Department of Anesthesiology, Luhe People's Hospital of Nanjing, 9 Jiankang Road, Nanjing, 211500, China.
Department of Anesthesiology, Nanjing Drum Tower Hospital, Medical College of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China.
Crit Care. 2020 Mar 5;24(1):80. doi: 10.1186/s13054-020-2770-5.
The association of central venous pressure (CVP) and mortality and acute kidney injury (AKI) in critically ill adult patients remains unclear. We performed a meta-analysis to determine whether elevated CVP is associated with increased mortality and AKI in critically ill adult patients.
We searched PubMed and Embase through June 2019 to identify studies that investigated the association between CVP and mortality and/or AKI in critically ill adult patients admitted into the intensive care unit. We calculated the summary odds ratio (OR) and 95% CI using a random-effects model.
Fifteen cohort studies with a broad spectrum of critically ill patients (mainly sepsis) were included. On a dichotomous scale, elevated CVP was associated with an increased risk of mortality (3 studies; 969 participants; OR, 1.65; 95% CI, 1.19-2.29) and AKI (2 studies; 689 participants; OR, 2.09; 95% CI, 1.39-3.14). On a continuous scale, higher CVP was associated with greater risk of mortality (5 studies; 7837 participants; OR, 1.10; 95% CI, 1.03-1.17) and AKI (6 studies; 5446 participants; OR, 1.14; 95% CI, 1.06-1.23). Furthermore, per 1 mmHg increase in CVP increased the odds of AKI by 6% (4 studies; 5150 participants; OR, 1.06; 95% CI, 1.01-1.12). Further analyses restricted to patients with sepsis showed consistent results.
Elevated CVP is associated with an increased risk of mortality and AKI in critically ill adult patients admitted into the intensive care unit.
PROSPERO, CRD42019126381.
中心静脉压（CVP）与危重症成年患者的死亡率和急性肾损伤（AKI）之间的关系尚不清楚。我们进行了一项荟萃分析，以确定 CVP 升高是否与危重症成年患者的死亡率和 AKI 增加有关。
我们通过 2019 年 6 月在 PubMed 和 Embase 中进行了搜索，以确定研究 CVP 与危重症成年患者入住重症监护病房的死亡率和/或 AKI 之间关系的研究。我们使用随机效应模型计算了汇总优势比（OR）和 95%置信区间。
纳入了 15 项涵盖广泛危重症患者（主要为脓毒症）的队列研究。在二分类尺度上，CVP 升高与死亡率增加相关（3 项研究；969 名参与者；OR，1.65；95%CI，1.19-2.29）和 AKI（2 项研究；689 名参与者；OR，2.09；95%CI，1.39-3.14）。在连续尺度上，较高的 CVP 与更高的死亡率风险相关（5 项研究；7837 名参与者；OR，1.10；95%CI，1.03-1.17）和 AKI（6 项研究；5446 名参与者；OR，1.14；95%CI，1.06-1.23）。此外，CVP 每增加 1mmHg，AKI 的几率增加 6%（4 项研究；5150 名参与者；OR，1.06；95%CI，1.01-1.12）。进一步仅限于脓毒症患者的分析显示出一致的结果。
在入住重症监护病房的危重症成年患者中，CVP 升高与死亡率和 AKI 风险增加相关。
PROSPERO，CRD42019126381。
