Elevated Pulse Pressure in Anesthetized Subjects Before Cardiopulmonary Bypass Is Associated Strongly With Postoperative Acute Kidney Injury Stage.
J Cardiothorac Vasc Anesth
; 33(6): 1620-1626, 2019 Jun.
Article
em En
| MEDLINE
| ID: mdl-30713052
ABSTRACT
OBJECTIVE:
To investigate whether pulse pressure (PP) in anesthetized patients undergoing cardiac surgery before and after cardiopulmonary bypass (CPB) is associated with higher postoperative acute kidney injury (AKI) stage.DESIGN:
Retrospective cohort of 597 patients undergoing cardiac surgery.SETTING:
Single academic health care center.PARTICIPANTS:
Adult patients undergoing cardiac surgery requiring CPB (coronary artery bypass grafting, valve, aortic, or combined surgery).INTERVENTIONS:
Pulse pressure was assessed during 3 time periods pre- and post-CPB, and in the first postoperative hour in the intensive care unit. Pulse pressure, patient characteristics, and intraoperative variables were evaluated using univariable generalized estimating equation analysis for a relationship with AKI stage. Significant risk factors from the univariable analysis then were evaluated in a multivariable generalized estimating equation analysis. Acute kidney injury stage was defined using the Acute Kidney Injury Network criteria. PRIMARYOUTCOME:
Stage of postoperative AKI. MEASUREMENTS AND MAINRESULTS:
Intraoperative prebypass PP was associated independently and significantly with postoperative AKI stage (odds ratio 1.0107; 95% Confidence Interval, 1.0046-1.0168; pâ¯=â¯0.0005). For every 1-mmHg increase in PP, the odds of a higher AKI stage increased 1.07%. The 2 other periods were not found to be significant predictors of AKI stage.CONCLUSION:
During general anesthesia prior to initiation of CPB, elevated PP is significantly predictive of postoperative AKI stage. This finding merits further research.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Pressão Sanguínea
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Ponte Cardiopulmonar
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Injúria Renal Aguda
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Anestesia Geral
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Cardiothorac Vasc Anesth
Ano de publicação:
2019
Tipo de documento:
Article