Observational studyBritish journal of anaesthesia2021
Intraoperative venous congestion and acute kidney injury in cardiac surgery: an observational cohort study.
Observational study in British journal of anaesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 31 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Application of Intraoperative Transesophageal Echocardiography Imaging of Vein and Controlled Low Central Venous Pressure in Early Prediction and Intervention of Acute Renal Injury Associated With Cardiac Surgery
Application of Controlled Low Central Venous Pressure Technique in Early Intervention of Cardiac Surgery-associated Acute Kidney Injury
Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- PeriOperative Quality Initiative (POQI) international consensus statement on perioperative arterial pressure management.British journal of anaesthesia · 2024Guideline
- Controlled low central venous pressure after cardiopulmonary bypass reduces acute kidney injury following cardiac surgery: a randomized controlled trial.Frontiers in medicine · 2026Trial
- Effects of changes in position, positive end-expiratory pressure and mean arterial pressure on renal, portal and hepatic Doppler ultrasound perfusion indices: a randomized crossover study in cardiac surgery patients.Journal of clinical monitoring and computing · 2022Trial
- Cardiac Surgery Management in Patients With Liver Cirrhosis.Reviews in cardiovascular medicine · 2026Review
- Central Venous Pressure Referencing in the Lateral Position: Comparison With Direct Right Atrial Pressure in Mechanically Ventilated ICU Patients.Acta anaesthesiologica Scandinavica · 2026Observational
- Validation of intraoperative processed electroencephalography and cerebral oximetry for prediction of postoperative delirium in cardiac surgery: a prospective observational study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2026Observational
- Association between intrarenal venous flow and postoperative acute kidney injury in cardiac surgery patients following cardiopulmonary bypass: a prospective cohort study.BMC cardiovascular disorders · 2026Observational
- Effect of positive end-expiratory pressure levels on splanchnic perfusion and intra-abdominal pressure: a prospective clinical-experimental study in lung-healthy patients.Journal of anesthesia, analgesia and critical care · 2026Article
- Dynamic machine learning prediction of persistent AKI after cardiac surgery with modifiable perioperative risk factors.iScience · 2026Article
- Rethinking ejection fraction for anesthesiologists: a narrative review.Perioperative medicine (London, England) · 2026Review
- Observational
- A comprehensive review of venous excess ultrasound (VExUS) score: evidence from original research.Internal and emergency medicine · 2026Review
- Exploring the Role of Central Venous Pressure in Cardiac Surgery-Associated Acute Kidney Injury: A Comprehensive Scoping Review.Archives of Iranian medicine · 2025Article
- Association between the Venous Excess Ultrasound (VExUS) score and acute kidney injury in critically ill patients with sepsis: a multicenter prospective observational study.Annals of intensive care · 2025Article
- Acute kidney injury and chronic kidney disease after left ventricular assist device placement.JTCVS open · 2025Article
- Fine-Mapping the Association of Acute Kidney Injury With Mean Arterial and Central Venous Pressures During Coronary Artery Bypass Surgery.Anesthesia and analgesia · 2025Article
- Re-exploring the association between the central venous pressure and the risk of sepsis-associated acute kidney injury according to the latest definition: Analysis of the MIMIC-IV database.Pakistan journal of medical sciences · 2025Article
- Prevalence of abnormal common femoral vein pulsatility on Doppler ultrasound in patients undergoing cardiac surgery and its association with adverse events: a prospective cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Observational
- Impact of early CVP monitoring on 1-year mortality in patients with congestive heart failure in the ICU: a retrospective analysis based on the MIMIC-IV2.2 database.BMC cardiovascular disorders · 2025Article
- Central Venous Pressure as a Predictor of Acute Kidney Injury in Cardiac Surgery: A Systematic Review of Observational Studies.Diagnostics (Basel, Switzerland) · 2025Review
Corrections and comments
- Commented on by
Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundIncreased intravascular volume has been associated with protection from acute kidney injury (AKI), but in patients with congestive heart failure, venous congestion is associated with increased AKI. We tested the hypothesis that intraoperative venous congestion is associated with AKI after cardiac surgery.
methodsIn patients enrolled in the Statin AKI Cardiac Surgery trial, venous congestion was quantified as the area under the curve (AUC) of central venous pressure (CVP) >12, 16, or 20 mm Hg during surgery (mm Hg min). AKI was defined using Kidney Disease Improving Global Outcomes (KDIGO) criteria and urine concentrations of tissue inhibitor of metalloproteinase-2 and insulin-like growth factor binding protein 7 ([TIMP-2]⋅[IGFBP7]), a marker of renal stress. We measured associations between venous congestion, AKI and [TIMP-2]⋅[IGFBP7], adjusted for potential confounders. Values are reported as median (25th-75th percentile).
resultsBased on KDIGO criteria, 104 of 425 (24.5%) patients developed AKI. The venous congestion AUCs were 273 mm Hg min (81-567) for CVP >12 mm Hg, 66 mm Hg min (12-221) for CVP >16 mm Hg, and 11 mm Hg min (1-54) for CVP >20 mm Hg. A 60 mm Hg min increase above the median venous congestion AUC above each threshold was independently associated with increased AKI (odds ratio=1.06; 95% confidence interval [CI], 1.02-1.10; P=0.008; odds ratio=1.12; 95% CI, 1.02-1.23; P=0.013; and odds ratio=1.30; 95% CI, 1.06-1.59; P=0.012 for CVP>12, >16, and >20 mm Hg, respectively). Venous congestion before cardiopulmonary bypass was also associated with increased [TIMP-2]⋅[IGFBP7] measured during cardiopulmonary bypass and after surgery, but neither venous congestion after cardiopulmonary bypass nor venous congestion throughout surgery was associated with postoperative [TIMP-2]⋅[IGFBP7].
conclusionIntraoperative venous congestion was independently associated with increased AKI after cardiac surgery.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.