Early predictive value of urine oxygen partial pressure monitoring for acute kidney injury related to cardiac surgery in adults
Objective To exploring the predicted value of intraoperative urinary oxygen partial pressure(PuO2)monitoring for acute kidney injury(AKI)in patients undergoing cardiac surgery under cardiopulmonary bypass therapy.Methods 46 patients aged from 44 to 65 years old who underwent elective heart surgery under cardiopulmonary bypass therapy were selected into this study.After anesthesia induction,values of PuO2 of patients were monitored and recorded continuously throughout the entire surgical period,and av-erage value of PuO2 of patients was calculated.All patient were divided into AKI group and non AKI group according to the standards proposed by improving kidney disease outcomes global organization(KDIGO).Logistic regression analysis was used to identify indepen-dent risk factors for the occurrence of AKI,and the receiver operating characteristic(ROC)curve was used to evaluate the predicted value of the average PuO2 value for the occurrence of AKI.Results Compared with the non acute kidney injury group,there was a sta-tistically significant difference in oxygen partial pressure,age,history of hypertension,surgical complexity,surgical time,and postopera-tive CVP of patients in the acute kidney injury group(P<0.05),while there were no statistically significant differences in other indica-tors between the two groups(P>0.05).Binary logistic regression analysis showed that average PuO2 value and history of hypertension were risk factors for AKI.ROC curve analysis showed when the critical value of the average PuO2 value was 37.5mmHg,the Jordan in-dex was the highest,with sensitivity and specificity of 100%and 28%,respectively.The area under curve(AUC)for predicting AKI was 0.827.Conclusion The average value of PuO2 and a history of hypertension are independent risk factors for AKI.The average value of PuO2<37.5mmHg can be used as a predictive indicator for the occurrence of AKI,providing assistance for the prevention and diagnosis of AKI.
Acute kidney injuryCardiac surgeryUrine oxygen partial pressureEarly stagePredicted value
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