Effect of early achievement of physiologic resuscitation goals in septic patients admitted from the ward on the kidneys

Journal of Critical Care
H D KiersDavid D Sweet

Abstract

The aim of the study was to evaluate if early achievement of physiologic goals of resuscitation in critically ill septic patients admitted from the ward may prevent acute kidney injury (AKI). Patients admitted to the intensive care unit (ICU) with a diagnosis of sepsis were retrospectively identified. Mean arterial pressure greater than 65 mm Hg, central venous pressure greater than 8 mm Hg, and central venous oxygenation greater than 70% achieved within 6 hours after ICU consultation at the ward was considered early achievement. Acute kidney injury was defined by the RIFLE criteria. Of 85 patients, 29% achieved all goals within 6 hours, 42% had late or no achievement of goals, and 28% had incomplete documentation of goals. Of these, 52% developed AKI. Patients who eventually developed AKI had a significantly higher creatinine level at ICU consultation before resuscitation. Delay in achievement of goals results in a 3.4% creatinine level rise per hour in multivariate analysis (P = .03). The development of AKI was significantly influenced by delayed achievement of physiologic goals on the ICU (P = .02). Although most of AKI occurred before ICU consultation, early physiologic resuscitation and achievement of hemodynamic goals on ...Continue Reading

References

Jan 17, 2002·The New England Journal of Medicine·E RiversUNKNOWN Early Goal-Directed Therapy Collaborative Group
Mar 28, 2003·Journal of the American Society of Nephrology : JASN·Eric A J HosteFrancis A Colardyn
Apr 28, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Itir YegenagaNorbert Lameire
Jan 21, 2006·Critical Care Medicine·Jean-Louis VincentUNKNOWN Sepsis Occurrence in Acutely Ill Patients Investigators
Feb 18, 2006·Critical Care Medicine·Nathan I ShapiroAlan Lisbon
Feb 18, 2006·Critical Care Medicine·Andreas KortgenMichael Bauer
Jun 20, 2006·Annals of Emergency Medicine·H Bryant NguyenUNKNOWN Emergency Department Sepsis Education Program and Strategies to Improve Survival (ED-SEPSIS) Working Group
Nov 2, 2006·Current Opinion in Critical Care·Sean M Bagshaw, Rinaldo Bellomo
May 1, 2007·Critical Care : the Official Journal of the Critical Care Forum·José António LopesMateus Martins Prata
Apr 12, 2008·Critical Care : the Official Journal of the Critical Care Forum·Sean M BagshawUNKNOWN ANZICS Database Management Committee
May 22, 2008·JAMA : the Journal of the American Medical Association·Ricard FerrerUNKNOWN Edusepsis Study Group
Sep 4, 2008·Critical Care Medicine·Alan E JonesUNKNOWN Emergency Medicine Shock Research Network investigators
Sep 4, 2008·Critical Care Medicine·Frank M BrunkhorstUNKNOWN German Sepsis Competence Network (SepNet)
Dec 19, 2008·Critical Care : the Official Journal of the Critical Care Forum·Marlies Ostermann

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Citations

Jun 8, 2011·Critical Care : the Official Journal of the Critical Care Forum·Julie BadinDominique Perrotin
Dec 2, 2014·Critical Care Clinics·Alexandre JoostenMaxime Cannesson
Jun 15, 2014·Journal of Critical Care·Manish M SoodUNKNOWN Cooperative Antimicrobial Therapy in Septic Shock (CATSS) Database Research Group
Sep 12, 2015·Critical Care : the Official Journal of the Critical Care Forum·Xin ZhangLi-Xin Xie
Sep 7, 2013·Clinical Journal of the American Society of Nephrology : CJASN·Karina SotoPrasad Devarajan
Jul 8, 2019·Journal of Tropical Pediatrics·Ahmed El-NawawyMay M Atta
Oct 22, 2013·Current Opinion in Critical Care·Kianoush Kashani, Vitaly Herasevich
Mar 13, 2020·PloS One·Nicolas MascretIsabelle Ragot-Court
May 12, 2016·Clinical Chemistry and Laboratory Medicine : CCLM·Charlotte Salmon-GandonnièreChantal Barin-Le Guellec
Aug 19, 2020·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Michael BernhardAndré Gries
Jun 20, 2021·Clinical Chemistry and Laboratory Medicine : CCLM·Huu-Hien HuynhVincent Delatour

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