Investigating preoperative myoglobin level as predictive factor for acute kidney injury following cardiac surgery with cardiopulmonary bypass: a retrospective observational study

Lee, Kuen Su; Kim, Hyun Joong; Lee, Yoon Sook; Choi, Yoon-Dong; Yoon, Sang Min; Kim, Woon Young; Kim, Jaehwan

doi:10.1016/j.bjane.2021.08.023

Cited by 2 publications

(1 citation statement)

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“…5 Its incidence is variable, less than 1% after urologic surgeries, 19% after coronary artery bypass grafting, and up to 75% after bariatric surgeries. 7,[11][12][13] In contrast to these studies, 42 of our patients developed RML at 48 hours postoperatively, with an incidence of 91.3%. These differences are probably due to the heterogeneity and lack of consensus when defining RML, and the use of different CK cutoff levels.…”

Section: Discussioncontrasting

confidence: 86%

Rhabdomyolysis following Nuss Procedure: A Prospective Study in Children

et al. 2022

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Introduction: Postoperative rhabdomyolysis (RML) has been documented after several surgical procedures in adults. Musculo-skeletal remodeling after Nuss procedure for pectus excavatum (PE) could cause RML. We evaluated the incidence of RML after Nuss procedure in children. Methods: Prospective study from 2018 to 2021. We enrolled all otherwise healthy patients who underwent PE correction with only one bar. Studied variables included demographic and clinical data, duration of surgery, complications, and length of hospitalization. The patients included underwent serial measurements of serum creatine kinase (CK), troponin I, and NT-proBNP, serum creatinine (Cr), urea, and glomerular filtration rate (GRF) at 6, 48 hours postoperatively, and hospital discharge. Results: Forty-six patients met criteria (40 male/6 female), with a mean age of 15.1 ± 1.4 years. Mean duration of surgery was 74 ± 28 minutes, and length of hospitalization was 4.6 ± 1.6 days. RML was diagnosed in 30.4% of patients at 6 hours, 91.3% at 48 hours, and 21.7% at hospital discharge. Mean preoperative CK value was 181.1 ± 141.6 IU/L, and postoperative values were 863.3 ± 302.6 IU/L at 6h, 1675.2 ± 561 IU/L at 48h, and 850 ± 683.7 IU/L at hospital discharge, with statistically significant differences (p=0.001). High-sensitivity troponin I and NT-proBNP levels increased significantly during the postoperative time (p=0.001). Renal function remained stable (p=0.55). Conclusions: Nuss technique produces RML without kidney injury in healthy patients. This knowledge should be considered for patients at increased risk of developing acute kidney injury and other complications.

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Section: Discussioncontrasting

confidence: 86%

Rhabdomyolysis following Nuss Procedure: A Prospective Study in Children

et al. 2022

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Dynamic increase in myoglobin level is associated with poor prognosis in critically ill patients: a retrospective cohort study

Liu,

Jiang,

Yuan

et al. 2024

Front. Med.

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BackgroundMyoglobin is an important biomarker for monitoring critically ill patients. However, the relationship between its dynamic changes and prognosis remains unclear.MethodsWe retrospectively enrolled 11,218 critically ill patients from a general and surgical intensive care unit (ICU) of a tertiary hospital between June 2016 and May 2020. Patients with acute cardiovascular events, cardiac and major vascular surgeries, and rhabdomyolysis were excluded. To investigate the early myoglobin distribution, the critically ill patients were stratified according to the highest myoglobin level within 48 h after ICU admission. Based on this, the critically ill patients with more than three measurements within 1 week after ICU admission were included, and latent class trajectory modeling was used to classify the patients. The characteristics and outcomes were compared among groups. Sensitivity analysis was performed to exclude patients who had died within 72 h after ICU admission. Restricted mean survival time regression model based on pseudo values was used to determine the 28-day relative changes in survival time among latent classes. The primary outcome was evaluated with comparison of in-hospital mortality among each Trajectory group, and the secondary outcome was 28-day mortality.ResultsOf 6,872 critically ill patients, 3,886 (56.5%) had an elevated myoglobin level (≥150 ng/mL) at admission to ICU, and the in-hospital mortality significantly increased when myoglobin level exceeded 1,000 μg/mL. In LCTM, 2,448 patients were unsupervisedly divided into four groups, including the steady group (n = 1,606, 65.6%), the gradually decreasing group (n = 523, 21.4%), the slowly rising group (n = 272, 11.1%), and the rapidly rising group (n = 47, 1.9%). The rapidly rising group had the largest proportion of sepsis (59.6%), the highest median Sequential Organ Failure Assessment (SOFA) score (10), and the highest in-hospital mortality (74.5%). Sensitivity analysis confirmed that 98.2% of the patients were classified into the same group as in the original model. Compared with the steady group, the rapidly rising group and the slowly rising group were significantly related to the reduction in 28-day survival time (β = −12.08; 95% CI −15.30 to −8.86; β = −4.25, 95% CI −5.54 to −2.97, respectively).ConclusionElevated myoglobin level is common in critically ill patients admitted to the ICU. Dynamic monitoring of myoglobin levels offers benefit for the prognosis assessment of critically ill patients.

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Investigating preoperative myoglobin level as predictive factor for acute kidney injury following cardiac surgery with cardiopulmonary bypass: a retrospective observational study

Cited by 2 publications

References 35 publications

Rhabdomyolysis following Nuss Procedure: A Prospective Study in Children

Rhabdomyolysis following Nuss Procedure: A Prospective Study in Children

Dynamic increase in myoglobin level is associated with poor prognosis in critically ill patients: a retrospective cohort study

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