The association of microalbuminuria and duration of mechanical ventilation in critically ill trauma patients.
BACKGROUND
Microalbuminuria, which predicts organ failure, probably predicts the necessity of mechanical ventilation as well as its duration. The primary goal of this study was to determine the incidence and presence of a relationship between microalbuminuria and duration of mechanical ventilation in trauma intensive care unit (ICU) patients.


METHODS
Sixty admitted critically ill trauma patients were categorized by duration of mechanical ventilation to group A (< or =7 days) or group B (>7 days) in this prospective observational study. We measured serial spot urine micro-albumin-creatinine ratios (ACR) on admission to the ICU (ACR-1), at 24, 72, and 120 hours after admission, and on the days of beginning and discontinuation of mechanical ventilation (ACR-2 and ACR-3, respectively).


RESULTS
Seventy percent of the patients had microalbuminuria and 63.3% had an ACR > or =100 mg g-1 at admission. ACR-1 [mean (SE)] in patient groups A and B was 30 (6) and 63 (16) mg g(-1) (p=0.0002); ACR-2 was 40 (4) and 52 (8) (p=0.007); and ACR-3 was 30 (11) and 44 (11), respectively (p=0.023). For all patients, mean (SE) ACR-2 fell from 37 (4) to 34 (8) mg g(-1) on the day of discontinuation of mechanical ventilation (p<0.01).


CONCLUSIONS
The ACR can be used in estimating the risk of prolonged mechanical ventilation, even on the first day of admission of critically ill trauma patients.
Honarmand
Azim
A
Department of Anesthesiology and Intensive Care, Isfahan University of Medical Sciences, Isfahan, Iran. honarmand@med.mui.ac.ir
Safavi
Mohammadreza
M
Baghery
Keivan
K
Momayezi
Ali
A
D018806:APACHE; D000419:Albuminuria / Q000150:complications*; D003404:Creatinine / Q000652:urine*; D016638:Critical Illness; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors
D003404:Creatinine