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Ralph JE, Ross JS, Zylstra AB, Kritcher AL, Robey HF, Young CV, Hurricane OA, Pak A, Callahan DA, Baker KL, Casey DT, Döppner T, Divol L, Hohenberger M, Pape SL, Patel PK, Tommasini R, Ali SJ, Amendt PA, Atherton LJ, Bachmann B, Bailey D, Benedetti LR, Berzak Hopkins L, Betti R, Bhandarkar SD, Biener J, Bionta RM, Birge NW, Bond EJ, Bradley DK, Braun T, Briggs TM, Bruhn MW, Celliers PM, Chang B, Chapman T, Chen H, Choate C, Christopherson AR, Clark DS, Crippen JW, Dewald EL, Dittrich TR, Edwards MJ, Farmer WA, Field JE, Fittinghoff D, Frenje J, Gaffney J, Gatu Johnson M, Glenzer SH, Grim GP, Haan S, Hahn KD, Hall GN, Hammel BA, Harte J, Hartouni E, Heebner JE, Hernandez VJ, Herrmann HW, Herrmann MC, Hinkel DE, Ho DD, Holder JP, Hsing WW, Huang H, Humbird KD, Izumi N, Jarrott LC, Jeet J, Jones O, Kerbel GD, Kerr SM, Khan SF, Kilkenny J, Kim Y, Geppert-Kleinrath H, Geppert-Kleinrath V, Kong C, Koning JM, Kroll JJ, Kruse MKG, Kustowski B, Landen OL, Langer S, Larson D, Lemos NC, Lindl JD, Ma T, MacDonald MJ, MacGowan BJ, Mackinnon AJ, MacLaren SA, MacPhee AG, Marinak MM, Mariscal DA, Marley EV, Masse L, Meaney KD, Meezan NB, Michel PA, Millot M, Milovich JL, Moody JD, Moore AS, Morton JW, Murphy TJ, Newman K, Di Nicola JMG, Nikroo A, Nora R, Patel MV, Pelz LJ, Peterson JL, Ping Y, Pollock BB, Ratledge M, Rice NG, Rinderknecht HG, Rosen M, Rubery MS, Salmonson JD, Sater J, Schiaffino S, Schlossberg DJ, Schneider MB, Schroeder CR, Scott HA, Sepke SM, Sequoia K, Sherlock MW, Shin S, Smalyuk VA, Spears BK, Springer PT, Stadermann M, Stoupin S, Strozzi DJ, Suter LJ, Thomas CA, Town RPJ, Trosseille C, Tubman ER, Volegov PL, Weber CR, Widmann K, Wild C, Wilde CH, Van Wonterghem BM, Woods DT, Woodworth BN, Yamaguchi M, Yang ST, Zimmerman GB. The impact of low-mode symmetry on inertial fusion energy output in the burning plasma state. Nat Commun 2024; 15:2975. [PMID: 38582938 PMCID: PMC10998902 DOI: 10.1038/s41467-024-47302-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 03/25/2024] [Indexed: 04/08/2024] Open
Abstract
Indirect Drive Inertial Confinement Fusion Experiments on the National Ignition Facility (NIF) have achieved a burning plasma state with neutron yields exceeding 170 kJ, roughly 3 times the prior record and a necessary stage for igniting plasmas. The results are achieved despite multiple sources of degradations that lead to high variability in performance. Results shown here, for the first time, include an empirical correction factor for mode-2 asymmetry in the burning plasma regime in addition to previously determined corrections for radiative mix and mode-1. Analysis shows that including these three corrections alone accounts for the measured fusion performance variability in the two highest performing experimental campaigns on the NIF to within error. Here we quantify the performance sensitivity to mode-2 symmetry in the burning plasma regime and apply the results, in the form of an empirical correction to a 1D performance model. Furthermore, we find the sensitivity to mode-2 determined through a series of integrated 2D radiation hydrodynamic simulations to be consistent with the experimentally determined sensitivity only when including alpha-heating.
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Affiliation(s)
- J E Ralph
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA.
| | - J S Ross
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA.
| | | | - A L Kritcher
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - H F Robey
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, NM, 87545, USA
| | - C V Young
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - O A Hurricane
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - A Pak
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | | | - K L Baker
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - D T Casey
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - T Döppner
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - L Divol
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - M Hohenberger
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - S Le Pape
- Laboratoire pour l'utilisation des Lasers Intenses chez École Polytechnique, F-91128, Palaiseau Cedex, France
| | - P K Patel
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - R Tommasini
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - S J Ali
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - P A Amendt
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - L J Atherton
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - B Bachmann
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - D Bailey
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - L R Benedetti
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - L Berzak Hopkins
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - R Betti
- Laboratory for Laser Energetics, University of Rochester, Rochester, NY, 14623, USA
| | - S D Bhandarkar
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J Biener
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - R M Bionta
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - N W Birge
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, NM, 87545, USA
| | - E J Bond
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - D K Bradley
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - T Braun
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - T M Briggs
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - M W Bruhn
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - P M Celliers
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - B Chang
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - T Chapman
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - H Chen
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - C Choate
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - A R Christopherson
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - D S Clark
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | | | - E L Dewald
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - T R Dittrich
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - M J Edwards
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - W A Farmer
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J E Field
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - D Fittinghoff
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J Frenje
- Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - J Gaffney
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - M Gatu Johnson
- Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - S H Glenzer
- SLAC National Accelerator Laboratory, Menlo Park, CA, 94025, USA
| | - G P Grim
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - S Haan
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - K D Hahn
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - G N Hall
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - B A Hammel
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J Harte
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - E Hartouni
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J E Heebner
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - V J Hernandez
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - H W Herrmann
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, NM, 87545, USA
| | - M C Herrmann
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - D E Hinkel
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - D D Ho
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J P Holder
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - W W Hsing
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - H Huang
- General Atomics, San Diego, CA, 92186, USA
| | - K D Humbird
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - N Izumi
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - L C Jarrott
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J Jeet
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - O Jones
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - G D Kerbel
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - S M Kerr
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - S F Khan
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J Kilkenny
- General Atomics, San Diego, CA, 92186, USA
| | - Y Kim
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, NM, 87545, USA
| | | | | | - C Kong
- General Atomics, San Diego, CA, 92186, USA
| | - J M Koning
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J J Kroll
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - M K G Kruse
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - B Kustowski
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - O L Landen
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - S Langer
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - D Larson
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - N C Lemos
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J D Lindl
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - T Ma
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - M J MacDonald
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - B J MacGowan
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - A J Mackinnon
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - S A MacLaren
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - A G MacPhee
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - M M Marinak
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - D A Mariscal
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - E V Marley
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - L Masse
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - K D Meaney
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, NM, 87545, USA
| | - N B Meezan
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - P A Michel
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - M Millot
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J L Milovich
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J D Moody
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - A S Moore
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J W Morton
- Atomic Weapons Establishment, Aldermaston, RG7 4PR, UK
| | - T J Murphy
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, NM, 87545, USA
| | - K Newman
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J-M G Di Nicola
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - A Nikroo
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - R Nora
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - M V Patel
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - L J Pelz
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J L Peterson
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - Y Ping
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - B B Pollock
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - M Ratledge
- General Atomics, San Diego, CA, 92186, USA
| | - N G Rice
- General Atomics, San Diego, CA, 92186, USA
| | - H G Rinderknecht
- Laboratory for Laser Energetics, University of Rochester, Rochester, NY, 14623, USA
| | - M Rosen
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - M S Rubery
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J D Salmonson
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - J Sater
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - S Schiaffino
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - D J Schlossberg
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - M B Schneider
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - C R Schroeder
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - H A Scott
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - S M Sepke
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - K Sequoia
- General Atomics, San Diego, CA, 92186, USA
| | - M W Sherlock
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - S Shin
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - V A Smalyuk
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - B K Spears
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - P T Springer
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - M Stadermann
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - S Stoupin
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - D J Strozzi
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - L J Suter
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - C A Thomas
- Laboratory for Laser Energetics, University of Rochester, Rochester, NY, 14623, USA
| | - R P J Town
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - C Trosseille
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - E R Tubman
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - P L Volegov
- Los Alamos National Laboratory, Mail Stop F663, Los Alamos, NM, 87545, USA
| | - C R Weber
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - K Widmann
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - C Wild
- Diamond Materials Gmbh, 79108, Freiburg, Germany
| | - C H Wilde
- Pacific Fusion, Fremont, CA, 94538, USA
| | - B M Van Wonterghem
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - D T Woods
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - B N Woodworth
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | | | - S T Yang
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
| | - G B Zimmerman
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, CA, 94551-0808, USA
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, 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M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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