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Master Thesis

Effet de l’hypotension artérielle peropératoire sur la survenue de l’insuffisance rénale aiguë au décours d’une chirurgie d’allogreffe cryopréservée aortique

Abstract : Introduction: aortic cryopreserved allograft represents one of the treatments of aortic graft infection. The procedure is subject to major intraoperative hemodynamic variations. The aim of this study is to demonstrate the impact of intraoperative arterial hypotension on acute kidney injury after aortic allograft. Materiel and methods: observational, retrospective, mono-centric study including dialysis-free patients treated by aortic allograft between January 2009 and December 2017. Intraoperative hypotension was defined as mean arterial pressure lower than 70 mmHg. Mean arterial pressure and patients characteristic between patients who developed AKI, according to AKIN, or not were compared to assess their association with AKI. Results: 140 aortic allografts were studied. Within 64 (49,6%) patients who developed AKI, 19 (30%) required hemodialysis. Independent risk factor of AKI was diabetes, a treatment by angiotensin II receptor inhibitor prior to the surgery, intraoperative use of Vancomycin and suprarenal clamping. Intraoperative arterial hypotension lower than 70 mmHg wasn’t associated with AKI in the logistic regression (p = 0,55). However, AKI reduced significatively survival within intensive care unit (p < 0,001). Conclusion: in our study, intraoperative hypotension wasn’t associated with AKI after aortic cryopreserved allograft. AKI after aortic allograft impacted significatively morbi-mortality in intensive care unit.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03129114
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Submitted on : Tuesday, February 2, 2021 - 4:29:35 PM
Last modification on : Wednesday, May 19, 2021 - 3:23:21 AM

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Mathieu Battelier. Effet de l’hypotension artérielle peropératoire sur la survenue de l’insuffisance rénale aiguë au décours d’une chirurgie d’allogreffe cryopréservée aortique. Médecine humaine et pathologie. 2019. ⟨dumas-03129114⟩

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