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Title
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The duration of hypotension determines the evolution of bacteremia-induced acute kidney injury in the intensive care unit
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Author
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Abstract
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| Background: Exploration of the impact of severe hypotension on the evolution of acute kidney injury in septic patients. Methods and Results: We reviewed the hemodynamic parameters of 137 adults with septic shock and proven blood stream infection in the ICU. Severe hypotension was defined as a mean arterial blood pressure (MAP) <= 65 mmHg. The influence of the duration of severe hypotension on the evolution of acute kidney injury was evaluated according to the RIFLE classification, with day 0 defined as the day of a positive blood stream infection. After bloodstream infection, the probability for a patient to be in Failure was significantly higher than before blood stream infection (OR=1.94, p=0.0276). Patients have a significantly higher risk of evolving to Failure if the duration of severe hypotension is longer (OR=1.02 for each 10 minutes increase in duration of a MAP <65 mmHg, p=0.0472). A cut-off of at least 51 minutes of severe hypotension (<65 mmHg) or at least 5.5 periods of severe hypotension within 1 day identified patients with increased risk to evolve to Failure. Conclusions: There is a significant influence of both the duration and the number of periods of severe hypotension on the evolution to Failure. Blood stream infection has a significantly negative effect on the relationship between severe hypotension and Failure. |
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Language
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English
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Source (journal)
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PLoS ONE
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Publication
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2014
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ISSN
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1932-6203
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DOI
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10.1371/JOURNAL.PONE.0114312
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Volume/pages
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9
:12
(2014)
, 16 p.
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Article Reference
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e114312
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ISI
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000346375400026
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Medium
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E-only publicatie
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Full text (Publisher's DOI)
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Full text (open access)
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