Acute renal failure after successful cardiopulmonary resuscitation.
OBJECTIVE
To assess the frequency and independent predictors of severe acute renal failure in patients resuscitated from out-of-hospital ventricular fibrillation cardiac arrest.


METHODS
A cohort study with a minimum follow-up of 6 months.


METHODS
Emergency department of a tertiary care 2200-bed university hospital.


METHODS
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.


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.
Domanovits
H
H
Department of Emergency Medicine, Vienna General Hospital, University of Vienna, Medical School, Austria. Hans.Domanovits@akh-wien.ac.at
Schillinger
M
M
Müllner
M
M
Thoennissen
J
J
Sterz
F
F
Zeiner
A
A
Druml
W
W
D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology*; D000328:Adult; D000368:Aged; D001317:Austria / Q000453:epidemiology; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000150:complications* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012306:Risk; D018709:Statistics, Nonparametric; D014693:Ventricular Fibrillation / Q000150:complications* / Q000628:therapy