• Crit Care · Jan 2011

    Increased creatinine clearance in polytrauma patients with normal serum creatinine: a retrospective observational study.

    • Vincent Minville, Karim Asehnoune, Ivan Tack, Kamran Samii, Olivier Fourcade, Audrey Breden, Thierry Seguin, Acil Jaafar, and Sylvie Saivin.
    • Department of Anesthesiology and Intensive Care, GRCB 48, IFR 150, Toulouse University Hospital, Toulouse, France. minville.v@chu-toulouse.fr
    • Crit Care. 2011 Jan 1;15(1):R49.

    IntroductionThe aim of this study, performed in an intensive care unit (ICU) population with a normal serum creatinine, was to estimate urinary creatinine clearance (CLCR) in a population of polytrauma patients (PT) through a comparison with a population of non trauma patients (NPT).MethodsThis was a retrospective, observational study in a medical and surgical ICU in a university hospital. A total of 284 patients were consecutively included. Two different groups were studied: PT (n = 144) and NPT (n = 140). Within the second week after admission to the ICU, renal function was assessed using serum creatinine, 24 h urinary CLCR .ResultsAmong the 106 patients with a CLCR above 120 mL minute(-1) 1.73 m(-2), 79 were PT and 27 NPT (P < 0.0001). Only 63 patients had a CLCR below 60 mL minute(-1) 1.73 m(-2) with 15 PT and 48 NPT (P < 0.0001). Patients with CLCR greater than 120 mL minute(-1). 1.73 m(-2) were younger, had a lower SAPS II score and a higher male ratio as compared to those having CLCR lower than 120 mL minute(-1). 1.73 m(-2). Through a logistic regression analysis, age and trauma were the only factors independently correlated to CLCR.ConclusionsIn ICU patients with normal serum creatinine, CLCR, is higher in PT than in NPT. The measure of CLCR should be proposed as routine for PT patients in order to adjust dose regimen, especially for drugs with renal elimination.

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