Synergistic effect of acute renal failure and respiratory failure in the surgical intensive care unit

1981 ◽  
Vol 141 (4) ◽  
pp. 492-496 ◽  
Author(s):  
Stephen J. Sweet ◽  
Christopher U. Glenney ◽  
John P. Fitzgibbons ◽  
Paul Friedmann ◽  
Daniel Teres
Keyword(s):  
Intensive Care Unit ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Synergistic Effect ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care

The Impact of Mild Renal Dysfunction on Postoperative Mortality in the Surgical Intensive Care Unit

2007 ◽  
Vol 73 (8) ◽  
pp. 743-747
Author(s):  
Mary-Margaret Brandt ◽  
Anthony Falvo ◽  
H. Mathilda Horst
Keyword(s):  
Intensive Care Unit ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Renal Dysfunction ◽  
Postoperative Mortality ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
The Impact

The negative impact of mild to moderate renal dysfunction on patient outcome is often underestimated. Any amount of renal dysfunction is deleterious in the surgical intensive care unit (SICU). We evaluated all surgery patients admitted to our SICU. We identified two groups of patients: no renal failure and acute renal failure. A total of 5152 patients were included in this study. There were 1259 patients in the acute renal failure group. The average number of ventilator days increased by 2.2 for every increase of creatinine by 1.0. Patients who required dialysis stayed an average of 11 days longer than patients who did not have any renal failure. For every increase of creatinine by 1.0, average cost increased by $23,048. Only 7 per cent of the patients with acute renal failure required dialysis (n = 85). The odds ratio for mortality compared with those patients without renal failure was 7.06 (confidence interval, 3.91–12.76) regardless of the definition of renal failure. This study demonstrates that even mild to moderate renal failure increases mortality. Moreover, we demonstrated that even a mild decline in renal function increases length of stay, ventilator days, and cost in patients in the SICU. Aggressive vigilance in the prevention of any loss of renal function is warranted in the SICU.

scholarly journals Heparin-induced thrombocytopenia and COVID-19

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Michelangelo Sartori ◽  
Benilde Cosmi
Keyword(s):  
Intensive Care Unit ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Platelet Count ◽  
Respiratory Failure ◽  
Heparin Dose ◽  
Heparin Induced Thrombocytopenia ◽  
Calcium Heparin ◽  
Possible Cause

Heparin-induced thrombocytopenia (HIT) has not been included as a possible cause of thrombocytopenia in Coronavirus Disease 2019 (COVID-19) patients. We report a case of HIT in a patient with COVID-19 treated with heparin. A 78-yearold man was admitted to our hospital for acute respiratory failure and acute renal failure due to SARS-CoV-2 infection; in intensive care unit, one 5000IU heparin dose (day 0, platelet count 305000/μL). On day 2, haemoglobin started to decrease and heparin was stopped. On day 10, platelet count was 153000/μL and 5000IU calcium heparin subcutaneously twice daily was started. The platelet further decreased, reaching 49000/μL on day 17, and the patient was investigated for suspected HIT: an IgG specific chemiluminescence test for heparin- PF4 antibodies was positive and a femoral DVT was found at ultrasound. Argatroban was started, platelet count increased without any bleeding and thrombosis complication. Our experience shows that HIT may develop in heparin treated COVID-19 patients and should be included among the possible cause of thrombocytopenia in such patients.

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