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. 2021 Sep-Oct;73(5):594-598.
doi: 10.1016/j.ihj.2021.08.003. Epub 2021 Aug 8.

Managing patients of shock and acute kidney injury in tertiary care cardiac ICU: Experience with continuous renal replacement therapy

Vivek Gupta  1 , Samir Kapoor  2 , Vikas Makkar  3 , Shibba Takkar Chhabra  4 , Naved Aslam  4 , Bishav Mohan  4 , Rajiv Kumar  2 , Vijita Pandey  5 , Himani Prashar  5 , Gurkirat Kaur  5 , Suvir Grover  5 , Suman Sethi  3 , Simran Kaur  3 , Sarju Ralhan  2 , G S Wander  4
Affiliations

Managing patients of shock and acute kidney injury in tertiary care cardiac ICU: Experience with continuous renal replacement therapy

Vivek Gupta et al. Indian Heart J. 2021 Sep-Oct.

Abstract

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.

Keywords: CRRT-Cycle; Cardiac intensive care unit; Continuous renal replacement therapy; Mean arterial pressure; Vasoactive-inotropic score.

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Conflict of interest statement

Declaration of competing interest There was no potential conflict of interest.

Figures

Fig. 1
Fig. 1
Overall survival rate after CRRT.
Fig. 2
Fig. 2
CRRT cycles and its relation with patient's outcome.
See this image and copyright information in PMC

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