Abstract: TH-PO058
Prevent Cardiac Surgery-Associated AKI by Perioperative Implementation of Care Bundles
Session Information
- AKI: Liver Disease, Nephrotoxicity, Novel Therapeutics
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Xu, Youjun, Ningbo No.2 Hospital, Ningbo, China
- Zhang, Shuzhen, Ningbo No.2 Hospital, Ningbo, China
- Zhou, Fangfang, Ningbo No.2 Hospital, Ningbo, China
- Zheng, Xingyue, Ningbo No.2 Hospital, Ningbo, China
- Luo, Qun, Ningbo No.2 Hospital, Ningbo, China
Background
Cardiac surgery-associated acute kidney injury (CSA-AKI) is a serious complication after cardiac surgery. Perioperative implementation of care bundles was recommended for high-risk patients. The study evaluated the impact of care bundles on the incidence and severity of CSA-AKI.
Methods
Patients underwent cardiac surgery with cardiopulmonary bypass in Ningbo No.2 Hospital from 1st October 2020 to 30th September 2021 were retrospectively collected as the control group, and patients from 1st October 2021 to 30th September 2022 were prospectively collected as the intervention group. In the intervention group, patients were treated by care bundles from nephrologists in addition to the standard care perioperatively. The clinical data, the incidence and severity of CSA-AKI were compared between two groups.
Results
A total of 135 patients were included in this study, including 80 cases in the control group and 55 cases in the intervention group. There were 24 patients (43.6%) in the intervention group developed CSA-AKI versus 41 patients (51.2%) in the control group. In the intervention group 7 patients (12.7%) had stage 2-3 AKI, and in the control group 15 patients (18.8%). Both the incidence and severity of AKI showed a decreasing trend in the intervention group.
Patients who used febuxostat and statins in the intervention group were significantly higher than the control group (20.0% vs. 1.3%, P=0.001; 40.0% vs. 21.3%, P=0.018). The intervention group had a higher proportion of completing urine examination and urinary albumin-to-creatinine ratio test than the control group (100.0% vs. 58.8%, P<0.001; 100.0% vs. 1.3%, P<0.001). Patients who used contrast agents within 48 hours prior to surgery was significantly less in the intervention group (3.6% vs. 15.0%, P=0.033). Compared with the control group, the intervention group had a higher proportion of use of albumin (83.6% vs. 53.8%, P<0.001), epinephrine (70.9% vs. 50.0%, P=0.015), norepinephrine (60.0% vs. 41.3%, P=0.032), and insulin (45.5% vs. 21.3%, P=0.003). Patients in the intervention group also had a higher mean arterial pressure than the control group (63.4±12.6mmHg vs. 40.5±16.6mmHg, P<0.001).
Conclusion
Perioperative implementation of care bundles may reduce the occurrence of CSA-AKI and prevent progression of CSA-AKI, larger sample size is needed for further verification.