Abstract:
OBJECTIVE:To assess whether or not a positive fluid balance masks acute kidney injury (AKI) and is associated with adverse outcomes after cardiac surgery. DESIGN:Retrospective analysis. SETTING:Tertiary university-affiliated metropolitan hospital: single center. PARTICIPANTS:Three thousand two hundred seven consecutive cardiac surgical patients admitted to the ICU from July 1, 2004 to June 30, 2012. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:The authors used AKI Network criteria to classify AKI. They then adjusted creatinine levels for weight-corrected fluid balance and categorized patients into 3 groups: group A (No AKI); group B (AKI only after adjustment); group C (AKI before and after adjustment). No patients had "AKI" before but "No AKI" after adjustment. Among 2,171 patients with weight and baseline creatinine available, after adjusting for fluid balance, the proportion of patients classified with AKI increased from 25.3% to 37.2% (p<0.001). In patients with AKI only after adjustment (group B), ICU mortality approximated that of group C (1.9% v 3.1%, p = 0.35) but was almost 3 times greater than group A (1.9% v 0.7%, p = 0.04). For group B, use of renal replacement therapy also was greater than group A (4.3% v 1.5%, p = 0.004) but less than group C (4.3% v 14.4%, p<0.001). The same trend was found for ICU length of stay (p≤0.001) and other adverse outcomes. CONCLUSIONS:Patients with AKI diagnosed after correction for the effect of a positive fluid balance on serum creatinine concentration have more adverse outcomes than patients without AKI by conventional criteria, but fewer than patients with AKI by conventional criteria.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Moore E,Tobin A,Reid D,Santamaria J,Paul E,Bellomo Rdoi
10.1053/j.jvca.2015.02.004subject
Has Abstractpub_date
2015-10-01 00:00:00pages
1229-35issue
5eissn
1053-0770issn
1532-8422pii
S1053-0770(15)00070-1journal_volume
29pub_type
杂志文章abstract:OBJECTIVE:The purpose of this study was to evaluate the effect of 0.1 microg/kg/min of fenoldopam mesylate on renal flow and central hemodynamics measured by echocardiography in hemodynamically stable patients with preserved renal function undergoing cardiac surgery. DESIGN:Experimental observational study. SETTING:S...
journal_title:Journal of cardiothoracic and vascular anesthesia
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更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:To assess the association between postoperative central venous oxygen saturation (ScvO(2)) and arterial lactate with outcome after cardiac surgery. DESIGN:Prospective observational study. SETTING:University-affiliated tertiary care hospital. PARTICIPANTS:Patients after coronary artery bypass and/or valve s...
journal_title:Journal of cardiothoracic and vascular anesthesia
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abstract:OBJECTIVE:Experimental inflammation induces degradation of glycocalyx. The authors hypothesized that inflammation is an important determinant of glycocalyx degradation in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). DESIGN:A prospective observational study. SETTING:Operation theater and inte...
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更新日期:2019-02-01 00:00:00
abstract::Pentamorphone is a new, highly potent opioid reported to have minimal cardiovascular effects in humans and a high therapeutic index in animals. Pentamorphone was injected intravenously (IV) as the sole anesthetic in 10 patients with left ventricular ejection fractions greater than 0.35 who were undergoing elective cor...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(92)90192-a
更新日期:1992-04-01 00:00:00
abstract:OBJECTIVES:To implement a statistical model for protamine titration. DESIGN:Prospective randomized trial. SETTING:University hospital. PARTICIPANTS:Sixty (n = 30+30) patients scheduled for elective coronary artery bypass surgery were randomly assigned to 2 groups. INTERVENTIONS:Protamine dose calculated according t...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,随机对照试验
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更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:In minimally invasive surgical ablation for atrial fibrillation during video-assisted thoracoscopy surgery, one-lung ventilation (OLV) with a double- lumen tube is commonly employed. In contrast with the majority of thoracic procedures, the patient lies supine; thus, the protective effect of gravity is lost a...
journal_title:Journal of cardiothoracic and vascular anesthesia
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更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate whether acute kidney injury (AKI) after coronary artery bypass grafting can be attributed to intraoperative hypotension during cardiopulmonary bypass (IOH-CPB). DESIGN:Retrospective analysis. SETTING:Tertiary-care hospital. PARTICIPANTS:Patients undergoing on-pump c...
journal_title:Journal of cardiothoracic and vascular anesthesia
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更新日期:2017-04-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
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更新日期:2006-10-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2009.09.013
更新日期:2010-08-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2002.31066
更新日期:2002-04-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2004-06-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
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doi:10.1053/j.jvca.2007.10.013
更新日期:2008-06-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(97)90252-4
更新日期:1997-02-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.03.005
更新日期:2019-11-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1053/j.jvca.2007.06.001
更新日期:2008-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1053/j.jvca.2009.09.016
更新日期:2010-08-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
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更新日期:2019-07-01 00:00:00
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doi:10.1053/jcan.2000.7922
更新日期:2000-08-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
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更新日期:2017-10-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1997-10-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2015.08.008
更新日期:2016-01-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
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更新日期:1994-06-01 00:00:00
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更新日期:1996-06-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s1053-0770(05)80105-3
更新日期:1995-08-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.07.130
更新日期:2020-04-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(00)90053-3
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVES:Methicillin-resistant Staphylococcus is a growing problem in intensive care units (ICUs). The aim of this study was to describe the epidemiology of methicillin-resistant Staphylococcus isolates in a cardiac surgical ICU over a 5-year period and to determine the risk factors and outcome of this condition. ME...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2004.12.002
更新日期:2006-02-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2015.10.022
更新日期:2016-04-01 00:00:00