Volume-associated hemodynamic variables for prediction of cardiac surgery-associated acute kidney injury
Volume-associated hemodynamic variables for prediction of cardiac surgery-associated acute kidney injury
复制标题
用于预测心脏手术相关急性肾损伤的容量相关血流动力学变量
DOI：
10.1007/s10157-020-01908-6
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发表时间：
2020-06
影响因子：
2.3
通讯作者：
Jiawei Yu
中科院分区：
文献类型：
--
作者：
Jiarui Xu;Wuhua Jiang;Yang Li;Bo Shen;Ziyan Shen;Yimei Wang;Jiachang Hu;Yi Fang;Zhe Luo;Chunsheng Wang;Jie Teng;Xiaoqiang Ding;Jiawei Yu
研究背景急性肾损伤（阿基）的延迟诊断是常见的，因为肾功能指标的变化往往滞后于损伤。我们的目的是找到最佳的非侵入性血流动力学变量的预测术后阿基和阿基肾脏替代治疗（RRT）。MethodsThe数据收集自2015年3月至2016年2月期间在我院接受心脏手术的1,180例患者。术后中心静脉压（CVP）、平均动脉压（MAP）、心率、PaO 2和PaCO 2在ICU入院时以及每日液体输入量和输出量（计算为24 h PFO）进行监测，并比较阿基与非AKI和RRT与非RRT病例之间的差异。阿基组和RRT组低心排综合征（LCOS）发生率明显高于非AKI组和非RRT组（13.2%vs3.9%，P < 0.01; 42.9%vs7.1%，P < 0.01）。阿基和RRT组ICU入院时CVP显著高于非AKI和非RRT组（11.5 vs. 9.0 mmHg，P< 0.01; 13.3 vs. 9.9 mmHg，P< 0.01）。阿基和RRT组24 h PFO均显著高于非AKI和非RRT组（1.6%vs.0.9%，P < 0.01; 3.9%vs.0.8%，P < 0.01）。ICU CVP预测术后阿基的ROC曲线下面积（> 11 mmHg）+ LCOS + 24 h PFO（> 5%），并通过ICU入院时的CVP预测AKI-RRT（> 13 mmHg）+ LCOS + 24 h PFO（> 5%）的平均值分别为0.763和0.886。术后24 h PFO可预测术后阿基和AKI RRT。
BackgroundDelayed diagnosis of acute kidney injury (AKI) is common because the changes in renal function markers often lag injury. We aimed to find optimal non-invasive hemodynamic variables for the prediction of postoperative AKI and AKI renal replacement therapy (RRT).MethodsThe data were collected from 1,180 patients who underwent cardiac surgery in our hospital between March 2015 and Feb 2016. Postoperative central venous pressure (CVP), mean arterial pressure (MAP), heart rate, PaO2, and PaCO2on ICU admission and daily fluid input and output (calculated as 24 h PFO) were monitored and compared between AKI vs. non-AKI and RRT vs non-RRT cases.ResultsThe AKI and AKI-RRT incidences were 36.7% (n= 433) and 1.2% (n= 14). Low cardiac output syndromes (LCOSs) occurred significantly more in AKI and RRT than in non-AKI or non-RRT groups (13.2% vs. 3.9%,P< 0.01; 42.9% vs. 7.1%,P< 0.01). CVP on ICU admission was significantly higher in AKI and RRT than in non-AKI and non-RRT groups (11.5 vs. 9.0 mmHg,P< 0.01; 13.3 vs. 9.9 mmHg,P< 0.01). 24 h PFO in AKI and RRT cases were significantly higher than in non-AKI or non-RRT patients (1.6% vs. 0.9%,P< 0.01; 3.9% vs. 0.8%,P< 0.01). The areas under the ROC curves to predict postoperative AKI by CVP on ICU admission (> 11 mmHg) + LCOS + 24 h PFO (> 5%) and to predict AKI-RRT by CVP on ICU admission (> 13 mmHg) + LCOS + 24 h PFO (> 5%) were 0.763 and 0.886, respectively.ConclusionThe volume-associated hemodynamic variables, including CVP on ICU admission, LCOS, and 24 h PFO after surgery could predict postoperative AKI and AKI-RRT.
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影响因子：
5.5
作者：
通讯作者：
--
DOI：
--
发表时间：
2015-08
期刊：
The Journal of cardiovascular surgery
影响因子：
--
作者：
J. Lopez-Delgado;F. Esteve;C. Javierre;H. Torrado;M. L. Carrio;D. Rodríguez-Castro;E. Farrero;J. Lluís Ventura;R. Mañez
通讯作者：
J. Lopez-Delgado;F. Esteve;C. Javierre;H. Torrado;M. L. Carrio;D. Rodríguez-Castro;E. Farrero;J. Lluís Ventura;R. Mañez
DOI：
10.1186/s13054-016-1352-z
发表时间：
2016-07-04
期刊：
Critical care (London, England)
影响因子：
--
作者：
O'Neal JB;Shaw AD;Billings FT 4th
通讯作者：
Billings FT 4th
影响因子：
1.6
作者：
Xu J;Shen B;Fang Y;Liu Z;Zou J;Liu L;Wang C;Ding X;Teng J
通讯作者：
Teng J
影响因子：
39.2
作者：
Collins, Gary S.;Reitsma, Johannes B.;Moons, Karel G. M.
通讯作者：
Moons, Karel G. M.