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Intensive Care Medicine

, Volume 27, Issue 7, pp 1194–1199 | Cite as

Acute renal failure after successful cardiopulmonary resuscitation

  • Hans Domanovits
  • Martin Schillinger
  • Marcus Müllner
  • Jana Thoennissen
  • Fritz Sterz
  • Andrea Zeiner
  • Wilfred Druml
Original

Abstract.

Objective: To assess the frequency and independent predictors of severe acute renal failure in patients resuscitated from out-of-hospital ventricular fibrillation cardiac arrest. Design: A cohort study with a minimum follow-up of 6 months. Setting: Emergency department of a tertiary care 2200-bed university hospital. Patients and participants: Consecutive adult (>18 years) patients admitted from 1 July 1991 to 31 October 1997 after witnessed ventricular fibrillation out-of-hospital cardiac arrest and successful resuscitation. Measurements and results: Acute renal failure was defined as a 25% decrease of creatinine clearance within 24 h after admission. Out of 187 eligible patients (median age 57 years, 146 male), acute renal failure occurred in 22 patients (12%); in 4 patients (18%) renal replacement therapy was performed. Congestive heart failure (OR 6.0, 95% CI 1.6–21.7; p=0.007), history of hypertension (OR 4.4, 95% CI 1.3–14.7; p=0.02) and total dose of epinephrine administered (OR 1.1, 95% CI 1.0–1.2; p=0.009) were independent predictors of acute renal failure. Duration of cardiac arrest, pre-existing impaired renal function and blood pressure at admission were not independently associated with renal outcome. Conclusions: Severe progressive acute renal failure after cardiopulmonary resuscitation (CPR) is rare. Pre-existing haemodynamics seem to be more important for the occurrence of acute renal failure than actual hypoperfusion during resuscitation.

Acute renal failure Cardiac arrest Ventricular fibrillation 

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Copyright information

© Springer-Verlag 2001

Authors and Affiliations

  • Hans Domanovits
    • 1
  • Martin Schillinger
    • 2
  • Marcus Müllner
    • 1
  • Jana Thoennissen
    • 1
  • Fritz Sterz
    • 1
  • Andrea Zeiner
    • 1
  • Wilfred Druml
    • 3
  1. 1.Department of Emergency Medicine, Vienna General Hospital, University of Vienna, Medical School, Waehringer Guertel 18–20/6D, 1090 Vienna, AustriaAustria
  2. 2.Department of Internal Medicine II, Division of Angiology, Vienna General Hospital, University of Vienna, Medical School, Waehringer Guertel 18–20, 1090 Vienna, AustriaAustria
  3. 3.Department of Internal Medicine III, Division of Nephrology and Dialysis, Vienna General Hospital, University of Vienna, Medical School, Waehringer Guertel 18–20, 1090 Vienna, AustriaAustria

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