Aadil Kakajiwala, MBBS, Ji Young Kim, PhD, John Z

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Presentation transcript:

Lack of Furosemide Responsiveness Predicts Acute Kidney Injury in Infants After Cardiac Surgery Aadil Kakajiwala, MBBS, Ji Young Kim, PhD, John Z. Hughes, MPH, Andrew Costarino, MD, MSCE, John Ferguson, J. William Gaynor, MD, Susan L. Furth, MD, PhD, Joshua J. Blinder, MD The Annals of Thoracic Surgery Volume 104, Issue 4, Pages 1388-1394 (October 2017) DOI: 10.1016/j.athoracsur.2017.03.015 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Study cohort. We excluded 104 patients who received nonstandard doses of furosemide and patients who were started on a furosemide drip. An additional 60 patients who received additional doses of diuretics within 6 hours of the first furosemide dose were also excluded. (AKI = acute kidney injury.) The Annals of Thoracic Surgery 2017 104, 1388-1394DOI: (10.1016/j.athoracsur.2017.03.015) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Box plots comparing the urine output (UOP) in the acute kidney injury (AKI) group and the no AKI group, determined after correcting serum creatinine for fluid balance, 2 and 6 hours after the initial furosemide dose. The Annals of Thoracic Surgery 2017 104, 1388-1394DOI: (10.1016/j.athoracsur.2017.03.015) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Receiver-operating characteristics (ROC) curves for lack of furosemide responsiveness, determined after correcting serum creatinine for fluid balance at (A) 2 hours after furosemide dose, and (B) 6 hours after furosemide dose. The area under the ROC curve (AUC) signifies the ability of the lack of furosemide response to predict acute kidney injury (AKI) development. The AUC can range from 0.5 to 1.0. A value of 0.5 suggests the test is not useful, whereas an AUC of 1.0 suggests a “perfect test.” (UOP2 = urine output 2 hours; UOP6 = urine output 6 hours.) The Annals of Thoracic Surgery 2017 104, 1388-1394DOI: (10.1016/j.athoracsur.2017.03.015) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Receiver-operating characteristics curves for lack of furosemide responsiveness in determining development of acute kidney injury (AKI), after correcting serum creatinine for fluid balance at (A) 2 hours after furosemide dose, adjusted for maximum STAT category, and (B) 6 hours after furosemide dose, adjusted for maximum STAT category. (AUC = area under the curve; STAT = The Society of Thoracic Surgeons/European Association for Cardiothoracic Surgery; UOP2 = urine output 2 hours; UOP6 = urine output 6 hours.) The Annals of Thoracic Surgery 2017 104, 1388-1394DOI: (10.1016/j.athoracsur.2017.03.015) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions