Blood Potassium Level During Continuous Renal Replacement Therapy Associated With Recovery Of Post-operative Gastrointestinal Motility In Patient Undergoing Open Abdominal Surgery

Objective:To explore the potential therapeutic goal of blood potassium level during continuous renal replacement therapy(CRRT)beneficial to post-operative recovery of gastrointestinal motility in patient umdergoing open abdominal surgery.Methods:538 patients after open abdominal surgery and receiving CRRT were retrospectively recruited as the study cohort.Demographic and clinical data including plasma potassium levels were recorded along with evaluation of post-operative gastrointestinal motility.We used gastrointestinal motility recovery during 4-day period and un-recovery at 4 days after the completion of surgery as the primary endpoints.To evaluate the effect of serum potassixum on the recovery of gastrointestinal function in these patients and to obtain the optimal serum potassium level conducive to the recovery of gastrointestinal function。Results:The received operating characteristic(ROC)curve analysis demonstrated that the post-operative blood potassium level during CRRT was significantly associated with the recovery of gastrointestinal motility(AUC＝0.72,p<0.001),and plasma potassium concentration at the cut-off point of the ROC curve was 4.00 mmol/L.Kaplan-Meier analysis indicated that compared with the patients with insufficient blood potassium level(plasma potassium concentration<4.00mmol/L),those with sufficient level(plasma potassium concentration≥4.00mmol/L)had higher rate of 4-day post-operative recovery of gastrointestinal motility(p<0.001).Logistic regression analysis indicated that the post-operative blood potassium level was independently associated with the recovery of gastrointestinal motility,patients with a sufficient blood potassium level conferred an increase in the rate of 4-day post-operative recovery of gastrointestinal motility(OR=4.36,95%Cl 2.92-6.52,P<0.001).Conclusion:Our data indicated that keeping the blood potassium concentration at a relative high level of the regular blood potassium range during CRRT,would be beneficial to post-operative recovery of gastrointestinal motility.