ISSN:
1432-1238
Keywords:
Key words Acute renal failure
;
Trauma
;
Rhabdomiolysis
;
Mechanical ventilation
;
Hemoperitoneum
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Objective: To elucidate the risk factors for the development of acute renal failure (ARF) in severe trauma. Design: Prospective observational study. Setting: A general intensive care unit (ICU) of a university hospital. Patients: A cohort of 153 consecutive trauma patients admitted to the ICU over a period of 30 months. Results: Forty-eight (31 %) patients developed ARF. They were older than the 105 patients without ARF (p = 0.002), had a higher Injury Severity Score (ISS) (p 〈 0.001), higher mortality (p 〈 0.001), a more compromised neurological condition (p = 0.007), and their arterial pressure at study entry was lower (p = 0.0015). In the univariate analysis, the risk of ARF increased by age, ISS 〉 17, the presence of hemoperitoneum, shock, hypotension, or bone fractures, rhabdomyolysis with creatine phosphokinase (CPK) 〉 10 000 IU/l, presence of acute lung injury requiring mechanical ventilation, and Glasgow Coma Score 〈 10. Sepsis and use of nephrotoxic agents were not associated with an increased risk of ARF. In the logistic model, the need for mechanical ventilation with a positive end-expiratory pressure 〉 6 cm H2O, rhabdomyolysis with CPK 〉 10 000 IU/l, and hemoperitoneum were the three conditions most strongly associated with ARF. Conclusions: The identified risk factors for post-traumatic acute renal failure may help the provision of future strategies.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001340050670
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