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Published in: Critical Care 1/2015

Open Access 01-12-2015 | Research

Acute kidney injury after cardiac arrest

Authors: Omar Tujjar, Giulia Mineo, Antonio Dell’Anna, Belen Poyatos-Robles, Katia Donadello, Sabino Scolletta, Jean-Louis Vincent, Fabio Silvio Taccone

Published in: Critical Care | Issue 1/2015

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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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Metadata
Title
Acute kidney injury after cardiac arrest
Authors
Omar Tujjar
Giulia Mineo
Antonio Dell’Anna
Belen Poyatos-Robles
Katia Donadello
Sabino Scolletta
Jean-Louis Vincent
Fabio Silvio Taccone
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2015
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-015-0900-2

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