Effect of acute kidney injury on weaning from mechanical ventilation in critically ill patients

Abstract

Acute Kidney Injury (AKI) is a frequently encountered condition in hospitalized patients specially critically ill patients in ICUs. This condition is not a single organ failure but it is a multi-organ syndrome as AKI negatively affects many other organs. In our study we chose to investigate the effect of AKI on respiratory system. Specifically on the mechanically ventilated patients and how AKI would affect the weaning of these patients. Our study sample was 150 mechanically ventilated patients. They were divided into 2 groups according to their renal function: Group A: 50 patients with normal kidney function; Group B: 100 patients suffered from AKI at any point during their admission. Serum Creatinin (SCr) and urine output was routinely recorded at admission and every 24 hours. Duration of MV, duration of weaning, rate of weaning failure and mortality rates were recorded among other data such as demographic data, SAPS score at admission, cause of admission and co-morbidities. These data were statistically analyzed between the 2 groups. As regard demographic data, SAPS score, cause of admission and co- morbidities, they all showed no statistical significant difference between the 2 groups. As regard duration of MV and duration of weaning (length of time elapsed from the moment the patient reached weaning criterion to the time the patient was extubated), there were significant statistical difference between the two groups. As the group of patients suffered from AKI lasted longer on MV and had longer duration of weaning. As regardrate of weaning failure, it was significantly higher in AKI patients (Group A). While successful first time weaning was higher in non AKI patients (Group B). Mortality rate was also significantly higher in patients was AKI (Group A) than non AKI patients (Group B). In conclusion, AKI has significant deleterious effect on respiratory system. Which is clearly seen in our resulted. As AKI significantly worsened the outcome of mechanically ventilated patients regarding days of MV, weaning failure and up to mortality rates.