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Open elective abdominal aortic surgery is a high risk procedure involving clamping of the aorta. Indications include abdominal aortic aneurysm (AAA) or aortic occlusive disease (AOD) causing lower limb ischaemia.
These patients are often regarded as one entity in postoperative study settings. However, previous studies indicate that risk profiles, inflammatory activity, and haemodynamic capacity may differ between these groups. The first aim of this study was to evaluate postoperative ICU-requirements after open elective abdominal aortic surgery, hypothesising that AAA-patients had longer ICU-stays and needed more mechanical ventilation or acute dialysis than did patients with AOD.
The investigators see a relatively high incidence of postoperative acute kidney injury (AKI) following aortic surgery. Neutrophil Gelatinase Associated Lipocalcin (NGAL) may be useful in the early diagnosis of postopeative AKI. However, NGAL is also known as a marker of inflammatory activation. The ischaemia-reperfusion injury and subsequent inflammatory response to aortic cross clamping may per se induce a rise in NGAL despite intact renal function. Therefore NGAL may not be a reliable marker of AKI after AAS.
The second aim of this study is to describe the changes in NGAL after AAS in patients with and without postoperative dialysis-dependent AKI.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Aortic aneurysm patients | 10 patients with a CT verified diagnosis of aortic aneurysm demanding open elective surgical correction with insertion of vascular prosthesis | ||
| Aortic occlusive disease patients | 10 patients with CT verified aortic occlusive disease demanding open elective surgical correction with insertion of vascular prosthesis |
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| Measure | Description | Time Frame |
|---|---|---|
| ICU length of stay | Number of patients with an ICU LOS > 24 hours | 24 hours postoperatively |
| Post-operative need for dialysis | Number of patients developing dialysis dependency during the first 72 hours postoperatively | 72 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Hemodynamic peroperative changes in AAD vs AOD | Stroke volume, cardiac index, systemic vasular resistance is recorded for AAD- and AOD patients at five time points during the operation using CardioQ, an oesophagus doppler monitor. | After anaesthesia induction, 10 minutes after aortic cross-clamping, 10 minutes after reperfusion, end of surgery |
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Inclusion Criteria:
Exclusion Criteria:
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10 patients sceduled for elective open operation for aortic aneurysm disease and 10 patients sceduled for elective open operation for aortic occlusive disease
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lillebaelt Hospital, Kolding Hospital | Kolding | DK-6000 | Denmark |
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| ID | Term |
|---|---|
| D017544 | Aortic Aneurysm, Abdominal |
| D001018 | Aortic Diseases |
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D001014 | Aortic Aneurysm |
| D000783 | Aneurysm |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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Urine samples taken from urinary catheter. Centrifuged, supernatant frozen at -80 degrees C. Immunoassay analyzed at Roche modular P quantifying NGAL.
| D051437 |
| Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |