['We sought to determine whether a pilot goal-directed perfusion initiative could reduce the incidence of acute kidney injury after cardiac surgery.', 'On the basis of the available literature, we identified goals to achieve during cardiopulmonary bypass (including maintenance of oxygen delivery >300\xa0mL O2/min/m', 'We used the goal-directed perfusion initiative in 88 patients and matched these to 88 control patients who were similar across all variables, including mean age (61\xa0years in controls vs 64\xa0years in goal-directed perfusion initiative patients, P\xa0=\xa0.12) and preoperative glomerular filtration rate (90 vs 83\xa0mL/min, P\xa0=\xa0.34). Controls received more phenylephrine on cardiopulmonary bypass (mean 2.1 vs\xa01.4\xa0mg, P\xa0<\xa0.001) and had lower nadir oxygen delivery (mean 241 vs 301\xa0mL O2/min/m'] Is a pilot goal-directed perfusion initiative associated with less acute kidney injury after cardiac surgery?