Incidence and outcome of rhabdomyolysis after type A aortic dissection surgery:A retrospective analysis  

作　　者：Praveen C Sivadasan Cornelia S Carr Abdul Rasheed A Pattath Samy Hanoura Suraj Sudarsanan Hany O Ragab Hatem Sarhan Arunabha Karmakar Rajvir Singh Amr S Omar 

机构地区：[1]Cardiac Anesthesia and ICU Section,Department of Cardiothoracic Surgery,Hamad Medical Corporation,Doha 3050,Qatar [2]Department of Clinical Surgery,College of Medicine,Qatar University,Doha 3050,Qatar [3]Department of Cardiothoracic Surgery,Hamad Medical Corporation,Doha 3050,Qatar [4]Department of Anesthesia and Intensive Care,Al-Azhar University,Cairo 11651,Egypt [5]Department of Thoracic and Cardiovascular Surgery,Cleveland Clinic,Cleveland,OH 44106,United States [6]Department of Medical Education,Hamad Medical Corporation,Doha 3050,Qatar [7]Department of Medical Research,Hamad Medical Corporation,Doha 3050,Qatar [8]Department of Critical Care Medicine,Beni Suef University,Beni Suef 2722165,Egypt

出　　处：《World Journal of Critical Care Medicine》2025年第2期121-130,共10页世界重症医学杂志(英文)

基　　金：Supported by Hamad Medical Corporation,No.MRC-01-18-073.

摘　　要：BACKGROUND Rhabdomyolysis(RML)as an etiological factor causing acute kidney injury(AKI)is sparsely reported in the literature.AIM To study the incidence of RML after surgical repair of an ascending aortic dissection(AAD)and to correlate with the outcome,especially regarding renal function.To pinpoint the perioperative risk factors associated with the development of RML and adverse renal outcomes after aortic dissection repair.METHODS Retrospective single-center cohort study conducted in a tertiary cardiac center.We included all patients who underwent AAD repair from 2011-2017.Post-operative RML workup is part of the institutional protocol;studied patients were divided into two groups:Group 1 with RML(creatine kinase above cut-off levels 2500 U/L)and Group 2 without RML.The potential determinants of RML and impact on patient outcome,especially postoperative renal function,were studied.Other outcome parameters studied were markers of cardiac injury,length of ventilation,length of stay in the intensive care unit),and length of hospitalization.RESULTS Out of 33 patients studied,21 patients(64%)developed RML(Group RML),and 12 did not(Group non-RML).Demographic and intraoperative factors,notably body mass index,duration of surgery,and cardiopulmonary bypass,had no significant impact on the incidence of RML.Preoperative visceral/peripheral malperfusion,though not statistically significant,was higher in the RML group.A significantly higher incidence of renal complications,including de novo postoperative dialysis,was noticed in the RML group.Other morbidity parameters were also higher in the RML group.There was a significantly higher incidence of AKI in the RML group(90%)than in the non-RML group(25%).All four patients who required de novo dialysis belonged to the RML group.The peak troponin levels were significantly higher in the RML group.CONCLUSION In this study,we noticed a high incidence of RML after aortic dissection surgery,coupled with an adverse renal outcome and the need for post-operative dialysis.Prompt recogn

关 键 词：RHABDOMYOLYSIS Ascending aortic dissection surgery Acute kidney injury Postoperative renal outcome Open heart surgery Type A aortic dissection 

分 类 号：R69[医药卫生—泌尿科学]