NGHIÊN CỨU ĐẶC ĐIỂM TỔN THƯƠNG THẬN CẤP Ở BỆNH NHÂN NHIỄM KHUẨN NẶNG

Abstract

Objective: to describe characteristics and progression of acute kidney injury in patients with severe sepsis. Subjects and methods: A prospective observational study was conducted in 246 patients with severe seppsis treated at the ICU of Bach Mai hospital. Results: mean age was 61.3 ± 16.22, male accounted for 73.2%, and 42.9% patients were elderly. On admission, heart rate and systolic blood pressure were 118 ±24.1 b/m and 68.1±31.23 mmHg, 88.4% patients were hypotention and 91.1% required mechanical ventilationo. APACHE II score was 23.5±7.41 and average SOFA was 6.8; much higher than those in the patient without AKI (p <0.001). Laboratory abnormalities: mean Hb 107.1 g/L; white blood cells 15.7 G/L; procalcitonin 33 U/L; blood lactate 3.88mmol/L and rhabdomyolysis 32.1%, all were higher than those in the patients without AKI (p <0.001), while blood pH and HCO₃^- were lower (p <0.001). AKI often occurred after admission 2.3 days, and maximum after 4.5 days. There were 61.6% of patients with more severely kidney damage after admission and 36.6% patients got complete recovery of renal function after treatment. Conclusions: AKI was very common in severe sepsis patients with high motality rate.