Vieira ACN, da Paixão DTT, Gouveia CKK, Viana SI, de Souza HPR, da Silva MMC

Language: Spanish
References: 38
Page: 1-21
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ABSTRACT

Introduction: Scientific evidence associates the use of invasive mechanical ventilation with a higher probability of developing acute kidney injury, but the lack of consensus on this association is not uncommon.
Objective: To identify the relationship between mechanical ventilation times and the onset and severity of acute kidney injury.
Methods: Historical cohort carried out, between 2016 and 2018, in an intensive care unit of the Federal District, Brazil. The population consisted of 387 patients, but the sample consisted of 52 patients who required invasive mechanical ventilation for one week and two. The data were recorded with a structured questionnaire composed of identification variables, clinical data, hemodynamic variables and laboratory parameters. Chi-square, Fisher's exact and Mann-Whitney tests were used for the association analysis. Results with P < 0.05 were considered significant.
Results: Acute kidney injury of different severity degrees predominated in more than half of the patients (55.80%), stage 2 being the most prevalent (approximately 30%). Patients who remained on mechanical ventilation for a week or two showed a decreased risk for acute kidney injury (OR: 0.85, 95% CI: 0.72-0.99, P = 0.038 and OR: 0.77, 95% CI: 0.63-0.94, P = 0.010, respectively).
Conclusion: Acute kidney injury of different severity degrees was present in patients with invasive mechanical ventilation. However, the time of mechanical ventilation alone was not a determinant of acute kidney injury.

REFERENCES

1. Mahjoubifard M, Fard AJ, Eraghi MG, Amini S, Hashemian SM, Behrooz Farzanegan B, et al. Does Airway Pressure Release Ventilation Mode Make Difference in Cardiopulmonary Function of ICU Patients? J Cardiothorac Med. 2015 [acceso: 10/05/2020];3(4):375-8. Disponible en: Disponible en: https://www.sid.ir/en/Journal/ViewPaper.aspx?ID=533718

2. Esteban A, Frutos-Vivar F, Muriel A, Ferguson ND, Peñuelas O, Abraira V, et al. Evolution of mortality over time in patients receiving mechanical ventilation. Am J Respir Crit Care Med. 2013;188:220-30. DOI: http://dx.doi.org/10.1164/rccm.201212-2169OC

3. Goligher EC, Ferguson ND, Brochard LJ. Clinical challenges in mechanical ventilation. Lancet. 2016;387:1856-66. DOI: http://dx.doi.org/10.1016/S0140-6736(16)30176-3

4. Hough CL, Caldwell ES, Cox CE, Douglas IS, Kahn JM, White DB, et al. Development and Validation of a Mortality Prediction Model for Patients Receiving 14 Days of Mechanical Ventilation. Crit Care Med. 2015;43(11):2339-45. DOI: http://dx.doi.org/10.1097/CCM.0000000000001205

5. Barcellos RA, Chatkin JM. Impact of a multidisciplinary checklist on the duration of invasive mechanical ventilation and length of ICU stay. J Bras Pneumol. 2020;46(3):e20180261. DOI: http://dx.doi.org/10.36416/1806-3756/e20180261

6. Ioannidis G, Lazaridis G, Baka S, Mpoukovinas I, Vasilis Karavasilis V, Lampaki S, et al. Barotrauma and pneumothorax. J Thorac Dis. 2015;7(Suppl 1):S38-S43. DOI: http://dx.doi.org/10.3978/j.issn.2072-1439.2015.01.31

7. Lombardi R, Nin N, Peñuelas O, Ferreiro A, Rios F, Marin MC, et al. Acute Kidney Injury in Mechanically Ventilated Patients: The Risk Factor Profile Depends on the Timing of Aki Onset. Shock. 2017;48(4):411-7. DOI: http://dx.doi.org/10.1097/SHK.0000000000000871

8. Donoso FA, Arriagada SD, Cruces RP. Pulmonary-renal crosstalk in the critically ill patient. Rev Chil Pediatr. 2015;86(5):309-17. DOI: http://dx.doi.org/10.1016/j.rchipe.2015.07.009

9. Teixeira JP, Ambruso S, Griffin BR, Faubel S. Pulmonary Consequences of Acute Kidney Injury. Semin Nephrol. 2019;39(1):3-16. DOI: http://dx.doi.org/10.1016/j.semnephrol.2018.10.001

10. KDIGO. Clinical Practice Guideline for Acute Kidney Injury. Kidney Int. 2012 [acceso: 10/05/2020];2(Suppl):1-138. Disponible en: Disponible en: https://kdigo.org/wp-content/uploads/2016/10/KDIGO-2012-AKI-Guideline-English.pdf

11. Abd ElHafeez S, Tripepi G, Quinn R, Naga Y, Abdelmonem S, AbdelHady M, et al. Risk, Predictors, and Outcomes of Acute Kidney Injury in Patients Admitted to Intensive Care Units in Egypt. Sci Rep. 2017;7(1):17163. DOI: http://dx.doi.org/10.1038/s41598-017-17264-7

12. Miot HA. Sample size in clinical and experimental trials. J Vasc Bras. 2011 [acceso: 10/05/2020];10(4):275-8. Disponible en: Disponible en: https://www.scielo.br/pdf/jvb/v10n4/en_v10n4a01.pdf .

13. Santos LL, Magro MCS. Mechanical ventilation and acute kidney injury in patients in the intensive care unit. Acta paul enferm. 2015;28(2):146-51. DOI: http://dx.doi.org/10.1590/1982-0194201500025

14. Cunha NVA, Santana BS, Duarte TTP, Lima WL, Nava LF, Magro MMS. Positive pressure on invasive mechanical ventilation and renal implications in critical patients. Rev enferm Cent-Oeste Min. 2019;9:e3505. DOI: http://dx.doi.org/10.19175/recom.v9i0.3505

15. Mehta S, Burry L, Cook D, Fergusson D, Steinberg M, Granton J, et al. Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol: a randomized controlled trial. JAMA. 2012;308(19):1985-92. DOI: http://dx.doi.org/10.1001/jama.2012.13872

16. Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM. Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup. Nat Rev Nephrol. 2017;13(4):241-57. DOI: http://dx.doi.org/10.1038/nrneph.2017.2

17. Thongprayoon C, Qureshi F, Petnak T, Cheungpasitporn W, Chewcharat A, Cato LD, et al. Impact of Acute Kidney Injury on Outcomes of Hospitalizations for Heat Stroke in the United States. Diseases. 2020;8(3):E28. DOI: http://dx.doi.org/10.3390/diseases8030028

18. Wu Y, Hua X, Yang G, Xiang B, Jiang X. Incidence, risk factors, and outcomes of acute kidney injury in neonates after surgical procedures. Pediatr Nephrol. 2020;35(7):1341-6. DOI: http://dx.doi.org/10.1007/s00467-020-04532-4

19. Kim J, Wu A, Grogan T, Wingert T, Scovotti J, Kratzert W, et al. Frequency and Outcomes of Elevated Perioperative Lactate Levels in Adult Congenital Heart Disease Patients Undergoing Cardiac Surgery. J Cardiothorac Vasc Anesth. 2020;34(10):2641-7. DOI: http://dx.doi.org/10.1053/j.jvca.2020.01.051

20. Liu JQ, Cai GY, Liang S, Wang WL, Wang SY, Zhu FL, et al. Characteristics of and risk factors for death in elderly patients with acute kidney injury: a multicentre retrospective study in China. Postgrad Med J. 2018;94(1111):249-53. DOI: http://dx.doi.org/10.1136/postgradmedj-2017-135455

21. Liu KD, Altmann C, Smits G, Krawczeski CD, Edelstein CL, Devarajan P, et al. Serum interleukin-6 and interleukin-8 are early biomarkers of acute kidney injury and predict prolonged mechanical ventilation in children undergoing cardiac surgery: a case-control study. Crit Care. 2009;13(4):R104. DOI: http://dx.doi.org/10.1186/cc7940

22. Shetty S, Malik AH, Ali A, Yang YC, Aronow WS, Briasoulis A. Impact of acute kidney injury on in-hospital outcomes among patients hospitalized with acute heart failure - A propensity-score matched analysis. Eur J Intern Med. 2020;72(1):76-80. DOI: http://dx.doi.org/10.1016/j.ejim.2020.05.044.

23. Abdalrahim MS, Khalil AA, Alramly M, Alshlool KN, Abed MA, Moser DK. Pre-existing chronic kidney disease and acute kidney injury among critically ill patients. Heart Lung. 2020;49(5):625-9. DOI: http://dx.doi.org/10.1016/j.hrtlng.2020.04.013

24. Ambrosino N, Vitacca M. The patient needing prolonged mechanical ventilation: a narrative review. Multidiscip Respir Med. 2018;13:6. DOI: http://dx.doi.org/10.1186/s40248-018-0118-7

25. Ghauri SK, Javaeed A, Mustafa KJ, Khan AS. Predictors of prolonged mechanical ventilation in patients admitted to intensive care units: A systematic review. Int J Health Sci (Qassim). 2019 [acceso: 15/05/2020];13(6):31-8. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852505/

26. Poston JT, Koyner JL. Sepsis associated acute kidney injury. BMJ. 2019;364:k4891. DOI: http://dx.doi.org/10.1136/bmj.k4891

27. Koulouridis I, Price LL, Madias NE, Jaber BL. Hospital-acquired acute kidney injury and hospital readmission: a cohort study. Am J Kidney Dis. 2015;65(2):275-82. DOI: http://dx.doi.org/10.1053/j.ajkd.2014.08.024

28. Hemlin M, Ljungman S, Carlson J. The effects of hypoxia and hypercapnia on renal and heart function, haemodynamics and plasma hormone levels in stable COPD patients. Clin Respir J. 2007;1:80-90. DOI: http://dx.doi.org/10.1111/j.1752-699X.2007.00031.x

29. Sengthavisouk N, Lumlertgul N, Keomany C, Banouvong P, Senavong P, Sayyaphet S, et al. Epidemiology and short-term outcomes of acute kidney injury among patients in the intensive care unit in Laos: a nationwide multicenter, prospective, and observational study. BMC Med. 2020;18(1):180. DOI: http://dx.doi.org/10.1186/s12916-020-01645-3

30. Sansone GR, Frengley JD, Vecchione JJ, Manogaram MG, Kaner RJ. Relationship of the duration of ventilator support to successful weaning and other clinical outcomes in 437 prolonged mechanical ventilation patients. J Intensive Care Med. 2017;32(4):283-91. DOI: http://dx.doi.org/10.1177/0885066615626897

31. Cuvello Neto AL, Sato VAH, Mohrbacher S. Fármacos vasoativos e o rim: Yu L, Marques IDB, Costa MC, Burdmann EA. Nefrologia Intensiva. Rio de Janeiro: Roca; 2016.237-41.

32. Homsi E, Alves MAR. Biomarcadores na lesão renal aguda. In: Moura LRR, Alves MAR, Santos DR, Pecoits Filho R. Tratado de Nefrologia. Rio de Janeiro: Atheneu, 2018. p. 1103-10.

33. Mohmand H, Goldfarb S. Renal dysfunction associated with intra-abdominal hypertension and the abdominal compartment syndrome. J Am Soc Nephrol. 2011;22(4):615-21. DOI: http://dx.doi.org/10.1681/ASN.2010121222

34. Hepokoski ML, Malhotra A, Singh P, Crotty Alexander LE. Ventilator-Induced Kidney Injury: Are Novel Biomarkers the Key to Prevention? Nephron. 2018;140(2):90-3. DOI: http://dx.doi.org/10.1159/000491557

35. Rose L, McGinlay M, Amin R, Burns KE, Connolly B, Hart N, et al. Variation in Definition of Prolonged Mechanical Ventilation. Respir Care. 2017;62(10):1324-32. DOI: http://dx.doi.org/10.4187/respcare.05485

36. Sawhney S, Marks A, Fluck N, Levin A, Prescott G, Black C. Intermediate and Long-term Outcomes of Survivors of Acute Kidney Injury Episodes: A Large Population-Based Cohort Study. Am J Kidney Dis. 2017;69(1):18-28. DOI: http://dx.doi.org/10.1053/j.ajkd.2016.05.018

37. Acosta-Ochoa I, Bustamante-Munguira J, Mendiluce-Herrero A, Bustamante-Bustamante J, Coca-Rojo A. Impact on Outcomes across KDIGO-2012 AKI Criteria According to Baseline Renal Function. J Clin Med. 2019;8(9):1323. DOI: http://dx.doi.org/10.3390/jcm8091323

38. Wiersema R, Eck RJ, Haapio M, Koeze J, Poukkanen M, Keus F, et al. Burden of acute kidney injury and 90-day mortality in critically ill patients. BMC Nephrol. 2019;21(1):1. DOI: http://dx.doi.org/10.1186/s12882-019-1645-y.