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. 2018 Mar;30(1):15-20.
doi: 10.5935/0103-507x.20180001. Epub 2018 Mar 1.

Acute kidney injury and intra-abdominal hypertension in burn patients in intensive care

[Article in English, Portuguese]
Thalita Bento Talizin  1 , Meiry Sayuri Tsuda  1 , Marcos Toshiyuki Tanita  1 , Ivanil Aparecida Moro Kauss  1 , Josiane Festti  1 , Cláudia Maria Dantas de Maio Carrilho  1 , Cintia Magalhães Carvalho Grion  1 , Lucienne Tibery Queiroz Cardoso  1
Affiliations

Acute kidney injury and intra-abdominal hypertension in burn patients in intensive care

[Article in English, Portuguese]
Thalita Bento Talizin et al. Rev Bras Ter Intensiva. 2018 Mar.

Abstract

Objective: To evaluate the frequency of intra-abdominal hypertension in major burn patients and its association with the occurrence of acute kidney injury.

Methods: This was a prospective cohort study of a population of burn patients hospitalized in a specialized intensive care unit. A convenience sample was taken of adult patients hospitalized in the period from 1 August 2015 to 31 October 2016. Clinical and burn data were collected, and serial intra-abdominal pressure measurements taken. The significance level used was 5%.

Results: A total of 46 patients were analyzed. Of these, 38 patients developed intra-abdominal hypertension (82.6%). The median increase in intra-abdominal pressure was 15.0mmHg (interquartile range: 12.0 to 19.0). Thirty-two patients (69.9%) developed acute kidney injury. The median time to development of acute kidney injury was 3 days (interquartile range: 1 - 7). The individual analysis of risk factors for acute kidney injury indicated an association with intra-abdominal hypertension (p = 0.041), use of glycopeptides (p = 0.001), use of vasopressors (p = 0.001) and use of mechanical ventilation (p = 0.006). Acute kidney injury was demonstrated to have an association with increased 30-day mortality (log-rank, p = 0.009).

Conclusion: Intra-abdominal hypertension occurred in most patients, predominantly in grades I and II. The identified risk factors for the occurrence of acute kidney injury were intra-abdominal hypertension and use of glycopeptides, vasopressors and mechanical ventilation. Acute kidney injury was associated with increased 30-day mortality.

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Conflict of interest statement

Conflicts of interest: ConvaTec Inc. donated all AbViser® AutoValve® intra-abdominal pressure monitoring devices used in this study.

Figures

Figure 1
Figure 1
Selection of burn patients admitted to a specialized intensive care unit at a university hospital, 2015-2016. ICF - informed consent form; BBS - burned body surface; IAH - intra-abdominal hypertension.
Figure 2
Figure 2
Comparison of 30-day survival between patients with and without acute kidney injury in burn patients admitted to a specialized intensive care unit at a university hospital, 2015-2016. AKI - acute kidney injury. Log-rank, p = 0.009.
See this image and copyright information in PMC

Comment in

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