Abstract

CINESI GOMEZ, César et al. Mortalidad y fracaso renal agudo en pacientes con ventilación no invasiva. Medicina (B. Aires) [online]. 2019, vol.79, n.5, pp.367-372. ISSN 0025-7680.

We developed a prospective observational study, obtaining clinical and analytical data of patients admitted to the intensive care unit of the Hospital Reina Sofía, who required noninvasive ventilation, from January 1, 2013 to December 31, 2015. The main objective was to determine the 90-day mortality in these patients and conditions, who required noninvasive ventilation as treatment for acute respiratory failure and who developed acute kidney injury. Acute renal failure was defined as an increase in serum creatinine > 0.3 mg/dl at 48 hours with respect to the baseline. The patients were followed for 90 days. We analyzed 221 patients, 65 (29.4%) presented acute kidney injury and 156 (70.6%) normal renal function. Overall mortality at 90 days was 44 (19.9%). In the group of acute kidneys injury, it was 33 (51.6%), being 11 (7.1%) in patients without acute kidney injury (RR 7.340, 95% CI: 3.974-13.559, p < 0.001). Hospital stay in days was 24.2 ± 24.1 with acute kidney injury vs. 21.5 ± 0.7, p = 0.429; stay in the intensive care unit in days was 10.9 ± 14.4 with acute kidney injury vs. 7.3 ± 9.6, p = 0.357, and days of non-invasive ventilation 3.4 ± 3.0 with acute kidney injury vs. 2.7 ± 1.9, p = 0.569, in those patients not affected by the presence of acute kidney injury. In conclusion, the presence of acute kidney injury is an independent factor of mortality in patients with acute respiratory failure requiring noninvasive ventilation.

Keywords : Acute respiratory failure; Acute kidney injury; Noninvasive ventilation; Intensive care unit; Chronic obstructive pulmonary disease; Acute pulmonary edema.

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