Cardiac output during targeted temperature management and renal function after out-of-hospital cardiac arrest

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Cardiac output during targeted temperature management and renal function after out-of-hospital cardiac arrest. / Grand, Johannes; Bro-Jeppesen, John; Hassager, Christian; Rundgren, Malin; Winther-Jensen, Matilde; Thomsen, Jakob Hartvig; Nielsen, Niklas; Wanscher, Michael; Kjærgaard, Jesper.

I: Journal of Critical Care, Vol. 54, 12.2019, s. 65-73.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Harvard

Grand, J, Bro-Jeppesen, J, Hassager, C, Rundgren, M, Winther-Jensen, M, Thomsen, JH, Nielsen, N, Wanscher, M & Kjærgaard, J 2019, 'Cardiac output during targeted temperature management and renal function after out-of-hospital cardiac arrest', Journal of Critical Care, vol. 54, s. 65-73. https://doi.org/10.1016/j.jcrc.2019.07.013

APA

Grand, J., Bro-Jeppesen, J., Hassager, C., Rundgren, M., Winther-Jensen, M., Thomsen, J. H., ... Kjærgaard, J. (2019). Cardiac output during targeted temperature management and renal function after out-of-hospital cardiac arrest. Journal of Critical Care, 54, 65-73. https://doi.org/10.1016/j.jcrc.2019.07.013

CBE

Grand J, Bro-Jeppesen J, Hassager C, Rundgren M, Winther-Jensen M, Thomsen JH, Nielsen N, Wanscher M, Kjærgaard J. 2019. Cardiac output during targeted temperature management and renal function after out-of-hospital cardiac arrest. Journal of Critical Care. 54:65-73. https://doi.org/10.1016/j.jcrc.2019.07.013

MLA

Vancouver

Author

Grand, Johannes ; Bro-Jeppesen, John ; Hassager, Christian ; Rundgren, Malin ; Winther-Jensen, Matilde ; Thomsen, Jakob Hartvig ; Nielsen, Niklas ; Wanscher, Michael ; Kjærgaard, Jesper. / Cardiac output during targeted temperature management and renal function after out-of-hospital cardiac arrest. I: Journal of Critical Care. 2019 ; Vol. 54. s. 65-73.

RIS

TY - JOUR

T1 - Cardiac output during targeted temperature management and renal function after out-of-hospital cardiac arrest

AU - Grand, Johannes

AU - Bro-Jeppesen, John

AU - Hassager, Christian

AU - Rundgren, Malin

AU - Winther-Jensen, Matilde

AU - Thomsen, Jakob Hartvig

AU - Nielsen, Niklas

AU - Wanscher, Michael

AU - Kjærgaard, Jesper

PY - 2019/12

Y1 - 2019/12

N2 - Purpose: After resuscitation from out-of-hospital cardiac arrest (OHCA), renal injury and hemodynamic instability are common. We aimed to assess the association between low cardiac output during targeted temperature management (TTM) and acute kidney injury (AKI) after OHCA. Materials and methods: Single-center substudy of 171 patients included in the prospective, randomized TTM-trial. Hemodynamic evaluation was performed with serial measurements by pulmonary artery catheter. AKI was the primary endpoint and was defined according to the KDIGO-criteria. Results: Of 152 patients with available hemodynamic data, 49 (32%) had AKI and 21 (14%) had AKI with need for renal replacement therapy (RRT) in the first three days. During targeted temperature management, patients with AKI had higher heart rate (11 beats/min, pgroup < 0.0001), higher mean arterial pressure (MAP) (4 mmHg, pgroup = 0.001) and higher lactate (1 mmol/L, pgroup < 0.0001) compared to patients without AKI. However, there was no difference in cardiac index (pgroup = 0.25). In a multivariate logistic regression model, adjusting for potential confounders, MAP (p = .03), heart rate (p = .01) and lactate (p = .006), but not cardiac output, were independently associated with AKI. Conclusions: Blood pressure, heart rate and lactate, but not cardiac output, during 24 h of TTM were associated with AKI in comatose OHCA-patients.

AB - Purpose: After resuscitation from out-of-hospital cardiac arrest (OHCA), renal injury and hemodynamic instability are common. We aimed to assess the association between low cardiac output during targeted temperature management (TTM) and acute kidney injury (AKI) after OHCA. Materials and methods: Single-center substudy of 171 patients included in the prospective, randomized TTM-trial. Hemodynamic evaluation was performed with serial measurements by pulmonary artery catheter. AKI was the primary endpoint and was defined according to the KDIGO-criteria. Results: Of 152 patients with available hemodynamic data, 49 (32%) had AKI and 21 (14%) had AKI with need for renal replacement therapy (RRT) in the first three days. During targeted temperature management, patients with AKI had higher heart rate (11 beats/min, pgroup < 0.0001), higher mean arterial pressure (MAP) (4 mmHg, pgroup = 0.001) and higher lactate (1 mmol/L, pgroup < 0.0001) compared to patients without AKI. However, there was no difference in cardiac index (pgroup = 0.25). In a multivariate logistic regression model, adjusting for potential confounders, MAP (p = .03), heart rate (p = .01) and lactate (p = .006), but not cardiac output, were independently associated with AKI. Conclusions: Blood pressure, heart rate and lactate, but not cardiac output, during 24 h of TTM were associated with AKI in comatose OHCA-patients.

KW - Acute kidney injury

KW - Cardiac arrest

KW - Cardiac output

KW - Dialysis

KW - Hemodynamic

KW - Post cardiac arrest syndrome

UR - http://www.scopus.com/inward/record.url?scp=85069645527&partnerID=8YFLogxK

U2 - 10.1016/j.jcrc.2019.07.013

DO - 10.1016/j.jcrc.2019.07.013

M3 - Article

VL - 54

SP - 65

EP - 73

JO - Journal of Critical Care

T2 - Journal of Critical Care

JF - Journal of Critical Care

SN - 1557-8615

ER -