Archive des Bibliothèques universitaires de Nantes

Insuffisance rénale aiguë et indice d'hémolyse : étude rétrospective en post opératoire de chirurgie cardiaque sous circulation extra-corporelle

Par : Golinvaux, Emmanuel

Document archivé le : 29/10/2021

Background: Haemolysis during cardiac surgery under carbiopulmonary bypass (CPB) is known to be a risk factor of acute kidney injury (AKI). It's evaluation by the Haemolysis Index (HI, a dimentionless value), an innovative measure of haemolysis, could be a fast and easy way to detect patients at risk of cardiac surgery associated AKI (CSA-AKI). Methods: In this retrospective case control study, we compared HI increased and risk factors of AKI between two groups of patients: those who developed AKI at 48 hours after a cardiac surgery under CBP and those who did not. The primary endpoint was the rate of patient who increased their post-operative HI superior to 20 mg. dL-1. Secondary outcomes were to describe the study population and to determine risk fators of CSA-AKI. Results: We enrolled 1146 patients in the study, 144 (12,6 %) patients developed AKI 48 hours after the surgery and 935 (81,6 %) did not. 67 patients (5,8 %) were excluded from the analysis because they rised serum creatinine at H+6 and had recovered from renal failure at H+ 48. 43,7 % of AKI patients had an increased HI vs 19,7 % in the control group (p<0,001). In the multivariate analysis, adjusted OR of increased (> 20mg.dL-1) HI in AKI patients were 2,30 95% IC (1,49-3,55) (p<0,001). Conclusions: In our large sample of patients, increased (> 20mg.dL-1) HI seems associated with CSA-AKI at H+48. Even though this study is not mean to be a predictive model of AKI, patients with high post operative HI should alert the physician regarding the risk of acute kidney injury. 21 NANT 132M

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