Abstract:
BACKGROUND:The use of noradrenaline to enable a restrictive approach to intra-operative fluid therapy to avoid salt and water overload has gained increasing acceptance. However, concerns have been raised about the impact of this approach on renal function. OBJECTIVES:To identify risk factors for acute kidney injury (AKI) in patients undergoing cystectomy with urinary diversion and determine whether administration of noradrenaline and intra-operative hydration regimens affect early postoperative renal function. DESIGN:Retrospective observational cohort study. SETTING:University hospital, from 2007 to 2016. PATIENTS:A total of 769 consecutive patients scheduled for cystectomy and urinary diversion. Those with incomplete data and having pre-operative haemodialysis were excluded. MAIN OUTCOME MEASURES:AKI was defined as a serum creatinine increase of more than 50% over 72 postoperative hours. Multiple logistic regression analysis was performed to model the association between risk factors and AKI. RESULTS:Postoperative AKI was diagnosed in 86/769 patients (11.1%). Independent predictors for AKI were the amount of crystalloid administered (odds ratio (OR) 0.79 [95% confidence interval (CI), 0.68 to 0.91], P = 0.002), antihypertensive medication (OR 2.07 [95% CI, 1.25 to 3.43], P = 0.005), pre-operative haemoglobin value (OR 1.02 [95% CI, 1.01 to 1.03], P = 0.010), duration of surgery (OR 1.01 [95% CI, 1.00 to 1.01], P = 0.002), age (OR 1.32 [95% CI, 1.44 to 1.79], P = 0.002) but not the administration of noradrenaline (OR 1.09 [95% CI, 0.94 to 1.21], P = 0.097). Postoperative AKI was associated with longer hospital stay (18 [15 to 22] vs. 16 [15 to 19] days; P = 0.035) and a higher 90-day major postoperative complication rate (41.9 vs. 27.5%; P = 0.002). CONCLUSION:Noradrenaline administration did not increase the risk for AKI. A too restrictive approach to administration of crystalloids was associated with an increased risk for AKI, particularly in older patients, those receiving antihypertensive medication, and those whose surgery was prolonged. As AKI was associated with longer hospital stay and increased postoperative morbidity, these observations should be taken into account to improve outcome when addressing peri-operative fluid management. TRIAL REGISTRATION:Not applicable.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Furrer MA,Schneider MP,Löffel LM,Burkhard FC,Wuethrich PYdoi
10.1097/EJA.0000000000000808subject
Has Abstractpub_date
2018-09-01 00:00:00pages
641-649issue
9eissn
0265-0215issn
1365-2346journal_volume
35pub_type
杂志文章abstract::Prolongation of the QT interval may produce potentially hazardous dysrhythmias. The effects on the QT interval of midazolam followed by administration of either vecuronium or atracurium have been investigated. Thirty patients, ASA I or II, without cardiovascular problems, electrolyte abnormalities or receiving any med...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Statins are prescribed for patients with hypercholesterolemia. Atorvastatin is metabolized by cytochrome P4503A4 and inhibits P4503A4 activity in vitro. Alfentanil is a potent opioid used in clinical anaesthetic practice and is also metabolized by P4503A4. This study tested the hypothesis that ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1017/s0265021503001078
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:the objective of this study was to assess whether antiemetic drugs metoclopramide and diphenhydramine, administered together as opposed to alone, can have better efficacy in preventing postoperative nausea and vomiting when added to patient-controlled morphine analgesia. PATIENTS AND METHODS:d...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32833f53b8
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Previous data show that lidocaine or magnesium has unique characteristics of stress inhibition and antiinflammation. OBJECTIVE:We aimed to observe the effects of lidocaine or magnesium on the quality of recovery (QoR) after laparoscopic cholecystectomy. DESIGN:Single-centre, prospective, randomised, double...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001348
更新日期:2021-03-01 00:00:00
abstract:BACKGROUND AND AIM:This study assessed the accuracy of using capnography with a modified, hollow gum elastic bougie in predicting tracheal intubation, and its effectiveness as a method of apnoeic oxygenation. METHODS:Patients were randomly allocated to having the gum elastic bougie inserted, under anaesthesia, in the ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.0265-0215.2000.00774.x
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The aim of study was to investigate the electron microscopic changes in the medulla of the spinal cord that occur with intrathecal midazolam administration. METHODS:Twenty-eight albino rabbits of New Zealand type were randomized into two groups. Following anaesthesia, 16 rabbits were given 300...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021505001547
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Low-dose mixture of hyperbaric bupivacaine and fentanyl is commonly used in day-case spinal anaesthesia. Using hyperbaric articaine, the onset may be faster and duration more predictable than with bupivacaine-fentanyl. We compared these two spinal anaesthetics for inguinal herniorrhaphy. METHO...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32834a11be
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Infants undergoing general anaesthesia have an increased risk of severe respiratory and cardiovascular critical events. Awake caudal anaesthesia is an alternative for small infants undergoing minor lower abdominal surgery. While clinical experience has shown stable intra-operative haemodynamic conditions, th...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001150
更新日期:2020-08-01 00:00:00
abstract:CONTEXT:We hypothesised that the Blind Intubation Device (BID) would be effective for nasotracheal intubation (NTI) in anaesthetised adults with Mallampati class 3. We also hypothesised that BID may cause less haemodynamic changes due to the avoidance of direct stimulation induced by the Macintosh blade. OBJECTIVE:The...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e328349a9f9
更新日期:2011-11-01 00:00:00
abstract::We studied the movement response to skin incision in 68 adult (males/females) ASA I-II patients receiving propofol +/- fentanyl intravenous anaesthesia using the bispectral index and 95% spectral edge frequency monitoring with an A-1050 EEG monitor. Following Ethics Committee approval, patients were randomly assigned ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2346.1999.00549.x
更新日期:1999-09-01 00:00:00
abstract::Pulmonary hypertension is usually treated with intravenous (i.v.) vasodilators, but their use is limited by systemic effects. In the current study, we compared the effects of inhaled nitric oxide and intravenous nitroglycerine on pulmonary and systemic haemodynamic responses as well as on gas exchange measurements in ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1996.d01-384.x
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The cerebral state index (CSI) is a low-cost and compact electroencephalographic monitor alternative to the bispectral index (BIS). Although both indices are shown as the number between 0 and 100, owing to the different calculation algorithms, both indices might be different during anaesthesia....
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e328324e946
更新日期:2009-08-01 00:00:00
abstract::In this case report an unusual complication is described following insertion of a Swan Ganz catheter. A 79-year-old male patient experienced knotting of the catheter. Methods of avoiding this problem and removal of a knotted catheter are discussed. ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1997.00201.x
更新日期:1997-09-01 00:00:00
abstract::The time profile of the neuromuscular block produced by a single bolus administration of vecuronium was simulated by a new model for the access of the relaxant to the receptors on the motor end plates. The receptors were assumed to be kinetically a part of the interstitial space of the muscle. The time course of the n...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The aim of this prospective, randomized, double-blind investigation was to assess the dose-effect characteristics of postoperative nausea and vomiting after intrathecal administration of small doses of morphine (from 0.015 to 0.25 mg) in opioid-naïve, non-surgical patients. METHODS:With Ethic ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S026502150600038X
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:ProSeal Laryngeal Mask Airway (PLMA) and Laryngeal Tube Suction (LTS), supraglottic airway devices allowing gastric drainage, were compared in this prospective, randomized study for airway management under conditions with elevated intra-abdominal pressure induced by capnoperitoneum. METHODS:Fi...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021505000220
更新日期:2005-02-01 00:00:00
abstract::Perioperative myocardial infarction or ischaemia is a potential consequence of cardiac surgery and elevated free fatty acids can increase the severity of myocardial ischaemic damage. We investigated perioperative changes in serum free fatty acids, and other serum lipids, as a consequence of using propofol infusions fo...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.0265-0215.2000.00789.x
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:The objective of this study was to determine the intracranial, cardiovascular and respiratory changes induced by conversion to high-frequency oscillator ventilation from conventional mechanical ventilation at increasing airway pressures. METHODS:In this study, 11 anaesthetized sheep had invasive cardiovascu...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506002006
更新日期:2007-05-01 00:00:00
abstract::The airway was managed successfully in two cases of difficult intubation using the Combitube, a new device for emergency intubation, which combines the functions of an oesophageal obturator airway and a conventional endotracheal airway. One patient could not be intubated due to lockjaw; in the other patient, the vocal...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:In most studies of cardiac output changes after spinal anaesthesia, the time-resolution is limited. The aim of this study was to demonstrate cardiac output changes with high time-resolution during onset of spinal anaesthesia in elderly patients. METHODS:We investigated 32 patients aged 60 yr s...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021507000427
更新日期:2007-09-01 00:00:00
abstract::The benefits of epidural anaesthesia combined with general anaesthesia were studied in young children scheduled for major abdominal surgical procedure (pull-through for Hirschsprung's disease). Two groups of nine children were studied receiving, respectively, general anaesthesia or general anaesthesia plus epidural an...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1987-09-01 00:00:00
abstract::Two groups of 25 patients were sedated during neuroradiological investigation. The first group was sedated with fentanyl and midazolam while the other was given fentanyl and a two-stage infusion of propofol in a subanaesthetic dose. Both techniques resulted in satisfactory sedation and recovery, although those who rec...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-09-01 00:00:00
abstract:CONTEXT:Strabismus surgery is one of the most common ophthalmic surgical procedures in children and is associated with significant postoperative nausea and vomiting (PONV). OBJECTIVE:We evaluated the effect of intravenous paracetamol on PONV in children after strabismus surgery. DESIGN:Prospective, placebo-controlled...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32834c580b
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:The respiratory exchange ratio (RER), defined as the ratio of CO2 production (VCO2) to O2 consumption (VO2), is reported to be a noninvasive marker of anaerobic metabolism. The intubated, ventilated patient's inspired and expired fractions of O2 and CO2 (FiO2, FeO2, FiCO2 and FeCO2) are monitored in the oper...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001111
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To determine if there is any significant difference between the effects of desflurane, isoflurane and sevoflurane on the QT interval, QT dispersion, heart rate corrected QT interval and QTc dispersion of the electrocardiogram. METHODS:The study was conducted in a prospective, double blind and ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021504007112
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Proinflammatory cytokines as well as nitric oxide (NO) play a major role in mediating the response to lipopolysaccharide (LPS). The present study tested the hypothesis that LPS induces proinflammatory cytokines in the lung via the Toll-like receptor 4 (TLR4)/CD14 signalling cascade. METHODS:Co...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021506001098
更新日期:2006-12-01 00:00:00
abstract::The post-operative period is particularly dangerous for obese patients. The aim of this study was to compare the immediate post-operative course after either laparoscopic or open gastroplasty. We studied retrospectively 20 and 14 consecutive patients who underwent laparoscopic or open adjustable silicone gastric bandi...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1999.00510.x
更新日期:1999-06-01 00:00:00
abstract::The thrombogenicity of polyethylene, silicone and polyurethane central venous catheters was compared in a prospective clinical, phlebographic and post-mortem study in 52 patients. The incidence of central venous thrombosis was high with polyethylene catheters (70%), but much lower with silicone (20%) and with polyuret...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Transurethral prostatectomy is routinely performed under spinal anaesthesia. This technique can cause hypotension, which is particularly undesirable in the elderly. The objective was to compare spinal anaesthesia for transurethral prostatectomy using hyperbaric bupivacaine 15 mg (control group)...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021503000899
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Lipid peroxidation plays an important role during liver ischaemia-reperfusion injury. Pentane in breath is often used as an index of lipid peroxidation. We observed the changes in levels of breath pentane during the lipid peroxidation process caused by liver ischaemia-reperfusion injury. METHO...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/eja.0b013e328326f7b7
更新日期:2009-06-01 00:00:00