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Cardiac surgery associated acute kidney injury (CSA-AKI) is one of the most frequent and severe complications after cardiac surgery. The association between acute kidney injury and the mismatch between oxygen consumption and delivery has been well established during cardiopulmonary bypass (CPB) and contributes to the development of CSA-AKI. In this study, the investigators aim to explore the use of gap CO2 during cardiac surgery and its relation with CSA-AKI. In order to explore this association, the invetigators built a retrospective, multicentric study. All patient who underwent cardiac surgery with cardiopulmonary bypass in two French ICU between 03/2019 and 04/2023 and for which information about gap CO2 during CPB is available will be included. After inclusion, patient will be divided in two groups according to the presence or absence of an elevated gap CO2. Occurence of CSA-AKI and other outcomes will be compared between groups, using multivariate analysis.
Cardiac surgery associated acute kidney injury (CSA-AKI) is one of the most frequent and severe complications after cardiac surgery. The association between acute kidney injury and the mismatch between oxygen consumption and delivery has been well established during cardiopulmonary bypass (CPB) and contributes to the development of CSA-AKI. In order to explore this association, investigators build a retrospective study including all patients who underwent cardiac surgery requiring CPB in two French hospitals and for which data about gap CO2 during CPB is available. Patients will be divided into two groups according to the presence or absence of an elevated gap CO2 during CPB, defined as > 6 mmHg. The primary outcome is the occurrence of CSA-AKI, defined by KDIGO recommendations, according gap CO2. Secondary outcomes include others post-operative complications as defined by international guidelines. Performance of gap CO2 to predict CSA-AKI will be evaluated by calculating the Area Under the Curve (AUC) of the associated ROC curve. We'll also assess the correlation between gap CO2 and other perfusion parameters (lactate, svO2) and with mean DO2 during CPB.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| elevated gap CO2 group and low gap CO2 group | Gap CO2 is calculated as PvCO2-PaCO2, using arterial and venous blood gases taken during CPB. Patients will be included in the elevated gap CO2 group when gap CO2 during CPB is > 6 mmHg |
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| Measure | Description | Time Frame |
|---|---|---|
| Acute Kidney Injury | proportion of patient with acute kidney injury of Acute Kidney Injury as defined in the KDIGO guidelines within the first 7 days after the cardiac surgery | within the 7 days after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Mortality, occurrence of other complications | proportion of patient with others post-operative complications as defined by international post-operative guidelines: atrial fibrillation, ARDS , VA-ECMO implantation, cardiac arrest, length of stay in ICU and hospital and the mortality rate within the first 28 days | within the 28 days after surgery |
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Inclusion criteria:
Non-inclusion criteria :
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Patients older than 18, which underwent cardiac surgery with cardiopulmonary bypass
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Service d'Anesthésie Réanimation, Hôpital de la Pitié-Salpêtrière | Paris | 75571 | France | |||
| Service d'Anesthésie-Réanimation, Hôpital Pontchaillou, Rennes |
The procedures carried out with the French data privacy authority (CNIL, Commission nationale de l'informatique et des libertés) do not provide for the transmission of the database, nor do the information and consent documents signed by the patients.
Consultation by the editorial board or interested researchers of individual participant data that underlie the results reported in the article after deidentification may nevertheless be considered, subject to prior determination of the terms and conditions of such consultation and in respect for compliance with the applicable regulations.
Beginning 3 months and ending 3 years following article publication. Requests out of these time frame can also be submitted to the sponsor
Researchers who provide a methodologically sound proposal.
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| Rennes |
| France |