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Title: | Carboxyhemoglobin as Potential Biomarker for Cardiac Surgery Associated Acute Kidney Injury. | Austin Authors: | Maeda, Akinori;Chaba, Anis;Inokuchi, Ryota;Pandey, Dinesh;Spano, Sofia;Phongphithakchai, Atthaphong;Hikasa, Yukiko;Pattamin, Nuttapol;Eastwood, Glenn M ;Jahanabadi, Hossein ;Seevanayagam, Siven ;Motley, Andrew N ;Bellomo, Rinaldo | Affiliation: | Intensive Care Department of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan; Department of Clinical Engineering, The University of Tokyo, Tokyo, Japan. Data Analytics Research and Evaluation (DARE) Centre Clinical Analytics and Reporting Department of Cardiac Surgery, Austin Hospital, Melbourne, VIC, Australia. Department of Haematology and Blood Bank, Austin Hospital, Melbourne, Australia. Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia; Department of Clinical Engineering, The University of Tokyo, Tokyo, Japan; Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia. |
Issue Date: | 10-Jul-2024 | Date: | 2024 | Publication information: | Journal of Cardiothoracic and Vascular Anesthesia 2024-07-10 | Abstract: | Carboxyhemoglobin (CO-Hb) is a marker of hemolysis and inflammation, both risk factors for cardiac surgery-associated AKI (CSA-AKI). However, the association between CO-Hb and CSA-AKI remains unknown. A retrospective cohort study. Tertiary university-affiliated metropolitan hospital: single center. Adult on-pump cardiac surgery patients from July 2014 to June 2022 (N = 1,698). None. Patients were stratified into quartiles based on CO-Hb levels at intensive care unit (ICU) admission. A progressive increased risk of CSA-AKI was observed with higher CO-Hb levels at ICU admission. On multivariable logistic regression analysis, the highest quartile (CO-Hb ≥ 1.4%) showed an independent association with the occurrence of CSA-AKI (odds ratio 1.45 compared to the lowest quartile [CO-Hb < 1.0%], 95% CI 1.023-2.071; p = 0.038). Compared to patients with CO-Hb <1.4%, patients with CO-Hb ≥ 1.4% at ICU admission had significantly higher postoperative creatinine (135 vs 116 μmol/L, p < 0.001), higher rates of postoperative RRT (6.7% vs 2.3%, p < 0.001) and AKI (p < 0.001) on univariable analysis and shorter time to event for AKI or death (p < 0.001). CO-Hb ≥ 1.4% at ICU admission is an independent risk factor for CSA-AKI, which is easily obtainable and available on routine arterial blood gas measurements. Thus, CO-Hb may serve as a practical and biologically logical biomarker for risk stratification and population enrichment in trials of CSA-AKI prevention. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/35452 | DOI: | 10.1053/j.jvca.2024.07.016 | ORCID: | Journal: | Journal of Cardiothoracic and Vascular Anesthesia | PubMed URL: | 39084930 | ISSN: | 1532-8422 | Type: | Journal Article | Subjects: | acute kidney injury biomarker carboxyhemoglobin cardiac surgery cardiopulmonary bypass |
Appears in Collections: | Journal articles |
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