Interleukin-10: A Potential Pre-Cannulation Marker for Development of Acute Kidney Injury in Patients Receiving Veno-Arterial Extracorporeal Membrane Oxygenation.

Autor: Grins E; Department of Anesthesiology and Intensive Care, Department of Clinical Sciences, Lund University, Lund, Sweden.; Department of Cardiothoracic and Vascular Surgery, Anesthesia, and Intensive Care, Skåne University Hospital, Lund, Sweden.; DeVos Cardiovascular Research Program, Spectrum Health and Van Andel Institute, Grand Rapids, Michigan, USA., Leacche M; DeVos Cardiovascular Research Program, Spectrum Health and Van Andel Institute, Grand Rapids, Michigan, USA.; Fredrik Meijer Heart and Vascular Institute, Spectrum Health Grand Rapids, Grand Rapids, Michigan, USA., Shrestha NM; DeVos Cardiovascular Research Program, Spectrum Health and Van Andel Institute, Grand Rapids, Michigan, USA.; Fredrik Meijer Heart and Vascular Institute, Spectrum Health Grand Rapids, Grand Rapids, Michigan, USA., Bjursten H; Department of Cardiothoracic and Vascular Surgery, Anesthesia, and Intensive Care, Skåne University Hospital, Lund, Sweden., Ederoth P; Department of Anesthesiology and Intensive Care, Department of Clinical Sciences, Lund University, Lund, Sweden.; Department of Cardiothoracic and Vascular Surgery, Anesthesia, and Intensive Care, Skåne University Hospital, Lund, Sweden., Jovinge S; DeVos Cardiovascular Research Program, Spectrum Health and Van Andel Institute, Grand Rapids, Michigan, USA.; Fredrik Meijer Heart and Vascular Institute, Spectrum Health Grand Rapids, Grand Rapids, Michigan, USA.; Cardiovascular Institute Stanford University, Palo Alto, California, USA.
Jazyk: angličtina
Zdroj: Blood purification [Blood Purif] 2023; Vol. 52 (7-8), pp. 631-641. Date of Electronic Publication: 2023 Aug 16.
DOI: 10.1159/000531328
Abstrakt: Introduction: Acute kidney injury (AKI) in patients treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is associated with high mortality. The objective of this study was to investigate whether cytokine levels before the initiation of ECMO treatment could predict AKI. We also aimed to investigate the impact of AKI on 30-day and 1-year mortality.
Methods: Serum cytokine levels were analyzed in 100 consecutive VA-ECMO-treated patients at pre-cannulation, at 48 h post-cannulation, and at 8 days. Clinical data to establish the incidence and outcome of AKI after the start of ECMO was retrieved from the local ECMO registry.
Setting: The study was conducted at tertiary care, university hospital. Participants included 100 patients treated with VA-ECMO.
Interventions: The blood samples for cytokine analysis were collected before VA-ECMO treatment, at 48 h after VA-ECMO treatment was started, and at 8 days.
Results: Pre-cannulation serum IL-10 levels were significantly higher in patients who developed AKI (212 [38.9, 620.7]) versus those who did not (49.0 [11.9, 102.2]; p = 0.007), and the development of AKI can be predicted by pre-cannulation IL-10 levels (p = 0.025, OR = 1.2 [1.02-1.32]). The development of AKI during ECMO treatment is associated with increased 30-day mortality (p = 0.049) compared to patients who did not develop AKI and had a pre-cannulation estimated glomerular filtration rate ≥ 45 mL/min. The 1-year survival rate for patients with AKI who survived the first 30 days of ECMO treatment is comparable to that of patients without AKI.
Conclusion: Increased pre-cannulation IL-10 levels are associated with the development of AKI during VA-ECMO support. AKI is associated with increased 30-day mortality compared to patients with no AKI and better renal function. However, patients with AKI who survive the first 30 days have a 1-year survival rate similar to those without AKI.
(© 2023 The Author(s). Published by S. Karger AG, Basel.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje