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Intraoperative mean arterial pressure and acute kidney injury after robot-assisted laparoscopic prostatectomy: a retrospective study

Authors
 Tae Lim Kim  ;  Namo Kim  ;  Hye Jung Shin  ;  Matthew R Cho  ;  Hae Ri Park  ;  So Yeon Kim 
Citation
 SCIENTIFIC REPORTS, Vol.13(1) : 3318, 2023-02 
Journal Title
SCIENTIFIC REPORTS
Issue Date
2023-02
MeSH
Acute Kidney Injury* / etiology ; Arterial Pressure ; Humans ; Laparoscopy* / adverse effects ; Male ; Prostatectomy / adverse effects ; Retrospective Studies ; Robotics*
Abstract
Intraoperative hemodynamics can affect postoperative kidney function. We aimed to investigate the effect of intraoperative mean arterial pressure (MAP) as well as other risk factors on the occurrence of acute kidney injury (AKI) after robot-assisted laparoscopic prostatectomy (RALP). We retrospectively evaluated the medical records of 750 patients who underwent RALP. The average real variability (ARV)-MAP, standard deviation (SD)-MAP, time-weighted average (TWA)-MAP, area under threshold (AUT)-65 mmHg, and area above threshold (AAT)-120 mmHg were calculated using MAPs collected within a 10-s interval. Eighteen (2.4%) patients developed postoperative AKI. There were some univariable associations between TWA-MAP, AUT-65 mmHg, and AKI occurrence; however, multivariable analysis found no association. Alternatively, American Society of Anesthesiologists physical status ≥ III and the low intraoperative urine output were independently associated with AKI occurrence. Moreover, none of the five MAP parameters could predict postoperative AKI, with the area under the receiver operating characteristic curve values for ARV-MAP, SD-MAP, TWA-MAP, AUT-65 mmHg, and AAT-120 mmHg being 0.561 (95% confidence interval [CI], 0.424-0.697), 0.561 (95% CI, 0.417-0.704), 0.584 (95% CI, 0.458-0.709), 0.590 (95% CI, 0.462-0.718), and 0.626 (95% CI, 0.499-0.753), respectively. Therefore, intraoperative MAP changes may not be a determining factor for AKI after RALP.
Files in This Item:
T202301613.pdf Download
DOI
10.1038/s41598-023-30506-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Namo(김남오) ORCID logo https://orcid.org/0000-0002-0829-490X
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Kim, Tae Lim(김태림) ORCID logo https://orcid.org/0000-0001-9421-7486
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193704
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