Association between dexmedetomidine administration and outcomes in critically ill patients with sepsis-associated acute kidney injury - 05/11/22
Abstract |
Study objective |
To investigate the association between dexmedetomidine administration and outcomes in critically ill patients with sepsis-associated acute kidney injury (SA-AKI).
Design |
A single-center, retrospective, cohort study.
Setting |
Intensive care unit (ICU).
Patients |
A total of 2192 critically ill patients with SA-AKI were included in the analysis, which identified from the Medical Information Mart for Intensive Care (MIMIC-IV) database between 2008 and 2019.
Interventions |
Intravenous infusion of dexmedetomidine.
Measurements |
The primary outcome was recovery of renal function. In-hospital mortality, vasopressor requirements, length of ICU and hospital stay were considered secondary outcomes. The Cox proportional hazards, logistic regression, and linear regression models were used to assess the association between dexmedetomidine and outcomes. Propensity score matching (PSM) analysis was used to match patients receiving dexmedetomidine to those without treatment.
Main results |
After PSM, 719 matched patient pairs were derived from patients who received dexmedetomidine and those who did not. The administration of dexmedetomidine was associated with a higher rate of renal recovery [61.8% vs. 55.8%, hazard ratio (HR) 1.35; P = 0.01], reduced in-hospital mortality [28.3% vs. 41.3%, HR 0.56; P < 0.001], and prolonged intensive care unit (ICU) stay [15.8d vs 12.6d, HR 2.34; P < 0.001] and hospital stay [23.7d vs 19.7d, HR 4.47; P < 0.001]. No significant difference was found in vasopressor requirements in patients with SA-AKI. Nevertheless, results illustrated that dose receiving between 0.30 and 1.00 μg/kg/h and duration using under 48 h of dexmedetomidine was associated with improvements in renal function recovery in SA-AKI patients.
Conclusion |
Dexmedetomidine administration was associated with improvements in renal function recovery and in-hospital survival in critically ill patients with SA-AKI. The results need to be verified in further randomized controlled trials.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The current treatment strategies for SA-AKI patients are separated, which therapeutic effects are controversial. |
• | A large patient cohort from MIMIC database was used for investigating the effect of dexmedetomidine in SA-AKI patients. |
• | Dexmedetomidine was associated with improvements in renal function recovery and in-hospital survival in SA-AKI patients. |
• | No significant difference was found in vasopressor requirements in overall SA-AKI patients. |
• | Dose and duration of dexmedetomidine might improved renal function recovery and attenuated mortality within a certain range. |
Keywords : Dexmedetomidine, sepsis, Acute kidney injury
Abbreviations : SA-AKI, AKI, MIMIC, ICU, DEX, Neq, MAP, RRT, SOFA, RASS, HR, IQR, CI, KDIGO, SCr, LOS, PSM, SMD, NGAL
Plan
Vol 83
Article 110960- décembre 2022 Retour au numéro
Article précédent
- The effect of hyperoxia on ventilation during recovery from general anesthesia: A randomized pilot study for a parallel randomized controlled trial
- Anthony G. Doufas, Lu Tian, Scott Kutscher, Eysteinn Finnsson, Jón Skírnir Ágústsson, Benjamin I. Chung, Periklis Panousis
- Mild acute kidney injury after pediatric surgery is not-associated with long-term renal dysfunction: A retrospective cohort study
- Ozkan Onal, Surendrasingh Chhabada, Xuan Pu, Liu Liu, Tetsuya Shimada, Kurt Ruetzler, Alparslan Turan
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?