Acute kidney injury in critically ill patients with 2009 influenza A (H1N1) viral pneumonia: an observational study.

OBJECTIVE: To describe the incidence, risk factors, and impact on mortality of acute kidney injury (AKI) in patients with 2009 influenza A (H1N1) viral pneumonia requiring mechanical ventilation. DESIGN: Observational cohort study. PATIENTS AND METHODS: AKI was defined as risk, injury or failure, according to the RIFLE classification. Early and late AKI were defined as AKI occurring on intensive care unit (ICU) day 2 or before, or after ICU day 2, respectively. Demographic data and information on organ dysfunction were collected daily. RESULTS: Of 84 patients, AKI developed in 43 patients (51%). Twenty (24%) needed renal replacement therapy. Early and late AKI were found in 28 (33%) and 15 (18%) patients, respectively. Patients with AKI, as compared with patients without AKI, had higher Acute Physiology and Chronic Health Evaluation (APACHE) II score and ICU mortality (72% versus 39%, p < 0.01) and presented on admission more marked cardiovascular, respiratory, and hematological dysfunction. Patients with early but not late AKI presented on admission higher APACHE II score and more marked organ dysfunction, as compared with patients without AKI. ICU mortality was higher in late versus early AKI (93% versus 61%, p < 0.001). On multivariate analysis, only APACHE II score and late but not early AKI [odds ratio (OR) 1.1 (95% confidence interval 1.0-1.1) and 15.1 (1.8-130.7), respectively] were associated with mortality. CONCLUSIONS: AKI is a frequent complication of 2009 influenza A (H1N1) viral pneumonia. AKI developing after 2 days in ICU appears to be associated with different risk factors than early AKI, and is related to a higher mortality rate.

Aspergilosis pulmonar invasiva en el paciente hematooncológico en las unidades de cuidados intensivos. Revisión de la literatura médica / Invasive pulmonary aspergillosis in a hematooncological patient in the intensive care units. A review of the literature

La aspergilosis invasiva es una entidad frecuente en los pacientes hematooncológicos. La sintomatología es sumamente inespecífica, por lo que es necesario conocer las herramientas diagnósticas para alcanzar diagnósticos precoces. Esta revisión intenta poner en claro la actual evidencia en los siguientes aspectos: la presentación clínica, los métodos de estudio y el tratamiento de esta entidad en pacientes hematooncológicos críticos (AU)

Invasive aspergillosis is a common condition in patients with hematologic malignancies. Symptoms are extremely non-specific, and therefore it is necessary to be familiar with the diagnostic tests for early diagnosis. This review has attempted to clarify the current evidence regarding the following areas: clinical presentation, methods of study and treatment of this condition in hemato-oncological critical patients (AU)

[Invasive pulmonary aspergillosis in a hematooncological patient in the intensive care units. A review of the literature]. / Aspergilosis pulmonar invasiva en el paciente hematooncológico en las unidades de cuidados intensivos. Revisión de la literatura médica.

Invasive aspergillosis is a common condition in patients with hematologic malignancies. Symptoms are extremely non-specific, and therefore it is necessary to be familiar with the diagnostic tests for early diagnosis. This review has attempted to clarify the current evidence regarding the following areas: clinical presentation, methods of study and treatment of this condition in hemato-oncological critical patients.