Acute renal failure in acute respiratory distress syndrome

1998 ◽  
pp. 1047-1053
Author(s):  
Daniel P. Schuster ◽  
David Windus
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome

scholarly journals Histological Changes in the Components of Aerogematic Barrier in 24 Hours after Modeling of Acute Renal Failure

2021 ◽  
Vol 6 (3) ◽  
pp. 96-101
Author(s):  
I. P. Klishch ◽  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Ultrastructural Changes ◽  
Blood Capillaries

Nowadays, acute renal failure remains one of the most complex problems in modern medicine. Multiple studies have proved that acute renal failure is frequently accompanied by the development of acute lung injury and its most severe form – acute respiratory distress syndrome. According to the literature, lethality in case of acute lung injury or acute respiratory distress syndrome is extremely high and is 30-65%. In case of combination of acute renal failure and acute lung injury or acute respiratory distress syndrome, the most frequently observed in critical patients, lethality reaches 80%. The purpose of the study was to study the possibility of ultrastructural changes of the respiratory tract in the lungs due to experimental modeling of acute renal failure. Materials and methods. The experiments were performed on 30 mature white male rats weighting 180-220 grams. Acute renal failure was induced by intramuscular administration of 50% glycerol water solution in dose of 10 ml per 1 kg of body mass. The sampling of lung tissue for electron microscopy study was carried out under the ketamine anaesthesia in 24 hours after beginning of the experiment. The pieces of lung tissue were fixed in 2.5% solution of gluteraldehyde with further postfixation in 1% solution of osmium tetroxide. After dehydration, the material was poured over epon araldite. The cuts, obtained on ultramicrotome “Tesla BS-490”, were studied using electron microscope “PEM-125K”. Results and discussion. In 24 hours after the beginning of the experiment, the changes in the alveolocytes of types I and II, endotheliocytes, alveolar macrophages are accompanied by the development of intracellular edema with ultrastructural disorder of organelles. Because of endotheliocytes edema and aggregation of forming blood elements, some blood capillaries lumens are closed or drastically narrowed. In some blood capillaries, we observe disorder of the luminal membrane integrity of endothelial cells accompanied by exit of the intracellular content into the micro blood vessel lumen. The expressed disorders of structural organization of the components of pulmonary aero-hematic barrier cause the exit of forming blood elements into the interstitial tissue and alveoli. Conclusion. Тhe detected changes in 24 hours of the experiment have a dystrophic-destructive character and are manifested by the development of edema in alveolocytes of types I and II, alveolar macrophages, endotheliocytes of hemocapillaries. Perspective for further research. Considering the severity of ultrastructural changes that develop in experimental acute renal failure, it would be reasonable to conduct a further study in order to find possible methods of prevention and timely correction

scholarly journals Features of imported falciparum malaria: the case report

2021 ◽  
pp. 68-73
Author(s):  
O. Golubovska ◽  
O. Gudzenko ◽  
A. Zaplotna ◽  
I. Shestakova ◽  
O. Bezrodna ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Case Report ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Falciparum Malaria ◽  
Clinical Case ◽  
Distress Syndrome ◽  
Severe Anemia

The clinical case of imported falciparum malaria is described in the article. The diagnosis was confirmed on the 6-th day of the disease when cerebral presentations manifested. The course of the disease was severe and it was characterized by serious complications due to late diagnosis and starting of treatment: malaria coma, malaria alhid, acute respiratory distress syndrome, nozocomial pneumonia, acute renal failure, malaria hepatitis, severe hemolytic anemia. The patient recovered. Presentations of severe anemia progressed after plasmodium disappearance in the blood and persisted after discharge of patient from the hospital.

scholarly journals CLINICAL COURSE AND OUTCOME OF COVID-19 ACUTE RESPIRATORY DISTRESS SYNDROME: DATA FROM A NATIONAL REPOSITORY

2020 ◽  
Author(s):  
Ali A. El-Solh ◽  
Umberto G. Meduri ◽  
Yolanda Lawson ◽  
Michael Carter ◽  
Kari A. Mergenhagen
Keyword(s):  
Septic Shock ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Hospitalized Patients ◽  
Historical Cohort ◽  
Risk Of Death

ABSTRACTBackgroundMortality attributable to coronavirus disease-19 (COVID-19) 2 infection occurs mainly through the development of viral pneumonia-induced acute respiratory distress syndrome (ARDS).Research QuestionThe objective of the study is to delineate the clinical profile, predictors of disease progression, and 30-day mortality from ARDS using the Veterans Affairs Corporate Data Warehouse.Study Design and MethodsAnalysis of a historical cohort of 7,816 hospitalized patients with confirmed COVID-19 infection between January 1, 2020, and August 1, 2020. Main outcomes were progression to ARDS and 30-day mortality from ARDS, respectively.ResultsThe cohort was comprised predominantly of men (94.5%) with a median age of 69 years (interquartile range [IQR] 60-74 years). 2,184 (28%) were admitted to the intensive care unit and 643 (29.4%) were diagnosed with ARDS. The median Charlson Index was 3 (IQR 1-5). Independent predictors of progression to ARDS were body mass index (BMI)≥ 40 kg/m2, diabetes, lymphocyte counts<700×109/L, LDH>450 U/L, ferritin >862 ng/ml, C-reactive protein >11 mg/dL, and D-dimer >1.5 ug/ml. In contrast, the use of an anticoagulant lowered the risk of developing ARDS (OR 0.66 [95% CI 0.49-0.89]. Crude 30-day mortality rate from ARDS was 41% (95% CI 38%-45%). Risk of death from ARDS was significantly higher in those who developed acute renal failure and septic shock. Use of an anticoagulant was associated with two-fold reduction in mortality. Survival benefit was observed in patients who received corticosteroids and/or remdesivir but there was no advantage of combination therapy over either agent alone.ConclusionsAmong those hospitalized for COVID-19, nearly one in ten progressed to ARDS. Septic shock, and acute renal failure are the leading causes of death in these patients. Treatment with either remdesivir and corticosteroids reduced the risk of mortality from ARDS. All hospitalized patients with COVID-19 should be placed at a minimum on prophylactic doses of anticoagulation.

scholarly journals Clinical Course and Outcome of COVID-19 Acute Respiratory Distress Syndrome: Data From a National Repository

2021 ◽  
pp. 088506662199447
Author(s):  
Ali A. El-Solh ◽  
Umberto G. Meduri ◽  
Yolanda Lawson ◽  
Michael Carter ◽  
Kari A. Mergenhagen
Keyword(s):  
Septic Shock ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Hospitalized Patients ◽  
Historical Cohort ◽  
Risk Of Death

Background: Mortality attributable to coronavirus disease-19 (COVID-19) 2 infection occurs mainly through the development of viral pneumonia-induced acute respiratory distress syndrome (ARDS). Research Question: The objective of the study is to delineate the clinical profile, predictors of disease progression, and 30-day mortality from ARDS using the Veterans Affairs Corporate Data Warehouse. Study Design and Methods: Analysis of a historical cohort of 7,816 hospitalized patients with confirmed COVID-19 infection between January 1, 2020, and August 1, 2020. Main outcomes were progression to ARDS and 30-day mortality from ARDS, respectively. Results: The cohort was comprised predominantly of men (94.5%) with a median age of 69 years (interquartile range [IQR] 60-74 years). 2,184 (28%) were admitted to the intensive care unit and 643 (29.4%) were diagnosed with ARDS. The median Charlson Index was 3 (IQR 1-5). Independent predictors of progression to ARDS were body mass index (BMI) ≥40 kg/m2, diabetes, lymphocyte counts <700 × 109/L, LDH >450 U/L, ferritin >862 ng/ml, C-reactive protein >11 mg/dL, and D-dimer >1.5 ug/ml. In contrast, the use of an anticoagulant lowered the risk of developing ARDS (OR 0.66 [95% CI 0.49-0.89]. Crude 30-day mortality rate from ARDS was 41% (95% CI 38%-45%). Risk of death from ARDS was significantly higher in those who developed acute renal failure and septic shock. Use of an anticoagulant was associated with 2-fold reduction in mortality. Survival benefit was observed in patients who received corticosteroids and/or remdesivir but there was no advantage of combination therapy over either agent alone. Conclusions: Among those hospitalized for COVID-19, nearly 1 in 10 progressed to ARDS. Septic shock, and acute renal failure are the leading causes of death in these patients. Treatment with either remdesivir and corticosteroids reduced the risk of mortality from ARDS. All hospitalized patients with COVID-19 should be placed at a minimum on prophylactic doses of anticoagulation.

scholarly journals Acute respiratory distress syndrome and acute renal failure from Plasmodium ovale infection with fatal outcome

2013 ◽  
Vol 12 (1) ◽  
Author(s):  
Yee-Ling Lau ◽  
Wenn-Chyau Lee ◽  
Lian-Huat Tan ◽  
Adeeba Kamarulzaman ◽  
Sharifah Faridah Syed Omar ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Fatal Outcome ◽  
Plasmodium Ovale

scholarly journals Acute pancreatitis : a newly recognised potential complication of canine babesiosis

2000 ◽  
Vol 71 (4) ◽  
Author(s):  
A.J. Möhr ◽  
R.G. Lobetti ◽  
J.J. Van der Lugt
Keyword(s):  
Renal Failure ◽  
Acute Pancreatitis ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Haemolytic Anaemia ◽  
Distress Syndrome ◽  
Pathophysiological Mechanism ◽  
Canine Babesiosis ◽  
Immune Mediated

This retrospective study describes 4 cases of canine babesiosis with histologically confirmed acute pancreatitis. In addition, 16 dogs with babesiosis are reported with serum amylase (>3500 U/l ) and/or lipase (>650 U/l ) activity elevations of a magnitude that would support a diagnosis of probable acute pancreatitis, although extra-pancreatic sources of the enzymes could not be excluded in these cases. Median time of pancreatitis diagnosis was 2.5 days post-admission, with primarily young (median age 3 years), sexually intact dogs affected. The development of pancreatitis was unrelated to the degree of anaemia at time of admission. In addition to pancreatitis, 80 % of cases suffered from other babesial complications, namely icterus (13), acute respiratory distress syndrome (6), immune-mediated haemolytic anaemia (6), renal failure (3), haemoconcentration (2) and cerebral syndrome (2). Acute respiratory distress syndrome, renal failure and cerebral syndrome were associated with a poor prognosis, with 4 of the 5 dogs included in the overall 26 % mortality rate having at least 1 of these complications. Haemolytic anaemia with ischaemia-reperfusion injury to the pancreas is proposed as a possible primary pathophysiological mechanism in babesial pancreatitis. Hypotensive shock, immune-mediated haemolytic anaemia, haemoconcentration and possibly altered lipid metabolism in babesiosis may also be involved. The previously postulated pro-inflammatory cytokine milieu of complicated babesiosis may underlie the progression, if not the primary initiation, of pancreatic pathology. Acute pancreatitis may represent the previously reported 'gut' form of babesiosis.

Does acute kidney injury affect survival in adults with acute respiratory distress syndrome requiring extracorporeal membrane oxygenation?

Perfusion ◽  
2018 ◽  
Vol 33 (5) ◽  
pp. 375-382 ◽  
Author(s):  
Richard Devasagayaraj ◽  
Nicholas C. Cavarocchi ◽  
Hitoshi Hirose
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Kidney Injury ◽  
Membrane Oxygenation ◽  
Vv Ecmo

Introduction: Patients who develop severe acute respiratory distress syndrome (ARDS) despite full medical management may require veno-venous extracorporeal membrane oxygenation (VV ECMO) to support respiratory function. Survival outcomes remain unclear in those who develop acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) during VV ECMO for isolated severe respiratory failure in adult populations. Methods: A retrospective chart review (2010-2016) of patients who underwent VV ECMO for ARDS was conducted with university institutional review board (IRB) approval. Patients supported by veno-arterial ECMO were excluded. AKI was defined by acute renal failure receiving CRRT and the outcomes of patients on VV ECMO were compared between the AKI and non-AKI groups. Results: We identified 54 ARDS patients supported by VV ECMO (mean ECMO days 12 ± 6.7) with 16 (30%) in the AKI group and 38 (70%) in the non-AKI group. No patient had previous renal failure and the serum creatinine was not significantly different between the two groups at the time of ECMO initiation. The AKI group showed a greater incidence of complications during ECMO, including liver failure (38% vs. 5%, p=0.002) and hemorrhage (94% vs. 45%, p=0.0008). ECMO survival of the AKI group (56% [9/16]) was inferior to the non-AKI group (87% [33/38], p=0.014). Conclusions: Our study demonstrated that VV ECMO successfully manages patients with severe isolated lung injury. However, once patients develop AKI during VV ECMO, they are likely to further develop multi-organ dysfunction, including hepatic and hematological complications, leading to inferior survival.

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