GDT following cardiac surgery and incidence of AKI

Patient Population
Cardiac surgery patients following coronary artery bypass grafting and/or aortic valve surgery.

LiDCO Monitor
LiDCOplus.

Trial Design
Prospective observational study in cardiothoracic ICU.

Outcome Impact
A nurse-led GDT protocol targeting maximum SV for 8hrs post surgery showed a reduction in the incidence of AKI and reduction in the number of patients requiring RRT.

PURPOSE
The purpose of this study was to assess the effect of goal directed therapy (GDT), following cardiac surgery, on the incidence of acute kidney injury.

MATERIALS AND METHODS
A total of 264 patients were included with 123 patients in the GDT group and 141 in the control.

RESULTS
Incidence of AKI was reduced in the GDT group (n=8 (6.5%) vs. n=28 (19.9%), P = 0.002). the rate of readmissions to the intensive care was reduced in the GDT group (9.2% vs. 3.3%, P = 0.049)

CONCLUSIONS
Post-operative GDT in patients following cardiac surgery was associated with reduction in the incidence of AKI and a reduction in ICU and hospital duration of stay.

Thomson R, Meeran H, Valencia O, Al-Subaie N. Goal-directed therapy after cardiac surgery and the incidence of acute kidney injury. J Crit Care. 2014;29(6):997-1000

“The significant reduction in the incidence of AKI has both short and log term implication on overall morbidity in addition to the financial impact as result of reducing duration of ICU and hospital stay.”

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