{
  "abstract": "Background and Aims Controlled hypotension is a commonly used anesthesia technique in shoulder arthroscopy to improve visual clarity. However, hypotension-related hypoperfusion may lead to postoperative acute kidney injury (AKI). The renal resistive index (RRI) is considered an effective and reliable parameter for identifying prerenal AKI. This study aimed to evaluate changes in RRI in patients undergoing shoulder arthroscopy with controlled hypotension and to assess the utility of RRI in predicting postoperative AKI.Methods Following ethics committee approval, 90 adult patients undergoing elective shoulder arthroscopy were prospectively enrolled. Controlled hypotension was induced with IV remifentanil (0.01–0.2 mcg/kg/min). RRI was measured pre- and postoperatively in pain-free, stable patients. AKI was defined based on KDIGO (kidney disease improving global outcomes) criteria using serum creatinine and GFR levels. The protocol for this clinical trial was registered at ClinicalTrials.gov ( NCT05945706).Results Data from 65 patients were analyzed. Postoperative RI values (mean±SD:0.683±0.85) were significantly higher than preoperative values (mean±SD:0.648±0.77) (p<0.001, figure 1), with a mean RRI increase of 5.6%. Stage 1 AKI developed in 3 patients (4.6%). Preoperative RI was positively correlated with age (p<0.001) and SPARK score (p=0.003), and negatively correlated with baseline GFR (p=0.03) (table 1). Preoperative RI >0.7 was associated with higher age, SPARK scores, ACE inhibitor use, diabetes prevalence, and lower baseline GFR (all p<0.05, table 2).Conclusions The increase in renal resistive index indicates that controlled hypotensive anesthesia in shoulder arthroscopy may affect renal perfusion. However, no long-term renal impairment was observed. Renal perfusion in shoulder surgeries with controlled hypotension can be assessed by monitoring delta RRI. Especially in high-risk patients undergoing hypotensive anesthesia, RRI monitoring appears promising for preserving renal function.Absttract EP087 Figure 1RRI variations in patients under controlled hypotensive anesthesia during shoulder arthroscopic surgery. Postoperative RRI values were significantly higher than preoperative RRI values (p <0.001)Abstract EP087 Table 1Factors associated with preoperative and postoperative renal resistive indexAbstract EP087 Table 2Comparison of clinical and demographic characteristics according to preoperative and postoperative RRI classification",
  "authors": [
    {
      "affiliations": [
        "Anesthesiology and Reanimation, Etlik City Hospital, Ankara, Turkey"
      ],
      "name": "Fatma Ozkan Sipahioglu"
    },
    {
      "affiliations": [
        "Anesthesiology and Reanimation, Etlik City Hospital, Ankara, Turkey"
      ],
      "name": "Funda Atar"
    },
    {
      "affiliations": [
        "Anesthesiology and Reanimation, Etlik City Hospital, Ankara, Turkey"
      ],
      "name": "Merve Bayraktaroglu"
    },
    {
      "affiliations": [
        "Anesthesiology and Reanimation, Etlik City Hospital, Ankara, Turkey"
      ],
      "name": "Filiz Karaca Akaslan"
    },
    {
      "affiliations": [
        "Anesthesiology and Reanimation, Etlik City Hospital, Ankara, Turkey"
      ],
      "name": "Derya Ozkan"
    }
  ],
  "title": "EP087 Assessment of renal resistive index in patients undergoing arthroscopic shoulder surgery with controlled hypotension",
  "uid": "839a20f7-0dba-5809-b2eb-1da04ec02cbc"
}