https://scholars.lib.ntu.edu.tw/handle/123456789/583340| Title: | Norepinephrine Administration Is Associated with Higher Mortality in Dialysis Requiring Acute Kidney Injury Patients with Septic Shock | Authors: | Chen, Ying-Ying VIN-CENT WU Huang, Wei-Chieh YU-CHANG YEH Wu, Mai-Szu Huang, Chiu-Ching Wu, Kwan-Dun Fang, Ji-Tseng Wu, Chih-Jen SHUEI-LIONG LIN TAI-SHUAN LAI YU-FENG LIN I-JUNG TSAI CHUN-FU LAI TAO-MIN HUANG Chu T.-S. YUNG-MING CHEN Chang Y.-H. Yeh Y.-C. Lai C.-H. Tseng L.-J. Wu K.-D. Wang J.-J. Chen C.-Y. Shiao C.-C. Wang W.-J. Lin J.-H. Wu C.-H. Wu C.-J. Lu K.-C. Kan W.-C. Huang C.-C. Chou C.-Y. Yang Y.-F. Tsai J.-P. Hu F.-C. Lee C.-T. Chen J.-B. Lee C.-H. Lee W.-C. Li L.-C. Chen T.-C. Lin H.Y.-H. Chen Y.-C. Lee C.-C. Sun C.-Y. Pan H.-C. Chang M.-Y. Jenq C.-C. Lin C.-Y. Chang C.-H. Tsai T.-Y. Chen C.-M. Lin E.-T. Wu C.-J. Lin C.-J. Wu P.-C. Kuo F.-C. Weng C.-J. Chen L.-K. Lin S.-L. Yang W.-S. Hsu W.-D. Leu J.-G. Chang J.-T. Liou H.-H. Hsu K.-H. Wu M.-J. Huang C.-T. You Z.-H. Chang C.-F. Chen T.-W. Chen H.-H. FAN-CHI CHANG Lin Y.-C. Wu M.-S. Kao C.-C. Hung S.-C. Kuo K.-L. Wu C.-H. Tarng D.-C. Chen J.-Y. Yang C.-Y. Lee K.-H. Ko S.-W. The NSARF, CAKS Group |
Keywords: | acute kidney injury; critical care; dialysis; norepinephrine; sepsis; vasoactive agents;Acute kidney injury; Critical care; Dialysis; Norepinephrine; Sepsis; Vasoactive agents | Issue Date: | 12-Sep-2018 | Journal Volume: | 7 | Journal Issue: | 9 | Source: | Journal of clinical medicine | Abstract: | (1) Background: Norepinephrine (NE) is the first-line vasoactive agent used in septic shock patients; however, the effect of norepinephrine on dialysis-required septic acute kidney injury (AKI-D) patients is uncertain. (2) Methods: To evaluate the impact of NE on 90-day mortality and renal recovery in septic AKI-D patients, we enrolled patients in intensive care units from 30 hospitals in Taiwan. (3) Results: 372 patients were enrolled and were divided into norepinephrine users and non-users. After adjustment by Inverse probability of treatment weighted (IPTW), there was no significant difference of baseline comorbidities between the two groups. NE users had significantly higher 90-day mortality rate and using NE is a strong predictor of 90-day mortality in the multivariate Cox regression (HR = 1.497, p = 0.027) after adjustment. The generalized additive model disclosed norepinephrine alone exerted a dose⁻dependent effect on 90-day mortality, while other vasoactive agents were not. (4) Conclusion: Using norepinephrine in septic AKI-D patients is associated with higher 90-day mortality and the effect is dose-dependent. Further study to explore the potential mechanism is needed. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/583340 | ISSN: | 2077-0383 | DOI: | 10.3390/jcm7090274 | SDG/Keyword: | noradrenalin; acute kidney failure; adult; aged; APACHE; Article; cohort analysis; comorbidity assessment; continuous renal replacement therapy; creatinine blood level; disease severity; female; fluid resuscitation; geographic distribution; Glasgow coma scale; heart failure; heart output; hemodialysis; hepatorenal syndrome; hospital discharge; human; intensive care unit; international normalized ratio; major clinical study; male; mean arterial pressure; middle aged; mortality rate; observational study; prospective study; renal replacement therapy; respiratory failure; septic shock; Sequential Organ Failure Assessment Score; urea nitrogen blood level [SDGs]SDG3 |
| Appears in Collections: | 醫學系 |
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