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Association between intraoperative tidal volume and postoperative acute kidney injury in non-cardiac surgical patients using a propensity score-weighted analysis.
Jung, Ji-Yoon; Song, Seung Eun; Hwangbo, Suhyun; Hwang, So Yeong; Kim, Won Ho; Yoon, Hyun-Kyu.
Afiliación
  • Jung JY; Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea.
  • Song SE; Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju, Republic of Korea.
  • Hwangbo S; Department of Genomic Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
  • Hwang SY; Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
  • Kim WH; Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
  • Yoon HK; Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Sci Rep ; 14(1): 20079, 2024 08 29.
Article en En | MEDLINE | ID: mdl-39210054
ABSTRACT
Acute kidney injury (AKI) is related to adverse clinical outcomes. Therefore, identifying patients at increased risk of postoperative AKI and proactively providing appropriate care is crucial. However, only a limited number of modifiable risk factors have been recognized to mitigate AKI risk. We retrospectively analyzed adult patients who underwent endotracheal intubation and mechanical ventilation of more than 2 h during non-cardiac surgery at Seoul National University Hospital from January 2011 to November 2022. Patients were grouped into low- or high-tidal volume groups based on their intraoperative tidal volume relative to their predicted body weight (PBW) of 8 ml/kg. The association between intraoperative tidal volume and postoperative AKI was evaluated using inverse probability of treatment weighting (IPTW), adjusting for various preoperative confounders. Among the 37,726 patients included, the incidence of postoperative AKI was 4.1%. The odds of postoperative AKI risk were significantly higher in the high-tidal volume group than in the low-tidal volume group before and after IPTW (odds ratio [OR] 1.20, 95% confidence interval [CI] 1.08-1.32, P = 0.001 and OR 1.10, 95% CI 1.02-1.19, P = 0.010, respectively). In the multivariable logistic regression analysis after IPTW, a high tidal volume was independently associated with an increased risk of postoperative AKI (OR 1.21, 95% CI 1.12-1.30, P < 0.001). In this propensity score-weighted analysis, an intraoperative high tidal volume of more than 8 ml/kg PBW was significantly associated with an increased risk of postoperative AKI after IPTW in non-cardiac surgical patients. Intraoperative tidal volume showed potential as a modifiable risk factor for preventing postoperative AKI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Volumen de Ventilación Pulmonar / Puntaje de Propensión / Lesión Renal Aguda Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Sci Rep Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Volumen de Ventilación Pulmonar / Puntaje de Propensión / Lesión Renal Aguda Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Sci Rep Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido