Early persistent exposure to high CVP is associated with increased mortality and AKI in septic shock : A retrospective study
Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved..
PURPOSE: This study's objective was to investigate the association between exposure to different intensities of central venous pressure (CVP) over time in patients with septic shock with 28-day mortality and acute kidney injury (AKI).
MATERIALS AND METHODS: We obtained data from the AmsterdamUMCdb, which includes data on patients ≥18 years old with septic shock undergoing CVP monitoring. The primary outcome was mortality by day 28. Piecewise exponential additive mixed models were used to estimate the strength of the association over time.
RESULTS: 9668 patients were included in the study. They exhibited 8.2% overall mortality at 28 days and 41.1% AKI incidence. Daily time-weighted average CVP was strongly associated with increased mortality at 28 days, primarily within 24 h of ICU admission. The mortality rate of patients was lowest when the CVP was 6-12 cmH2O. When the time of high CVP (TWA-CVP >12 cmH2O) exposure within the first 24 h was >5 h, the risk of death increased by 2.69-fold. Additionally, patients exposed to high CVP had a significantly increased risk of developing AKI.
CONCLUSIONS: The optimal CVP range for patients with septic shock within 24 h of ICU admission is 6-12 cmH2O. Mortality increased when patients were exposed to high CVP for >5 h.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:74 |
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| Enthalten in: |
The American journal of emergency medicine - 74(2023) vom: 12. Dez., Seite 146-151 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Xiao, Wenyan [VerfasserIn] |
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| Links: |
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| Themen: |
Acute kidney injury |
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| Anmerkungen: |
Date Completed 24.11.2023 Date Revised 24.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ajem.2023.09.043 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363307818 |
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| 100 | 1 | |a Xiao, Wenyan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Early persistent exposure to high CVP is associated with increased mortality and AKI in septic shock |b A retrospective study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 24.11.2023 | ||
| 500 | |a Date Revised 24.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: This study's objective was to investigate the association between exposure to different intensities of central venous pressure (CVP) over time in patients with septic shock with 28-day mortality and acute kidney injury (AKI) | ||
| 520 | |a MATERIALS AND METHODS: We obtained data from the AmsterdamUMCdb, which includes data on patients ≥18 years old with septic shock undergoing CVP monitoring. The primary outcome was mortality by day 28. Piecewise exponential additive mixed models were used to estimate the strength of the association over time | ||
| 520 | |a RESULTS: 9668 patients were included in the study. They exhibited 8.2% overall mortality at 28 days and 41.1% AKI incidence. Daily time-weighted average CVP was strongly associated with increased mortality at 28 days, primarily within 24 h of ICU admission. The mortality rate of patients was lowest when the CVP was 6-12 cmH2O. When the time of high CVP (TWA-CVP >12 cmH2O) exposure within the first 24 h was >5 h, the risk of death increased by 2.69-fold. Additionally, patients exposed to high CVP had a significantly increased risk of developing AKI | ||
| 520 | |a CONCLUSIONS: The optimal CVP range for patients with septic shock within 24 h of ICU admission is 6-12 cmH2O. Mortality increased when patients were exposed to high CVP for >5 h | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute kidney injury | |
| 650 | 4 | |a Central venous pressure | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Septic shock | |
| 650 | 4 | |a Time-varying intensity | |
| 700 | 1 | |a Liu, Wanjun |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Jin |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Lisha |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Juanjuan |e verfasserin |4 aut | |
| 700 | 1 | |a Hua, Tianfeng |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Min |e verfasserin |4 aut | |
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