Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/33995
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dc.contributor.authorChaba, Anis-
dc.contributor.authorHacking, Doug-
dc.contributor.authorSlifirski, Hugh-
dc.contributor.authorCogan, Rebecca-
dc.contributor.authorSpano, Sofia-
dc.contributor.authorMaeda, Akinori-
dc.contributor.authorEastwood, Glenn M-
dc.contributor.authorBellomo, Rinaldo-
dc.date2023-
dc.date.accessioned2023-10-18T03:29:31Z-
dc.date.available2023-10-18T03:29:31Z-
dc.date.issued2023-10-13-
dc.identifier.citationJournal of Clinical Monitoring and Computing 2023-10-13en_US
dc.identifier.issn1573-2614-
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/33995-
dc.description.abstractThe impact of blood pressure targets and surgical approach (laparoscopic or open) on continuous urinary oxygenation (PuO2), a validated surrogate of renal medullary PO2, during general surgery, is unclear. We aimed to assess the effects of different blood pressure targets and surgical procedures on PuO2. We randomized patients receiving either laparoscopic or open surgery into two mean arterial pressure (MAP) target groups: usual MAP or a high MAP. We measured PuO2 in real-time and analyzed it according to the type of surgery and blood pressure target. The study was retrospectively registered on the 5th of July 2023 (ACTRN12623000726651). We included 43 participants who underwent either laparoscopic (n = 20) or open surgery (n = 23). We found that PuO2 significantly decreased during both laparoscopic and open surgery under a usual blood pressure target (- 51% and - 49%, respectively). However, there was a sharper fall with laparoscopic surgery resulting in a higher PuO2 with open surgery (mean difference: 11 ± 1 mmHg higher; p < 0.001). Targeting a higher MAP resulted in a higher PuO2 over time during laparoscopic surgery (mean difference: 7 ± 1 mmHg, p < 0.001). In contrast, targeting a usual MAP resulted in a higher PuO2 during open surgery (mean difference: 7 ± 1 mmHg, p < 0.001). Surgical approach and intraoperative blood pressure targets significantly impact urinary oxygenation. Further studies with larger sample sizes are needed to confirm these findings and understand their potential clinical implications.Registration number: ACTRN12623000726651; Date of registration: 05/07/2023 (retrospectively registered).en_US
dc.language.isoeng-
dc.subjectAcute kidney injuryen_US
dc.subjectLaparoscopic surgeryen_US
dc.subjectMean arterial pressureen_US
dc.subjectMedullary oxygenationen_US
dc.subjectOpen surgeryen_US
dc.subjectUrinary oxygenationen_US
dc.titleRenal medullary oxygenation during laparoscopic vs open surgery: the impact of blood pressure management-a pilot randomized controlled trial.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleJournal of Clinical Monitoring and Computingen_US
dc.identifier.affiliationIntensive Careen_US
dc.identifier.affiliationAnaesthesiaen_US
dc.identifier.affiliationAustralian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia.;Data Analytics Research and Evaluation Centre, Austin Hospital, Melbourne, Australia.;Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia.en_US
dc.identifier.affiliationDepartment of Critical Care, The University of Melbourne, Melbourne, Australia.en_US
dc.identifier.doi10.1007/s10877-023-01079-1en_US
dc.type.contentTexten_US
dc.identifier.pubmedid37831377-
item.fulltextNo Fulltext-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.languageiso639-1en-
item.grantfulltextnone-
item.openairetypeJournal Article-
crisitem.author.deptIntensive Care-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
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