Acute kidney injury and intra-abdominal hypertension in burn patients in intensive care.

Autor: Talizin TB; Universidade Estadual de Londrina, Londrina, PR, Brazil., Tsuda MS; Universidade Estadual de Londrina, Londrina, PR, Brazil., Tanita MT; Universidade Estadual de Londrina, Londrina, PR, Brazil., Kauss IAM; Universidade Estadual de Londrina, Londrina, PR, Brazil., Festti J; Universidade Estadual de Londrina, Londrina, PR, Brazil., Carrilho CMDM; Universidade Estadual de Londrina, Londrina, PR, Brazil., Grion CMC; Universidade Estadual de Londrina, Londrina, PR, Brazil., Cardoso LTQ; Universidade Estadual de Londrina, Londrina, PR, Brazil.
Jazyk: English; Portuguese
Zdroj: Revista Brasileira de terapia intensiva [Rev Bras Ter Intensiva] 2018 Mar; Vol. 30 (1), pp. 15-20. Date of Electronic Publication: 2018 Mar 01.
DOI: 10.5935/0103-507x.20180001
Abstrakt: Objective: To evaluate the frequency of intra-abdominal hypertension in major burn patients and its association with the occurrence of acute kidney injury.
Methods: This was a prospective cohort study of a population of burn patients hospitalized in a specialized intensive care unit. A convenience sample was taken of adult patients hospitalized in the period from 1 August 2015 to 31 October 2016. Clinical and burn data were collected, and serial intra-abdominal pressure measurements taken. The significance level used was 5%.
Results: A total of 46 patients were analyzed. Of these, 38 patients developed intra-abdominal hypertension (82.6%). The median increase in intra-abdominal pressure was 15.0mmHg (interquartile range: 12.0 to 19.0). Thirty-two patients (69.9%) developed acute kidney injury. The median time to development of acute kidney injury was 3 days (interquartile range: 1 - 7). The individual analysis of risk factors for acute kidney injury indicated an association with intra-abdominal hypertension (p = 0.041), use of glycopeptides (p = 0.001), use of vasopressors (p = 0.001) and use of mechanical ventilation (p = 0.006). Acute kidney injury was demonstrated to have an association with increased 30-day mortality (log-rank, p = 0.009).
Conclusion: Intra-abdominal hypertension occurred in most patients, predominantly in grades I and II. The identified risk factors for the occurrence of acute kidney injury were intra-abdominal hypertension and use of glycopeptides, vasopressors and mechanical ventilation. Acute kidney injury was associated with increased 30-day mortality.
Databáze: MEDLINE
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