Teresa Moon1, January Y Tsai1, Shital Vachhani1, Szu-Po Peng2, Lei Feng2, Ara A Vaporciyan3, Juan P Cata4. 1. Departments of *Anesthesiology and Perioperative Medicine. 2. Biostatistics. 3. Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX. 4. Departments of *Anesthesiology and Perioperative Medicine; Outcomes Research Consortium, Cleveland, OH. Electronic address: jcata@mdanderson.org.
Abstract
OBJECTIVE: To evaluate whether the use of intraoperative dexmedetomidine (DEX) during lung cancer surgery may reduce the incidence of acute kidney injury (AKI). DESIGN: A retrospective study. SETTING: An academic hospital. PARTICIPANTS: Data were collected from 1,207 adult patients who underwent resection for non-small-cell lung cancer between January 2004 and December 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: All patients had a general balanced anesthetic technique, and dexmedetomidine use was at the discretion of the anesthesiologist. Data analysis was done utilizing the Wilcoxon rank sum tests and Chi-square tests to compare continuous variables and categoric variables between the 2 groups, respectively. Multivariate logistic analysis with backward selection was fitted to find out factors for AKI incidence. Overall, 8.1% of the patients developed AKI during their hospital stay. There were no statistically significant differences in demographic, perioperative variables, and the incidence of AKI between patients who did and did not receive DEX. A logistic regression model was fitted to determine factors independently associated with AKI. Factors that were independently associated with AKI included body mass index, American Society of Anesthesiologists 3-4, hypertension, smoking status, and thoracotomy procedure. DISCUSSION: The authors hypothesized that DEX use would be associated with a decreased incidence of AKI in thoracic surgery; however, they were unable to prove this hypothesis. Their results did demonstrate that there are 5 factors independently associated with AKI.
OBJECTIVE: To evaluate whether the use of intraoperative dexmedetomidine (DEX) during lung cancer surgery may reduce the incidence of acute kidney injury (AKI). DESIGN: A retrospective study. SETTING: An academic hospital. PARTICIPANTS: Data were collected from 1,207 adult patients who underwent resection for non-small-cell lung cancer between January 2004 and December 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: All patients had a general balanced anesthetic technique, and dexmedetomidine use was at the discretion of the anesthesiologist. Data analysis was done utilizing the Wilcoxon rank sum tests and Chi-square tests to compare continuous variables and categoric variables between the 2 groups, respectively. Multivariate logistic analysis with backward selection was fitted to find out factors for AKI incidence. Overall, 8.1% of the patients developed AKI during their hospital stay. There were no statistically significant differences in demographic, perioperative variables, and the incidence of AKI between patients who did and did not receive DEX. A logistic regression model was fitted to determine factors independently associated with AKI. Factors that were independently associated with AKI included body mass index, American Society of Anesthesiologists 3-4, hypertension, smoking status, and thoracotomy procedure. DISCUSSION: The authors hypothesized that DEX use would be associated with a decreased incidence of AKI in thoracic surgery; however, they were unable to prove this hypothesis. Their results did demonstrate that there are 5 factors independently associated with AKI.
Authors: M Joannidis; W Druml; L G Forni; A B J Groeneveld; P M Honore; E Hoste; M Ostermann; H M Oudemans-van Straaten; M Schetz Journal: Intensive Care Med Date: 2017-06-02 Impact factor: 17.440