Objectives:

Extracorporeal cardiopulmonary resuscitation (eCPR) is increasingly used due to its beneficial outcomes and results compared with conventional CPR. Data after eCPR for acute kidney injury (AKI) are lacking. We sought to investigate factors predicting AKI in patients who underwent eCPR.

Methods:

From January 2016 until December 2020, patients who underwent eCPR at our institution were retrospectively analyzed and divided into two groups: patients who developed AKI (n = 60) and patients who did not develop AKI (n = 35) and analyzed for outcome parameters.

Results:

Overall, 63% of patients suffered AKI after eCPR and 45% of patients who developed AKI needed subsequent dialysis. Patients who developed AKI showed higher values of creatinine (1.1 mg/dL vs 1.5 mg/dL, p ⩽ 0.01), urea (34 mg/dL vs 42 mg/dL, p = 0.04), CK (creatine kinase) (923 U/L vs 1707 U/L, p = 0.07) on admission, and CK after 24 hours of ECMO support (1705 U/L vs 4430 U/L, p = 0.01). ECMO explantation was significantly more often performed in patients who suffered AKI (24% vs 48%, p = 0.01). In-hospital mortality (86% vs 70%; p = 0.07) did not differ significantly.

Conclusion:

Patients after eCPR are at high risk for AKI, comparable to those after conventional CPR. Baseline urea levels predict the development of AKI during the hospital stay.

中文翻译：

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体外心肺复苏后患者急性肾损伤的预测因素

目标：

与传统心肺复苏术相比，体外心肺复苏术 (eCPR) 因其有益的结果和结果而越来越多地被使用。缺乏针对急性肾损伤 (AKI) 的 eCPR 后的数据。我们试图调查预测接受 eCPR 的患者发生 AKI 的因素。

方法：

从 2016 年 1 月到 2020 年 12 月，对在我们机构接受 eCPR 的患者进行回顾性分析，并将其分为两组：发生 AKI 的患者（n  = 60）和未发生 AKI 的患者（n  = 35），并分析结果参数。

结果：

总体而言，63% 的患者在 eCPR 后出现 AKI，而 45% 发生 AKI 的患者需要后续透析。发生 AKI 的患者表现出更高的肌酐值（1.1 mg/dL 对比 1.5 mg/dL，p < 0.01）、尿素（34 mg/dL 对比 42 mg/dL，p = 0.04）、CK（肌酸激酶）（923 U /L 对比 1707 U/L，p = 0.07）入院时，以及 ECMO 支持 24 小时后的 CK（1705 U/L 对比 4430 U/L，p = 0.01）。ECMO 移植术在患有 AKI 的患者中进行的频率更高（24% 对 48%，p = 0.01）。住院死亡率（86% 对 70%；p = 0.07）没有显着差异。

结论：

eCPR 后的患者发生 AKI 的风险与常规 CPR 后的患者相当。基线尿素水平预测住院期间 AKI 的发展。