Austin Health

Title
Carboxyhemoglobin as Potential Biomarker for Cardiac Surgery Associated Acute Kidney Injury.
Publication Date
2024-10
Author(s)
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
Subject
acute kidney injury
biomarker
carboxyhemoglobin
cardiac surgery
cardiopulmonary bypass
Type of document
Journal Article
OrcId
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DOI
10.1053/j.jvca.2024.07.016
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.
Link
Citation
Journal of Cardiothoracic and Vascular Anesthesia 2024-10; 38(10)
Jornal Title
Journal of Cardiothoracic and Vascular Anesthesia
ISSN
1532-8422

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