{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:59:09Z","timestamp":1790686749941,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"publisher","award":["VG107338"],"award-info":[{"award-number":["VG107338"]}],"id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"publisher","award":["FLF105666"],"award-info":[{"award-number":["FLF105666"]}],"id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT2025266"],"award-info":[{"award-number":["GNT2025266"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT2040939"],"award-info":[{"award-number":["GNT2040939"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Acute kidney injury is common after cardiac surgery requiring cardiopulmonary bypass, yet preventive strategies are limited. Progress has been hindered by a lack of clinically relevant experimental models incorporating pre\u2010existing heart disease. This study aimed to evaluate the impact of heart failure on renal oxygenation and histopathological injury during and after cardiopulmonary bypass in a large animal model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Heart failure was induced in 10 sheep (study group) via progressive coronary artery ligation; 10 healthy sheep served as controls (control group). We measured renal blood flow, renal function and renal cortical and medullary oxygenation before and after induction of anaesthesia, during 2\u2009h of cardiopulmonary bypass and for 48\u2009h postoperatively. Kidneys were collected at 48\u2009h for histopathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Cardiopulmonary bypass reduced renal blood flow (55%) and medullary oxygen tension (50%) in both groups (both p\u2009&lt;\u20090.001). During the 48\u2010h recovery period, medullary oxygen tension remained low in the study group but normalised in the control group (mean (SD) 11 (11) vs. 31 (10) mmHg at 48\u2009h, p\u2009=\u20090.01). Urine output was lower in the study group than in the control group over the 48\u2010h recovery period (mean (SD) 0.90 (0.54) vs. 2.24 (1.84) ml.kg\n                      <jats:sup>\u20101<\/jats:sup>\n                      .h\n                      <jats:sup>\u20101<\/jats:sup>\n                      at 48\u2009h, p\u2009=\u20090.03). Histopathologically, the study group had a higher incidence of neutrophil infiltration (89% vs. 30%, p\u2009=\u20090.04), although the incidence of acute tubular necrosis, fibrosis and tubular casts did not differ significantly between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this ovine model of heart failure, cardiopulmonary bypass led to persistent renal medullary hypoxia, oliguria and increased renal inflammation. These findings suggest that impaired renal medullary oxygenation and inflammation\u00a0may drive cardiac surgery\u2010associated acute kidney injury and represent a key target for renoprotective strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.70425","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:25:52Z","timestamp":1790684752000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Renal oxygenation, function and histopathology in an ovine model of heart failure undergoing cardiopulmonary bypass with 48\u2009hours of recovery: a prospective, observational study*"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4058-8905","authenticated-orcid":false,"given":"Anton L.","family":"Trask\u2010Marino","sequence":"first","affiliation":[{"name":"The Florey Institute of Neuroscience and Mental Health The University of Melbourne  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Melbourne Medical School The University of Melbourne  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4256-0968","authenticated-orcid":false,"given":"Jai","family":"Raman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Melbourne Medical School The University of Melbourne  Melbourne VIC Australia"},{"name":"Townsville University Hospital  Townsville QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2036-013X","authenticated-orcid":false,"given":"Andrew D.","family":"Cochrane","sequence":"additional","affiliation":[{"name":"The Florey Institute of Neuroscience and Mental Health The University of Melbourne  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1209-6882","authenticated-orcid":false,"given":"Peter R.","family":"McCall","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Austin Health  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terase F.","family":"Lancefield","sequence":"additional","affiliation":[{"name":"Department of Cardiology Austin Health  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger G.","family":"Evans","sequence":"additional","affiliation":[{"name":"The Florey Institute of Neuroscience and Mental Health The University of Melbourne  Melbourne VIC Australia"},{"name":"Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology Monash University  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0124-626X","authenticated-orcid":false,"given":"Ian E.","family":"Birchall","sequence":"additional","affiliation":[{"name":"The Florey Institute of Neuroscience and 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Anesthesiology Amsterdam University Medical Center  Amsterdam the Netherlands"},{"name":"Department of Endocrinology Amsterdam University Medical Center  Amsterdam the Netherlands"},{"name":"Amsterdam Cardiovascular Sciences Research Institute  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munenori","family":"Kusunoki","sequence":"additional","affiliation":[{"name":"The Florey Institute of Neuroscience and Mental Health The University of Melbourne  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally G.","family":"Hood","sequence":"additional","affiliation":[{"name":"The Florey Institute of Neuroscience and Mental Health The University of Melbourne  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Cornthwaite","sequence":"additional","affiliation":[{"name":"The Florey Institute of Neuroscience and Mental Health The University of Melbourne  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