Sugammadex use in patients with end-stage renal disease: a historical cohort study
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Sugammadex use in patients with end-stage renal disease: a historical cohort study Utilisation de sugammadex chez les patients atteints d’insuffisance re´nale terminale : une e´tude de cohorte historique Stephania Paredes, MD . Steven B. Porter, MD . Ivan E. Porter II, MD . J. Ross Renew, MD, FASA, FASE Received: 27 April 2020 / Revised: 2 July 2020 / Accepted: 5 July 2020 Ó Canadian Anesthesiologists’ Society 2020
Abstract Purpose While sugammadex (SGX) is not approved for use in patients with end-stage renal disease (ESRD), its administration in this patient population has been reported. We designed the current study to review all instances of patients with ESRD receiving SGX and to describe their clinical outcomes. Methods This is a historical cohort study of 219 patients with chronic kidney disease stage 5 who received SGX in one of three hospital locations within the same academic health system. Data were collected between 7 March 2016 and 1 August 2019 and included demographics, notable events from the anesthesia records, and postoperative complications. The primary outcome included any complication possibly related to SGX such as hypersensitivity reactions, need for reintubation, hypoxemia, pneumonia, and residual neuromuscular blockade. Secondary outcomes included any other complication not included in the primary outcome and/or patient mortality within 30 days after the procedure. Results No patient experienced a hypersensitivity reaction. Three patients required reintubation while two patients developed hypoxemia that did not require reintubation. One patient developed hospital-acquired pneumonia. Fifty (23%) patients developed other
S. Paredes, MD S. B. Porter, MD J.Ross Renew, MD, FASA, FASE (&) Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, 4500 San Pablo Road, Jacksonville, FL, USA e-mail: [email protected] I. E. Porter II, MD Division of Nephrology & Hypertension, Mayo Clinic College of Medicine, Jacksonville, FL, USA
postoperative complications (different from our primary outcome) and nine patients (4%) died during the subsequent 30 postoperative days. None of the primary or secondary outcomes appeared to be related to SGX use. Conclusions We provide incremental evidence that SGX could be considered as an alternative neuromuscular blockade reversal agent in patients with ESRD. Re´sume´ Objectif Bien que le sugammadex (SGX) ne compte pas parmi ses indications une utilisation chez les patients atteints d’insuffisance re´nale terminale (IRT), son administration a` cette population de patients est rapporte´e. Nous avons conc¸u cette e´tude afin de passer en revue tous les cas de patients atteints d’IRT ayant rec¸u du SGX et de´crire leurs devenirs cliniques. Me´thode Il s’agit d’une e´tude de cohorte historique portant sur 219 patients atteints d’insuffisance re´nale chronique de stade 5 ayant rec¸u du SGX dans l’un de trois hoˆpitaux appartenant au meˆme re´seau de sante´ universitaire. Les donne´es de´mographiques, le
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