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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2018

Open Access 01-12-2018 | Research

Impact of individualized target mean arterial pressure for septic shock resuscitation on the incidence of acute kidney injury: a retrospective cohort study

Authors: Rajat N. Moman, Stuart A. Ostby, Abbasali Akhoundi, Rahul Kashyap, Kianoush Kashani

Published in: Annals of Intensive Care | Issue 1/2018

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Abstract

Background

To examine the relationship between delta mean arterial pressure (ΔMAP; MAP change between pre-admission minus post-resuscitation) and acute kidney injury (AKI) among patients with septic shock. In this retrospective, single-center cohort study of adult patients pre-admission MAP is defined as the median MAP recorded from 365 to 7 days before admission. Post-resuscitation MAP was median MAP during the 7th hour after initiating resuscitation.

Results

In our cohort (N = 233; 55% male), the median (interquartile range [IQR]) age was 71 (58–81) years and the median (IQR) acute physiology, age, chronic health evaluation (APACHE) III score was 81 (66–97). Although those in the lowest ΔMAP quartile (−24.5 to 3.9 mmHg) had no demographic differences compared with the rest of the cohort, the odds ratio for AKI was 0.26 (95% CI 0.11–0.57) after adjustment for other known AKI risk factors. Among patients with a history of hypertension, the lowest quartile had an odds ratio for AKI of 0.12 (95% CI 0.04–0.37) after adjusting for risk factors for AKI in this cohort.

Conclusions

The incidence of AKI was lowest among those whose post-resuscitation MAP was closest to or higher than their pre-admission MAP. Further study regarding the effect of targeting the pre-admission MAP for post-resuscitation on the incidence of AKI is warranted.
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Metadata
Title
Impact of individualized target mean arterial pressure for septic shock resuscitation on the incidence of acute kidney injury: a retrospective cohort study
Authors
Rajat N. Moman
Stuart A. Ostby
Abbasali Akhoundi
Rahul Kashyap
Kianoush Kashani
Publication date
01-12-2018
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2018
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-018-0468-5

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