Intraoperative Normal Saline Administration and Acute Kidney Injury in Patients Undergoing Liver Transplantation: a Retrospective Cohort Study
试验速览
- 阶段
- 不适用
- 入组人数
- 1,440
- 试验地点
- 1
- 主要终点
- Acute kidney injury
研究概览
简要总结
The investigators attempted to investigate the association of the type of crystalloid administered during liver transplantation with postoperative clinical outcomes. The investigators hypothesized that the greater amount of normal saline or half-saline administered during liver transplantation might be associated with the increased risk of acute kidney injury compared to the balanced crystalloids.
详细描述
Liver transplantation requires a long operation time and is often associated with a significant amount of surgical bleeding. It is common for the anesthesiologist to infuse large amounts of fluid or blood products due to bleeding, hemodynamic instability, or ascites drainage. Therefore, in the anesthesia for liver transplantation, optimal management of fluid administration is necessary and the choice of the type of crystalloid may affect the prognosis or the incidence of postoperative complications of patients.
The investigators attempted to investigate the association of the type of crystalloid administered during liver transplantation with postoperative clinical outcomes. The investigators hypothesized that the greater amount of normal saline or half-saline administered during liver transplantation might be associated with the increased risk of acute kidney injury compared to the balanced crystalloids.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 20 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Consecutive patients who underwent living or deceased donor liver transplantation at our tertiary care university hospital between 2004 and 2018
排除标准
- •patients with baseline renal dysfunction of hepatorenal syndrome or chronic kidney disease
- •missing preoperative serum creatinine value
- •missing other baseline or outcome variables
- •patients who received retransplantation
研究组 & 干预措施
Balanced group
Patients who received balanced crystalloids of lactated Ringer's solution or plasma solution during liver transplantation surgery
干预措施: Balanced crystalloid solution (Drug)
Saline group
Patients who received only normal saline during liver transplantation surgery
干预措施: Normal saline (Drug)
结局指标
主要结局
Acute kidney injury
时间窗: the first 7 postoperative days
The investigators defined acute kidney injury by the KDIGO (Kidney Disease Improving Global Outcomes) criteria, which was determined according to the greatest change in serum creatinine level during the postoperative seven days (Stage 1: more than 1.5-fold; stage 2: more than 2-fold; stage 3: more than 3-fold increase of baseline or increase in SCr to ≥ 4.0 mg/dL or the initiation of renal replacement therapy). The most recent SCr level measured before surgery was collected as a baseline value.
次要结局
- In-hospital mortality(the first month after admission)
- One-year mortality(one year after transplantation)
- Length of intensive care unit stay(the first month after admission)
- Length of hospital stay(the first month after admission)
- Incidence of postoperative hemodialysis(the first month after admission)
- Early allograft dysfunction(the first 7 postoperative days)
研究者
Won Ho Kim, MD
Professor
Seoul National University Hospital