Abstract P226: Aggressive Blood Pressure Control Status Post-acute Aortic Dissection May be Associated With Acute Kidney Injury: A Pilot Study

摘要: Management of acute aortic dissection includes appropriate blood pressure control (120/80 mmHg per AHA guidelines) but this is not based on evidence. Excessive lowering may contribute to organ malperfusion. The kidneys are the most commonly affected organs, causing refractory hypertension and kidney injury (AKI). Recent landmark trials with intensive goals have a significant incidence AKI. This pilot study tested hypothesis that achieved systolic less than 120 has higher AKI those treated pressures > mmHg. Methods: Patients were identified via surgical log. Retrospective chart review was performed patients in setting following dissection. Daily average calculated. included if they underwent repair survived first 24 hours. excluded demonstrated shock physiology or required renal replacement therapy Serum creatinine clinical course (including anti-hypertensive regimen) recorded. primary endpoint in-hospital occurrence (defined KDIGO criteria) status post receiving therapy. An unadjusted odds ratio Data potential confounders covariates (baseline sCR, contrast exposure etc) also collected. Results: From 2013-2017, 37 cases surgically repaired 16 met inclusion/exclusion criteria. an 120mmHg 75% compared 50% greater mmhg. OR =3.0 [95% CI 0.3612-24.9];p=0.3019. Covariates balanced between groups given small numbers additional statistical adjustments performed. Conclusion: numerically group achieving more targets. Our limited by sample size selection bias. Both these issues can be addressed we apply similar methodologies address same question lager size.