Impact of invasive mechanical ventilation support on renal function in critically ill patients.
João Marcos Santos Rocha, Tayse Tâmara da Paixão Duarte, Michelle Zampieri Ipolito and 3 others
PMID 41791003WHAT IT FOUND
In 51 ICU patients on invasive ventilation, acute kidney injury was common and severe; those with AKI had higher organ-failure and nursing-workload scores.
Longer ventilation went with higher ventilator pressure and stay, not more deaths.
Key findings
01Fifty-one ICU patients on invasive ventilation were followed; 38 had acute kidney injury, and 21 recovered renal function by day 15.
02Patients with acute kidney injury had higher organ-failure and nursing-workload scores and higher lactate than patients without acute kidney injury.
03Longer ventilation (more than seven days) was seen with higher maximum PEEP and longer stay, but not with more deaths or more acute kidney injury.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a single-center retrospective cohort with a convenience sample of 51 patients, so the results may not apply to other hospitals or patient groups. The study did not assign patients to ventilation or compare it with a control group, so it cannot show that invasive mechanical ventilation caused acute kidney injury. Patients received invasive mechanical ventilation, positive end-expiratory pressure, norepinephrine, vasopressin, amikacin, vancomycin, meropenem, and tazocin together, so the contribution of any single treatment cannot be separated. Urine volume was not systematically recorded, so acute kidney injury severity was based on creatinine criteria only. The authors noted measurement bias and a small sample size.
The easy way to misread this
Do not conclude that invasive mechanical ventilation caused acute kidney injury. The paper does not separate the contributions of invasive mechanical ventilation, positive end-expiratory pressure, norepinephrine, vasopressin, amikacin, vancomycin, meropenem, and tazocin, and longer ventilation was not associated with more deaths or acute kidney injury in this small group.