อุบัติการณ์การเกิดภาวะแทรกซ้อนของผู้ป่วยวิกฤตที่มีไตวายเฉียบพลันระหว่างฟอกเลือดด้วยเครื่องไตเทียม

Duangrat  Thimsi

Authors

Duangrat Thimsi Hemodialysis Unit Buddhachinaraj Hospital, Phitsanulok

Keywords:

acute kidney injury, hemodialysis complications, critically ill patients

Abstract

This retrospective descriptive study aimed to determine the incidence of complications among critically ill patients with acute kidney injury (AKI) undergoing hemodialysis at Buddhachinaraj Hospital, Phitsanulok. Data were collected retrospectively from the medical records of 78 critically ill patients with AKI who underwent hemodialysis between October 1, 2023, and September 30, 2024. The research instrument was a complication data collection form, which was validated for content validity (CVI = 0.94). Data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation.

The findings revealed that the majority of the sample was male (76.92%), with a mean age of 61.79 years (SD = 8.75). The primary diagnosis was infection-related AKI (62.82%), and caused by pre-renal abnormalities (94.87%). Most patients required mechanical ventilation (91.03%), maintained a pre-dialysis mean arterial pressure of greater than 75 mmHg (76.90%), and received vasopressors (65.39%). The majority successfully completed their planned hemodialysis sessions (84.62%). The overall incidence of complications was 55.13%, sequentially comprising intradialytic hypotension (34.62%), tachyarrhythmia (14.10%), hypoxemia (3.85%), bradyarrhythmia (1.28%), and dialysis disequilibrium syndrome (1.28%), respectively.

This study highlights the high risks associated with hemodialysis in critically ill patients, particularly the occurrence of hypotension during the first hour. It underscores the critical importance of close blood pressure monitoring every 15 minutes during the initial phase, and the adjustment of dialysis parameters to align with the patient’s hemodynamic status to ensure optimal safety.

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