Evolución del paciente quirúrgico grave con ventilación mecánica en cuidados intensivos, según valor de creatininuria

Introduction:  The nutritional status at admission influences the evolution of the severely ill surgical patient. Urine creatinine, an indicator of this state, could show its possible association with the evolution of these patients. Objectives:  To identify the evolution of critically ill surgical patients with invasive mechanical ventilation and its possible association with urine creatinine on admission. Methods:  A descriptive and longitudinal observational study was carried out in 85 surgical patients with invasive mechanical ventilation, admitted to the Intensive Care Unit, from January 2000 to August 2007. The APACHE II index on admission and urine creatinine in the 24-hour urine for 3 consecutive days, with a Hitachi 902 microprocessor equipment. The mean value was contrasted with mortality, morbidity, stay in intensive care and time on mechanical ventilation. Quantitative variables were expressed as mean, with standard deviation, and qualitative variables, as absolute frequencies or percentages. The comparison of means was carried out with Student's t test. The association between qualitative variables was evaluated with chi square. Results:  The mean age was 52,3 ± 15,8 years; 54,1 % corresponded to the male sex and the APACHE II index was 20,4 ± 6 points. The most frequent diagnosis was secondary peritonitis (49,4 %). Lower urine creatinine values were associated with mortality, the presence of complications, a longer stay in intensive care and the time on mechanical ventilation. Conclusions:  Urine creatinine on admission is associated with the evolution of surgical patients with invasive mechanical ventilation.