[HTML][HTML] Acute kidney injury after cardiac arrest
O Tujjar, G Mineo, A Dell'Anna, B Poyatos-Robles… - Critical Care, 2015 - Springer
Critical Care, 2015•Springer
Introduction The aim of this study was to evaluate the incidence and determinants of AKI in a
large cohort of cardiac arrest patients. Methods We reviewed all patients admitted, for at
least 48 hours, to our Dept. of Intensive Care after CA between January 2008 and October
2012. AKI was defined as oligo-anuria (daily urine output< 0.5 ml/kg/h) and/or an increase in
serum creatinine (≥ 0.3 mg/dl from admission value within 48 hours or a 1.5 time from
baseline level). Demographics, comorbidities, CA details, and ICU interventions were …
large cohort of cardiac arrest patients. Methods We reviewed all patients admitted, for at
least 48 hours, to our Dept. of Intensive Care after CA between January 2008 and October
2012. AKI was defined as oligo-anuria (daily urine output< 0.5 ml/kg/h) and/or an increase in
serum creatinine (≥ 0.3 mg/dl from admission value within 48 hours or a 1.5 time from
baseline level). Demographics, comorbidities, CA details, and ICU interventions were …
Introduction
The aim of this study was to evaluate the incidence and determinants of AKI in a large cohort of cardiac arrest patients.
Methods
We reviewed all patients admitted, for at least 48 hours, to our Dept. of Intensive Care after CA between January 2008 and October 2012. AKI was defined as oligo-anuria (daily urine output <0.5 ml/kg/h) and/or an increase in serum creatinine (≥0.3 mg/dl from admission value within 48 hours or a 1.5 time from baseline level). Demographics, comorbidities, CA details, and ICU interventions were recorded. Neurological outcome was assessed at 3 months using the Cerebral Performance Category scale (CPC 1–2 = favorable outcome; 3–5 = poor outcome).
Results
A total of 199 patients were included, 85 (43%) of whom developed AKI during the ICU stay. Independent predictors of AKI development were older age, chronic renal disease, higher dose of epinephrine, in-hospital CA, presence of shock during the ICU stay, a low creatinine clearance (CrCl) on admission and a high cumulative fluid balance at 48 hours. Patients with AKI had higher hospital mortality (55/85 vs. 57/114, p = 0.04), but AKI was not an independent predictor of poor 3-month neurological outcome.
Conclusions
AKI occurred in more than 40% of patients after CA. These patients had more severe hemodynamic impairment and needed more aggressive ICU therapy; however the development of AKI did not influence neurological recovery.
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