeure-dit-Latte D, Asehnoune K (2015) Speckle-tracking analysis of left ventricular systolic function in the intensive care unit. Anaesthesiol intensive Ther 47:482–486PubMedGoogle Scholar
  43. 43.
    Kato TS, Jiang J, Schulze PC, Jorde U, Uriel N, Kitada S, Takayama H, Naka Y, Mancini D, Gillam L, Homma S, Farr M (2013) Serial echocardiography using tissue Doppler and speckle tracking imaging to monitor right ventricular failure before and after left ventricular assist device surgery. JACC Heart Fail 1:216–222CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Kinnunen EM, De Feo M, Reichart D, Tauriainen T, Gatti G, Onorati F, Maschietto L, Bancone C, Fiorentino F, Chocron S, Bounader K, Dalen M, Svenarud P, Faggian G, Franzese I, Santarpino G, Fischlein T, Maselli D, Dominici C, Nardella S, Gherli R, Musumeci F, Rubino AS, Mignosa C, Mariscalco G, Serraino FG, Santini F, Salsano A, Nicolini F, Gherli T, Zanobini M, Saccocci M, Ruggieri VG, Philippe Verhoye J, Perrotti A, Biancari F (2017) Incidence and prognostic impact of bleeding and transfusion after coronary surgery in low-risk patients. Transfusion 57:178–186CrossRefPubMedGoogle Scholar
  45. 45.
    Thiele RH, Raphael J (2014) A 2014 update on coagulation management for cardiopulmonary bypass. Semin Cardiothorac Vasc Anesth 18:177–189CrossRefPubMedGoogle Scholar
  46. 46.
    Fominskiy E, Nepomniashchikh VA, Lomivorotov VV, Monaco F, Vitiello C, Zangrillo A, Landoni G (2016) Efficacy and safety of fibrinogen concentrate in surgical patients: a meta-analysis of randomized controlled trials. J Cardiothorac Vasc Anesth 30:1196–1204CrossRefPubMedGoogle Scholar
  47. 47.
    Myles PS, Smith JA, Forbes A, Silbert B, Jayarajah M, Painter T, Cooper DJ, Marasco S, McNeil J, Bussieres JS, Wallace S (2016) Stopping vs. continuing aspirin before coronary artery surgery. N Engl J Med 374:728–737CrossRefPubMedGoogle Scholar
  48. 48.
    Mazzeffi MA, Lee K, Taylor B, Tanaka KA (2017) Perioperative management and monitoring of antiplatelet agents: a focused review on aspirin and P2Y12 inhibitors. Korean J Anesthesiol 70:379–389Google Scholar
  49. 49.
    Task Force M, Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, Falk V, Filippatos G, Hamm C, Head SJ, Juni P, Kappetein AP, Kastrati A, Knuuti J, Landmesser U, Laufer G, Neumann FJ, Richter DJ, Schauerte P, Sousa Uva M, Stefanini GG, Taggart DP, Torracca L, Valgimigli M, Wijns W, Witkowski A (2014) 2014 ESC/EACTS Guidelines on myocardial revascularization: the task force on myocardial revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J 35:2541–2619CrossRefGoogle Scholar
  50. 50.
    Kilic A, Whitman GJ (2014) Blood transfusions in cardiac surgery: indications, risks, and conservation strategies. Ann Thorac Surg 97:726–734CrossRefPubMedGoogle Scholar
  51. 51.
    Hajjar LA, Vincent JL, Galas FR, Nakamura RE, Silva CM, Santos MH, Fukushima J, Kalil Filho R, Sierra DB, Lopes NH, Mauad T, Roquim AC, Sundin MR, Leao WC, Almeida JP, Pomerantzeff PM, Dallan LO, Jatene FB, Stolf NA, Auler JO Jr (2010) Transfusion requirements after cardiac surgery: the TRACS randomized controlled trial. JAMA 304:1559–1567CrossRefPubMedGoogle Scholar
  52. 52.
    Murphy GJ, Pike K, Rogers CA, Wordsworth S, Stokes EA, Angelini GD, Reeves BC (2015) Liberal or restrictive transfusion after cardiac surgery. N Engl J Med 372:997–1008CrossRefPubMedGoogle Scholar
  53. 53.
    Mazer CD, Whitlock RP, Fergusson DA, Hall J, Belley-Cote E, Connolly K, Khanykin B, Gregory AJ, de Medicis E, McGuinness S, Royse A, Carrier FM, Young PJ, Villar JC, Grocott HP, Seeberger MD, Fremes S, Lellouche F, Syed S, Byrne K, Bagshaw SM, Hwang NC, Mehta C, Painter TW, Royse C, Verma S, Hare GMT, Cohen A, Thorpe KE, Juni P, Shehata N (2017) Restrictive or liberal red-cell transfusion for cardiac surgery. N Engl J Med 377:2133–2144CrossRefPubMedGoogle Scholar
  54. 54.
    Cooper DJ, McQuilten ZK, Nichol A, Ady B, Aubron C, Bailey M, Bellomo R, Gantner D, Irving DO, Kaukonen KM, McArthur C, Murray L, Pettila V, French C (2017) Age of red cells for transfusion and outcomes in critically ill adults. N Engl J Med 377:1858–1867CrossRefPubMedGoogle Scholar
  55. 55.
    Heddle NM, Cook RJ, Arnold DM, Liu Y, Barty R, Crowther MA, Devereaux PJ, Hirsh J, Warkentin TE, Webert KE, Roxby D, Sobieraj-Teague M, Kurz A, Sessler DI, Figueroa P, Ellis M, Eikelboom JW (2016) Effect of short-term vs. long-term blood storage on mortality after transfusion. N Engl J Med 375:1937–1945CrossRefPubMedGoogle Scholar
  56. 56.
    Cappabianca G, Mariscalco G, Biancari F, Maselli D, Papesso F, Cottini M, Crosta S, Banescu S, Ahmed AB, Beghi C (2016) Safety and efficacy of prothrombin complex concentrate as first-line treatment in bleeding after cardiac surgery. Critical Care (Lond, Engl) 20:5CrossRefGoogle Scholar
  57. 57.
    Gill R, Herbertson M, Vuylsteke A, Olsen PS, von Heymann C, Mythen M, Sellke F, Booth F, Schmidt TA (2009) Safety and efficacy of recombinant activated factor VII: a randomized placebo-controlled trial in the setting of bleeding after cardiac surgery. Circulation 120:21–27CrossRefPubMedGoogle Scholar
  58. 58.
    Levi M, Levy JH, Andersen HF, Truloff D (2010) Safety of recombinant activated factor VII in randomized clinical trials. N Engl J Med 363:1791–1800CrossRefPubMedGoogle Scholar
  59. 59.
    Koltai K, Kesmarky G, Feher G, Tibold A, Toth K (2017) Platelet aggregometry testing: molecular mechanisms, techniques and clinical implications. Int J Mol Sci 18:1803. CrossRefPubMedCentralGoogle Scholar
  60. 60.
    Corredor C, Wasowicz M, Karkouti K, Sharma V (2015) The role of point-of-care platelet function testing in predicting postoperative bleeding following cardiac surgery: a systematic review and meta-analysis. Anaesthesia 70:715–731CrossRefPubMedGoogle Scholar
  61. 61.
    Orlov D, McCluskey SA, Callum J, Rao V, Moreno J, Karkouti K (2017) Utilization and effectiveness of desmopressin acetate after cardiac surgery supplemented with point-of-care hemostatic testing: a propensity-score-matched analysis. J Cardiothorac Vasc Anesth 31:883–895CrossRefPubMedGoogle Scholar
  62. 62.
    Ho KM, Bham E, Pavey W (2015) Incidence of venous thromboembolism and benefits and risks of thromboprophylaxis after cardiac surgery: a systematic review and meta-analysis. J Am Heart Assoc 4:e002652CrossRefPubMedPubMedCentralGoogle Scholar
  63. 63.
    Hobson CE, Yavas S, Segal MS, Schold JD, Tribble CG, Layon AJ, Bihorac A (2009) Acute kidney injury is associated with increased long-term mortality after cardiothoracic surgery. Circulation 119:2444–2453CrossRefPubMedGoogle Scholar
  64. 64.
    Wang Y, Bellomo R (2017) Cardiac surgery-associated acute kidney injury: risk factors, pathophysiology and treatment. Nat Rev Nephrol 13:697–711CrossRefPubMedGoogle Scholar
  65. 65.
    Kandler K, Jensen ME, Nilsson JC, Moller CH, Steinbruchel DA (2015) Arterial pressure during cardiopulmonary bypass is not associated with acute kidney injury. Acta Anaesthesiol Scand 59:625–631CrossRefPubMedGoogle Scholar
  66. 66.
    Gambardella I, Gaudino M, Ronco C, Lau C, Ivascu N, Girardi LN (2016) Congestive kidney failure in cardiac surgery: the relationship between central venous pressure and acute kidney injury. Interactive Cardiovasc Thorac Surg 23:800–805CrossRefGoogle Scholar
  67. 67.
    Khwaja A (2012) KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract 120:c179–c184PubMedGoogle Scholar
  68. 68.
    Parikh CR, Puthumana J, Shlipak MG, Koyner JL, Thiessen-Philbrook H, McArthur E, Kerr K, Kavsak P, Whitlock RP, Garg AX, Coca SG (2017) Relationship of kidney injury biomarkers with long-term cardiovascular outcomes after cardiac surgery. J Am Soc Nephrol 28:3699–3707CrossRefPubMedGoogle Scholar
  69. 69.
    Zou H, Hong Q, Xu G (2017) Early versus late initiation of renal replacement therapy impacts mortality in patients with acute kidney injury post cardiac surgery: a meta-analysis. Critical Care (Lond, Engl) 21:150CrossRefGoogle Scholar
  70. 70.
    Brown CH (2014) Delirium in the cardiac surgical ICU. Curr Opin Anaesthesiol 27:117–122CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Megens MR, Churilov L, Thijs V, (2017) New-onset atrial fibrillation after coronary artery bypass graft and long-term risk of stroke: a meta-analysis. J Am Heart Assoc 6.
  72. 72.
    Serraino GF, Murphy GJ (2017) Effects of cerebral near-infrared spectroscopy on the outcome of patients undergoing cardiac surgery: a systematic review of randomised trials. BMJ Open 7:e016613CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    Ono M, Brady K, Easley RB, Brown C, Kraut M, Gottesman RF, Hogue CW Jr (2014) Duration and magnitude of blood pressure below cerebral autoregulation threshold during cardiopulmonary bypass is associated with major morbidity and operative mortality. J Thorac Cardiovasc Surg 147:483–489CrossRefPubMedGoogle Scholar
  74. 74.
    Hori D, Brown C, Ono M, Rappold T, Sieber F, Gottschalk A, Neufeld KJ, Gottesman R, Adachi H, Hogue CW (2014) Arterial pressure above the upper cerebral autoregulation limit during cardiopulmonary bypass is associated with postoperative delirium. Br J Anaesth 113:1009–1017CrossRefPubMedPubMedCentralGoogle Scholar
  75. 75.
    Liu X, Xie G, Zhang K, Song S, Song F, Jin Y, Fang X (2017) Dexmedetomidine vs propofol sedation reduces delirium in patients after cardiac surgery: a meta-analysis with trial sequential analysis of randomized controlled trials. J Crit Care 38:190–196CrossRefPubMedGoogle Scholar
  76. 76.
    Maas JJ, Geerts BF, van den Berg PC, Pinsky MR, Jansen JR (2009) Assessment of venous return curve and mean systemic filling pressure in postoperative cardiac surgery patients. Crit Care Med 37:912–918CrossRefPubMedGoogle Scholar
  77. 77.
    Gupta K, Sondergaard S, Parkin G, Leaning M, Aneman A (2015) Applying mean systemic filling pressure to assess the response to fluid boluses in cardiac post-surgical patients. Intensive Care Med 41:265–272CrossRefPubMedGoogle Scholar
  78. 78.
    Maas JJ, Pinsky MR, Aarts LP, Jansen JR (2012) Bedside assessment of total systemic vascular compliance, stressed volume, and cardiac function curves in intensive care unit patients. Anesth Analg 115:880–887CrossRefPubMedGoogle Scholar
  79. 79.
    Guinot PG, Longrois D, Kamel S, Lorne E, Dupont H (2018) Ventriculo-arterial coupling analysis predicts the hemodynamic response to norepinephrine in hypotensive postoperative patients: a prospective observational study. Crit Care Med 46:e17–e25CrossRefPubMedGoogle Scholar
  80. 80.
    Montaigne D, Marechal X, Modine T, Coisne A, Mouton S, Fayad G, Ninni S, Klein C, Ortmans S, Seunes C, Potelle C, Berthier A, Gheeraert C, Piveteau C, Deprez R, Eeckhoute J, Duez H, Lacroix D, Deprez B, Jegou B, Koussa M, Edme JL, Lefebvre P, Staels B (2018) Daytime variation of perioperative myocardial injury in cardiac surgery and its prevention by Rev-Erbalpha antagonism: a single-centre propensity-matched cohort study and a randomised study. Lancet 391:59–69CrossRefPubMedGoogle Scholar
  81. 81.
    Modi P, Chitwood WR Jr (2013) Retrograde femoral arterial perfusion and stroke risk during minimally invasive mitral valve surgery: is there cause for concern? Ann Cardiothorac Surg 2:E1PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature and ESICM 2018

Authors and Affiliations

  • Anders Aneman
    • 1
    Email author
  • Nicholas Brechot
    • 2
  • Daniel Brodie
    • 3
  • Frances Colreavy
    • 4
  • John Fraser
    • 5
  • Charles Gomersall
    • 6
  • Peter McCanny
    • 7
  • Peter Hasse Moller-Sorensen
    • 8
  • Jukka Takala
    • 9
  • Kamen Valchanov
    • 10
  • Michael Vallely
    • 11
  1. 1.Intensive Care UnitLiverpool Hospital, Southwestern Sydney Local Health DistrictLiverpool BCAustralia
  2. 2.Medical-Surgical Intensive Care UnitHôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de ParisParisFrance
  3. 3.Department of MedicineColumbia University College of Physicians and Surgeons, New York-Presbyterian HospitalNew YorkUSA
  4. 4.Department of Critical Care MedicineMater Misericordiae University HospitalDublinIreland
  5. 5.Adult Intensive Care ServiceThe Prince Charles HospitalBrisbaneAustralia
  6. 6.Department of Anaesthesia & Intensive CarePrince of Wales Hospital, The Chinese University of Hong KongShatinHong Kong
  7. 7.Intensive Care UnitLiverpool Hospital, Southwestern Sydney Local Health DistrictSydneyAustralia
  8. 8.Department of Cardiothoracic AnesthesiologyRigshospitalet, University of CopenhagenCopenhagenDenmark
  9. 9.Department of Intensive Care MedicineInselspital, Bern University Hospital, University of BernBernSwitzerland
  10. 10.Department of AnaesthesiaPapworth HospitalCambridgeUK
  11. 11.Cardiothoracic Surgical UnitRoyal Prince Alfred Hospital, The University of SydneySydneyAustralia

Personalised recommendations