Perioperative dexmedetomidine reduces the incidence and severity of acute kidney injury following valvular heart surgery
Adrenergic alpha-2 Receptor Agonists/administration & dosage*
Male
Infusions
Time Factors
Heart Valve Diseases
Cardiac Surgical Procedures/adverse effects*
610
Heart Valves/surgery*
Severity of Illness Index
Drug Administration Schedule
03 medical and health sciences
Dexmedetomidine/adverse effects
0302 clinical medicine
Parenteral
Risk Factors
Republic of Korea
Adrenergic alpha-2 Receptor Agonists
Humans
Infusions, Parenteral
Prospective Studies
Acute Kidney Injury/physiopathology
Cardiac Surgical Procedures
Acute Kidney Injury/prevention & control*
Aged
Dexmedetomidine/administration & dosage*
Incidence
Heart Valve Diseases/physiopathology
Hemodynamics
dexmedetomidine
600
Adrenergic alpha-2 Receptor Agonists/adverse effects
Acute Kidney Injury
Length of Stay
Middle Aged
Heart Valves
Heart Valve Diseases/surgery*
3. Good health
Hemodynamics/drug effects
Treatment Outcome
acute kidney injury
Female
Republic of Korea/epidemiology
Heart Valves/physiopathology
cardiopulmonary bypass
Acute Kidney Injury/epidemiology
cardiac surgery
Dexmedetomidine
DOI:
10.1038/ki.2015.306
Publication Date:
2015-10-07T15:56:12Z
AUTHORS (5)
ABSTRACT
Acute kidney injury (AKI) following cardiac surgery is closely interrelated with hemodynamic instability and sympathetic activity, and adversely influences prognosis. Here, we investigated in a randomized placebo-controlled trial whether dexmedetomidine, an α2 adrenoreceptor agonist, could prevent AKI after valvular heart surgery. Two hundred patients undergoing valvular heart surgery were randomly assigned to equal placebo or treatment groups. Dexmedetomidine was infused at a rate of 0.4 μg/kg/h starting immediately after anesthetic induction and continuing for 24 h after surgery. We then assessed the incidence of AKI during the first 48 postoperative hours, hemodynamic variables, and a composite of major morbidity end points. The incidence of AKI, based on Acute Kidney Injury Network criteria, was significantly lower in the treatment group compared with the control group (14 vs. 33%). The dexmedetomidine group exhibited a significantly lower incidence of a composite of major morbidity end points (21 vs. 38%) and a significantly shorter length of intensive care unit stay (3 [2, 3] days vs. 3 [2, 4] days) compared with the control group. Thus, perioperative infusion of dexmedetomidine effectively reduced both the incidence and severity of AKI, and improved outcome in patients undergoing valvular heart surgery without untoward hemodynamic side effects.
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CITATIONS (122)
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