Carboxyhemoglobin as Potential Biomarker for Cardiac Surgery Associated Acute Kidney Injury.
J Cardiothorac Vasc Anesth
; 38(10): 2221-2230, 2024 Oct.
Article
em En
| MEDLINE
| ID: mdl-39084930
ABSTRACT
OBJECTIVES:
Carboxyhemoglobin (CO-Hb) is a marker of hemolysis and inflammation, both risk factors for cardiac surgery-associated AKI (CSA-AKI). However, the association between CO-Hb and CSA-AKI remains unknown.DESIGN:
A retrospective cohort study.SETTING:
Tertiary university-affiliated metropolitan hospital single center.PARTICIPANTS:
Adult on-pump cardiac surgery patients from July 2014 to June 2022 (N = 1,698).INTERVENTIONS:
None. MEASUREMENTS AND MAINRESULTS:
Patients were stratified into quartiles based on CO-Hb levels at intensive care unit (ICU) admission. A progressive increased risk of CSA-AKI was observed with higher CO-Hb levels at ICU admission. On multivariable logistic regression analysis, the highest quartile (CO-Hb ≥ 1.4%) showed an independent association with the occurrence of CSA-AKI (odds ratio 1.45 compared to the lowest quartile [CO-Hb < 1.0%], 95% CI 1.023-2.071; p = 0.038). Compared to patients with CO-Hb <1.4%, patients with CO-Hb ≥ 1.4% at ICU admission had significantly higher postoperative creatinine (135 vs 116 µmol/L, p < 0.001), higher rates of postoperative RRT (6.7% vs 2.3%, p < 0.001) and AKI (p < 0.001) on univariable analysis and shorter time to event for AKI or death (p < 0.001).CONCLUSIONS:
CO-Hb ≥ 1.4% at ICU admission is an independent risk factor for CSA-AKI, which is easily obtainable and available on routine arterial blood gas measurements. Thus, CO-Hb may serve as a practical and biologically logical biomarker for risk stratification and population enrichment in trials of CSA-AKI prevention.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Carboxihemoglobina
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Biomarcadores
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Injúria Renal Aguda
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Procedimentos Cirúrgicos Cardíacos
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article