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Prevention of kidney injury during open heart surgery

Professor Roger Evans, Institution: Monash University

2018 Vanguard Grant

Years funded: 2019-2020


Open heart surgery saves thousands of lives each year in Australia. But it injures the kidney in about 30% of patients. Patients who do not experience kidney injury after cardiac surgery have a 1% chance of dying in hospital. This increases to 4% in those with mild kidney injury, 12% in those with moderate kidney injury, and 39% in those with severe kidney injury. We have recently developed the first and only available method to monitor kidney health during surgery, by continuous measurement of the amount of oxygen in the patient’s urine. This method works because the level of oxygen in the patients urine can be used to estimate the oxygen level in the inner part of their kidney (the renal medulla).

Patients who have low levels of oxygen in their urine during surgery have a high risk of developing kidney injury after the operation. We have also found that we can improve the oxygen levels in the inner part of the kidney during cardiac surgery by small adjustments to the settings on the heart lung machine used during surgery. The aim of this project is to perform a small-scale clinical trial, to test the feasibility and safety of a larger trial, to intervene to make these adjustments to the settings on the heart lung machine in patients we identify as having a high risk of developing kidney injury through measurement of the levels of oxygen in their urine.

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