Association between hydroxocobalamin administration and acute kidney injury after smoke inhalation: a multicenter retrospective study
François Dépret,
Clément Hoffmann,
Laura Daoud,
Camille Thieffry,
Laure Monplaisir,
Jules Creveaux,
Djillali Annane,
Erika Parmentier,
Daniel Mathieu,
Sandrine Wiramus,
Dominique Demeure DIt Latte,
Aubin Kpodji,
Julien Textoris,
Florian Robin,
Kada Klouche,
Emmanuel Pontis,
Guillaume Schnell,
François Barbier,
Jean-Michel Constantin,
Thomas Clavier,
Damien du Cheyron,
Nicolas Terzi,
Bertrand Sauneuf,
Emmanuel Guerot,
Thomas Lafon,
Alexandre Herbland,
Bruno Megarbane,
Thomas Leclerc,
Vincent Mallet,
Romain Pirracchio,
Matthieu Legrand
Affiliations
François Dépret
Department of Anesthesiology and Critical Care and Burn Unit, AP-HP, GH Saint Louis-Lariboisière
Clément Hoffmann
Burn Center, Percy Military Teaching Hospital
Laura Daoud
Department of Anesthesiology and Critical Care and Burn Unit, AP-HP, GH Saint Louis-Lariboisière
Camille Thieffry
Intensive Care Unit and Hyperbaric Center, Lille University Hospital
Laure Monplaisir
Department of Anesthesiology and Critical Care and Burn Unit, AP-HP, GH Saint Louis-Lariboisière
Jules Creveaux
Burn Center, Percy Military Teaching Hospital
Djillali Annane
General ICU, Service de Réanimation, Hôpital Raymond Poincaré, Laboratory of Infection and Inflammation, U1173, AP-HP, University of Versailles SQY and INSERM
Erika Parmentier
Intensive Care Unit and Hyperbaric Center, Lille University Hospital
Daniel Mathieu
Intensive Care Unit and Hyperbaric Center, Lille University Hospital
Sandrine Wiramus
Centre de traitement des grands brûlés Hopital de la Conception APHM
Dominique Demeure DIt Latte
Intensive Care Unit, Anaesthesia and Critical Care Department, Hôtel Dieu—HME, CHU Nantes
Aubin Kpodji
Centre de traitement des grands brûlés Hopital de Mercy,1 Allée du Château
Julien Textoris
Anesthesiology and Critical Care Medicine, Hospices Civils de Lyon—Université Claude Bernard Lyon 1
Florian Robin
Anesthesiology and Critical Care Medicine, CHU Bordeaux
Kada Klouche
Intensive Care Medicine Department, University of Montpellier Lapeyronie Hospital
Emmanuel Pontis
Intensive Care Medicine Department, CHU de Rennes
Guillaume Schnell
Service de réanimation médico-chirurgicale, Groupe Hospitalier du Havre—Hôpital Jacques Monod
François Barbier
Medical Intensive Care Unit, La Source Hospital, CHR Orléans
Jean-Michel Constantin
Department of Perioperative Medicine, University Hospital of Clermont-Ferrand
Thomas Clavier
Department of Anesthesiology and Critical Care, Rouen University Hospital
Damien du Cheyron
Medical Intensive Care Unit, Caen University Hospital
Nicolas Terzi
Service de Réanimation Médicale, Centres Hospitaliers Universitaires Grenoble Alpes
Bertrand Sauneuf
Service de Réanimation Médicale Polyvalente, Centre Hospitalier Public du Cotentin
Emmanuel Guerot
Service de Réanimation Médicale, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris
Thomas Lafon
Département des urgences, service des urgences, SAMU, CHU de Limoges
Alexandre Herbland
Intensive Care Unit, Saint Louis Hospital
Bruno Megarbane
Service de réanimation médicale et toxicologie, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris
Thomas Leclerc
Paris Diderot University
Vincent Mallet
Service d’hépato gastro entérologie Hôpital Cochin, hépato Cochin, Assistance Publique-Hôpitaux de Paris
Romain Pirracchio
Department of Anesthesia and perioperative care, University of California San Francisco
Matthieu Legrand
Department of Anesthesiology and Critical Care and Burn Unit, AP-HP, GH Saint Louis-Lariboisière
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
