Influence of Fluid Therapy on Kidney Function in the Early Postoperative Period After Lung Transplantation |
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| Institution: | 1. Department of Cardiac Anesthesia and Intensive Therapy, Silesian Centre for Heart Diseases, Medical University of Silesia, Zabrze, Poland;2. Medical University of Silesia, Faculty of Medical Sciences in Zabrze, Katowice, Poland;3. Medical University of Silesia, Doctoral School, Katowice, Poland;4. Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland;1. Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases in Zabrze, Medical University of Silesia, Katowice, Poland;2. Department of General, Vascular and Transplant Surgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland;1. Department of General, Vascular and Transplant Surgery, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland;2. Organizational and Coordination Center for Transplantation POLTRANSPLANT, Warsaw, Poland;3. Department of Statistics, Department of Instrumental Analysis, Medical University of Silesia, Katowice, Poland;1. Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland;2. Department of Cardiac Transplantation and Mechanical Circulatory Support, Silesian Center for Heart Diseases, Zabrze, Poland;3. Cardiac Surgery, Transplantology and Mechanical Circulatory Support in Children, Silesian Center for Heart Diseases, Zabrze, Poland;1. Polish Transplant Coordinating Center Poltransplant, Warsaw, Poland;2. Department of Emergency Medicine, Medical University of Warsaw, Poland;3. Department of Transplantology and National Tissue and Cell Banking Center, Medical University of Warsaw, Poland;1. Department of General Surgery and Transplantology, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland;2. Centre of Postgraduate Medical Education, Warsaw, Poland |
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| Abstract: | BackgroundPerioperative fluid therapy among patients undergoing lung transplantation (LT) has a significant clinical importance, including developing of acute kidney injury (AKI). The presence of AKI in the early postoperative period is associated with increased mortality in lung transplant recipients. Analysis includes the relationship between the volume of infused fluids, the balances of crystalloids and colloids during LT procedure and in the first 24 hours and the estimated glomerular filtration rate (eGFR) values in the following days of the postoperative period.MethodsRetrospective study of 73 consecutive patients undergoing LT between 2015 and 2018 in our institution. Deterioration of renal function was defined as the change in eGFR that occurred between baseline eGFR and the first and 7 first postoperative days following transplantation. The Chronic Kidney Disease Epidemiology Collaboration formula was used to calculate the eGFR value.ResultsThe greatest decline of eGFR in the early postoperative period was demonstrated on day 7 (ΔeGFR = 75.76 ± 40.08). Increased negative crystalloid balances during the LT procedure were strongly associated to less decrease in eGFR value on the seventh day post-LT (r = –0.997, P < .05). Increased volumes of transfused colloids during LT were correlated to less decline of eGFR value on day 7 (r = –0.3981, P < .05).ConclusionsNegative crystalloid balance in the early postoperative period post-LT has a potentially protective effect on kidney function, although fluid balances management should be individually considered for potential clinical benefits. The impact of the fluid administration after LT on the occurrence and recovery of AKI among lung transplant recipients requires further investigation. |
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