1. The effect of higher or lower mean arterial pressure on kidney function after cardiac arrest: a post hoc analysis of the COMACARE and NEUROPROTECT trials
- Author
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Johanna Laurikkala, Koen Ameloot, Matti Reinikainen, Pieter-Jan Palmers, Cathy De Deyne, Ferdinande Bert, Matthias Dupont, Stefan Janssens, Joseph Dens, Johanna Hästbacka, Pekka Jakkula, Pekka Loisa, Thomas Birkelund, Erika Wilkman, Suvi T. Vaara, and Markus B. Skrifvars
- Subjects
Acute kidney injury ,Kidney Disease Improving Global Outcomes ,Out-of-hospital cardiac arrest ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background We aimed to study the incidence of acute kidney injury (AKI) in out-of-hospital cardiac arrest (OHCA) patients treated according to low-normal or high-normal mean arterial pressure (MAP) targets. Methods A post hoc analysis of the COMACARE (NCT02698917) and Neuroprotect (NCT02541591) trials that randomized patients to lower or higher targets for the first 36 h of intensive care. Kidney function was defined using the Kidney Disease Improving Global Outcome (KDIGO) classification. We used Cox regression analysis to identify factors associated with AKI after OHCA. Results A total of 227 patients were included: 115 in the high-normal MAP group and 112 in the low-normal MAP group. Eighty-six (38%) patients developed AKI during the first five days; 40 in the high-normal MAP group and 46 in the low-normal MAP group (p = 0.51). The median creatinine and daily urine output were 85 μmol/l and 1730 mL/day in the high-normal MAP group and 87 μmol/l and 1560 mL/day in the low-normal MAP group. In a Cox regression model, independent AKI predictors were no bystander cardiopulmonary resuscitation (p
- Published
- 2023
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