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Báo cáo y học: " Increased creatinine clearance in polytrauma patients with normal serum creatinine: a retrospective observational study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Increased creatinine clearance in polytrauma patients with normal serum creatinine: a retrospective observational study. | Minville et al. Critical Care 2011 15 R49 http ccforum.eom content 15 1 R49 KS CRITICAL CARE RESEARCH Open Access Increased creatinine clearance in polytrauma patients with normal serum creatinine a retrospective observational study 1.4 2 11 11 Vincent Minville Karim Asehnoune Stephanie Ruiz Audrey Breden Bernard Georges Thierry Seguin Ivan Tack3 Acil Jaafar3 Sylvie Saivin3 Olivier Fourcade1 Kamran Samii1 Jean Marie Conil1 Abstract Introduction The aim of this study performed in an intensive care unit ICU population with a normal serum creatinine was to estimate urinary creatinine clearance CLcr in a population of polytrauma patients PT through a comparison with a population of non trauma patients NPT . Methods This was a retrospective observational study in a medical and surgical ICU in a university hospital. A total of 284 patients were consecutively included. Two different groups were studied PT n 144 and NPT n 140 . Within the second week after admission to the ICU renal function was assessed using serum creatinine 24 h urinary CLCR . Results Among the 106 patients with a CLcr above 120 mL minute-1 1.73 m-2 79 were PT and 27 NPT P 0.0001 . Only 63 patients had a CLcr below 60 mL minute-1 1.73 m-2 with 15 PT and 48 NPT P 0.0001 . Patients with CLcr greater than 120 mL minute-1. 1.73 m -2 were younger had a lower SAPS II score and a higher male ratio as compared to those having CLcr lower than 120 mL minute-1. 1.73 m -2. Through a logistic regression analysis age and trauma were the only factors independently correlated to CLcr. Conclusions In ICU patients with normal serum creatinine CLcr is higher in PT than in NPT. The measure of CLcr should be proposed as routine for PT patients in order to adjust dose regimen especially for drugs with renal elimination. Introduction Early detection of renal dysfunction in intensive care unit ICU patients is important. Indeed an increase of the glomerular filtration rate GFR was demonstrated in some ICU patients populations .