Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/11470
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dc.contributor.authorSchneider, Antoine Gen
dc.contributor.authorEastwood, Glenn Men
dc.contributor.authorSeevanayagam, Sivenen
dc.contributor.authorMatalanis, Georgesen
dc.contributor.authorBellomo, Rinaldoen
dc.date.accessioned2015-05-16T01:04:54Z
dc.date.available2015-05-16T01:04:54Z
dc.date.issued2012-04-03en
dc.identifier.citationJournal of Critical Care 2012; 27(5): 488-95en
dc.identifier.govdoc22480577en
dc.identifier.otherPUBMEDen
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/11470en
dc.description.abstractIt is controversial whether all critically ill patients with risk, injury, failure, loss, and end-stage renal failure (RIFLE) F class acute kidney injury (AKI) should receive renal replacement therapy (RRT). We reviewed the outcome of open heart surgery patients with severe RIFLE-F AKI who did not receive RRT.We identified all patients with AKI after cardiac surgery over 4 years and obtained baseline characteristics, intraoperative details, and in-hospital outcomes. We analyzed physiologic and biochemical features at RRT initiation or at peak creatinine if no RRT was provided.We reviewed 1504 patients. Of these, 137 (9.1%) developed postoperative AKI with 71 meeting RIFLE-F criteria and 23 (32.4% of RIFLE-F cases) not receiving RRT. Compared with RRT-treated RIFLE-F patients, "no-RRT" patients had lower Acute Physiology and Chronic Health Evaluation III scores, less intra-aortic balloon pump requirements, shorter intensive care stay, and a trend toward lower mortality. At peak RIFLE score, their urinary output, arterial pH, and Pao(2)/fraction of inspired oxygen ratio were all significantly higher. Their serum creatinine was also higher (304 vs 262 μmol/L; P = .02). Only 3 RIFLE-F no-RRT patients died in-hospital. Detailed review of cause and mode of death was consistent with non-RRT-preventable deaths. In contrast, 27 patients with RIFLE-R or RIFLE-I class received RRT. Compared with RRT-treated RIFLE-F patients, such RIFLE-R or RIFLE-I treated patients had a more severe presentation and higher mortality (51.8% vs 29.2%; P = .02).After cardiac surgery, RRT was typically applied to patients with the most severe clinical presentation irrespective of creatinine levels. A RIFLE score-based trigger for RRT is unlikely to improve patient survival.en
dc.language.isoenen
dc.subject.otherAcute Kidney Injury.diagnosis.mortality.therapyen
dc.subject.otherAgeden
dc.subject.otherAged, 80 and overen
dc.subject.otherBlood Chemical Analysisen
dc.subject.otherCardiac Surgical Proceduresen
dc.subject.otherCreatinine.blooden
dc.subject.otherCritical Illnessen
dc.subject.otherEnd Stage Liver Disease.diagnosis.mortality.therapyen
dc.subject.otherFemaleen
dc.subject.otherHumansen
dc.subject.otherMaleen
dc.subject.otherMiddle Ageden
dc.subject.otherPatient Acuityen
dc.subject.otherRenal Replacement Therapy.methodsen
dc.titleA risk, injury, failure, loss, and end-stage renal failure score-based trigger for renal replacement therapy and survival after cardiac surgery.en
dc.typeJournal Articleen
dc.identifier.journaltitleJournal of Critical Careen
dc.identifier.affiliationIntensive Care Unit, Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.doi10.1016/j.jcrc.2012.02.008en
dc.description.pages488-95en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/22480577en
dc.type.austinJournal Articleen
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.grantfulltextnone-
item.openairetypeJournal Article-
item.languageiso639-1en-
item.fulltextNo Fulltext-
crisitem.author.deptIntensive Care-
crisitem.author.deptEndocrinology-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
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