Romano Thiago Gomes, Tierno Paulo Fernando Guimarães Morando Marzocchi
Hospital Sírio Libanês, Faculdade de Medicina do ABC.
J Bras Nefrol. 2013 Jan-Mar;35(1):48-56. doi: 10.5935/01012800.20130008.
Acute Kidney Injury (AKI) in trauma is, in most cases, multifactorial. Factors related to the initial ressuscitation protocol, degree of the systemic inflamatory response to trauma, contrast nephropathy in diagnostic procedures, rhabdomyolysis and abdominal compartment syndrome are some of those factors. Nowadays a uniformization in diagnostic criteria for AKI has been proposed by the Acute Kidney Injury Network (AKIN) and as a result the incidence of AKI and its impact in outcomes in trauma patients also needs to be reconsider. In this review we aim to approach epidemiologic, physiologic and clinical relevant data in the critical care of patients victims of trauma and also to expose the risks of indiscriminate use of volume expanders and the interaction between renal replacement theraphy and intracranial hypertension.
创伤性急性肾损伤(AKI)在大多数情况下是多因素导致的。与初始复苏方案、对创伤的全身炎症反应程度、诊断程序中的造影剂肾病、横纹肌溶解症和腹腔间隔室综合征相关的因素就是其中一些因素。如今,急性肾损伤网络(AKIN)已提出了AKI诊断标准的统一化,因此AKI的发病率及其对创伤患者预后的影响也需要重新审视。在本综述中,我们旨在探讨创伤患者重症监护中与流行病学、生理学和临床相关的数据,同时揭示不加区分使用扩容剂的风险以及肾脏替代治疗与颅内高压之间的相互作用。