Abstract: FR-PO050
The Effect of Therapeutic Hypothermia on Urine Output After Cardiopulmonary Resuscitation
Session Information
- AKI: Clinical Outcomes, Trials
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Author
- Lee, MinJeong, Ajou University School of Medicine, Suwon, Korea (the Republic of)
Background
Therapeutic temperature management (TTM) was strongly recommended by the 2015 International Lision Committee on Resuscitation as a component of post-resuscitation care. It has been known to be effective in improving the survival rate and neurologic functional outcome of patients after cardiac arrest. While commonly described cold diuresis, renal tubular function is diminished in the induction and maintenance phase of TTM, few studies have characterized cold-induced diuresis or rewarm anti-diuresis during TTM. In this study, we sought to characterize urine output changes during postcardiac arrest therapeutic hypothermia.
Methods
We conducted retrospective cohort study to determine urine output changes during TTM of the postcardiac arrest patients. We analyzed 104 patients who underwent all phase TTM for 3 years from Jan 1, 2012 to Dec 31, 2014. We calculated the hourly IV fluid input and urine output rates for each TTM phase. We fit a generalized linear mixed model with each TTM phase as a categorical variable to compare the urine output at each phase of analysis.
Results
Four-fifths of the patients suffered out-of-hospital arrest. Approximately 70% survived to hospital discharge. Urine output rate was highest at 249.1 ± 255.7 mL/hr in the hypothermia induction phase but lowest at 96.4 ± 65.3 mL/hr during rewarming phase even though total I/O showed the most positive balance during the rewarming phase.
Conclusion
We observed modest increases in urine output during induction phase of TTM. This has important implications for fluid management in patients undergoing therapeutic hypothermia. We will collabrate with the statistics team to analyze changes in continuous urine output and overall I / O data rather than average data of the larger number of patients.
Fluid input and output during therapeutic hypothermia
| Hypothermia induction | Hypothermia maintenance | Hypothermia rewarm | Post-rewarm | P-value | |
| IV fluid input (mean, mlL/hour) | 300.5 ± 189.1 | 206.7 ± 92.3 | 181.9 ± 77.5 | 165.0 ± 63.7 | <0.001 |
| Urine Output (mean, mL/hour) | 249.1 ± 255.7 | 130.4 ± 97.5 | 96.4 ± 65.3 | 119.9 ± 72.7 | <0.001 |
| Output except urine output (mean, mL/hour) | 15.8 ± 94.2 | 3.5 ± 8.6 | 3.5 ± 7.7 | 4.1 ± 8.5 | 0.193 |
| Total Output (mean, mL/hour) | 264.9 ± 259.9 | 133.9 ± 98.1 | 99.9 ± 67.1 | 124.0 ± 71.7 | <0.001 |
| Total I/O balance (mean, mL/hour) | 35.7 ± 261.8 | 72.8 ± 92.2 | 82.9 ± 81.8 | 39.6 ± 73.2 | 0.081 |
| MAP (mmHg) | 107.0 ± 26.2 | 95.6 ± 11.6 | 89.8 ± 11.8 | 89.6 ± 12.7 | <0.001 |