Abstract
BackgroundAcute kidney injury (AKI) worsens the outcome in mechanically ventilated patients. The occurrence of AKI may have an effect on weaning from mechanical ventilation (MV). The purpose of this work is to study the effect of AKI on weaning from MV for chronic obstructive pulmonary disease (COPD) patients with respiratory failure (RF). The study included 100 mechanically ventilated COPD patients with RF. Patients were classified into group 1, mechanically ventilated COPD patients with type 2 RF who developed AKI, and group 2, mechanically ventilated COPD patients with type 2 RF, who did not develop AKI.ResultsThe age of the studied group ranged between 46 and 80 years, and serum creatinine on admission was within normal. There is a significant difference in a serum creatinine level after 2 days and after 1 week of MV in an intensive care unit (ICU) among AKI cases. There is a significant difference in weaning success between AKI and non-AKI patients with much higher weaning success in non-AKI group. Also, there is a significant reduction in glomerular filtration rate (GFR) in AKI patients after 48 h of admission.ConclusionsAKI is frequent in COPD patients within 48 h of ICU admission and MV increases the risk of AKI in COPD patients.
Highlights
Acute kidney injury (AKI) worsens the outcome in mechanically ventilated patients
Weaning success in chronic obstructive pulmonary disease (COPD) patients was related to lower APACHE Acute physiology and chronic health evaluation II (II) score, low Positive end-expiratory pressure (PEEP) used during mechanical ventilation, less days in intensive care unit (ICU), and less days on mechanical ventilation (Table 3)
APACHE II score was found to be significantly higher in COPD patients with AKI compared with patients without AKI
Summary
Acute kidney injury (AKI) worsens the outcome in mechanically ventilated patients. The occurrence of AKI may have an effect on weaning from mechanical ventilation (MV). The purpose of this work is to study the effect of AKI on weaning from MV for chronic obstructive pulmonary disease (COPD) patients with respiratory failure (RF). Acute kidney injury (AKI) is the abrupt loss of kidney function, resulting in the retention of urea and other nitrogenous waste products and dysregulation of extracellular volume and electrolytes. It is most detected by measurement of the serum creatinine, which is used to estimate the glomerular filtration rate (GFR). Mechanical ventilation (MV) causes hemodynamic abnormalities, which can, in turn, affect renal perfusion by reducing cardiac output and stimulating hormonal and sympathetic pathways [3]
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