May renal resistive index be an early predictive tool of postoperative complications in major surgery? Preliminary results

Enrico Giustiniano, Massimo Meco, Emanuela Morenghi, Nadia Ruggieri, Daniele Cosseta, Silvia Cirri, Orazio Difrancesco, Paola Cosma Zito, Yari Gollo, Ferdinando Raimondi

Research output: Contribution to journalArticle

Abstract

Background. Patients who undergo high-risk surgery represent a large amount of post-operative ICU-admissions. These patients are at high risk of experiencing postoperative complications. Renal Resistive Index was found to be related with renal dysfunction, hypertension, and posttraumatic hemorrhagic shock, probably due to vasoconstriction. We explored whether Renal Resistive Index (RRI), measured after awakening from general anesthesia, could have any relationship with postoperative complications. Methods. In our observational, stratified dual-center trial, we enrolled patients who underwent general anesthesia for high-risk major surgery. After awakening in recovery room (or during awakening period in subjects submitted to cardiac surgery) we measured RRI by echo-color-Doppler method. Primary endpoint was the association of altered RRI (>0.70) and outcome during the first postoperative week. Results. 205 patients were enrolled: 60 (29.3%) showed RRI > 0.70. The total rate of adverse event was 27 (18.6%) in RRI ≤ 0.7 group and 19 (31.7%) in RRI > 0.7 group (P = 0.04 2). Significant correlation between RRI > 0.70 and complications resulted in pneumonia (P = 0.016), septic shock (P = 0.003), and acute renal failure (P = 0.00 1) subgroups. Patients with RRI > 0.7 showed longer ICU stay (P = 0. 001) and lasting of mechanical ventilation (P = 0.004). These results were confirmed in cardiothoracic surgery subgroup. RRI > 0.7 duplicates triplicates the risk of complications, both in general (OR 2.03 93 95% CI 1.02-4.02, P = 0.044) and in cardiothoracic (OR 2.62 95% CI 1.11-6.16, P = 0.027) population. Furthermore, we found RRI > 0.70 was associated with a triplicate risk of postoperative septic shock (OR 3.04, CI 95% 1.5-7.01; P = 0.002).

Original languageEnglish
Article number917985
JournalBioMed Research International
Volume2014
DOIs
Publication statusPublished - 2014

Fingerprint

Surgery
Kidney
Intensive care units
Septic Shock
General Anesthesia
Color
Recovery
Recovery Room
Renal Hypertension
Hemorrhagic Shock
Vasoconstriction
Artificial Respiration
Acute Kidney Injury
Thoracic Surgery
Pneumonia

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)
  • Medicine(all)

Cite this

Giustiniano, E., Meco, M., Morenghi, E., Ruggieri, N., Cosseta, D., Cirri, S., ... Raimondi, F. (2014). May renal resistive index be an early predictive tool of postoperative complications in major surgery? Preliminary results. BioMed Research International, 2014, [917985]. https://doi.org/10.1155/2014/917985

May renal resistive index be an early predictive tool of postoperative complications in major surgery? Preliminary results. / Giustiniano, Enrico; Meco, Massimo; Morenghi, Emanuela; Ruggieri, Nadia; Cosseta, Daniele; Cirri, Silvia; Difrancesco, Orazio; Zito, Paola Cosma; Gollo, Yari; Raimondi, Ferdinando.

In: BioMed Research International, Vol. 2014, 917985, 2014.

Research output: Contribution to journalArticle

Giustiniano, E, Meco, M, Morenghi, E, Ruggieri, N, Cosseta, D, Cirri, S, Difrancesco, O, Zito, PC, Gollo, Y & Raimondi, F 2014, 'May renal resistive index be an early predictive tool of postoperative complications in major surgery? Preliminary results', BioMed Research International, vol. 2014, 917985. https://doi.org/10.1155/2014/917985
Giustiniano, Enrico ; Meco, Massimo ; Morenghi, Emanuela ; Ruggieri, Nadia ; Cosseta, Daniele ; Cirri, Silvia ; Difrancesco, Orazio ; Zito, Paola Cosma ; Gollo, Yari ; Raimondi, Ferdinando. / May renal resistive index be an early predictive tool of postoperative complications in major surgery? Preliminary results. In: BioMed Research International. 2014 ; Vol. 2014.
@article{567b9481656d4cd1902d33b27cb516c0,
title = "May renal resistive index be an early predictive tool of postoperative complications in major surgery? Preliminary results",
abstract = "Background. Patients who undergo high-risk surgery represent a large amount of post-operative ICU-admissions. These patients are at high risk of experiencing postoperative complications. Renal Resistive Index was found to be related with renal dysfunction, hypertension, and posttraumatic hemorrhagic shock, probably due to vasoconstriction. We explored whether Renal Resistive Index (RRI), measured after awakening from general anesthesia, could have any relationship with postoperative complications. Methods. In our observational, stratified dual-center trial, we enrolled patients who underwent general anesthesia for high-risk major surgery. After awakening in recovery room (or during awakening period in subjects submitted to cardiac surgery) we measured RRI by echo-color-Doppler method. Primary endpoint was the association of altered RRI (>0.70) and outcome during the first postoperative week. Results. 205 patients were enrolled: 60 (29.3{\%}) showed RRI > 0.70. The total rate of adverse event was 27 (18.6{\%}) in RRI ≤ 0.7 group and 19 (31.7{\%}) in RRI > 0.7 group (P = 0.04 2). Significant correlation between RRI > 0.70 and complications resulted in pneumonia (P = 0.016), septic shock (P = 0.003), and acute renal failure (P = 0.00 1) subgroups. Patients with RRI > 0.7 showed longer ICU stay (P = 0. 001) and lasting of mechanical ventilation (P = 0.004). These results were confirmed in cardiothoracic surgery subgroup. RRI > 0.7 duplicates triplicates the risk of complications, both in general (OR 2.03 93 95{\%} CI 1.02-4.02, P = 0.044) and in cardiothoracic (OR 2.62 95{\%} CI 1.11-6.16, P = 0.027) population. Furthermore, we found RRI > 0.70 was associated with a triplicate risk of postoperative septic shock (OR 3.04, CI 95{\%} 1.5-7.01; P = 0.002).",
author = "Enrico Giustiniano and Massimo Meco and Emanuela Morenghi and Nadia Ruggieri and Daniele Cosseta and Silvia Cirri and Orazio Difrancesco and Zito, {Paola Cosma} and Yari Gollo and Ferdinando Raimondi",
year = "2014",
doi = "10.1155/2014/917985",
language = "English",
volume = "2014",
journal = "BioMed Research International",
issn = "2314-6133",
publisher = "Hindawi Publishing Corporation",

}

TY - JOUR

T1 - May renal resistive index be an early predictive tool of postoperative complications in major surgery? Preliminary results

AU - Giustiniano, Enrico

AU - Meco, Massimo

AU - Morenghi, Emanuela

AU - Ruggieri, Nadia

AU - Cosseta, Daniele

AU - Cirri, Silvia

AU - Difrancesco, Orazio

AU - Zito, Paola Cosma

AU - Gollo, Yari

AU - Raimondi, Ferdinando

PY - 2014

Y1 - 2014

N2 - Background. Patients who undergo high-risk surgery represent a large amount of post-operative ICU-admissions. These patients are at high risk of experiencing postoperative complications. Renal Resistive Index was found to be related with renal dysfunction, hypertension, and posttraumatic hemorrhagic shock, probably due to vasoconstriction. We explored whether Renal Resistive Index (RRI), measured after awakening from general anesthesia, could have any relationship with postoperative complications. Methods. In our observational, stratified dual-center trial, we enrolled patients who underwent general anesthesia for high-risk major surgery. After awakening in recovery room (or during awakening period in subjects submitted to cardiac surgery) we measured RRI by echo-color-Doppler method. Primary endpoint was the association of altered RRI (>0.70) and outcome during the first postoperative week. Results. 205 patients were enrolled: 60 (29.3%) showed RRI > 0.70. The total rate of adverse event was 27 (18.6%) in RRI ≤ 0.7 group and 19 (31.7%) in RRI > 0.7 group (P = 0.04 2). Significant correlation between RRI > 0.70 and complications resulted in pneumonia (P = 0.016), septic shock (P = 0.003), and acute renal failure (P = 0.00 1) subgroups. Patients with RRI > 0.7 showed longer ICU stay (P = 0. 001) and lasting of mechanical ventilation (P = 0.004). These results were confirmed in cardiothoracic surgery subgroup. RRI > 0.7 duplicates triplicates the risk of complications, both in general (OR 2.03 93 95% CI 1.02-4.02, P = 0.044) and in cardiothoracic (OR 2.62 95% CI 1.11-6.16, P = 0.027) population. Furthermore, we found RRI > 0.70 was associated with a triplicate risk of postoperative septic shock (OR 3.04, CI 95% 1.5-7.01; P = 0.002).

AB - Background. Patients who undergo high-risk surgery represent a large amount of post-operative ICU-admissions. These patients are at high risk of experiencing postoperative complications. Renal Resistive Index was found to be related with renal dysfunction, hypertension, and posttraumatic hemorrhagic shock, probably due to vasoconstriction. We explored whether Renal Resistive Index (RRI), measured after awakening from general anesthesia, could have any relationship with postoperative complications. Methods. In our observational, stratified dual-center trial, we enrolled patients who underwent general anesthesia for high-risk major surgery. After awakening in recovery room (or during awakening period in subjects submitted to cardiac surgery) we measured RRI by echo-color-Doppler method. Primary endpoint was the association of altered RRI (>0.70) and outcome during the first postoperative week. Results. 205 patients were enrolled: 60 (29.3%) showed RRI > 0.70. The total rate of adverse event was 27 (18.6%) in RRI ≤ 0.7 group and 19 (31.7%) in RRI > 0.7 group (P = 0.04 2). Significant correlation between RRI > 0.70 and complications resulted in pneumonia (P = 0.016), septic shock (P = 0.003), and acute renal failure (P = 0.00 1) subgroups. Patients with RRI > 0.7 showed longer ICU stay (P = 0. 001) and lasting of mechanical ventilation (P = 0.004). These results were confirmed in cardiothoracic surgery subgroup. RRI > 0.7 duplicates triplicates the risk of complications, both in general (OR 2.03 93 95% CI 1.02-4.02, P = 0.044) and in cardiothoracic (OR 2.62 95% CI 1.11-6.16, P = 0.027) population. Furthermore, we found RRI > 0.70 was associated with a triplicate risk of postoperative septic shock (OR 3.04, CI 95% 1.5-7.01; P = 0.002).

UR - http://www.scopus.com/inward/record.url?scp=84902130566&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902130566&partnerID=8YFLogxK

U2 - 10.1155/2014/917985

DO - 10.1155/2014/917985

M3 - Article

C2 - 24967414

AN - SCOPUS:84902130566

VL - 2014

JO - BioMed Research International

JF - BioMed Research International

SN - 2314-6133

M1 - 917985

ER -