Clinical Analysis Of Injury In Children With Severe Pneumonia Complicated By Acute Kidney PICU

Objective: KDIGO by evaluating criteria in the evaluation of severe pneumonia(SP) and acute renal impairment(AKI) clinical significance,investigate SP merger AKI predisposing factors and prognostic factors.Method: Collected from January 2014 to December 2014 the clinical data in children with severe pneumonia in PICU Children's Hospital of Hunan Province. Guidelines adopted in 2012 KDIGO AKI diagnostic criteria for children with severe pneumonia complicated by acute kidney injury were retrospectively evaluated. According to the presence or absence of concurrent AKI group and merged into SP non-concurrent AKI group were between the two groups on statistical machine time, hospital stay, cost of hospitalization, mortality;. The SP merger AKI group were serum creatinine(Scr) of the sub-rise is 3, AKI I of: Scr increase ?26.5umol / L, or greater than or equal to a rise of 1.5to 1.9 times, and(or) urine output <0.5 ml Kg-1 ? h-1 baseline value for6 to 12 hours;(2) AKI II period: Scr increased to greater than or equal to2.0 to 2.9 times the baseline value and(or) urine output <0.5 m1. Kg-1 ?h-1 ? 12 h;(3) of AKI III: Scr increased to greater than or equal to 3.0times the baseline value or ? 354 umol / L, or <18 year-old patient,estimated glomerular filtration rate(e GFR) <35ml /(min.1.73m2), and(or) urine output <0.3 m1 ? kg-1 ? h-1 or no urine sustained ?24 h 12 h. Children with urine and serum creatinine(Scr) in line with the differentstages, the adoption of the highest stage. Each collection of general,pathogens(sputum culture and(or) blood culture results shall prevail),the diagnosis of AKI when blood oxygen pressure, presence or absence of acute lung injury, with or without positive pressure ventilator-assisted breathing, SOFA Rating evaluation of the number of organs involved and associated with other diseases, the comparison of the above factors for each period of children mortality, prognosis.Results:1. A total of 739 cases of children with severe pneumonia,severe pneumonia(SP) combined with acute kidney injury(AKI) total187 cases(25.30%), of which 99 cases of male children, female children with 88 cases and 35 deaths in children SP merger AKI mortality was18.7%(35/187).2. SP merger in children with AKI, AKI I of 85 cases, II 50 cases,III of 52 cases; age distribution mainly to 3 years of age; complications including sepsis in 41 cases, 10 cases of diarrhea, bloodstream infections20 Example; wherein the pathogens are: bacteria 100 cases, 55 cases of the virus, 31 cases of chlamydia and mycoplasma, fungi in 4 cases, of which 70% were mixed infections; compared with children with severe pneumonia in non-consolidated AKI group, consolidated group AKI sequential organ failure assessment(SOFA) higher, which is greater than the total number of white blood cells 20 × 109 / L, when the subjects with severe acute hypoxemia and acidosis(PH less than 7.2), and increases KDIGO stage, severe pneumonia complicated by acute kidney injury mortality was significantly higher in children.Conclusion 1 ICU in children with severe pneumonia complicated by AKI significantly increased mortality, length of stay and hospital costs.2 SP merger AKI to 3 years of age age-based, AKI stage is proportional to the severity and mortality.3 Severe hypoxemia, positive pressure mechanical assistance support,hypoalbuminemia and SP combined incidence of AKI and prognosis.