RESUMEN
PURPOSE: This study investigates the association between mean arterial pressure (MAP) and renal function after out-of-hospital cardiac arrest (OHCA). MATERIALS AND METHODS: Post-hoc analysis of 851 comatose OHCA-patients surviving >48â¯h included in the targeted temperature management (TTM)-trial. RESULTS: Patients were stratified by mean MAP during TTM in the following groups; <70â¯mmHg (22%), 70-80â¯mmHg (43%), andâ¯>â¯80â¯mmHg (35%). Median (interquartile range) eGFR (ml/min/1.73â¯m2) 48â¯h after OHCA was inversely associated with MAP-group (70 (47-102), 84 (56-113), 94 (61-124), pâ¯<â¯.001, for the <70-group, 70-80-group andâ¯>â¯80-group respectively). After adjusting for potential confounders, in a mixed model including eGFR after 1, 2 and 3â¯days this association remained significant (pgroup_adjustedâ¯=â¯0.0002). Higher mean MAP was independently associated with lower odds of renal replacement therapy (odds ratioadjustedâ¯=â¯0.77 [95% confidence interval, 0.65-0.91] per 5â¯mmHg increase; pâ¯=â¯.002]). CONCLUSIONS: Low mean MAP during TTM was independently associated with decreased renal function and need of renal replacement therapy in a large cohort of comatose OHCA-patients. Increasing MAP above the recommended 65â¯mmHg could potentially be renal-protective. This hypothesis should be investigated in prospective trials.