Fatores associados à mortalidade em pacientes transplantados renais admitidos na unidade de terapia intensiva com insuficiência respiratória aguda

• Ano de defesa: 2016
• Autor(a) principal: Silva, Rafael Mendes da [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Kidney transplantation; Respiratory insufficiency; Intensive care units; Transplante de rim; Insuficiência respiratória; Unidades de terapia intensiva
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4632394; http://repositorio.unifesp.br/handle/11600/47138

Objective. To identify the factors associated with mortality in TxR and TxRP patients admitted to the intensive care unit with respiratory failure, describing the epidemiological characteristics of the patient TxR and TxRP Methods. This retrospective study evaluated adult patients with acute respiratory failure admitted to the intensive care unit (ICU) of a center with high volume of transplants from August 2013 to August 2015. Demographic, clinical, and transplant characteristics were analyzed. Multivariate logistic regression analysis was performed to identify factors associated with hospital mortality. Results. 183 patients were included with age of 55.32 + 13.56 years. 126 (68.8%) were deceased-donor transplant, and 37 (20.2%) patients had previous history of rejection. The ICU admission SAPS3 and SOFA score were 54.39 ± 10.32 and 4.81 ± 2.32, respectively. The main cause of hospitalization was community-acquired pneumonia (18.6%), followed by acute pulmonary edema (15.3%). Opportunistic infections were common: PCP (9.3%), tuberculosis (2.7%), and cytomegalovirus (2.2%). Factors associated with mortality were requirement for vasopressor (OD 8.13, CI 2.83 to 23.35, p <0.001), invasive mechanical ventilation (OD 3.87, CI: 1.29 to 11.66, p = 0.016), and SAPS3 (OD 1.04, CI 1.0 to 1.08, p = 0.045). Conclusion. Bacterial pneumonia is the leading cause of acute respiratory failure requiring intensive care, followed by acute pulmonary edema. Requirement for vasopressor, invasive mechanical ventilation and SAP3 were associated with hospital mortality.