Markers of cardiogenic shock predict persistent acute kidney injury after out of hospital cardiac arrest.

Single-centre retrospective observational study in a tertiary care centre, so results may not generalise to other settings. The analysis used 74 of 98 patients; 24 were excluded because they did not survive 72 hours or lacked recent baseline creatinine, so the findings apply to patients with available data and longer survival. Cardiac arrest and kidney data came from clinical and electronic laboratory records, which have variable reliability. Some patients had diagnostic coronary angiography, and contrast infusion may have influenced kidney function. Wall motion score index was measured only in the first 6 hours after return of spontaneous circulation, and the authors note it may not be valid in cardiac arrest patients. All patients received the same therapeutic normothermia protocol, so other temperature strategies may produce different results. The study is observational, so associations do not prove that adrenaline, lactate or dobutamine caused persistent AKI.

The authors declared no conflict of interest. The paper does not state a funding source.

Do not conclude that poor cardiac wall motion predicts persistent kidney injury. Total wall motion score index did not differ between patients with and without persistent AKI, and the study was observational, so associations do not prove cause.