title: Renal replacement therapy in prolonged mechanical ventilation patients with renal failure in Taiwan.
abstract: BACKGROUND
  Renal failure requiring renal replacement therapy (RRT) is associated with a high mortality rate in intensive care unit (ICU) patients. Little information is available on the outcomes of patients having prolonged mechanical ventilation (PMV) in addition to RRT. The purpose of this study was to investigate the impact of RRT in PMV patients.
  
  
  METHODS
  This was an observational, retrospective study in the 24-bed respiratory care center (RCC) of Chang Gung Memorial Hospital, Taiwan, between May 2001 and April 2007. The end points were weaning rate and survival rate at the RCC.
  
  
  RESULTS
  Of the 1301 RCC patients, 157 patients (13.7%) underwent RRT. The RRT patients had lower successful weaning rate (39.5% vs 58.4%, P < .001) and RCC survival rate (45.9% vs 71.9%, P < .001) compared with without-RRT patients. The successful weaning rates of end-stage renal disease (ESRD) patients, patients with RRT initiated at the ICU and continued at RCC, and patients whose RRT was initiated at the RCC were 49.2%, 39.1%, and 22.2%, respectively. The RCC survival rates were 50.8%, 47.8%, and 29.6%, respectively. The odds ratios of successful weaning rate and survival rate were 0.295 (95% confidence interval, 0.105-0.833; P = .021) and 0.407 (95% confidence interval, 0.155-1.021; P = .069) for patients whose RRT was initiated at the RCC vs ESRD patients.
  
  
  CONCLUSIONS
  The present study demonstrates that the need for RRT had a negative impact on weaning and mortality in PMV patients compared with patients without RRT. Patients who had RRT initiated at the RCC had a significantly lower weaning rate compared with ESRD patients.
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Kao
authors.forename: Han-Chung
authors.initials: HC
authors.lastname: Hu
authors.forename: Jui-Ying
authors.initials: JY
authors.lastname: Fu
authors.forename: Meng-Jer
authors.initials: MJ
authors.lastname: Hsieh
authors.forename: Yao-Kuang
authors.initials: YK
authors.lastname: Wu
authors.forename: Yung-Chang
authors.initials: YC
authors.lastname: Chen
authors.forename: Yen-Huey
authors.initials: YH
authors.lastname: Chen
authors.forename: Chung-Chi
authors.initials: CC
authors.lastname: Huang
authors.forename: Cheng-Ta
authors.initials: CT
authors.lastname: Yang
authors.forename: Ying-Huang
authors.initials: YH
authors.lastname: Tsai
mesh_terms: D018806:APACHE; D000368:Aged; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000628:therapy*; D008297:Male; D017063:Outcome Assessment, Health Care; D017582:Renal Replacement Therapy; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000150:complications / Q000628:therapy*; D016019:Survival Analysis; D013624:Taiwan; D016896:Treatment Outcome