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Mean arterial press...
Mean arterial pressure during targeted temperature management and renal function after out-of-hospital cardiac arrest
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- Grand, Johannes (author)
- Copenhagen University Hospital
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- Hassager, Christian (author)
- Copenhagen University Hospital
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- Winther-Jensen, Matilde (author)
- Copenhagen University Hospital
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- Rundgren, Malin (author)
- Lund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital
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- Friberg, Hans (author)
- Lund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Center for cardiac arrest,Lund University Research Groups
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- Horn, Janneke (author)
- University of Amsterdam,Academic Medical Center of University of Amsterdam (AMC)
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- Wise, Matt P. (author)
- University Hospital of Wales
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- Nielsen, Niklas (author)
- Helsingborg Hospital
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- Kuiper, Michael (author)
- Medical Center Leeuwarden
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- Wiberg, Sebastian (author)
- Copenhagen University Hospital
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- Thomsen, Jakob Hartvig (author)
- Copenhagen University Hospital
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- Jaeger Wanscher, Michael C. (author)
- Copenhagen University Hospital,University of Copenhagen
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- Frydland, Martin (author)
- Copenhagen University Hospital
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- Kjaergaard, Jesper (author)
- Copenhagen University Hospital
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(creator_code:org_t)
- Elsevier BV, 2019
- 2019
- English 8 s.
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In: Journal of Critical Care. - : Elsevier BV. - 0883-9441. ; 50, s. 234-241
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http://dx.doi.org/10...
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https://doi.org/10.1...
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Abstract
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- Purpose: This study investigates the association between mean arterial pressure (MAP) and renal function after out-of-hospital cardiac arrest (OHCA). Materials and methods: Post-hoc analysis of 851 comatose OHCA-patients surviving >48 h included in the targeted temperature management (TTM)-trial. Results: Patients were stratified by mean MAP during TTM in the following groups; <70 mmHg (22%), 70–80 mmHg (43%), and > 80 mmHg (35%). Median (interquartile range) eGFR (ml/min/1.73 m2) 48 h after OHCA was inversely associated with MAP-group (70 (47–102), 84 (56–113), 94 (61–124), p <.001, for the <70-group, 70–80-group and > 80-group respectively). After adjusting for potential confounders, in a mixed model including eGFR after 1, 2 and 3 days this association remained significant (pgroup_adjusted = 0.0002). Higher mean MAP was independently associated with lower odds of renal replacement therapy (odds ratioadjusted = 0.77 [95% confidence interval, 0.65–0.91] per 5 mmHg increase; p =.002]). Conclusions: Low mean MAP during TTM was independently associated with decreased renal function and need of renal replacement therapy in a large cohort of comatose OHCA-patients. Increasing MAP above the recommended 65 mmHg could potentially be renal-protective. This hypothesis should be investigated in prospective trials.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- Acute Kidney Injury
- Blood pressure
- Cardiac arrest
- Dialysis
- Post-resuscitation syndrome
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Grand, Johannes
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Hassager, Christ ...
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Winther-Jensen, ...
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Rundgren, Malin
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Friberg, Hans
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Horn, Janneke
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Wise, Matt P.
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Nielsen, Niklas
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Kuiper, Michael
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Wiberg, Sebastia ...
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Thomsen, Jakob H ...
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Jaeger Wanscher, ...
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Frydland, Martin
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Kjaergaard, Jesp ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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Lund University