Incidence of acute kidney injury and attributive mortality in acute respiratory distress syndrome randomized trials

Intensive Care Medicine, Journal Year: 2024, Volume and Issue: 50(8), P. 1240 - 1250

Published: June 12, 2024

The development of acute kidney injury (AKI) after the respiratory distress syndrome (ARDS) reduces chance organ recovery and survival. purpose this study was to examine AKI rate attributable mortality in ARDS patients.

Language: Английский

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Awake prone positioning in acute hypoxaemic respiratory failure

European Respiratory Review, Journal Year: 2023, Volume and Issue: 32(168), P. 220245 - 220245

Published: May 3, 2023

Awake prone positioning (APP) of patients with acute hypoxaemic respiratory failure gained considerable attention during the early phases coronavirus disease 2019 (COVID-19) pandemic. Prior to pandemic, reports APP were limited case series in influenza and immunocompromised patients, encouraging results terms tolerance oxygenation improvement. Prone awake appears result many same physiological changes improving seen invasively ventilated moderate–severe distress syndrome. A number randomised controlled studies published on varying severity COVID-19 have reported apparently contrasting outcomes. However, there is consistent evidence that more requiring advanced support, who are managed higher care environments can be for several hours, benefit most from use. We review basis by which lung mechanics gas exchange summarise latest base primarily COVID-19. examine key factors influence success APP, optimal target populations unknowns will shape future research.

Language: Английский

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Impact of mechanical ventilation on severe acute kidney injury in critically ill patients with and without COVID-19 – a multicentre propensity matched analysis

Annals of Intensive Care, Journal Year: 2025, Volume and Issue: 15(1)

Published: Jan. 25, 2025

Abstract Background Acute kidney injury (AKI) is common in critically ill patients and associated with increased morbidity mortality. Its complications often require renal replacement therapy (RRT). Invasive mechanical ventilation (IMV) infections are considered risk factors for the occurrence of AKI. The use IMV non-invasive (NIV) has changed over course pandemic. Concomitant this change treatment a reduction incidences AKI RRT was observed. We aimed to investigate impact on initiation by comparing without COVID-19. Furthermore, we wanted rates timing as well outcome patients, who were treated RRT. Results A total 8,678 included, which 555 (12.8%) COVID-19 554 control group In first week ICU stay showed significantly lower probability (day 1: p < 0.0001, day 2: = 0.021). However, after 7 reversed HR found. mechanically ventilated higher entire stay. While non-COVID-19 non-significant trend, increased. median delay between requirement observed be longer (5 days [IQR: 2–11] vs. 2 1–5]). analysis restricted death requiring compared IMV. Conclusion demonstrated that an association given all investigated time intervals. Additionally, during within admitted due respiratory disease. RRT, patients.

Language: Английский

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Acute kidney injury in the pandemic years revisited: distinct patterns of staging and recovery in patients with and without COVID-19

Journal of Nephrology, Journal Year: 2025, Volume and Issue: 38(2), P. 609 - 620

Published: March 5, 2025

Language: Английский

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Intubation in Eosinophilic Lung Disease: Predictors, Outcomes, and Characteristics from a National Inpatient Sample Analysis

Medicina, Journal Year: 2025, Volume and Issue: 61(4), P. 556 - 556

Published: March 21, 2025

Background and Objectives: Eosinophilic lung diseases (ELD) encompass disorders with an abnormally high number of polymorphonuclear eosinophils in the lungs. Presentation severity can range from low-grade fever cough to life-threatening acute respiratory distress syndrome (ARDS). Due rarity these conditions, no large sample studies have been performed assess characteristics patients pulmonary eosinophilia. Materials Methods: Patients admitted a diagnosis eosinophilia between years 2016 2020 were extracted largest inpatient US database, Nationwide Inpatient Sample (NIS). under age eighteen those diabetic ketoacidosis excluded. Baseline demographic medical comorbidities evaluated for individuals depending on intubation requirement. The primary outcomes included in-hospital mortality, intubation, length stay (LOS). Results: 3784 records extracted, among which 384 required intubation. who had higher rates mortality (23.9% vs. 1.2% p < 0.0001%) significantly more prolonged hospital (19 days 6 0.001) compared did not need Factors associated intubated group increasing (OR: 1.022, 95% CI 1.002–1.042), duration superior 96 h 2.705, 1.235–5.927), AKI 2.964, 1.637–5.366). Conclusions: Our findings suggest that ELD requiring experience kidney injury, deep venous thrombosis, ARDS.

Language: Английский

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Are Kidneys Affected by SARS-CoV-2 Infection? An Updated Review on COVID-19-Associated AKI

Pathogens, Journal Year: 2024, Volume and Issue: 13(4), P. 325 - 325

Published: April 16, 2024

Background: Human kidneys are an important target of SARS-CoV-2 infection, and many renal abnormalities have been found in patients with including proteinuria, hematuria, acute kidney injury. Acute injury is now considered a common complication COVID-19, the epidemiology AKI SARS-CoV-2-infected continues to be controversial. Aim Methods: We carried out narrative review evaluate frequency risk factors for among hospitalized due latest surveys on this topic included. The mechanisms by which occurs COVID-19 also reviewed. Results: Multiple development infection identified; these classified various groups (management background factors, others). targets indirect activity, but infects tubular epithelial cells podocytes. retrieved 24 reports (n = 502,593 unique infection) incidence 31.8% (range, 0.5% 56.9%). Only minority 2) studies had prospective design. that was greater who underwent in-hospital deaths vs. those survived; summary estimate unadjusted RR 2.63 (95% CI, 2.37; 2.93) (random-effects model). A stratified analysis showed where COVID-19-positive having comorbidities (diabetes mellitus, arterial hypertension, advanced age) high. relative (aRR) ICU admission did not; pooled 2.64 1.96; 3.56) according random-effects model. Conclusions: patients, some it. direct activity virus has mentioned pathogenesis patients. Further ongoing order identify underlying population. role survival another area active investigation.

Language: Английский

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Incidence of major adverse kidney events after ICU admission in COVID-19 and non-COVID-19 ARDS patients

BMJ Open, Journal Year: 2025, Volume and Issue: 15(5), P. e094887 - e094887

Published: May 1, 2025

Objectives To compare the incidence and drivers of major adverse kidney events (MAKEs) between COVID-19 non-COVID-19 acute respiratory distress syndrome (ARDS) patients, with a focus on long-term outcomes. Design Retrospective cohort study. Setting Single-centre intensive care unit in Midlands, UK. Participants 708 ARDS patients (458 COVID-19, 250 non-COVID-19). Primary secondary outcome measures The primary was MAKE at 365 days (MAKE-365), defined as new renal replacement therapy (RRT), estimated glomerular filtration rate (eGFR) <75% baseline or all-cause mortality. Secondary analyses examined non-mortality components. Results MAKE-365 significantly higher group compared (66% vs 39%, p<0.001), primarily driven by increased RRT initiation, followed mortality eGFR decline (p=0.055). Independent predictors included lower elevated bilirubin both groups. Age (p<0.001) diabetes (p=0.041) were additional cohort, while albumin (p=0.002) significant group. Excluding mortality, remained outcomes cohort. Conclusions Non-COVID-19 face greater risk due to requirements rates. These findings underscore importance tailored interventions nephrology follow-up, particularly for reduced eGFR, comorbidities like hypoalbuminaemia.

Language: Английский

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Incidence, Outcomes, and Predictors of Subphenotypes of Acute Kidney Injury among Acute Respiratory Distress Syndrome Patients: A Prospective Observational Study

Indian Journal of Critical Care Medicine, Journal Year: 2023, Volume and Issue: 27(10), P. 724 - 731

Published: Sept. 29, 2023

Background: Acute kidney injury (AKI) is a heterogeneous syndrome with subphenotypes.Acute one of the most common complications in acute respiratory distress (ARDS) patients, which influences mortality.Material and methods: It was single-center observational study on 266 ARDS patients invasive mechanical ventilation (IMV) to determine subphenotypes AKI associated ARDS.Subphenotyping done based serum creatinine (SCr) trajectories from day 1 5 IMV into resolving (subphenotype 1) or non-resolving 2) AKI.Results: Out 222 were included for data analysis.141 (63.51%) had AKI.The incidence subphenotype 2 among cohort 78/222 (35.13%).Subphenotype significantly more non-survivors (87.7% vs 36.2 %, p < 0.001).Subphenotype an independent predictor mortality (p 0.001, adjusted odds ratio 8.978, 95% CI [2.790-28.89].AKI higher median SCr than but lower levels by 3 IMV.The time survival 8 days 45 [Log-Rank (Mantel-Cox) 0.001].The novel DRONE score (Driving pressure, Oxygenation, Nutritional Evaluation) ≥ 4 predicted AKI.Conclusion: The (non-resolving) about 35% (vs 20% AKI), it mortality.The ≥4 can predict 2. Highlights: trajectory-based (resolving non-resolving) determines patients.Non-resolving ARDS.The (driving oxygenation, nutritional evaluation) within 48 hours ventilated patients.

Language: Английский

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New definition of AKI: shifting the focus beyond mortality

Critical Care, Journal Year: 2024, Volume and Issue: 28(1)

Published: Nov. 20, 2024

Language: Английский

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Perfusion deficits may underlie lung and kidney injury in severe COVID-19 disease: insights from a multicenter international cohort study

Journal of Anesthesia Analgesia and Critical Care, Journal Year: 2024, Volume and Issue: 4(1)

Published: July 6, 2024

Abstract Background Lung perfusion defects, mainly due to endothelial and coagulation activation, are a key contributor COVID-19 respiratory failure. patients may also develop acute kidney injury (AKI) because of renal deficit. We aimed explore AKI-associated factors the independent prediction standardized minute ventilation (MV)—a proxy alveolar dead space—on AKI onset persistence in mechanically ventilated patients. Methods This is multicenter observational cohort study. enrolled 157 requiring mechanical intensive care unit (ICU) admission. collected clinical information, ventilation, laboratory data. was defined by 2012 KDIGO guidelines classified as transient or persistent according serum creatinine criteria within 48 h. Ordered univariate multivariate logistic regression analyses were employed identify variables associated with persistence. Results Among on 47% developed AKI: 10% had AKI, 37% AKI. The degree hypoxia not differences severity. Across increasing severity groups, despite similar levels paCO 2 , we observed an increased MV MV, robust space. After adjusting for other covariates, remained predictor development d -dimer higher Conclusions In critically ill failure, wasted independently greater risk These hypothesis-generating findings suggest that derangements link pathophysiology both our population.

Language: Английский

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