Influence of positive pressure variations on renal function

Abstract

Objective: to verify whether the use of invasive mechanical ventilation (IMV) with positive pressure predisposes to the appearance of acute kidney injury (AKI) in critically ill patients. Method: prospective cohort of quantitative approach developed in intensive care unit (ICU) of a public hospital. Eligible patients were selected by convenience sampling. For data collection, a questionnaire consisting of items on clinical and laboratory variables was applied. The information was extracted from the medical records during a period of 15 days. Data analysis was descriptive and inferential. Significant results with p≤0.05 were considered significant. Results: hypertension was among the most incident comorbidities (29.1%) of the 79 patients evaluated. Among the patients analyzed, 59.5% required IMV with PEEP ≥10 cmH2 O. Of the total number of patients, 91.1% evolved with renal dysfunction, according to the KDIGO classification. As an outcome, 34.2% of patients died. Patients who used PEEP >5 cmH2 0 showed significant predisposition to renal dysfunction (p≤0.05). Conclusion: invasive mechanical ventilation with positive pressure (PEEP) was a factor that contributed to aggravate renal function in different gradations. It was found that patients receiving IMV with PEEP >5 cmH2 O are more predisposed to the onset of AKI in the ICU, due to the tendency to advanced age, overweight, long time of mechanical ventilation and also hypertension.