Correlation Between Vasoactive-Inotropic Score and Postoperative Acute Kidney Injury after Cardiovascular Surgery

Hou, Kelong; Chen, Qi; Zhu, Xiaojie; Shen, Xiao; Zou, Lei; Mu, Xinwei; Sun, Xiangdong

doi:10.1532/hsf.3537

Cited by 15 publications

(20 citation statements)

References 27 publications

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“…Based on the literature research, the following five of the nine significant variables were included into multivariate binary logistic regression (see Table 3 ): ECMO [ 9 , 10 , 11 ], all cause infection after surgery [ 12 , 13 ], levosimendan [ 14 , 15 , 16 ], duration of NE therapy [ 17 , 18 , 19 ] and increase in Tacrolimus plasma levels [ 18 , 20 , 21 ]. Evidence for the choice to include these five variables can be found as references next to each variable.…”

Section: Resultsmentioning

confidence: 99%

Risk Factors for Acute Kidney Injury Requiring Renal Replacement Therapy after Orthotopic Heart Transplantation in Patients with Preserved Renal Function

M‘Pembele

Roth

Stroda

et al. 2021

JCM

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Acute kidney injury (AKI), requiring renal replacement therapy (RRT). is a serious complication after orthotopic heart transplantation (HTX). In patients with preexisting impaired renal function, postoperative AKI is unsurprising. However, even in patients with preserved renal function, AKI requiring RRT is frequent. Therefore, this study aimed to identify risk factors associated with postoperative AKI requiring RRT after HTX in this sub-cohort. This retrospective cohort study included patients ≥18 years of age with preserved renal function (defined as preoperative glomerular filtration rate ≥60 mL/min) who underwent HTX between 2010 and 2021. In total, 107 patients were included in the analysis (mean age 52 ± 12 years, 78.5% male, 45.8% AKI requiring RRT). Based on univariate logistic regression, use of extracorporeal membrane oxygenation, postoperative infection, levosimendan therapy, duration of norepinephrine (NE) therapy and maximum daily increase in tacrolimus plasma levels were chosen to be included into multivariate analysis. Duration of NE therapy and maximum daily increase in tacrolimus plasma levels remained as independent significant risk factors (NE: OR 1.01, 95%CI: 1.00–1.02, p = 0.005; increase in tacrolimus plasma level: OR 1.18, 95%CI: 1.01–1.37, p = 0.036). In conclusion, this study identified long NE therapy and maximum daily increase in tacrolimus plasma levels as risk factors for AKI requiring RRT in HTX patients with preserved renal function.

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Section: Resultsmentioning

confidence: 99%

Risk Factors for Acute Kidney Injury Requiring Renal Replacement Therapy after Orthotopic Heart Transplantation in Patients with Preserved Renal Function

M‘Pembele

Roth

Stroda

et al. 2021

JCM

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“…In the multivariate analysis, we observed that hematologic oncologic disease, thrombocytopenia, and MODS are independently associated with the development of AKI. As an indicator of hypotension, increased inotropic requirements and higher VIS scores were associated with the occurrence of AKI 8 17 . The maximum value of the VIS score was found to be an independent predictor of postoperative AKI in adults 17 .…”

Section: Discussionmentioning

confidence: 99%

“…As an indicator of hypotension, increased inotropic requirements and higher VIS scores were associated with the occurrence of AKI 8 17 . The maximum value of the VIS score was found to be an independent predictor of postoperative AKI in adults 17 . The requirement of MV is also an important factor for AKI.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Risk Factors and Impact of Acute Kidney Injury in Critically Ill Children

Çeleğen

2023

Klin Padiatr

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Background Acute kidney injury (AKI) is a serious clinical condition in critically ill children and is associated with worse outcomes. A few pediatric studies focused on the risk factors of AKI. We aimed to identify the incidence, risk factors, and outcomes of AKI in the pediatric intensive care unit (PICU). Patients and methods All the patients admitted to PICU over a period of 20 months were included. We compared both groups the risk factors between AKI and non-AKI. Results A total of 63 patients (17.5%) of the 360 patients developed AKI during PICU stay. The presence of comorbidity, diagnosis of sepsis, increased PRISM III score, and positive renal angina index were found to be risk factors for AKI on admission. Thrombocytopenia, multiple organ failure syndrome, the requirement of mechanical ventilation, use of inotropic drugs, intravenous iodinated contrast media, and exposure to an increased number of nephrotoxic drugs were independent risk factors during the hospital stay. The patients with AKI had a lower renal function on discharge and had worse overall survival. Conclusions AKI is prevalent and multifactorial in critically sick children. The risk factors of AKI may be present on admission and during the hospital stay. AKI is related to prolonged mechanical ventilation days, longer PICU stays, and a higher mortality rate. Based on the presented results early prediction of AKI and consequent modification of nephrotoxic medication may generate positive effects on the outcome of critically ill children.

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“…Therefore, we decided to use the vasoactive-inotropic score (VIS) change pre-operatively to post-operatively as our primary endpoint. VIS has been validated in adult cardiac surgery and has been found to be an independent predictor of combined morbidity and mortality [ 25 , 26 ] with apparently promising prospects in future study designs [ 27 ]. Considering the effect of a decreased need for vasoactive medications concomitant with the CytoSorb ® -mediated attenuation of hyper-inflammation associated vasoplegia in our patients, we expected the VIS change from pre-op to post-op to be improved in the CytoSorb ® group compared to controls.…”

Section: Discussionmentioning

confidence: 99%

Hemoadsorption in Complex Cardiac Surgery—A Single Center Experience

Manohar

Jawali

Neginahal

et al. 2022

JCM

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(1) Background: Cardiac surgery may evoke a generalized inflammatory response, typically magnified in complex, combined, redo, and emergency procedures with long aortic cross-clamp times. Various treatment options have been introduced to help regain control over post-cardiac surgery hyper-inflammation, including hemoadsorptive immunomodulation with CytoSorb®. (2) Methods: We conducted a single-center retrospective observational study of patients undergoing complex cardiac surgery. Patients intra-operatively treated with CytoSorb® were compared to a control group. The primary outcome was the change in the vasoactive-inotropic score (VIS) from pre-operatively to post-operatively. (3) Results: A total of 52 patients were included in the analysis, where 23 were treated with CytoSorb® (CS) and 29 without (controls). The mean VIS increase from pre-operative to post-operative values was significantly lower in the CS group compared to the control group (3.5 vs. 5.5, respectively, p = 0.05). In-hospital mortality in the control group was 20.7% (6 patients) and 9.1% (2 patients) in the CS group (p = 0.26). Lactate level changes were comparable, and the median intensive care unit and hospital lengths of stay were similar between groups. (4) Conclusions: Despite notable imbalances between the groups, the signals revealed point toward better hemodynamic stability with CytoSorb® hemoadsorption in complex cardiac surgery and a trend of lower mortality.

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Correlation Between Vasoactive-Inotropic Score and Postoperative Acute Kidney Injury after Cardiovascular Surgery

Cited by 15 publications

References 27 publications

Risk Factors for Acute Kidney Injury Requiring Renal Replacement Therapy after Orthotopic Heart Transplantation in Patients with Preserved Renal Function

Risk Factors for Acute Kidney Injury Requiring Renal Replacement Therapy after Orthotopic Heart Transplantation in Patients with Preserved Renal Function

A Retrospective Analysis of Risk Factors and Impact of Acute Kidney Injury in Critically Ill Children

Hemoadsorption in Complex Cardiac Surgery—A Single Center Experience

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