Intraoperative fluid management is not predictive of AKI in major pancreatic surgery: a retrospective cohort study

Autor: Kerri Lydon, Saurin Shah, Kai L. Mongan, Paul D. Mongan, Michael Calvin Cantrell, Ziad Awad
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Anesthesia, Analgesia and Critical Care, Vol 4, Iss 1, Pp 1-8 (2024)
Druh dokumentu: article
ISSN: 2731-3786
DOI: 10.1186/s44158-024-00176-0
Popis: Abstract Background Pancreatic surgery is associated with a significant risk for acute kidney injury (AKI) and clinically relevant postoperative pancreatic fistula (CR-POPF). This investigation evaluated the impact of intraoperative volume administration, vasopressor therapy, and blood pressure management on the primary outcome of AKI and the secondary outcome of a CR-POPF after pancreatic surgery. Methods This retrospective single-center cohort investigated 200 consecutive pancreatic surgeries (January 2018–December 2021). Patients were categorized for the presence/absence of AKI (Kidney Disease Improving Global Outcomes) and CR-POPF. After univariate analysis, multivariable models were constructed to control for the univariate cofactor differences in the primary and secondary outcomes. Results AKI was identified in 20 patients (10%) with significant univariate differences in demographics (body mass index and gender), comorbidities, indices of chronic renal insufficiency, and an increased AKI Risk score. Surgical characteristics, intraoperative fluid, vasopressor, and blood pressure management were similar in patients with and without AKI. Patients with AKI had increased blood loss, lower urine output, and packed red blood cell administration. After multivariate analysis, male gender (OR = 7.9, 95% C.I. 1.8–35.1) and the AKI Risk score (OR = 6.3, 95% C.I. 2.4–16.4) were associated with the development of AKI (p
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