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  1. Toho Journal of Medicine
  2. Vol.7
  3. No.1(p.1-83)

Postoperative Acute Kidney Injury Associated with Anesthesia Induction in Extremely Hypertensive Patients Undergoing Elective Non-Cardiac Surgery

https://doi.org/10.14994/tohojmed.2020-018
https://doi.org/10.14994/tohojmed.2020-018
d87bb6bb-2b99-4ced-8563-13b483d5b4c3
名前 / ファイル ライセンス アクション
td08998715.pdf td08998715.pdf (145.4 KB)
Item type *学術雑誌論文 / Journal Article(1)
公開日 2021-03-12
タイトル
タイトル Postoperative Acute Kidney Injury Associated with Anesthesia Induction in Extremely Hypertensive Patients Undergoing Elective Non-Cardiac Surgery(en)
言語
言語 eng
キーワード
主題 preinduction hypertension, anesthesia, surgery, postoperative complications, acute kidney injury
資源タイプ
資源タイプ journal article
ID登録
ID登録 10.14994/tohojmed.2020-018
ID登録タイプ JaLC
著者 Morozumi, Kohei

× Morozumi, Kohei

en Morozumi, Kohei
Department of Anesthesiology, Toho University Graduate School of Medicine

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Satomoto, Maiko

× Satomoto, Maiko

en Satomoto, Maiko
Department of Anesthesiology, Toho University Omori Medical Center

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Hanai, Yuki

× Hanai, Yuki

en Hanai, Yuki
Department of Pharmacy, Toho University Omori Medical Center

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Ochiai, Ryoichi

× Ochiai, Ryoichi

en Ochiai, Ryoichi
Department of Anesthesiology, Toho University Omori Medical Center

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Kotake, Yoshifumi

× Kotake, Yoshifumi

en Kotake, Yoshifumi
Department of Anesthesiology, Toho University Ohashi Medical Center

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内容記述
内容記述タイプ Other
内容記述 Original Article
内容記述
内容記述タイプ Other
内容記述 Introduction: Some patients exhibit extreme hypertension before anesthetic induction. Although it is important to avoid hypotension during anesthesia to prevent major postoperative complications, it remains unknown how anesthetic hypotension should be managed in patients with hypertension. Therefore, we investigated the incidence of postoperative complications and their associations with low blood pressure during surgery in patients with a systolic blood pressure >200 mmHg before anesthetic induction. Methods: We assessed the incidence of postoperative acute kidney injury (AKI), myocardial infarction (MI), and ischemic stroke. For postoperative AKI, we investigated the duration, between intubation and surgery initiation, for which the patients' mean arterial pressure (MAP) was below the threshold, and the duration from surgery initiation to the end of anesthesia. Based on these analyses, factors considered to be clinically associated with postoperative AKI were extracted and subjected to multivariate logistic regression analysis. Results: In total, 274 patients were enrolled. Of these, 35 developed AKI and one experienced MI and ischemic stroke. The durations for which the MAP was <65, 70, and 75 mmHg between intubation and incision were significantly longer in the AKI group than in the non-AKI group (P < 0.01). Multivariate regression analysis revealed a statistically significant association between the duration of having a MAP <75 mmHg and postoperative AKI (adjusted odds ratio = 1.04, confidence interval=1.02-1.07, P < 0.001). Conclusions: In patients with extreme hypertension before anesthetic induction undergoing elective non-cardiac surgery, a MAP <75 mmHg between intubation and incision may be an independent risk factor for postoperative AKI.
書誌情報 ja : Toho Journal of Medicine
en : Toho Journal of Medicine

巻 7, 号 1, p. 20-28, 発行日 2021-03-01
出版者
出版者 The Medical Society of Toho University
ISSN
収録物識別子タイプ PISSN
収録物識別子 21891990
著者版フラグ
出版タイプ VoR
出版タイプResource http://purl.org/coar/version/c_970fb48d4fbd8a85
レコードID
内容記述 TD08998715
資源タイプ(ローカル)
内容記述タイプ Other
内容記述 TOHO University Scholarly Publication
出版地
内容記述 Tokyo
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