Hepatic and renal effects of cardiopulmonary bypass

Abstract

Although associated with low morbidity and mortality, cardiopulmonary bypass remains a "non-physiologic" device that carries a set of complications. Hepatic and renal impairment are associated with a poor outcome. The knowledge of pathophysiology, risk factors and therapeutic interventions can help the anaesthesiologist in preventing these complications in daily practice. The present narrative review provides an update of the literature on the effects of cardiopulmonary bypass on hepatic and renal functions, focussing on markers of hepatic and renal injuries, perioperative strategies in preserving organ function and replacement therapies.

Keywords: acute kidney injury; anaesthesia; cardiac anaesthesia; cardiopulmonary bypass; hepatic dysfunction; intensive care; renal injury; shock liver.