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体外循环期间的动脉压与急性肾损伤无关。

Arterial pressure during cardiopulmonary bypass is not associated with acute kidney injury.

作者信息

Kandler K, Jensen M E, Nilsson J C, Møller C H, Steinbrüchel D A

机构信息

Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

出版信息

Acta Anaesthesiol Scand. 2015 May;59(5):625-31. doi: 10.1111/aas.12484. Epub 2015 Feb 27.

Abstract

BACKGROUND

Acute kidney injury (AKI) after cardiac surgery is common and is associated with increased mortality. We wanted to investigate if the arterial pressure or the use of norepinephrine during cardiopulmonary bypass were associated with AKI.

METHODS

A retrospective analysis of patients who underwent coronary artery bypass grafting with or without concomitant procedures was conducted. AKI was defined using the RIFLE criteria. Data on arterial pressure and use of norepinephrine during cardiopulmonary bypass were entered in a binary logistic regression model to control for possible perioperative confounders.

RESULTS

A total of 623 patients were included. Mean age was 68.3 ± 9.7 years and 81% were males. AKI was observed in 198 patients (32%). Mean arterial pressure was 47 ± 6 mmHg and 45 ± 6 mmHg (P = 0.008) in the AKI and no-AKI group, respectively. Norepinephrine was used more frequently and in higher amounts, during cardiopulmonary bypass, in patients who developed AKI. These differences in arterial pressures and use of norepinephrine between the groups were not found to be significant when entered in the binary logistic regression model.

CONCLUSION

No independent relationship between arterial pressure or use of norepinephrine and AKI was found.

摘要

背景

心脏手术后急性肾损伤(AKI)很常见,且与死亡率增加相关。我们想研究体外循环期间的动脉压或去甲肾上腺素的使用是否与AKI有关。

方法

对接受或未接受同期手术的冠状动脉搭桥术患者进行回顾性分析。AKI采用RIFLE标准定义。将体外循环期间的动脉压数据和去甲肾上腺素的使用情况输入二元逻辑回归模型,以控制可能的围手术期混杂因素。

结果

共纳入623例患者。平均年龄为68.3±9.7岁,81%为男性。198例患者(32%)发生AKI。AKI组和非AKI组的平均动脉压分别为47±6mmHg和45±6mmHg(P = 0.008)。发生AKI的患者在体外循环期间更频繁、更大剂量地使用去甲肾上腺素。当将两组间动脉压和去甲肾上腺素使用情况的这些差异输入二元逻辑回归模型时,未发现有统计学意义。

结论

未发现动脉压或去甲肾上腺素的使用与AKI之间存在独立关系。

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