Associations between tricuspid annular plane systolic excursion to reflect right ventricular function and acute kidney injury in critically ill patients: a SICS-I sub-study

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dc.contributor.author Wiersema, Renske
dc.contributor.author Koeze, Jacqueline
dc.contributor.author Hiemstra, Bart
dc.contributor.author Pettilä, Ville
dc.contributor.author Perner, Anders
dc.contributor.author Keus, Frederik
dc.contributor.author van der Horst, Iwan C C
dc.date.accessioned 2019-03-17T04:21:50Z
dc.date.available 2019-03-17T04:21:50Z
dc.date.issued 2019-03-13
dc.identifier.citation Annals of Intensive Care. 2019 Mar 13;9(1):38
dc.identifier.uri http://hdl.handle.net/10138/300148
dc.description.abstract Abstract Background Acute kidney injury (AKI) occurs in up to 50% of all critically ill patients and hemodynamic abnormalities are assumed to contribute, but their nature and share is still unclear. We explored the associations between hemodynamic variables, including cardiac index and right ventricular function, and the occurrence of AKI in critically ill patients. Methods In this prospective cohort study, we included all patients acutely admitted to an intensive care unit (ICU). Within 24 h after ICU admission clinical and hemodynamic variables were registered including ultrasonographic measurements of cardiac index and right ventricular function, assessed using tricuspid annular plane systolic excursion (TAPSE) and right ventricular systolic excursion (RV S’). Maximum AKI stage was assessed according to the KDIGO criteria during the first 72 h after admission. Multivariable logistic regression modeling was used including both known predictors and univariable significant predictors of AKI. Secondary outcomes were days alive outside ICU and 90-day mortality. Results A total of 622 patients were included, of which 338 patients (54%) had at least AKI stage 1 within 72 h after ICU admission. In the final multivariate model higher age (OR 1.01, 95% CI 1.00–1.03, for each year), higher weight (OR 1.03 CI 1.02–1.04, for each kg), higher APACHE IV score (OR 1.02, CI 1.01–1.03, per point), lower mean arterial pressure (OR 1.02, CI 1.01–1.03, for each mmHg decrease) and lower TAPSE (OR 1.05, CI 1.02–1.09 per millimeter decrease) were all independent predictors for AKI in the final multivariate logistic regression model. Sepsis, cardiac index, RV S’ and use of vasopressors were not significantly associated with AKI in our data. AKI patients had fewer days alive outside of ICU, and their mortality rate was significantly higher than those without AKI. Conclusions In our cohort of acutely admitted ICU patients, the incidence of AKI was 54%. Hemodynamic variables were significantly different between patients with and without AKI. A worse right ventricle function was associated with AKI in the final model, whereas cardiac index was not.
dc.publisher Springer International Publishing
dc.subject Prospective study
dc.subject Hemodynamics
dc.subject Acute kidney injury
dc.subject Ultrasonography
dc.subject Critical care
dc.title Associations between tricuspid annular plane systolic excursion to reflect right ventricular function and acute kidney injury in critically ill patients: a SICS-I sub-study
dc.date.updated 2019-03-17T04:21:50Z
dc.language.rfc3066 en
dc.rights.holder The Author(s)
dc.type.uri http://purl.org/eprint/entityType/ScholarlyWork
dc.type.uri http://purl.org/eprint/entityType/Expression
dc.type.uri http://purl.org/eprint/type/JournalArticle

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