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Duration of critically low oxygen delivery is associated with acute kidney injury after cardiac surgery

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@article{df946e27b17c450a8b33e33b80a365fa,
title = "Duration of critically low oxygen delivery is associated with acute kidney injury after cardiac surgery",
abstract = "BACKGROUND: Acute kidney injury is a serious complication following cardiac surgery associated with mortality. Restricted oxygen delivery is a potential risk factor for acute kidney injury. The aim of this study was to investigate the impact of the duration of low oxygen delivery (<272 mL min-1 m-2 ), during cardiopulmonary bypass on kidney function.METHODS: Patients undergoing coronary artery bypass graft surgery ± valve repair were included n = 1968. Oxygen delivery was monitored during cardiopulmonary bypass. Data were explored using multiple regression analyses regarding association between low oxygen delivery and renal replacement therapy (RRT), acute kidney injury (AKI) and post-operative peak serum creatinine (PPSC).RESULTS: Post-operative peak serum creatinine, incidence of acute kidney injury, and need for dialysis increased in a dose-dependent manner in relation to duration of a mean oxygen delivery <272 mL min-1 m-2 . Using multiple regression analyses, only exposure for at least 30 minutes was independently associated with increased PPSC and AKI. In contrast, both short (1-5 min, OR: 2.58 [1.20, 5.54]; P = .015) and at least 30-minute (OR: 2.85 [1.27-6.41]; P = .011) exposure to low DO2 were both independently associated with the need for RRT.CONCLUSION: A low oxygen delivery during cardiopulmonary bypass was in a dose-dependent manner associated with an increased risk of renal injury.",
author = "Rasmussen, {Sebastian R} and Kristian Kandler and Nielsen, {Rikke V} and {Cornelius Jakobsen}, Peter and Knudsen, {Nikoline N} and Marco Ranucci and {Christian Nilsson}, Jens and Ravn, {Hanne B}",
note = "{\circledC} 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.",
year = "2019",
doi = "10.1111/aas.13457",
language = "English",
volume = "63",
pages = "1290--1297",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Wiley-Blackwell Munksgaard",
number = "10",

}

RIS

TY - JOUR

T1 - Duration of critically low oxygen delivery is associated with acute kidney injury after cardiac surgery

AU - Rasmussen, Sebastian R

AU - Kandler, Kristian

AU - Nielsen, Rikke V

AU - Cornelius Jakobsen, Peter

AU - Knudsen, Nikoline N

AU - Ranucci, Marco

AU - Christian Nilsson, Jens

AU - Ravn, Hanne B

N1 - © 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

PY - 2019

Y1 - 2019

N2 - BACKGROUND: Acute kidney injury is a serious complication following cardiac surgery associated with mortality. Restricted oxygen delivery is a potential risk factor for acute kidney injury. The aim of this study was to investigate the impact of the duration of low oxygen delivery (<272 mL min-1 m-2 ), during cardiopulmonary bypass on kidney function.METHODS: Patients undergoing coronary artery bypass graft surgery ± valve repair were included n = 1968. Oxygen delivery was monitored during cardiopulmonary bypass. Data were explored using multiple regression analyses regarding association between low oxygen delivery and renal replacement therapy (RRT), acute kidney injury (AKI) and post-operative peak serum creatinine (PPSC).RESULTS: Post-operative peak serum creatinine, incidence of acute kidney injury, and need for dialysis increased in a dose-dependent manner in relation to duration of a mean oxygen delivery <272 mL min-1 m-2 . Using multiple regression analyses, only exposure for at least 30 minutes was independently associated with increased PPSC and AKI. In contrast, both short (1-5 min, OR: 2.58 [1.20, 5.54]; P = .015) and at least 30-minute (OR: 2.85 [1.27-6.41]; P = .011) exposure to low DO2 were both independently associated with the need for RRT.CONCLUSION: A low oxygen delivery during cardiopulmonary bypass was in a dose-dependent manner associated with an increased risk of renal injury.

AB - BACKGROUND: Acute kidney injury is a serious complication following cardiac surgery associated with mortality. Restricted oxygen delivery is a potential risk factor for acute kidney injury. The aim of this study was to investigate the impact of the duration of low oxygen delivery (<272 mL min-1 m-2 ), during cardiopulmonary bypass on kidney function.METHODS: Patients undergoing coronary artery bypass graft surgery ± valve repair were included n = 1968. Oxygen delivery was monitored during cardiopulmonary bypass. Data were explored using multiple regression analyses regarding association between low oxygen delivery and renal replacement therapy (RRT), acute kidney injury (AKI) and post-operative peak serum creatinine (PPSC).RESULTS: Post-operative peak serum creatinine, incidence of acute kidney injury, and need for dialysis increased in a dose-dependent manner in relation to duration of a mean oxygen delivery <272 mL min-1 m-2 . Using multiple regression analyses, only exposure for at least 30 minutes was independently associated with increased PPSC and AKI. In contrast, both short (1-5 min, OR: 2.58 [1.20, 5.54]; P = .015) and at least 30-minute (OR: 2.85 [1.27-6.41]; P = .011) exposure to low DO2 were both independently associated with the need for RRT.CONCLUSION: A low oxygen delivery during cardiopulmonary bypass was in a dose-dependent manner associated with an increased risk of renal injury.

U2 - 10.1111/aas.13457

DO - 10.1111/aas.13457

M3 - Journal article

VL - 63

SP - 1290

EP - 1297

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 10

ER -

ID: 58987748