Evidence map›Paper›PMID 30564306›Full record

ArticlePerioperative medicine (London, England)2018

Acute kidney injury in postoperative shock: is hyperoncotic albumin administration an unrecognized resuscitation risk factor?

Chiedozie I Udeh, Jing You, Matthew R Wanek, Jarrod Dalton, Belinda L Udeh, Sevag Demirjian, Nadeem Rahman, J Steven Hata

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Perioperative medicine (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Chiedozie I UdehCenter for Critical Medicine, Anesthesiology Institute, 9500 Euclid Avenue, (J4-331), Cleveland, OH 44195 USA.ORCID 0000-0002-5673-9483
Jing YouDepartment of Special Line Product Development, Progressive Insurance, 300 N. Commons Blvd, Cleveland, OH 44143 USA.
Matthew R Wanek3Department of Inpatient Pharmacy, Cleveland Clinic Pharm D, 9500 Euclid Avenue, Cleveland, OH 44195 USA.
Jarrod Dalton4Department of Quantitative Health Sciences, Lemer Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195 USA.
Belinda L Udeh4Department of Quantitative Health Sciences, Lemer Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195 USA.
Sevag Demirjian6Department of Nephrology, Glickman Urology and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195 USA.
Nadeem RahmanCritical Care Institute, Cleveland Clinic, P.O. Box 112412, Al Maryah Island, Abu Dhabi, United Arab Emirates.
J Steven HataCenter for Critical Medicine, Anesthesiology Institute, 9500 Euclid Avenue, (J4-331), Cleveland, OH 44195 USA.
Cleveland Clinic · USCreative Commons · USTechnology Innovation Institute · AE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of hyperoncotic albumin (HA) for shock resuscitation is controversial given concerns about its cost, effectiveness, and potential for nephrotoxicity. We evaluated the association between early exposure to hyperoncotic albumin (within the first 48 h of onset of shock) and acute organ dysfunction in post-surgical patients with shock.

methodsThis retrospective, cohort study included 11,512 perioperative patients with shock from 2009 to 2012. Shock was defined as requirement for vasopressors to maintain adequate mean arterial pressure and/or elevated lactate (> 2.2 mmol/L). Subsets of 3600 were selected after propensity score and exact matching on demographics, comorbidities, and treatment variables (> 30). There was a preponderance of cardiac surgery patients. Proportional odds logistic regression, multivariable logistic regression or Cox proportional hazard regression models measured association between hyperoncotic albumin and acute kidney injury (AKI), hepatic injury, ICU days, and mortality.

resultsHyperoncotic albumin-exposed patients showed greater risk of acute kidney injury compared to controls (OR 1.10, 95% CI 1.04, 1.17.

conclusionsEarly exposure to hyperoncotic albumin in postoperative shock appeared to be associated with acute kidney injury. There did not appear to be any association with hepatic injury, mortality, or ICU days. The clinical and economic implications of this finding warrant further investigation.

Indexed as

Acute kidney injuryMultiple organ failure(National Library of Medicine-Medical Subject Headings): AlbuminResuscitationShock

Identifiers

PMID30564306
PMCPMC6293561
OpenAlexW2902327060

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.