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Title: Postoperative blood pressure deficit and acute kidney injury progression in vasopressor-dependent cardiovascular surgery patients.
Austin Authors: Saito, Shinjiro;Uchino, Shigehiko;Takinami, Masanori;Uezono, Shoichi;Bellomo, Rinaldo 
Affiliation: Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Nishi-Shinbashi, Minato-ku, Tokyo, Japan
Intensive Care Unit, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 24-Mar-2016 2016
Publication information: Critical Care 2016; 20: 74
Abstract: In vasopressor-dependent patients who had undergone cardiovascular surgery, we examined whether those with progression of acute kidney injury (AKI) had a greater difference (deficit) between premorbid and within-ICU hemodynamic pressure-related parameters compared to those without AKI progression. We assessed consecutive adults who underwent cardiovascular surgery and who stayed in our ICU for at least 48 hours and received vasopressor support for more than 4 hours. We obtained premorbid and vasopressor-associated, time-weighted average values for hemodynamic pressure-related parameters (systolic [SAP], diastolic [DAP], and mean arterial pressure [MAP]; central venous pressure [CVP], mean perfusion pressure [MPP], and diastolic perfusion pressure [DPP]) and calculated deficits in those values. We defined AKI progression as an increase of at least one Kidney Disease: Improving Global Outcomes stage. We screened 159 patients who satisfied the inclusion criteria and identified 76 eligible patients. Thirty-six patients (47%) had AKI progression. All achieved pressure-related values were similar between patients with or without AKI progression. However, deficits in DAP (P = 0.027), MPP (P = 0.023), and DPP (P = 0.002) were significantly greater in patients with AKI progression. Patients with AKI progression had greater DAP, MPP, and DPP deficits compared to patients without AKI progression. Such deficits might be modifiable risk factors for the prevention of AKI progression.
DOI: 10.1186/s13054-016-1253-1
ORCID: 0000-0002-1650-8939
Journal: Critical Care
PubMed URL: 27013056
Type: Journal Article
Subjects: Acute kidney injury
Blood pressure
Blood pressure target
Critical care
Perfusion pressure
Relative hypotension
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