Association of exposure below various thresholds of hemodynamic parameters during cardiopulmonary bypass with acute kidney injury.

IF 1.3 4区医学 Q4 ENGINEERING, BIOMEDICAL

International Journal of Artificial Organs Pub Date : 2025-08-25 DOI:10.1177/03913988251365814

Takumi Sasaki, Toshiyuki Nakanishi, Tatsuya Tsuji, Eisuke Kako, Tetsuya Tamura, Koichi Fujiwara, Miho Murashima, Takayuki Hamano, Kazuya Sobue

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引用次数: 0

Abstract

Introduction: This study aimed to investigate the association of exposure below various thresholds of mean arterial pressure (MAP), pump flow rates, and hemoglobin levels during cardiopulmonary bypass (CPB) with cardiac surgery-associated acute kidney injury (CSA-AKI).

Methods: Adult patients undergoing cardiac surgery with CPB at a university hospital between April 2015 and August 2023 were included. The primary outcome was CSA-AKI within 7 days postoperatively. The primary exposures were the area under the threshold (AUT) of MAP, pump flow rate, and Hb during CPB. A multivariable logistic regression using covariates selected via Lasso regularization estimated the adjusted odds ratios (aORs) and 95% confidence intervals (CIs).

Results: We finally analyzed 333 patients, of which 156 patients (46.8%) developed CSA-AKI. The AUT of hemoglobin, but not those of MAP and pump flow rate, was associated with CSA-AKI. The lower the threshold, the stronger the association (<8 g/dL, aOR = 1.132 per 10 g/dL × min, 95% CI = 1.036-1.243, p = 0.007; <9 g/dL, aOR = 1.048, 95% CI = 1.013-1.086, p = 0.007; and <10 g/dL, aOR = 1.027, 95% CI = 1.007-1.048, p = 0.010).

Conclusion: Hemoglobin levels during CPB below 8.0 g/dL were associated with CSA-AKI, while MAP and pump flow rates indicated no such association.

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体外循环期间血液动力学参数低于不同阈值暴露与急性肾损伤的关系。

本研究旨在探讨体外循环（CPB）期间暴露于低于不同阈值的平均动脉压（MAP）、泵流量和血红蛋白水平与心脏手术相关急性肾损伤（CSA-AKI）的关系。方法：纳入2015年4月至2023年8月在某大学医院行CPB心脏手术的成年患者。术后7天内CSA-AKI为主要预后指标。在CPB过程中，主要暴露于MAP阈下面积（AUT）、泵流量和Hb。使用Lasso正则化选择的协变量进行多变量逻辑回归，估计调整优势比（aORs）和95%置信区间（ci）。结果：我们最终分析了333例患者，其中156例（46.8%）发展为CSA-AKI。血红蛋白AUT与CSA-AKI相关，而MAP和泵流量与CSA-AKI无关。阈值越低，相关性越强（p = 0.007; p = 0.007; p = 0.010）。结论：CPB期间血红蛋白水平低于8.0 g/dL与CSA-AKI相关，而MAP和泵流量无相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Artificial Organs 医学-工程：生物医学

CiteScore

3.40

自引率

5.90%

发文量

审稿时长

3 months

期刊介绍： The International Journal of Artificial Organs (IJAO) publishes peer-reviewed research and clinical, experimental and theoretical, contributions to the field of artificial, bioartificial and tissue-engineered organs. The mission of the IJAO is to foster the development and optimization of artificial, bioartificial and tissue-engineered organs, for implantation or use in procedures, to treat functional deficits of all human tissues and organs.