A Multinational Observational Study Exploring Adherence With the Kidney Disease: Improving Global Outcomes Recommendations for Prevention of Acute Kidney Injury After Cardiac Surgery.
In: Anesthesia and analgesia, Jg. 130 (2020-04-01), Heft 4, S. 910-916
Online
academicJournal
Zugriff:
Background: The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend a bundle of different measures for patients at increased risk of acute kidney injury (AKI). Prospective, single-center, randomized controlled trials (RCTs) have shown that management in accordance with the KDIGO recommendations was associated with a significant reduction in the incidence of postoperative AKI in high-risk patients. However, compliance with the KDIGO bundle in routine clinical practice is unknown.
Methods: This observational prevalence study was performed in conjunction with a prospective RCT investigating the role of the KDIGO bundle in high-risk patients undergoing cardiac surgery. A 2-day observational prevalence study was performed in all participating centers before the RCT to explore routine clinical practice. The participating hospitals provided the following data: demographics and surgical characteristics, AKI rates, and compliance rates with the individual components of the bundle.
Results: Ninety-five patients were enrolled in 12 participating hospitals. The incidence of AKI within 72 hours after cardiac surgery was 24.2%. In 5.3% of all patients, clinical management was fully compliant with all 6 components of the bundle. Nephrotoxic drugs were discontinued in 52.6% of patients, volume optimization was performed in 70.5%, 52.6% of the patients underwent functional hemodynamic monitoring, close monitoring of serum creatinine and urine output was undertaken in 24.2% of patients, hyperglycemia was avoided in 41.1% of patients, and no patient received radiocontrast agents. The patients received on average 3.4 (standard deviation [SD] ±1.1) of 6 supportive measures as recommended by the KDIGO guidelines. There was no significant difference in the number of applied measures between AKI and non-AKI patients (3.2 [SD ±1.1] vs 3.5 [SD ±1.1]; P = .347).
Conclusions: In patients after cardiac surgery, compliance with the KDIGO recommendations was low in routine clinical practice.
Titel: |
A Multinational Observational Study Exploring Adherence With the Kidney Disease: Improving Global Outcomes Recommendations for Prevention of Acute Kidney Injury After Cardiac Surgery.
|
---|---|
Autor/in / Beteiligte Person: | Küllmar, M ; Weiß, R ; Ostermann, M ; Campos, S ; Grau Novellas, N ; Thomson, G ; Haffner, M ; Arndt, C ; Wulf, H ; Irqsusi, M ; Monaco, F ; Di Prima, AL ; García-Alvarez, M ; Italiano, S ; Felipe Correoso, M ; Kunst, G ; Nair, S ; L'Acqua, C ; Hoste, E ; Vandenberghe, W ; Honore, PM ; Kellum, JA ; Forni, L ; Grieshaber, P ; Wempe, C ; Meersch, M ; Zarbock, A |
Link: | |
Zeitschrift: | Anesthesia and analgesia, Jg. 130 (2020-04-01), Heft 4, S. 910-916 |
Veröffentlichung: | 1998- : Baltimore, Md. : Lippincott Williams & Wilkins ; <i>Original Publication</i>: Cleveland, International Anesthesia Research Society., 2020 |
Medientyp: | academicJournal |
ISSN: | 1526-7598 (electronic) |
DOI: | 10.1213/ANE.0000000000004642 |
Schlagwort: |
|
Sonstiges: |
|