scholarly journals Acute Kidney Injury in Patients of Intensive Care Unit

2017 ◽  
Vol 8 (1) ◽  
pp. 38-44
Author(s):  
Nazneen Mahmood ◽  
Md Fazlur Rahman ◽  
Md Mostafizur Rahman ◽  
SM Hossain Shahid ◽  
Md Mahmudur Ahman Siddiqui

Background: Acute Kidney Injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU) and numerous causes are responsible for its development. The aim of the present study is to assess the incidence, risk factors, and outcome of patients who develop AKI in our ICU.Methodology: This study was conducted by the Department of Nephrology, Anwer Khan Modern Medical College Hospital (AKMMCH), a tertiary level center of Dhaka, during the period of January 2015 to December 2015. This is a Cross Sectional Descriptive type of Observational study on patients of Acute Kidney Injury (AKI) admitted to Intensive Care Unit (ICU) of AKMMCH.Result: A total number of 271 patients were admitted. Out of 271 patients, 59 (21.77%) patients with AKI who met our study requirements were included in the study and were evaluated. Among 59 patients 32 (54.23%) were males and 27 (45.77%) were females, with a male to female ratio of 1.19:1. The cause of admission were Diabetes mellitus with complication 11 (18.64%), Hepato-renal syndrome 10 (16.94%), Malignancy 7 (11.86%), Septicaemia 6 (10.18% ), Pneumonia 6 (10.18%), Intra-uterine death (IUD) 5 (8.48%) and others (Acute Myocardial Infarction, Non ST segment Elevated MI, Cerebro Vascular Disease, Gullain Burre Syndrome, Laparatomy, Type I and Type II Respiratory failure) 14 (23.72%). According to RIFLE's criteria most of the patients were from Injury group 32 (54.23%). Next to this, was Risk group 17 (28.83%) and in Failure, Loss and ESRD group were 7 (11.86%), 1(1.69%) and 2 (3.39%) accordingly. Regarding biochemical abnormality, mean Serum creatinine was 3.68 ± 2.15 and that of Urine output, HbA1C and HCO3 level ( in ABG ) were 4.57 ± 8.89, 6.91±1.4 and 17.14 ± 3.8 respectively. Out of 59 patients 10 (16.95%) needed Haemodialysis. According to RIFLE's criteria 7 (70%) were from Failure group, 1 patient from Loss group and 2 from ESRD group who received haemodialysis. 72.88% (43) patients improved, out of which 57.62% (34) got discharged from ICU after full recovery. 6.48% (4) patients expired and 3.38% (2) turned into ESRD and advised for regular haemodialysis.Conclusion: The incidence of AKI is high in patients admitted to ICU, and the development of AKI is associated with poor outcome and reduced survival. AKI significantly increases the duration of ICU stay, and this is likely to add to the healthcare burden. Age, gender or the presence of comorbidities do not appear to influence the incidence of AKI in our ICU patients.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 38-44

Author(s):  
Mukhlesur Rahman ◽  
Mahmuda Begum ◽  
Mujibul Hoque Khan ◽  
Mostsfa Mahfuzul Anwar

<p><strong> </strong></p><p class="abstract"><strong>Background:</strong> Tracheostomy is a commonly performed surgical procedure in the intensive care unit (ICU) in which creation of a stoma between the skin and the anterior wall of the trachea where there is need for prolong mechanical ventilation. Tracheostomy has considered a safe procedure in ICU but has been found to lead to life threatening complications intra and post operatively.</p><p class="abstract"><strong>Methods:</strong> This is a cross sectional study, was carried out in ICU, Chittagong Medical College Hospital, Chattogram from January 2018 to December 2019. A total of 120 patients irrespective of age and sex whose tracheostomy has done after admission in ICU by ENT surgeons.  </p><p class="abstract"><strong>Results:</strong> Out of 120 patients maximum 34 (28.33%) were from 21-30 years age group and male to female ratio was 1.79:1, male patients were 77 (64.16%) and female patients were 43 (35.83%). The most common indication for tracheostomy in ICU was head injury and history of RTA 34 (28.33%) followed by post-operative case of intracranial space occupying lesion 30 (25%). Post tracheostomy complication was surgical emphysema 4 (3.33%). The rate of complication of tracheostomy in ICU was 10.83% in this study. Regarding benefits of tracheostomy over endotracheal tube in ICU, we found that 100% patients had greater comfort.</p><p class="abstract"><strong>Conclusions:</strong> Tracheostomy in ICU is an important and safe procedure if prolonged endotracheal in tubation is advised for varying underlying causes.</p>


Author(s):  
Sharif Qamar Uddin ◽  
M. Nazrul Islam ◽  
M. Nizamuddin Chowdhury ◽  
Nizam Uddin Ahmed Chowdhury ◽  
Mohammad Zahir Uddin ◽  
...  

Background: Early detection of acute kidney injury (AKI) in burn-injured patients can help modify the treatment to prevent progression of acute renal failure and reduce the need for renal replacement therapy. The aim of the study was to evaluate urinary interleukin-18 in the early post-burn period to predict the AKI for the various degrees of burn patients.Methods: This prospective observational study was conducted in the department of nephrology, Dhaka medical college in collaboration with burn and plastic surgery unit of the same medical college hospital, from July 2017 to June 2018 for a period of one year. The 48 burn patients (Age>18 years) who attended in the burn unit of Dhaka medical college, Dhaka of both sexes were enrolled in this study. Data were analyzed by using SPSS 22.0. A value of p<0.05 was considered statistically significant for all tests.Results: In this study, mean age of the burn patients was 32.41±10.59 years. Male female ratio was 3.36:1. Urinary IL-18 in diagnosis of AKI showed accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 93.8%, 91.7%, 94.4%, 84.6% and 97.1% respectively. AUC for urinary IL-18 at admission was 0.968 (CI, 0.921-1.000) and AUC for serum creatinine at admission was 0.937 (CI, 0.871-1.000). Conclusions: According to Kappa value, AUC and sensitivity and specificity urinary IL-18 is a good biomarker in predicting of early AKI in burn patients.


2015 ◽  
Vol 21 (1) ◽  
pp. 28-32
Author(s):  
Muddassir Mahmud ◽  
Md Abul Hossain ◽  
Md Zakaria Sarkar ◽  
HS Mubarak Hossain ◽  
Md Obaidul Islam ◽  
...  

Objectives: To see the common indications of tracheostomy in ICU in this country, to compare the benefits over endotracheal intubation and to find out the pattern of complication of tracheostomy in the ICU to enrich the ideas for minimizing the complications.Methods: This is a cross sectional study was carried out at the Department of Otolaryngology and Head-Neck Surgery and Intensive Care Unit of Bangabandhu Sheikh Mujib Medical University & Dhaka Medical college Hospital, Dhaka from October 2012 to march 2013.This study includes all ICU patients, irrespective of age and sex, whose tracheostomy has done after admission in Intensive Care Unit.Results: The study revealed that the commonest indication of tracheostomy in the ICU was head injury with history of RTA (27.5%), followed by post operative case of Intracranial space occupying lesion (25%). Next common indications were Guillain-Barre syndrome (15%), cerebrovascular accident (12.5%), Maxillofacial trauma (5%), RTA with cervical spinal cord injury (5%), and post operative pneumonia (5%)., Regarding benefits of tracheostomy over endotracheal intubation in ICU we found that 100% patient had greater comfort.The rate of complication of tracheostomy in ICU was 10% in this study. Surgical emphysema was the commonest complications (5%) followed by haemorrhage(2.5%) and tube displacement(2.5%).Bangladesh J Otorhinolaryngol; April 2015; 21(1): 28-32


2016 ◽  
Vol 44 (2) ◽  
pp. 82-86
Author(s):  
Nitai Chandra Ray ◽  
Md Ayub Ali Chowdhury ◽  
Ashutosh Saha Roy ◽  
Md Abdul Muqueet ◽  
Binoy Paul ◽  
...  

Stroke represents a continuously evolving medical and social problem, being the third leading cause of death after heart disease and cancer in developed countries. Acute kidney injury (AKI) may develop as a possible complication after acute stroke. Insufficient care of acute stroke patients is an important factor behind it. It may be associated with a significant burden of morbidity and mortality. This cross sectional observational study was conducted in Mymensingh Medical College & Hospital, Mymensingh from July 2012 to June 2014. A total of 240 patients with newly detected acute stroke confirmed by CT scan of brain were included in this study. According to this study, 15.42% of acute stroke patients developed AKI. Majority (54.05%) of the AKI patients were in >60 years age group. 17.93 % of male patients developed AKI and 11.58% of female patients developed AKI. So, AKI was a common complication after acute stroke. Early diagnosis and management of AKI may be an important part of management of these stroke patients.Bangladesh Med J. 2015 May; 44 (2): 82-86


2017 ◽  
Vol 39 (4) ◽  
Author(s):  
Geraldo Bezerra da Silva Junior ◽  
Suzanne Vieira Saintrain ◽  
Gabriel de Castro Castelo ◽  
Vanessa Ribeiro de Vasconcelos ◽  
Juliana Gomes Ramalho de Oliveira ◽  
...  

PRILOZI ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 83-89
Author(s):  
Silvana Naunova Timovska ◽  
Svetlana Cekovska ◽  
Katerina Tosheska-Trajkovska

Abstract Objective: Acute kidney injury is common condition in the neonatal intensive care unit and it is associated with poor outcome. The incidence of neonatal AKI is the highest one followed by adults and children, depending on different factors such as the gestational age, birth weight, contributing conditions and the facilities of the neonatal intensive care unit. The aim of the study was to determine the incidence, risk factors and the outcome of the neonatal acute kidney injury. Subjects and Methods: This was a clinical, prospective study that was performed in a referent NICU at the University Children′s Hospital in Skopje. All neonates admitted from January 2012 to December 20014 with documented acute kidney injury were included. The medical data records of the admitted neonates with AKI were analyzed. The material was statistically processed using methods of the descriptive statistics. Results: During the study period 770 newborn infants were admitted to the NICU and 50 (6.5%) infants developed acute kidney injury. The male to female ratio was 2.1:1. Most of the neonates involved in the study were neonates born at term (62%). Oliguric AKI was found in 28 cases (56%) and no oliguric in 22 cases (44%). The prevalence of prerenal, renal and post renal AKI were 78.5%, 19.5% and 2.0% respectively. Perinatal asphyxia was the most common predisposing factor for AKI and was evaluated in 38% of the cases with predominance of term infants and male. The mortality rate was 32% and was significantly higher in the group of patients with congenital heart diseases. Conclusion: AKI is a life threatening condition with still high mortality rate. Early recognition of the risk factors and the rapid effective treatment of the contributing conditions will reduce AKI in the neonatal period.


2021 ◽  
Vol 13 (2) ◽  
pp. 88-98
Author(s):  
Buyung Hartiyo Laksono ◽  
Arie Zainul Fatoni ◽  
Vilda Prasastri Yuwono ◽  
Aswoco Andyk Asmoro

Latar belakang: Pengukuran central venous pressure (CVP) merupakan salah satu metode guiding deresusitasi pada pasien dengan kasus tertentu. Kenaikan nilai CVP 1 mmHg dikaitkan dengan peningkatan angka kejadian acute kidney injury (AKI). Namun sebagai sebuah metode yang invasif, pemasangan CVP memiliki risiko yang perlu diperhatikan. Di sisilain, pengukuran diameter dan indeks IVC yang bermuara di atrium kanan dengan menggunakan ultrasonografi (USG) non-invasif dinilai mampu untuk memprediksi nilai CVP pada pasien. Namun beberapa penelitian hubungan antara CVP dengan diameter dan indeks IVC memberikan hasil yang kontroversial.Tujuan: Penelitian untuk mengetahui hubungan antara nilai CVP dengan diameter dan indeks IVC.Metode: Penelitian ini menggunakan metode cross-sectional pada 30 pasien yang dilakukan ventilasi mekanik dan pemasangan CVC di unit perawatan intensif. Parameter CVP, diameter minimum dan maksimum inferior vein cava (IVC mak, IVC min), distensibillity index (DI-index), dan aortacaval index (Cava/Ao index) diukur. Data dianalisis menggunakan uji korelasi pada SPPS 18.0 (p<0.05).Hasil: Didapatkan korelasi signifikan antara CVP dan semua variabel yang diuji (IVC mak, IVC min, DI-index, dan Cava/Ao index) (p<0.05), dengan korelasi terkuat antara CVP dan IVC min (R= 0,908). Korelasi bersifat positif, kecuali antara DI-index dan CVP.Kesimpulan: Parameter IVC min, IVC mak, Cava/Ao- index, dan DI-index signifikan berkorelasi kuat dengan CVP. Korelasi terjadi bersifat positif, kecuali antara DI-index dan CVP.


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