11th MAP Seminar Report

Date: September 9, 2022

Speaker: Dr. Sakura, Dr. Fu, and Dr. Matsumoto

We held our 11th MAP seminar on September 9, 2022. A total of 16 members participated in this seminar. Three members presented their research in English, Dr. Sakura, Dr. Fu, and Dr. Matsumoto.

The first was Dr. Sakura, whose study was on the association of plasma free hemoglobin (PFH) and postoperative acute kidney injury in pediatric cardiac surgery. He took plasma free hemoglobin at different time points intraoperatively and postoperatively, as well as defined the incidence of postoperative acute kidney injury using the KDIGO guidelines. The results were that peak PFH was different in the AKI and non-AKI patient, but the maximum PFH was not associated with AKI in multivariate regression, possibly suggesting that other factors may be more associated with AKI than plasma free hemoglobin produced by hemolysis in the younger cohorts. We were very interested in this novel topic and many questions were asked enthusiastically. We look forward to the new information Dr. Sakura will share with us next time.

Next up was Dr. Fu with her study on the Impact of different KDIGO criteria on clinical outcomes for early identification of acute kidney injury after non-cardiac surgery. Her study focused on the use of creatinine and urine output criteria in the KDIGO guidelines and how different methods of calculating urine output produce different diagnostic criteria, which can lead to large differences in the incidence and prognosis of postoperative AKI. The study was of great interest to the audience, who asked questions about the limitations of the urine output criteria in clinical practice in the KDIGO guidelines and about the impact of diuretic use on the diagnosis, to which Dr. Fu responded, indicating that if the clinical diagnosis of AKI is made using only creatinine criteria, this may lead to underdiagnosis of patients with oliguric AKI.

Finally, Dr. Matsumoto presented his study. Association between intraoperative hyperglycemia and postoperative end-organ dysfunctions after cardiac surgery: a retrospective observational study. His findings showed that the intraoperative GE index, the product of the magnitude and duration of a BG concentration ≥ 180 mg/dL, was an independent predictor of end-organ damage within 72 hours after surgery, defined as a composite event of AKI, POCD, MI and PMV. Dr. Matsumoto’s presentation led to a very intense discussion with questions about perioperative insulin dosing, preoperative glycemic control, use of medications for diabetic patients and intraoperative drugs that may cause a rise in blood glucose, and Dr. Matsumoto answered all questions carefully. This topic was a real eye-opener for us and we are very grateful to him for sharing this valuable research with us and we are looking forward to the next exchange.

Three speakers presented their research in this workshop, and other participants asked questions of their own interest about their presentations. I thought it was a good chance to present their research and also to get professional advice to think more deeply about their own research.

At the end we congratulated the graduating students, and these two students also expressed their feelings. I believe the next seminar will be even more exciting.

Jingwen Fu