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Acute pulmonary oedema in chronic dialysis patients admitted into an intensive care unit

Identifieur interne : 005E88 ( Main/Exploration ); précédent : 005E87; suivant : 005E89

Acute pulmonary oedema in chronic dialysis patients admitted into an intensive care unit

Auteurs : Marie-Patrice Halle [France, Cameroun] ; Alexandre Hertig [France] ; Andre Pascal Kengne [Australie] ; Gloria Ashuntantang [Cameroun] ; Eric Rondeau [France] ; Christophe Ridel [France]

Source :

RBID : Pascal:12-0176546

Descripteurs français

English descriptors

Abstract

Background. Acute pulmonary oedema (APO) in patients undergoing chronic dialysis (CD), a common cause of hospital admission in this population, is poorly documented. The objective of this study was to determine the causes, profile, clinical course and outcomes of APO in CD patients admitted in an intensive care unit (ICU). Methods. Medical charts of all CD patients consecutively admitted for APO in the renal ICU of the Tenon Hospital (Paris, France) between January 2000 and December 2007 were considered. Data collection included patient characteristics, etiologic factors for chronic renal failure and comorbidities, past history of APO, precipitating factors, clinical evolution and outcomes. Results. Of the 112 files considered, 102 (65% men) were included in the final analysis. Patients were aged 20-88 years and had been dialysed for a median duration of 2 years. Hypertension (36.3%), chronic glomerulonephritis (25.5%) and diabetes mellitus (17.6%) were the main etiologic factors of chronic renal failure; 38.2% had a past history of APO. Acute pulmonary infection (26%), excessive interdialytic weight gain (25%) and inappropriate dry weight prescription (23%) were the leading causes of APO. The duration of hospitalization was <4 days in 60% of participants. Nine deaths (four being of cardiac origin) were recorded. Being referred from another hospital service was the main predictor of death. Conclusions. APO fuelled in part by chest infection, excessive interdialytic weight gain and inappropriate dry weight are important causes of hospitalization in CD patients. Mortality is high among those referred from other services usually in critical conditions.


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Le document en format XML

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<name sortKey="Halle, Marie Patrice" sort="Halle, Marie Patrice" uniqKey="Halle M" first="Marie-Patrice" last="Halle">Marie-Patrice Halle</name>
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<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>6 aut.</sZ>
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<country>France</country>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
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<name sortKey="Hertig, Alexandre" sort="Hertig, Alexandre" uniqKey="Hertig A" first="Alexandre" last="Hertig">Alexandre Hertig</name>
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<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
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<author>
<name sortKey="Pascal Kengne, Andre" sort="Pascal Kengne, Andre" uniqKey="Pascal Kengne A" first="Andre" last="Pascal Kengne">Andre Pascal Kengne</name>
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<s1>The George Institute for International Health, The University of Sydney</s1>
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<country>Australie</country>
<placeName>
<settlement type="city">Sydney</settlement>
<region type="état">Nouvelle-Galles du Sud</region>
<settlement type="city">Sydney</settlement>
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<orgName type="university">Université de Sydney</orgName>
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<name sortKey="Ashuntantang, Gloria" sort="Ashuntantang, Gloria" uniqKey="Ashuntantang G" first="Gloria" last="Ashuntantang">Gloria Ashuntantang</name>
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<sZ>4 aut.</sZ>
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<wicri:noRegion>Yaounde</wicri:noRegion>
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<name sortKey="Rondeau, Eric" sort="Rondeau, Eric" uniqKey="Rondeau E" first="Eric" last="Rondeau">Eric Rondeau</name>
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<s1>Department of Nephrology Intensive Care and Transplantation, Tenon Hospital</s1>
<s2>Paris</s2>
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<country>France</country>
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<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
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<name sortKey="Ridel, Christophe" sort="Ridel, Christophe" uniqKey="Ridel C" first="Christophe" last="Ridel">Christophe Ridel</name>
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<s1>Department of Nephrology Intensive Care and Transplantation, Tenon Hospital</s1>
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<sZ>1 aut.</sZ>
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</inist:fA14>
<country>France</country>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
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<series>
<title level="j" type="main">Nephrology, dialysis, transplantation : (Print)</title>
<title level="j" type="abbreviated">Nephrol. dial. transplant. : (Print)</title>
<idno type="ISSN">0931-0509</idno>
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<date when="2012">2012</date>
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<title level="j" type="main">Nephrology, dialysis, transplantation : (Print)</title>
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<idno type="ISSN">0931-0509</idno>
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<keywords scheme="KwdEn" xml:lang="en">
<term>Dialysis</term>
<term>Extrarenal dialysis</term>
<term>Hemodialysis</term>
<term>Human</term>
<term>Intensive care unit</term>
<term>Prognosis</term>
<term>Renal failure</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Insuffisance rénale</term>
<term>Dialyse</term>
<term>Hémodialyse</term>
<term>Homme</term>
<term>Unité soin intensif</term>
<term>Pronostic</term>
<term>Epuration extrarénale</term>
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<term>Homme</term>
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<front>
<div type="abstract" xml:lang="en">Background. Acute pulmonary oedema (APO) in patients undergoing chronic dialysis (CD), a common cause of hospital admission in this population, is poorly documented. The objective of this study was to determine the causes, profile, clinical course and outcomes of APO in CD patients admitted in an intensive care unit (ICU). Methods. Medical charts of all CD patients consecutively admitted for APO in the renal ICU of the Tenon Hospital (Paris, France) between January 2000 and December 2007 were considered. Data collection included patient characteristics, etiologic factors for chronic renal failure and comorbidities, past history of APO, precipitating factors, clinical evolution and outcomes. Results. Of the 112 files considered, 102 (65% men) were included in the final analysis. Patients were aged 20-88 years and had been dialysed for a median duration of 2 years. Hypertension (36.3%), chronic glomerulonephritis (25.5%) and diabetes mellitus (17.6%) were the main etiologic factors of chronic renal failure; 38.2% had a past history of APO. Acute pulmonary infection (26%), excessive interdialytic weight gain (25%) and inappropriate dry weight prescription (23%) were the leading causes of APO. The duration of hospitalization was <4 days in 60% of participants. Nine deaths (four being of cardiac origin) were recorded. Being referred from another hospital service was the main predictor of death. Conclusions. APO fuelled in part by chest infection, excessive interdialytic weight gain and inappropriate dry weight are important causes of hospitalization in CD patients. Mortality is high among those referred from other services usually in critical conditions.</div>
</front>
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<affiliations>
<list>
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<li>Australie</li>
<li>Cameroun</li>
<li>France</li>
</country>
<region>
<li>Nouvelle-Galles du Sud</li>
<li>Île-de-France</li>
</region>
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<li>Sydney</li>
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<country name="France">
<region name="Île-de-France">
<name sortKey="Halle, Marie Patrice" sort="Halle, Marie Patrice" uniqKey="Halle M" first="Marie-Patrice" last="Halle">Marie-Patrice Halle</name>
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<name sortKey="Hertig, Alexandre" sort="Hertig, Alexandre" uniqKey="Hertig A" first="Alexandre" last="Hertig">Alexandre Hertig</name>
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<name sortKey="Rondeau, Eric" sort="Rondeau, Eric" uniqKey="Rondeau E" first="Eric" last="Rondeau">Eric Rondeau</name>
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<name sortKey="Halle, Marie Patrice" sort="Halle, Marie Patrice" uniqKey="Halle M" first="Marie-Patrice" last="Halle">Marie-Patrice Halle</name>
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<name sortKey="Ashuntantang, Gloria" sort="Ashuntantang, Gloria" uniqKey="Ashuntantang G" first="Gloria" last="Ashuntantang">Gloria Ashuntantang</name>
<name sortKey="Ashuntantang, Gloria" sort="Ashuntantang, Gloria" uniqKey="Ashuntantang G" first="Gloria" last="Ashuntantang">Gloria Ashuntantang</name>
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<region name="Nouvelle-Galles du Sud">
<name sortKey="Pascal Kengne, Andre" sort="Pascal Kengne, Andre" uniqKey="Pascal Kengne A" first="Andre" last="Pascal Kengne">Andre Pascal Kengne</name>
</region>
</country>
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