Acute kidney injury following severe trauma

Eriksson, Mikael; Brattström, Olof; Mårtensson, Johan; Larsson, Emma; Oldner, Anders

doi:10.1097/ta.0000000000000727

Cited by 95 publications

(107 citation statements)

References 30 publications

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“…A minority of patients received colloids, similar to the recent FENICE survey . Many studies have questioned both the safety and the volume expansion efficacy of colloids, and especially the risk associated with HES . The use of HES in this study was scarce, and notably lower than that shown in the FENICE study, where it accounted for 11% of all fluid challenges.…”

Section: Discussionmentioning

confidence: 48%

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Shock treatment in a cohort of Scandinavian intensive care units in 2014

Kollind

Wickbom

Snäckestrand

et al. 2016

Acta Anaesthesiol Scand

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Section: Discussionmentioning

confidence: 48%

“…This has led to major changes in clinical practice, and HES is no longer recommended for fluid loading in patients with sepsis and renal impairment . Newer studies also indicate that HES may be associated with acute kidney injury in trauma, in critically ill patients in general, and is not superior to alternative intravenous fluids in the surgical setting …”

mentioning

confidence: 99%

Shock treatment in a cohort of Scandinavian intensive care units in 2014

Kollind

Wickbom

Snäckestrand

et al. 2016

Acta Anaesthesiol Scand

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“…Traumas typical in low-resourced settingsroad traffic injuries, burns, crushing in earthquakes or structural collapsescan result in AKI secondary to fluid loss, hemorrhage, and rhabdomyolysis from crush injuries. The majority of trauma-based AKI studies worldwide have looked at critically ill adult trauma patients and these report highly variable AKI rates, ranging 1-50% [9][10][11][12][13][14]. Though pediatric trauma studies on AKI are scarce, a California study suggests 13% of pediatric post-traumatic rhabdomyolysis patients experience AKI [15].…”

Section: Introductionmentioning

confidence: 99%

Incidence and epidemiology of acute kidney injury in a pediatric Malawian trauma cohort: a prospective observational study

et al. 2020

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Background: Acute kidney injury (AKI) is highly associated with mortality risk in children worldwide. Trauma can lead to AKI and is a leading cause of pediatric death in Africa. However, there is no information regarding the epidemiology of pediatric, trauma-associated AKI in Africa.Methods: Prospective cohort study of pediatric trauma patients admitted to a tertiary referral hospital in Malawi. Participants enrolled at admission were followed prospectively throughout their hospitalization. AKI was defined by creatinine-only Kidney Disease Improving Global Outcomes criteria. We calculated descriptive statistics and univariate relative risks (RR) for hypothesis-generation of potential risk factors associated with AKI. Results: We analyzed data from 114 participants. Depending on baseline creatinine definition, AKI incidence ranged from 4 to 10%. The new Schwartz equation estimated baseline creatinine values best and yielded an AKI incidence of 9.7%. Almost one in ten children died during hospitalization, but those with AKI (n = 4) were at significantly higher risk of death compared to those without AKI (40.0% vs 6.2%; RR 6.5, 95% CI 2.2-19.1). Burn injuries were most commonly associated with AKI (63.6%). Other potential AKI risk factors included multiple injuries, trunk or facial injuries, and recent consumption of herbal remedies. Conclusions: AKI occurs in up to 10% of admitted pediatric trauma patients in Malawi and increases the risk of death 7-fold compared to those without AKI. This large unrecognized burden in trauma requires further investment by researchers, clinicians and policymakers to develop evidenced-based triage, recognition, and management approaches to prevent the associated sequelae and potential mortality from AKI.

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“…The results are also supported by some studies in trauma populations that failed to identify contrast dosage as a predisposing factor for CIN 810 13 14 16 17 19 25 Accordingly, it appears that the risk of intravenous contrast-induced nephrotoxicity may not really be as great as we have come to believe 11…”

Section: Discussionmentioning

confidence: 53%

Does angiography increase the risk of impairment in renal function during non-operative management of patients with blunt splenic injuries? A cross-sectional study in southern Taiwan

et al. 2016

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ObjectivesThe aim of the present study was to assess whether angiography after contrast-enhanced CT (CECT) as per the policy of non-operative management would add to the risk of acute kidney injury in patients with blunt splenic injuries (BSIs).DesignCross-sectional study.SettingTaiwan.ParticipantsPatients with BSI aged >16 years, admitted to a level I trauma centre during the period of January 2004 to December 2014, were retrospectively reviewed. A total of 326 patients with BSI with CECT were included in the study, of whom 100 underwent subsequent angiography and 226 did not.Main outcome measuresIncidence of contrast-induced nephropathy (CIN) and renal function as measured by the 48-hour serum creatinine (SCr) levels.ResultsNo significant difference between the patients who underwent angiography and those who did not in terms of the initial haemoglobin (Hb), SCr or estimated glomerular filtration rate (eGFR) level on arrival at the emergency department, 48 hours later, or at discharge. No significant difference in the incidence of CIN was found between these two groups of patients regardless of the criteria for identifying CIN. In the group of patients aged ≥55 years, those who underwent angiography had a significantly worse 48-hour SCr level than those who did not undergo the treatment. In addition, there was no significant difference in the 48-hour SCr level between the two groups of patients when subgrouping the patients according to sex, large haemoperitoneum revealed on CT, systolic blood pressure, initial Hb, initial SCr and initial eGFR levels.ConclusionsThis study demonstrated that angiography does not increase the incidence of CIN, and was not a risk factor to renal function impairment in patients with BSI who had undergone CECT.

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Acute kidney injury following severe trauma

Abstract: Prognostic study, level III; therapeutic study, level IV.

Cited by 95 publications

References 30 publications

Shock treatment in a cohort of Scandinavian intensive care units in 2014

Shock treatment in a cohort of Scandinavian intensive care units in 2014

Incidence and epidemiology of acute kidney injury in a pediatric Malawian trauma cohort: a prospective observational study

Does angiography increase the risk of impairment in renal function during non-operative management of patients with blunt splenic injuries? A cross-sectional study in southern Taiwan

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