Title
The duration of hypotension determines the evolution of bacteremia-induced acute kidney injury in the intensive care unit The duration of hypotension determines the evolution of bacteremia-induced acute kidney injury in the intensive care unit
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Subject
Engineering sciences. Technology
Source (journal)
PLoS ONE
Volume/pages
9(2014) :12 , 16 p.
ISSN
1932-6203
1932-6203
Article Reference
e114312
Carrier
E-only publicatie
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
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.
Full text (open access)
https://repository.uantwerpen.be/docman/irua/1cd382/9407.pdf
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