Echocardiography-guided haemodynamic management and cardiorenal interaction in young children after surgical repair of congenital heart defects

After surgical repair of congenital heart disease (CHD), acute kidney injury frequently develops as part of a systemic cardiorenal dysfunction. Low cardiac output reduces renal inflow, while elevated central venous pressure (CVP) and venous congestion reduce the effective renal perfusion gradient. Conventional haemodynamic management guided mainly by arterial pressure and CVP does not distinguish between these mechanisms. Bedside echocardiography (Echo) makes it possible to identify the dominant haemodynamic phenotype and to individualise inotropic, vasoactive and fluid therapy [1–4].