Department of Anesthesiology, Columbia University, P&S Box 46 (PH-5) 630 West 168th Street, New York, NY 10032-3784, USA.
Department of Anesthesiology, Columbia University, P&S Box 46 (PH-5) 630 West 168th Street, New York, NY 10032-3784, USA.
J Crit Care. 2021 Apr;62:172-175. doi: 10.1016/j.jcrc.2020.12.012. Epub 2020 Dec 19.
COVID-19 has created an enormous health crisis and this spring New York City had a severe outbreak that pushed health and critical care resources to the limit. A lack of adequate space for mechanically ventilated patients induced our hospital to convert operating rooms into critical care areas (OR-ICU). A large number of COVID-19 will develop acute kidney injury that requires renal replacement therapy (RRT). We included 116 patients with COVID-19 who required mechanical ventilation and were cared for in our OR-ICU. At 90 days and at discharge 35 patients died (30.2%). RRT was required by 45 of the 116 patients (38.8%) and 18 of these 45 patients (40%) compared to 17 with no RRT (23.9%, ns) died during hospitalization and after 90 days. Only two of the 27 patients who required RRT and survived required RRT at discharge and 90 days. When defining renal recovery as a discharge serum creatinine within 150% of baseline, 68 of 78 survivors showed renal recovery (87.2%). Survival was similar to previous reports of patients with severe COVID-19 for patients cared for in provisional ICUs compared to standard ICUs. Most patients with severe COVID-19 and AKI are likely to recover full renal function.
COVID-19 大流行造成了巨大的健康危机，今年春天，纽约市爆发了严重疫情，使医疗和重症监护资源达到极限。由于缺乏足够的空间用于机械通气患者，我们的医院将手术室改造成了重症监护区（OR-ICU）。大量 COVID-19 患者会发生急性肾损伤，需要肾脏替代治疗（RRT）。我们纳入了 116 名需要机械通气并在我们的 OR-ICU 接受治疗的 COVID-19 患者。在 90 天和出院时，35 名患者死亡（30.2%）。116 名患者中有 45 名（38.8%）需要 RRT，其中 18 名（40%）与不需要 RRT 的 17 名（23.9%，无统计学差异）相比，住院期间和 90 天后死亡。在需要 RRT 并存活的 27 名患者中，只有 2 名患者在出院和 90 天后需要 RRT。当将出院时血清肌酐恢复到基线水平的 150%以内定义为肾脏恢复时，78 名幸存者中有 68 名（87.2%）显示肾脏恢复。与在临时 ICU 接受治疗的重症 COVID-19 患者相比，与在标准 ICU 接受治疗的患者的存活率相似。大多数 COVID-19 合并 AKI 的重症患者可能会完全恢复肾功能。
