Acute kidney injury occurred in an average of 15% of cardiac surgery patients. The research obtained hemodynamics on cardiac surgery-associated acute kidney injury (CSA-AKI) evolution and reversal. Adult patients in cardiac surgery were retrospectively included. Hemodynamic help was numbered with a new time-weighted vaso-inotropic score (VISAUC), and hemodynamic differentiations were expressed by mean perfusion pressure and its components. The primary result was AKI stage more than or equal to 2 (CSA-AKI ≥2), and the secondary result was full AKI reversal before ICU discharge. Furthermore, 3,415 patients were included. CSA-AKI more than or equal 2 occurred in 37.4%. Mean perfusion pressure (MPP) (OR 0.95,95%CI 0.94–0.96, P<0.001); and central venous pressure (CVP) (OR 1.17, 95% CI 1.13–1.22, P<0.001) are associated with CSA-AKI more than or equal to development, while VISAUC/h was not (P=0.104). Out of 1,085 CSA-AKI more than or equal to 2 patients not require kidney replacement therapy, 76.3% fully recovered from AKI. Full CSA-AKI reversal was related to MPP (OR 1.02 per mmHg (95% CI 1.01–1.03, P=0.003), and MAP (OR=1.01 per mmHg (95% CI 1.00–1.02), P=0.047), but not with VISAUC/h (P=0.461). Development and full recovery of CSA-AKI more than or equal 2 were affected by average perfusion pressure, independent of vaso-inotropic usage. CVP had a particular impact on AKI development, whereas MAP had full AKI reversal.
Source – sciencedirect.com/science/article/abs/pii/S0883944122001307
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