Objectives : Despite efforts to treat critically ill patients requiring continuous renal replacement therapy (CRRT) due to acute kidney injury (AKI), their mortality risk remains high. This worse condition may be attributable to complications of CRRT, such as arrhythmias. We addressed the occurrence of ventricular tachycardia (VT) during CRRT and its relationship with patient outcomes.
Methods : A total of 2,397 patients who started CRRT due to AKI were retrospectively enrolled from 2010 to 2020 at Seoul National University Hospital, Korea. The occurrence of VT was evaluated from starting to weaning from CRRT. The odds ratios (ORs) of mortality outcomes were measured using logistic regression models after adjustment for multiple variables.
Results : VT occurred in 150 (6.3%) patients after starting CRRT. Among them, 95 cases were defined as sustained VT (i.e., lasting ≥ 30 sec), and the other 55 cases were defined as nonsustained VT (i.e., lasting < 30 sec). The occurrence of sustained VT was associated with a higher mortality rate than nonoccurrence (OR, 2.04 [1.23-3.39] for 30-day mortality; and OR, 4.06 [2.04-8.08] for 90-day mortality). The mortality risk did not differ between patients with nonsustained VT and nonoccurrence. History of myocardial infarction, vasopressors, and certain trends of blood laboratory findings such as acidosis and hyperkalemia were associated with the subsequent risk of sustained VT.
Conclusion: Sustained VT after starting CRRT is associated with patient mortality. The monitoring of electrolytes and acid-base status during CRRT is essential because of its relationship with the risk of VT.