2. Academic Validation
  3. Association between hydroxocobalamin administration and acute kidney injury after smoke inhalation: a multicenter retrospective study

Association between hydroxocobalamin administration and acute kidney injury after smoke inhalation: a multicenter retrospective study

  • Crit Care. 2019 Dec 23;23(1):421. doi: 10.1186/s13054-019-2706-0.
François Dépret 1 2 3 4,  Clément Hoffmann 5,  Laura Daoud 1,  Camille Thieffry 6,  Laure Monplaisir 1,  Jules Creveaux 5,  Djillali Annane 7,  Erika Parmentier 6,  Daniel Mathieu 6,  Sandrine Wiramus 8,  Dominique Demeure DIt Latte 9,  Aubin Kpodji 10,  Julien Textoris 11,  Florian Robin 12,  Kada Klouche 13,  Emmanuel Pontis 14,  Guillaume Schnell 15,  François Barbier 16,  Jean-Michel Constantin 17,  Thomas Clavier 18 19,  Damien du Cheyron 20,  Nicolas Terzi 21,  Bertrand Sauneuf 22,  Emmanuel Guerot 23 24,  Thomas Lafon 25 26,  Alexandre Herbland 27,  Bruno Megarbane 28,  Thomas Leclerc 4,  Vincent Mallet 29,  Romain Pirracchio 30,  Matthieu Legrand 31 32 33 34 35
Affiliations

Affiliations

  • 1 Department of Anesthesiology and Critical Care and Burn Unit, AP-HP, GH Saint Louis-Lariboisière, Paris, France.
  • 2 UMR INSERM 942, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France.
  • 3 F-CRIN, INICRCT network, Paris, France.
  • 4 Paris Diderot University, F-75475, Paris, France.
  • 5 Burn Center, Percy Military Teaching Hospital, BP 406, 101, avenue Henri-Barbusse, 92141, Clamart CEDEX, France.
  • 6 Intensive Care Unit and Hyperbaric Center, Lille University Hospital, F-59037, Lille CEDEX, France.
  • 7 General ICU, Service de Réanimation, Hôpital Raymond Poincaré, Laboratory of Infection and Inflammation, U1173, AP-HP, University of Versailles SQY and INSERM, 104 Boulevard Raymond Poincaré, 92380, Garches, France.
  • 8 Centre de traitement des grands brûlés Hopital de la Conception APHM, 147 boulevard Baille, 13005, Marseille, France.
  • 9 Intensive Care Unit, Anaesthesia and Critical Care Department, Hôtel Dieu-HME, CHU Nantes, Nantes, France.
  • 10 Centre de traitement des grands brûlés Hopital de Mercy,1 Allée du Château, 57245 Ars-Laquenexy-C.H.R Metz-, Thionville, France.
  • 11 Anesthesiology and Critical Care Medicine, Hospices Civils de Lyon-Université Claude Bernard Lyon 1, Lyon, France.
  • 12 Anesthesiology and Critical Care Medicine, CHU Bordeaux, Place Amélie Raba Léon, 33000, Bordeaux, France.
  • 13 Intensive Care Medicine Department, University of Montpellier Lapeyronie Hospital, 371, Av Doyen Gaston Giraud, 34295, Montpellier, France.
  • 14 Intensive Care Medicine Department, CHU de Rennes, 2 rue Henri Le Guilloux, 35033, Rennes CEDEX 9, France.
  • 15 Service de réanimation médico-chirurgicale, Groupe Hospitalier du Havre-Hôpital Jacques Monod, Montivilliers, France.
  • 16 Medical Intensive Care Unit, La Source Hospital, CHR Orléans, Orléans, France.
  • 17 Department of Perioperative Medicine, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.
  • 18 Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France.
  • 19 Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France.
  • 20 Medical Intensive Care Unit, Caen University Hospital, Avenue côte de Nacre, 14033, Caen CEDEX, France.
  • 21 Service de Réanimation Médicale, Centres Hospitaliers Universitaires Grenoble Alpes, Grenoble, France.
  • 22 Service de Réanimation Médicale Polyvalente, Centre Hospitalier Public du Cotentin, BP 208, 50102, Cherbourg-Octeville, France.
  • 23 Service de Réanimation Médicale, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France.
  • 24 Faculté de Médecine, Université Paris Descartes, Paris, France.
  • 25 Département des urgences, service des urgences, SAMU, CHU de Limoges, 87042, Limoges CEDEX, France.
  • 26 Inserm CIC 1435, 87042, Limoges, France.
  • 27 Intensive Care Unit, Saint Louis Hospital, La Rochelle, France.
  • 28 Service de réanimation médicale et toxicologie, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France.
  • 29 Service d'hépato gastro entérologie Hôpital Cochin, hépato Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France.
  • 30 Department of Anesthesia and perioperative care, University of California San Francisco, San Francisco, USA.
  • 31 Department of Anesthesiology and Critical Care and Burn Unit, AP-HP, GH Saint Louis-Lariboisière, Paris, France. [email protected].
  • 32 UMR INSERM 942, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France. [email protected].
  • 33 F-CRIN, INICRCT network, Paris, France. [email protected].
  • 34 Burn Center, Percy Military Teaching Hospital, BP 406, 101, avenue Henri-Barbusse, 92141, Clamart CEDEX, France. [email protected].
  • 35 Department of Anesthesiology and Perioperative care Parnassus hospital, UCSF, San Francisco, USA. [email protected].
PMID: 31870461 DOI: 10.1186/s13054-019-2706-0
Abstract

Background: The use of hydroxocobalamin has long been advocated for treating suspected cyanide poisoning after smoke inhalation. Intravenous hydroxocobalamin has however been shown to cause oxalate nephropathy in a single-center study. The impact of hydroxocobalamin on the risk of acute kidney injury (AKI) and survival after smoke inhalation in a multicenter setting remains unexplored.

Methods: We conducted a multicenter retrospective study in 21 intensive care units (ICUs) in France. We included patients admitted to an ICU for smoke inhalation between January 2011 and December 2017. We excluded patients discharged at home alive within 24 h of admission. We assessed the risk of AKI (primary endpoint), severe AKI, major adverse kidney (MAKE) events, and survival (secondary endpoints) after administration of hydroxocobalamin using logistic regression models.

Results: Among 854 patients screened, 739 patients were included. Three hundred six and 386 (55.2%) patients received hydroxocobalamin. Mortality in ICU was 32.9% (n = 243). Two hundred eighty-eight (39%) patients developed AKI, including 186 (25.2%) who developed severe AKI during the first week. Patients who received hydroxocobalamin were more severe and had higher mortality (38.1% vs 27.2%, p = 0.0022). The adjusted odds ratio (95% confidence interval) of AKI after intravenous hydroxocobalamin was 1.597 (1.055, 2.419) and 1.772 (1.137, 2.762) for severe AKI; intravenous hydroxocobalamin was not associated with survival or MAKE with an adjusted odds ratio (95% confidence interval) of 1.114 (0.691, 1.797) and 0.784 (0.456, 1.349) respectively.

Conclusion: Hydroxocobalamin was associated with an increased risk of AKI and severe AKI but was not associated with survival after smoke inhalation.

Trial registration: ClinicalTrials.gov, NCT03558646.

Keywords

Acute kidney injury; Burn; Hydroxocobalamin; Intensive care unit; Mortality; Smoke inhalation.

Figures
Products