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Impact of early mean arterial pressure level on severe acute kidney injury occurrence after out-of-hospital cardiac arrest.
Dupont, Vincent; Bonnet-Lebrun, Anne-Sophie; Boileve, Alice; Charpentier, Julien; Mira, Jean-Paul; Geri, Guillaume; Cariou, Alain; Jozwiak, Mathieu.
Afiliación
  • Dupont V; Centre Hospitalier Universitaire de Reims, University Hospital of Reims, Reims, France. vdupont@chu-reims.fr.
  • Bonnet-Lebrun AS; French Clinical Research Infrastructure Network, Investigation Network Initiative - Cardiovascular and Renal Clinical Trialists (F-CRIN INI-CRCT), Reims, France. vdupont@chu-reims.fr.
  • Boileve A; British Antarctic Survey, High Cross, Madingley Road, Cambridge, CB4 0ET, UK.
  • Charpentier J; Département de Médecine Oncologique, Gustave Roussy, 94805, Villejuif, France.
  • Mira JP; Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris-Centre, Hôpital Cochin, Service de Médecine Intensive Réanimation, 27, Rue du Faubourg Saint Jacques, Paris, France.
  • Geri G; Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris-Centre, Hôpital Cochin, Service de Médecine Intensive Réanimation, 27, Rue du Faubourg Saint Jacques, Paris, France.
  • Cariou A; Université de Paris, Paris, France.
  • Jozwiak M; Service de Médecine Intensive et Réanimation, Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Ambroise Paré, Boulogne-Billancourt, France.
Ann Intensive Care ; 12(1): 69, 2022 Jul 18.
Article en En | MEDLINE | ID: mdl-35843964
BACKGROUND: The optimal early mean arterial pressure (MAP) level in terms of renal function remains to be established in patients with out-of-hospital cardiac arrest (OHCA). We aimed to evaluate the association between early MAP level and severe acute kidney injury (AKI) occurrence in patients with OHCA. RESULTS: In 568 consecutive patients, the percentage time spent below a predefined MAP threshold and the corresponding area below threshold (ABT) were calculated from continuous MAP measurement. Both MAP-derived variables were calculated for different MAP thresholds (65, 75 and 85 mmHg) and time periods (the first 6 and 12 after ICU admission). 274 (48%) patients developed severe AKI defined as stage 3 of KDIGO. Both ABT and percentage time were independently associated with severe AKI, regardless of the MAP threshold and time period considered. Highest adjusted odds ratios for developing severe AKI were observed while considering the first 6 h period. Within the first 6 h, every 100 mmHg-h increase in ABT under MAP thresholds of 65, 75 and 85 mmHg increased severe AKI risk by 69% (OR = 1.69; 95% CI 1.26-2.26; p < 0.01), 13% (OR = 1.13; 95% CI 1.07-1.20; p < 0.01) and 4% (OR = 1.04; 95% CI 1.02-1.06; p < 0.01), respectively. Every 10% increase in percentage time spent under MAP thresholds of 65, 75 and 85 mmHg increased severe AKI risk by 19% (OR = 1.19; 95% CI 1.06-1.33; p < 0.01), 12% (OR = 1.12; 95% CI 1.04-1.19; p < 0.01) and 8% (OR = 1.08; 95% CI 1.02-1.14; p < 0.01), respectively. CONCLUSIONS: Both severity and duration of early arterial hypotension after ICU admission remained associated with severe AKI occurrence while considering a MAP threshold as high as 85 mmHg after OHCA.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Intensive Care Año: 2022 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Intensive Care Año: 2022 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Alemania