The Use of Intraoperative Dexmedetomidine Is Not Associated With a Reduction in Acute Kidney Injury After Lung Cancer Surgery

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• 作者：Teresa Moon ; MD^* ; January Y. Tsai ; MD^* ; Shital Vachhani ; MD^* ; Szu-Po Peng ; MS^&dagger ; ; Lei Feng ; MS^&dagger ; ; Ara A. Vaporciyan ; MD^&Dagger ; ; Juan P. Cata ; MD^* ; ^§ ; ; ^{jcata@mdanderson.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：acute kidney injury ; lung neoplasms ; thoracic surgery ; dexmedetomidine
• 刊名：Journal of Cardiothoracic and Vascular Anesthesia
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：30
• 期：1
• 页码：51-55
• 全文大小：199 K

文摘

To evaluate whether the use of intraoperative dexmedetomidine (DEX) during lung cancer surgery may reduce the incidence of acute kidney injury (AKI).

Design

A retrospective study.

Setting

An academic hospital.

Participants

Data were collected from 1,207 adult patients who underwent resection for non-small-cell lung cancer between January 2004 and December 2012.

Interventions

None.

Measurements and Main Results

All patients had a general balanced anesthetic technique, and dexmedetomidine use was at the discretion of the anesthesiologist. Data analysis was done utilizing the Wilcoxon rank sum tests and Chi-square tests to compare continuous variables and categoric variables between the 2 groups, respectively. Multivariate logistic analysis with backward selection was fitted to find out factors for AKI incidence. Overall, 8.1% of the patients developed AKI during their hospital stay. There were no statistically significant differences in demographic, perioperative variables, and the incidence of AKI between patients who did and did not receive DEX. A logistic regression model was fitted to determine factors independently associated with AKI. Factors that were independently associated with AKI included body mass index, American Society of Anesthesiologists 3-4, hypertension, smoking status, and thoracotomy procedure.

Discussion

The authors hypothesized that DEX use would be associated with a decreased incidence of AKI in thoracic surgery; however, they were unable to prove this hypothesis. Their results did demonstrate that there are 5 factors independently associated with AKI.