Mazo MB, Esquivel PA, Herrera PLJ, Aguirre SJS, Martínez DB, Bórquez LYF

Language: Spanish
References: 19
Page: 262-270
PDF size: 308.46 Kb.

ABSTRACT

Introduction: acute kidney injury (AKI) is a heterogeneous disease that affects morbidity and mortality, as well as long-term prognosis. It frequently occurs in patients with septic shock, a condition where the cornerstone of treatment is resuscitation with intravenous fluids. In these patients, venous congestion secondary to fluid resuscitation is known as a precipitating cause of AKI, which is why the identification of a marker of venous congestion that allows precise and early interventions is important to reduce the risk of AKI in this patient. population. Objective: To know if the Portal Vein Pulsatility Index (PVPI) greater than 30% is a risk factor for the development of AKI in patients with septic shock. Material and methods: this is a retrospective, observational and longitudinal cohort that was carried out in patients over 18 years of age admitted to the Intensive Care Unit at the ABC Medical Center, in patients with a diagnosis of septic shock, where the relationship between IPVP > 30% was determined. and risk of AKI, during a period from March 2023 to August 2023. Results: 47 patients were analyzed; 53.2% were women; 42.6% (n = 20) presented AKI upon admission and 38% (n = 18) at 48 hours. Of the population that was admitted without kidney injury, 66% (n = 18) presented acute kidney injury at 48 hours. 20% of patients required advanced airway management. At 48 hours the balance was positive in 48.9% of the patients and of these, 28.3% had an IPVP > 30%. The population was divided into two groups, one without acute kidney injury (n = 27) and the other with acute kidney injury (n = 20). In the multivariate analysis, an OR 11.4 was observed, (1.272 - 103.57), with p = 0.030 for IPVP > 30%. In the bivariate analysis, in the group without AKI at admission, IPVP > 30% (OR 13.3, CI 95% 1.7-103.7, p = 0.013) was associated with the final outcome. Conclusions: a relationship was found between the group of patients with septic shock who were admitted without acute kidney injury and IPVP > 30% as a risk factor for the development of acute kidney injury at 48 hours; however, these results should not be applied to other critical patients, since the relationship that exists between these two variables must be studied more thoroughly in subsequent studies.

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