초록접수 현황
| 20F-060 | 구연 발표 |
Oxygen delivery during cardiopulmonary bypass as a predictor of acute kidney injury after aortic valve replacement
Sue Hyun Kim, MD, Ho Young Hwang, MD, PhD, Yeiwon Lee MD, Suk Ho Sohn, MD, Jae Woong Choi, MD, PhD, Kyung Hwan Kim, MD, PhD, Ki-Bong Kim, MD, PhD.
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : Acute kidney injury (AKI) is a common complication after cardiac surgery with increased mortality and morbidity. This study was conducted to evaluate the association between target pump flow to achieve adequate oxygen delivery (DO2) and postoperative AKI after aortic valve replacement.
Methods : From January 2017 to May 2020, 281 patients (male:female = 160:121, mean age: 68±11 years) who underwent aortic valve replacement were retrospectively reviewed. Target pump flow was calculated based on DO2 level of 280 mL·min-1·m-2. The primary end-point for AKI evaluation was a ratio of postoperative peak creatinine level to preoperative value. The ratio of actual pump flow to target pump flow, the other hemodynamic variables related with cardiopulmonary bypass, intraoperative transfusion and preoperative characteristics were analyzed to identify factors associated with postoperative AKI using a multivariable linear regression model.
Results : Preoperative and peak postoperative creatinine levels were 0.94±0.33, and 1.15±0.56 mg/dL, respectively (ratio = 1.22±0.33). Maximum target flow was 4.70±0.59 L/min, whereas lowest actual pump flow was 3.77±0.47 L/min (ratio = 0.81±0.13). The multivariable model showed that the ratio of lowest pump flow to maximum target pump flow (β±standard error = -0.405±0.162, P=0.013), as well as transfusion (0.099±0.033, P=0.003), stroke history (0.197±0.066, P=0.003) and emergency (0.364±0.181, P=0.045) were associated with the primary end-point for AKI.
Conclusion : Lower ratio of actual nadir pump flow to maximum target pump flow based on the DO2 is associated with an increase of creatinine level after aortic valve replacement.
Methods : From January 2017 to May 2020, 281 patients (male:female = 160:121, mean age: 68±11 years) who underwent aortic valve replacement were retrospectively reviewed. Target pump flow was calculated based on DO2 level of 280 mL·min-1·m-2. The primary end-point for AKI evaluation was a ratio of postoperative peak creatinine level to preoperative value. The ratio of actual pump flow to target pump flow, the other hemodynamic variables related with cardiopulmonary bypass, intraoperative transfusion and preoperative characteristics were analyzed to identify factors associated with postoperative AKI using a multivariable linear regression model.
Results : Preoperative and peak postoperative creatinine levels were 0.94±0.33, and 1.15±0.56 mg/dL, respectively (ratio = 1.22±0.33). Maximum target flow was 4.70±0.59 L/min, whereas lowest actual pump flow was 3.77±0.47 L/min (ratio = 0.81±0.13). The multivariable model showed that the ratio of lowest pump flow to maximum target pump flow (β±standard error = -0.405±0.162, P=0.013), as well as transfusion (0.099±0.033, P=0.003), stroke history (0.197±0.066, P=0.003) and emergency (0.364±0.181, P=0.045) were associated with the primary end-point for AKI.
Conclusion : Lower ratio of actual nadir pump flow to maximum target pump flow based on the DO2 is associated with an increase of creatinine level after aortic valve replacement.
책임저자: Ho Young Hwang
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Sue Hyun Kim, E-mail : annesue01@gmail.com