Perioperative Gelatin Use Is Associated With Increased Complication Rates and Does Not Prevent Postoperative Fluid Overload in Patients Undergoing Elective Cardiac Surgery

Katona, Hajna; Dobronte, Laszlo; Soltész, Ádám; Tamáska, Eszter; Fabry, Szabolcs; Csikós, Gergely; Szakal–Toth, Zsofia; Fule, Balazs Krisztian; Láng, Zsolt; Merkely, Béla; Gal, Janos; Németh, Endre

doi:10.1053/j.jvca.2022.11.037

Cited by 2 publications

(1 citation statement)

References 34 publications

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“…Smart L [21] found that uid resuscitation after heart surgery with succinyl gelatin (4%) was related to the increase of biomarker concentration of renal tubular injury and dysfunction compared with crystalloid uid. Katona [22] similarly reported a signi cant association between gelatin administration and an increased risk for early postoperative AKI in a dose-dependent manner. These ndings raise concern regarding the potential for intravenous gelatin solution to contribute to clinically relevant postoperative AKI.…”

Section: Discussionmentioning

confidence: 92%

The Impact of Intraoperative Hypotension on Postoperative Acute Kidney Injury, Mortality and Length of Stay following Off-Pump Coronary Artery Bypass Grafting Surgery: a single-center retrospective cohort study

xiao,

yang,

cao

et al. 2024

Preprint

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Background Off-pump coronary artery bypass grafting (OPCABG) presents distinct hemodynamic characteristics, yet the relationship between intraoperative hypotension and short-term adverse outcomes remains clear. Our study aims to investigate association between intraoperative hypotension and postoperative acute kidney injury (AKI), mortality and length of stay in OPCABG patients. Methods Retrospective data of 494 patients underwent OPCABG from January 2016 to July 2023 were collected. We analyzed the relationship between intraoperative various hypotension absolute values (MAP >75, 65< MAP ≤ 75, 55< MAP ≤65, MAP ≤55 mmHg) and postoperative AKI, mortality and length of stay. Logistic regression assessed the impacts of exposure variable on AKI and postoperative mortality. Linear regression was used to analyze risk factors on the length of intensive care unit stay (ICU) and hospital stay. Results The incidence of AKI was 31.8 %, with in-hospital and 30-day mortality at 2.8 % and 3.5 %, respectively. Maintaining a MAP greater than or equal 65 mmHg [odds ratio (OR) 0.408; p=0.008] and 75 mmHg (OR 0.479; p=0.024) was significantly associated with a decrease risk of AKI compared to MAP less than 55 mmHg for at least 10 minutes. Prolonged hospital stays were linked to low MAP, while in-hospital mortality and 30-day mortality were not linked to IOH but exhibited correlation with a history of myocardial infarction. AKI showed correlation with length of ICU stay. Conclusions MAP > 65 mmHg emerges as a significant independent protective factor for AKI in OPCABG and IOH is related to length of hospital stay. Proactive intervention targeting intraoperative hypotension may provide a potential opportunity to reduce postoperative renal injury and hospital stay. Trial registration ChiCTR2400082518. Registered 31 March 2024. https://www.chictr.org.cn/bin/project/edit?pid=225349

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Section: Discussionmentioning

confidence: 92%

The Impact of Intraoperative Hypotension on Postoperative Acute Kidney Injury, Mortality and Length of Stay following Off-Pump Coronary Artery Bypass Grafting Surgery: a single-center retrospective cohort study

xiao,

yang,

cao

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

The impact of intraoperative hypotension on postoperative acute kidney injury, mortality and length of stay following off-pump coronary artery bypass grafting surgery: a single-center retrospective cohort study

Xiao,

Yang,

Cao

et al. 2024

BMC Anesthesiol

View full text Add to dashboard Cite

Background Off-pump coronary artery bypass grafting (OPCABG) presents distinct hemodynamic characteristics, yet the relationship between intraoperative hypotension and short-term adverse outcomes remains clear. Our study aims to investigate association between intraoperative hypotension and postoperative acute kidney injury (AKI), mortality and length of stay in OPCABG patients. Methods Retrospective data of 494 patients underwent OPCABG from January 2016 to July 2023 were collected. We analyzed the relationship between intraoperative various hypotension absolute values (MAP > 75, 65 < MAP ≤ 75, 55 < MAP ≤ 65, MAP ≤ 55 mmHg) and postoperative AKI, mortality and length of stay. Logistic regression assessed the impacts of exposure variable on AKI and postoperative mortality. Linear regression was used to analyze risk factors on the length of intensive care unit stay (ICU) and hospital stay. Results The incidence of AKI was 31.8%, with in-hospital and 30-day mortality at 2.8% and 3.5%, respectively. Maintaining a MAP greater than or equal 65 mmHg [odds ratio (OR) 0.408; p = 0.008] and 75 mmHg (OR 0.479; p = 0.024) was significantly associated with a decrease risk of AKI compared to MAP less than 55 mmHg for at least 10 min. Prolonged hospital stays were linked to low MAP, while in-hospital mortality and 30-day mortality were not linked to IOH but exhibited correlation with a history of myocardial infarction. AKI showed correlation with length of ICU stay. Conclusions MAP > 65 mmHg emerges as a significant independent protective factor for AKI in OPCABG and IOH is related to length of hospital stay. Proactive intervention targeting intraoperative hypotension may provide a potential opportunity to reduce postoperative renal injury and hospital stay. Trial registration ChiCTR2400082518. Registered 31 March 2024. https://www.chictr.org.cn/bin/project/edit?pid=225349.

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Perioperative Gelatin Use Is Associated With Increased Complication Rates and Does Not Prevent Postoperative Fluid Overload in Patients Undergoing Elective Cardiac Surgery

Cited by 2 publications

References 34 publications

The Impact of Intraoperative Hypotension on Postoperative Acute Kidney Injury, Mortality and Length of Stay following Off-Pump Coronary Artery Bypass Grafting Surgery: a single-center retrospective cohort study

The Impact of Intraoperative Hypotension on Postoperative Acute Kidney Injury, Mortality and Length of Stay following Off-Pump Coronary Artery Bypass Grafting Surgery: a single-center retrospective cohort study

The impact of intraoperative hypotension on postoperative acute kidney injury, mortality and length of stay following off-pump coronary artery bypass grafting surgery: a single-center retrospective cohort study

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