Chuan-Yu Chen1, Yan Zhou1, Peng Wang1, En-Yao Qi1, Wan-Jie Gu2. 1. Department of Anesthesiology, Luhe People's Hospital of Nanjing, 9 Jiankang Road, Nanjing, 211500, China. 2. Department of Anesthesiology, Nanjing Drum Tower Hospital, Medical College of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China. wanjiegu@hotmail.com.
Abstract
BACKGROUND: The association of central venous pressure (CVP) and mortality and acute kidney injury (AKI) in critically ill adult patients remains unclear. We performed a meta-analysis to determine whether elevated CVP is associated with increased mortality and AKI in critically ill adult patients. METHODS: We searched PubMed and Embase through June 2019 to identify studies that investigated the association between CVP and mortality and/or AKI in critically ill adult patients admitted into the intensive care unit. We calculated the summary odds ratio (OR) and 95% CI using a random-effects model. RESULTS: Fifteen cohort studies with a broad spectrum of critically ill patients (mainly sepsis) were included. On a dichotomous scale, elevated CVP was associated with an increased risk of mortality (3 studies; 969 participants; OR, 1.65; 95% CI, 1.19-2.29) and AKI (2 studies; 689 participants; OR, 2.09; 95% CI, 1.39-3.14). On a continuous scale, higher CVP was associated with greater risk of mortality (5 studies; 7837 participants; OR, 1.10; 95% CI, 1.03-1.17) and AKI (6 studies; 5446 participants; OR, 1.14; 95% CI, 1.06-1.23). Furthermore, per 1 mmHg increase in CVP increased the odds of AKI by 6% (4 studies; 5150 participants; OR, 1.06; 95% CI, 1.01-1.12). Further analyses restricted to patients with sepsis showed consistent results. CONCLUSIONS: Elevated CVP is associated with an increased risk of mortality and AKI in critically ill adult patients admitted into the intensive care unit. TRIAL REGISTRATION: PROSPERO, CRD42019126381.
BACKGROUND: The association of central venous pressure (CVP) and mortality and acute kidney injury (AKI) in critically ill adult patients remains unclear. We performed a meta-analysis to determine whether elevated CVP is associated with increased mortality and AKI in critically ill adult patients. METHODS: We searched PubMed and Embase through June 2019 to identify studies that investigated the association between CVP and mortality and/or AKI in critically ill adult patients admitted into the intensive care unit. We calculated the summary odds ratio (OR) and 95% CI using a random-effects model. RESULTS: Fifteen cohort studies with a broad spectrum of critically illpatients (mainly sepsis) were included. On a dichotomous scale, elevated CVP was associated with an increased risk of mortality (3 studies; 969 participants; OR, 1.65; 95% CI, 1.19-2.29) and AKI (2 studies; 689 participants; OR, 2.09; 95% CI, 1.39-3.14). On a continuous scale, higher CVP was associated with greater risk of mortality (5 studies; 7837 participants; OR, 1.10; 95% CI, 1.03-1.17) and AKI (6 studies; 5446 participants; OR, 1.14; 95% CI, 1.06-1.23). Furthermore, per 1 mmHg increase in CVP increased the odds of AKI by 6% (4 studies; 5150 participants; OR, 1.06; 95% CI, 1.01-1.12). Further analyses restricted to patients with sepsis showed consistent results. CONCLUSIONS: Elevated CVP is associated with an increased risk of mortality and AKI in critically ill adult patients admitted into the intensive care unit. TRIAL REGISTRATION: PROSPERO, CRD42019126381.
Entities:
Keywords:
Acute kidney injury; Central venous pressure; Critical illness; Mortality
Authors: Holger Scholz; Felix J Boivin; Kai M Schmidt-Ott; Sebastian Bachmann; Kai-Uwe Eckardt; Ute I Scholl; Pontus B Persson Journal: Nat Rev Nephrol Date: 2021-02-05 Impact factor: 28.314