Managing patients of shock and acute kidney injury in tertiary care cardiac ICU: Experience with continuous renal replacement therapy
Background: Clinical experience on details of CRRT initiation and outcomes in cardiac intensive care unit (CICU) patients is not available from developing countries like India. This study shares the 5-year clinical experience of managing CICU patients requiring CRRT in a tertiary care cardiac center...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-09-01
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| Series: | Indian Heart Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483221001759 |
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| author | Vivek Gupta Samir Kapoor Vikas Makkar Shibba Takkar Chhabra Naved Aslam Bishav Mohan Rajiv Kumar Vijita Pandey Himani Prashar Gurkirat Kaur Suvir Grover Suman Sethi Simran Kaur Sarju Ralhan G.S. Wander |
| author_facet | Vivek Gupta Samir Kapoor Vikas Makkar Shibba Takkar Chhabra Naved Aslam Bishav Mohan Rajiv Kumar Vijita Pandey Himani Prashar Gurkirat Kaur Suvir Grover Suman Sethi Simran Kaur Sarju Ralhan G.S. Wander |
| author_sort | Vivek Gupta |
| collection | DOAJ |
| description | Background: Clinical experience on details of CRRT initiation and outcomes in cardiac intensive care unit (CICU) patients is not available from developing countries like India. This study shares the 5-year clinical experience of managing CICU patients requiring CRRT in a tertiary care cardiac center of North India. Materials and methods: Medical records of all CICU patients with acute kidney injury (AKI) managed by CRRT from October 2011 to September 2016 at tertiary referral center in North India were retrospectively reviewed. Multiple logistic regression analysis was used to identify predictors of post-CRRT mortality. Results: A total of 630 patients received CRRT during the study period. Most commonly AKI developed in patients with acute coronary syndrome (30.2 %) with cardiogenic shock. 55.9 % of the CRRT patients were >60 years of age, and/or on multiple supports in ICU including, mechanical ventilation, high doses of inotropes & vasopressors and other cardiovascular support. Of those on CRRT, 130 (20.6 %) patients had died, 215 (34.1 %) were discharged and 285 (45.2 %) could not complete the desired course. Multivariate regression analysis showed independent association of mortality with high vasoactive-inotropic score, single CRRT cycle and low mean arterial pressure in CRRT patients. Conclusion: About 34.1 % of patients receiving CRRT were alive at discharge, emphasizing the feasibility and utility of CRRT as a promising modality in this population for improving outcomes. |
| first_indexed | 2024-12-17T23:34:01Z |
| format | Article |
| id | doaj.art-e4ec8d31224245bd89c3b0712897ec17 |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-12-17T23:34:01Z |
| publishDate | 2021-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-e4ec8d31224245bd89c3b0712897ec172022-12-21T21:28:35ZengElsevierIndian Heart Journal0019-48322021-09-01735594598Managing patients of shock and acute kidney injury in tertiary care cardiac ICU: Experience with continuous renal replacement therapyVivek Gupta0Samir Kapoor1Vikas Makkar2Shibba Takkar Chhabra3Naved Aslam4Bishav Mohan5Rajiv Kumar6Vijita Pandey7Himani Prashar8Gurkirat Kaur9Suvir Grover10Suman Sethi11Simran Kaur12Sarju Ralhan13G.S. Wander14Department of Cardiac Anaesthesia & Intensive Care, Hero DMC Heart Institute, Ludhiana, Punjab, 141001, India; Corresponding author. Consultant Cardiac Anaesthesia & Intensive Care Hero DMC Heart Institute Tagore Nagar, Ludhiana, Punjab, 141001, India.Department of Cardiovascular & Thoracic Surgery, Hero DMC Heart Institute, Ludhiana, Punjab, 141001, IndiaDepartment of Nephrology, Dayanand Medical College & Hospital, Ludhiana, Punjab, 141001, IndiaDepartment of Cardiology, Hero DMC Heart Institute Ludhiana, Punjab, 141001, IndiaDepartment of Cardiology, Hero DMC Heart Institute Ludhiana, Punjab, 141001, IndiaDepartment of Cardiology, Hero DMC Heart Institute Ludhiana, Punjab, 141001, IndiaDepartment of Cardiovascular & Thoracic Surgery, Hero DMC Heart Institute, Ludhiana, Punjab, 141001, IndiaDepartment of Cardiac Anaesthesia & Intensive Care, Hero DMC Heart Institute, Ludhiana, Punjab, 141001, IndiaDepartment of Cardiac Anaesthesia & Intensive Care, Hero DMC Heart Institute, Ludhiana, Punjab, 141001, IndiaDepartment of Cardiac Anaesthesia & Intensive Care, Hero DMC Heart Institute, Ludhiana, Punjab, 141001, IndiaDepartment of Cardiac Anaesthesia & Intensive Care, Hero DMC Heart Institute, Ludhiana, Punjab, 141001, IndiaDepartment of Nephrology, Dayanand Medical College & Hospital, Ludhiana, Punjab, 141001, IndiaDepartment of Nephrology, Dayanand Medical College & Hospital, Ludhiana, Punjab, 141001, IndiaDepartment of Cardiovascular & Thoracic Surgery, Hero DMC Heart Institute, Ludhiana, Punjab, 141001, IndiaDepartment of Cardiology, Hero DMC Heart Institute Ludhiana, Punjab, 141001, IndiaBackground: Clinical experience on details of CRRT initiation and outcomes in cardiac intensive care unit (CICU) patients is not available from developing countries like India. This study shares the 5-year clinical experience of managing CICU patients requiring CRRT in a tertiary care cardiac center of North India. Materials and methods: Medical records of all CICU patients with acute kidney injury (AKI) managed by CRRT from October 2011 to September 2016 at tertiary referral center in North India were retrospectively reviewed. Multiple logistic regression analysis was used to identify predictors of post-CRRT mortality. Results: A total of 630 patients received CRRT during the study period. Most commonly AKI developed in patients with acute coronary syndrome (30.2 %) with cardiogenic shock. 55.9 % of the CRRT patients were >60 years of age, and/or on multiple supports in ICU including, mechanical ventilation, high doses of inotropes & vasopressors and other cardiovascular support. Of those on CRRT, 130 (20.6 %) patients had died, 215 (34.1 %) were discharged and 285 (45.2 %) could not complete the desired course. Multivariate regression analysis showed independent association of mortality with high vasoactive-inotropic score, single CRRT cycle and low mean arterial pressure in CRRT patients. Conclusion: About 34.1 % of patients receiving CRRT were alive at discharge, emphasizing the feasibility and utility of CRRT as a promising modality in this population for improving outcomes.http://www.sciencedirect.com/science/article/pii/S0019483221001759Continuous renal replacement therapyCardiac intensive care unitVasoactive-inotropic scoreCRRT-CycleMean arterial pressure |
| spellingShingle | Vivek Gupta Samir Kapoor Vikas Makkar Shibba Takkar Chhabra Naved Aslam Bishav Mohan Rajiv Kumar Vijita Pandey Himani Prashar Gurkirat Kaur Suvir Grover Suman Sethi Simran Kaur Sarju Ralhan G.S. Wander Managing patients of shock and acute kidney injury in tertiary care cardiac ICU: Experience with continuous renal replacement therapy Indian Heart Journal Continuous renal replacement therapy Cardiac intensive care unit Vasoactive-inotropic score CRRT-Cycle Mean arterial pressure |
| title | Managing patients of shock and acute kidney injury in tertiary care cardiac ICU: Experience with continuous renal replacement therapy |
| title_full | Managing patients of shock and acute kidney injury in tertiary care cardiac ICU: Experience with continuous renal replacement therapy |
| title_fullStr | Managing patients of shock and acute kidney injury in tertiary care cardiac ICU: Experience with continuous renal replacement therapy |
| title_full_unstemmed | Managing patients of shock and acute kidney injury in tertiary care cardiac ICU: Experience with continuous renal replacement therapy |
| title_short | Managing patients of shock and acute kidney injury in tertiary care cardiac ICU: Experience with continuous renal replacement therapy |
| title_sort | managing patients of shock and acute kidney injury in tertiary care cardiac icu experience with continuous renal replacement therapy |
| topic | Continuous renal replacement therapy Cardiac intensive care unit Vasoactive-inotropic score CRRT-Cycle Mean arterial pressure |
| url | http://www.sciencedirect.com/science/article/pii/S0019483221001759 |
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