Acute renal failure after successful cardiopulmonary resuscitation.

Abstract

OBJECTIVE:

To assess the frequency and independent predictors of severe acute renal failure in patients resuscitated from out-of-hospital ventricular fibrillation cardiac arrest.

DESIGN:

A cohort study with a minimum follow-up of 6 months.

SETTING:

Emergency department of a tertiary care 2200-bed university hospital.

PATIENTS AND PARTICIPANTS:

Consecutive adult (> 18 years) patients admitted from 1 July 1991 to 31 October 1997 after witnessed ventricular fibrillation out-of-hospital cardiac arrest and successful resuscitation.

MEASUREMENTS AND RESULTS:

Acute renal failure was defined as a 25% decrease of creatinine clearance within 24 h after admission. Out of 187 eligible patients (median age 57 years, 146 male), acute renal failure occurred in 22 patients (12%); in 4 patients (18%) renal replacement therapy was performed. Congestive heart failure (OR 6.0, 95% CI 1.6-21.7; p = 0.007), history of hypertension (OR 4.4, 95% CI 1.3-14.7; p = 0.02) and total dose of epinephrine administered (OR 1.1, 95% CI 1.0-1.2; p = 0.009) were independent predictors of acute renal failure. Duration of cardiac arrest, pre-existing impaired renal function and blood pressure at admission were not independently associated with renal outcome.

CONCLUSIONS:

Severe progressive acute renal failure after cardiopulmonary resuscitation (CPR) is rare. Pre-existing haemodynamics seem to be more important for the occurrence of acute renal failure than actual hypoperfusion during resuscitation.

• Authors: H Domanovits, M Schillinger, M Müllner, J Thoennissen, F Sterz, A Zeiner, W Druml
• Journal: Intensive care medicine (Intensive Care Med) Vol. 27 Issue 7 Pg. 1194-9 (Jul 2001) ISSN: 0342-4642 [Print] United States
• PMID: 11534568 (Publication Type: Journal Article)

Topics

• Acute Kidney Injury (epidemiology, etiology)
• Adult
• Aged
• Austria (epidemiology)
• Cardiopulmonary Resuscitation
• Female
• Heart Arrest (complications, therapy)
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Retrospective Studies
• Risk
• Statistics, Nonparametric
• Ventricular Fibrillation (complications, therapy)