Abstract | 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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Authors | Omar Tujjar, Giulia Mineo, Antonio Dell'Anna, Belen Poyatos-Robles, Katia Donadello, Sabino Scolletta, Jean-Louis Vincent, Fabio Silvio Taccone |
Journal | Critical care (London, England)
(Crit Care)
Vol. 19
Pg. 169
(Apr 17 2015)
ISSN: 1466-609X [Electronic] England |
PMID | 25887258
(Publication Type: Journal Article)
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Topics |
- Acute Kidney Injury
(epidemiology, etiology, therapy)
- Anuria
(diagnosis)
- Heart Arrest
(complications, epidemiology, mortality, therapy)
- Hospital Mortality
- Humans
- Intensive Care Units
- Length of Stay
- Oliguria
(diagnosis)
- Retrospective Studies
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