Acute and Critical Care

Original Article

Nephrology
Epidemiology and outcome of an acute kidney injuries in the polytrauma victims admitted at the apex trauma center in Dubai: Bhushan Sudhakar Wankhade, Zeyad Faoor Alrais, Ghaya Zeyad Alrais, Ammar Mohamed Abdel Hadi, Gopala Arun Kumar Naidu, Mohammed Shahid Abbas, Ahmed Tarek Youssef Aboul Kheir, Hasan Hadad, Sundareswaran Sharma, Mohammad Sait; Acute Crit Care. 2023;38(2):217-225. Published online May 25, 2023; DOI: https://doi.org/10.4266/acc.2023.00388

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Background
Polytrauma from road accidents is a common cause of hospital admissions and deaths, frequently leading to acute kidney injury (AKI) and impacting patient outcomes.
Methods
This retrospective, single-center study included polytrauma victims with an Injury Severity Score (ISS) >25 at a tertiary healthcare center in Dubai.
Results
The incidence of AKI in polytrauma victims is 30.5%, associated with higher Carlson comorbidity index (P=0.021) and ISS (P=0.001). Logistic regression shows a significant relationship between ISS and AKI (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.150–1.233; P<0.05). The main causes of trauma-induced AKI are hemorrhagic shock (P=0.001), need for massive transfusion (P<0.001), rhabdomyolysis (P=0.001), and abdominal compartment syndrome (ACS; P<0.001). On multivariate logistic regression AKI can be predicated by higher ISS (OR, 1.08; 95% CI, 1.00–1.17; P=0.05) and low mixed venous oxygen saturation (OR, 1.13; 95% CI, 1.05–1.22; P<0.001). The development of AKI after polytrauma increases length of stay (LOS)-hospital (P=0.006), LOS-intensive care unit (ICU; P=0.003), need for mechanical ventilation (MV) (P<0.001), ventilator days (P=0.001), and mortality (P<0.001).
Conclusions
After polytrauma, the occurrence of AKI leads to prolonged hospital and ICU stays, increased need for mechanical ventilation, more ventilator days, and a higher mortality rate. AKI could significantly impact their prognosis.

Citations

Citations to this article as recorded by

Normotensive trauma patients with renal injuries: Hidden candidates for massive transfusion
Xin‐Hong Lin, Pi‐Chieh Lin, Ching‐Hua Tsai, Wei‐Ti Su, Shiun‐Yuan Hsu, Ching‐Hua Hsieh
Hong Kong Journal of Emergency Medicine.2025;[Epub] CrossRef
Acute kidney injury in critically ill patients with traumatic brain injury: A single-center retrospective cohort study
Bhushan Sudhakar Wankhade, Mohamed Hamed Ibrahim Ali El Kholi, Zeyad Faoor Alrais, Adel Elsaid Salem Elkhouly, Gopala Arun Kumar Naidu, Alim Akbar Patel, Mohamed Sameer, Mohammed Shahid Abbas, Nowar Nouralla Fadol Elbasier, Aala Fadlalla El Hadi
World Journal of Critical Care Medicine.2025;[Epub] CrossRef

Case Report

Neurosurgery
What should an intensivist know about pneumocephalus and tension pneumocephalus?: Bhushan Sudhakar Wankhade, Maged Mohsen Kamel Beniamein, Zeyad Faoor Alrais, Jyoti Ittoop Mathew, Ghaya Zeyad Alrais; Acute Crit Care. 2023;38(2):244-248. Published online April 13, 2022; DOI: https://doi.org/10.4266/acc.2021.01102

46,514 View
638 Download
10 Web of Science
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Abstract PDF

Collection of air in the cranial cavity is called pneumocephalus. Although simple pneumocephalus is a benign condition, accompanying increased intracranial pressure can produce a life-threatening condition comparable to tension pneumothorax, which is termed tension pneumocephalus. We report a case of tension pneumocephalus after drainage of a cerebrospinal fluid hygroma. The tension pneumocephalus was treated with decompression craniotomy, but the patient later died due to the complications related to critical care. Traumatic brain injury and neurosurgical intervention are the most common causes of pneumocephalus. Pneumocephalus and tension pneumocephalus are neurosurgical emergencies, and anesthetics and intensive care management like the use of nitrous oxide during anesthesia and positive pressure ventilation have important implications in their development and progress. Clinically, patients can present with various nonspecific neurological manifestations that are indistinguishable from a those of a primary neurological condition. If the diagnosis is questionable, patients should be investigated using computed tomography of the brain. Immediate neurosurgical consultation with decompression is the treatment of choice.

Citations

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Neurocirugía (English Edition).2026; : 500763. CrossRef
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