Associates of Cardiopulmonary Arrest in the Perihemodialytic Period
Cardiopulmonary arrest during and proximate to hemodialysis is rare but highly fatal. Studies have examined peridialytic sudden cardiac event risk factors, but no study has considered associates of cardiopulmonary arrests (fatal and nonfatal events including cardiac and respiratory causes). This stu...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2014-01-01
|
| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2014/961978 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832552759856988160 |
|---|---|
| author | Jennifer E. Flythe Nien-Chen Li Shu-Fang Lin Steven M. Brunelli Jeffrey Hymes Eduardo Lacson |
| author_facet | Jennifer E. Flythe Nien-Chen Li Shu-Fang Lin Steven M. Brunelli Jeffrey Hymes Eduardo Lacson |
| author_sort | Jennifer E. Flythe |
| collection | DOAJ |
| description | Cardiopulmonary arrest during and proximate to hemodialysis is rare but highly fatal. Studies have examined peridialytic sudden cardiac event risk factors, but no study has considered associates of cardiopulmonary arrests (fatal and nonfatal events including cardiac and respiratory causes). This study was designed to elucidate patient and procedural factors associated with peridialytic cardiopulmonary arrest. Data for this case-control study were taken from the hemodialysis population at Fresenius Medical Care, North America. 924 in-center cardiopulmonary events (cases) and 75,538 controls were identified. Cases and controls were 1 : 5 matched on age, sex, race, and diabetes. Predictors of cardiopulmonary arrest were considered for logistic model inclusion. Missed treatments due to hospitalization, lower body mass, coronary artery disease, heart failure, lower albumin and hemoglobin, lower dialysate potassium, higher serum calcium, greater erythropoietin stimulating agent dose, and normalized protein catabolic rate (J-shaped) were associated with peridialytic cardiopulmonary arrest. Of these, lower albumin, hemoglobin, and body mass index; higher erythropoietin stimulating agent dose; and greater missed sessions had the strongest associations with outcome. Patient health markers and procedural factors are associated with peridialytic cardiopulmonary arrest. In addition to optimizing nutritional status, it may be prudent to limit exposure to low dialysate potassium (<2 K bath) and to use the lowest effective erythropoietin stimulating agent dose. |
| format | Article |
| id | doaj-art-2764169531d848749676fb9ecb8d92e0 |
| institution | Kabale University |
| issn | 2090-214X 2090-2158 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-2764169531d848749676fb9ecb8d92e02025-02-03T05:57:49ZengWileyInternational Journal of Nephrology2090-214X2090-21582014-01-01201410.1155/2014/961978961978Associates of Cardiopulmonary Arrest in the Perihemodialytic PeriodJennifer E. Flythe0Nien-Chen Li1Shu-Fang Lin2Steven M. Brunelli3Jeffrey Hymes4Eduardo Lacson5Department of Medicine, Renal Division, Brigham and Women’s Hospital, Boston, MA, USAFresenius Medical Care North America, Waltham, MA, USAFresenius Medical Care North America, Waltham, MA, USADepartment of Medicine, Renal Division, Brigham and Women’s Hospital, Boston, MA, USAFresenius Medical Care North America, Waltham, MA, USAFresenius Medical Care North America, Waltham, MA, USACardiopulmonary arrest during and proximate to hemodialysis is rare but highly fatal. Studies have examined peridialytic sudden cardiac event risk factors, but no study has considered associates of cardiopulmonary arrests (fatal and nonfatal events including cardiac and respiratory causes). This study was designed to elucidate patient and procedural factors associated with peridialytic cardiopulmonary arrest. Data for this case-control study were taken from the hemodialysis population at Fresenius Medical Care, North America. 924 in-center cardiopulmonary events (cases) and 75,538 controls were identified. Cases and controls were 1 : 5 matched on age, sex, race, and diabetes. Predictors of cardiopulmonary arrest were considered for logistic model inclusion. Missed treatments due to hospitalization, lower body mass, coronary artery disease, heart failure, lower albumin and hemoglobin, lower dialysate potassium, higher serum calcium, greater erythropoietin stimulating agent dose, and normalized protein catabolic rate (J-shaped) were associated with peridialytic cardiopulmonary arrest. Of these, lower albumin, hemoglobin, and body mass index; higher erythropoietin stimulating agent dose; and greater missed sessions had the strongest associations with outcome. Patient health markers and procedural factors are associated with peridialytic cardiopulmonary arrest. In addition to optimizing nutritional status, it may be prudent to limit exposure to low dialysate potassium (<2 K bath) and to use the lowest effective erythropoietin stimulating agent dose.http://dx.doi.org/10.1155/2014/961978 |
| spellingShingle | Jennifer E. Flythe Nien-Chen Li Shu-Fang Lin Steven M. Brunelli Jeffrey Hymes Eduardo Lacson Associates of Cardiopulmonary Arrest in the Perihemodialytic Period International Journal of Nephrology |
| title | Associates of Cardiopulmonary Arrest in the Perihemodialytic Period |
| title_full | Associates of Cardiopulmonary Arrest in the Perihemodialytic Period |
| title_fullStr | Associates of Cardiopulmonary Arrest in the Perihemodialytic Period |
| title_full_unstemmed | Associates of Cardiopulmonary Arrest in the Perihemodialytic Period |
| title_short | Associates of Cardiopulmonary Arrest in the Perihemodialytic Period |
| title_sort | associates of cardiopulmonary arrest in the perihemodialytic period |
| url | http://dx.doi.org/10.1155/2014/961978 |
| work_keys_str_mv | AT jennifereflythe associatesofcardiopulmonaryarrestintheperihemodialyticperiod AT nienchenli associatesofcardiopulmonaryarrestintheperihemodialyticperiod AT shufanglin associatesofcardiopulmonaryarrestintheperihemodialyticperiod AT stevenmbrunelli associatesofcardiopulmonaryarrestintheperihemodialyticperiod AT jeffreyhymes associatesofcardiopulmonaryarrestintheperihemodialyticperiod AT eduardolacson associatesofcardiopulmonaryarrestintheperihemodialyticperiod |