{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T01:55:25Z","timestamp":1773885325189,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T00:00:00Z","timestamp":1636848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Ministry of Science and Technology of Taiwan","award":["MOST-104-2313-B-005-043-MY3"],"award-info":[{"award-number":["MOST-104-2313-B-005-043-MY3"]}]},{"name":"The Ministry of Education in Taiwan","award":["MOE-110-S-0023-A"],"award-info":[{"award-number":["MOE-110-S-0023-A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: In the intensive care unit (ICU), renal failure and respiratory failure are two of the most common organ failures in patients with systemic inflammatory response syndrome (SIRS). These clinical symptoms usually result from sepsis, trauma, hypermetabolism or shock. If this syndrome is caused by septic shock, the Surviving Sepsis Campaign Bundle suggests that vasopressin be given to maintain mean arterial pressure (MAP) &gt; 65 mmHg if the patient is hypotensive after fluid resuscitation. Nevertheless, it is important to note that some studies found an effect of various mean arterial pressures on organ function; for example, a MAP of less than 75 mmHg was associated with the risk of acute kidney injury (AKI). However, no published study has evaluated the risk factors of mortality in the subgroup of acute kidney injury with respiratory failure, and little is known of the impact of general risk factors that may increase the mortality rate. Materials and Methods: The objective of this study was to determine the risk factors that might directly affect survival in critically ill patients with multiple organ failure in this subgroup. We retrospectively constructed a cohort study of patients who were admitted to the ICUs, including medical, surgical, and neurological, over 24 months (2015.1 to 2016.12) at Chiayi Chang Gung Memorial Hospital. We only considered patients who met the criteria of acute renal injury according to the Acute Kidney Injury Network (AKIN) and were undergoing mechanical ventilator support due to acute respiratory failure at admission. Results: Data showed that the overall ICU and hospital mortality rate was 63.5%. The most common cause of ICU admission in this cohort study was cardiovascular disease (31.7%) followed by respiratory disease (28.6%). Most patients (73%) suffered sepsis during their ICU admission and the mean length of hospital stay was 24.32 \u00b1 25.73 days. In general, the factors independently associated with in-hospital mortality were lactate &gt; 51.8 mg\/dL, MAP \u2264 77.16 mmHg, and pH \u2264 7.22. The risk of in-patient mortality was analyzed using a multivariable Cox regression survival model. Adjusting for other covariates, MAP \u2264 77.16 mmHg was associated with higher probability of in-hospital death [OR = 3.06 (1.374\u20136.853), p = 0.006]. The other independent outcome predictor of mortality was pH \u2264 7.22 [OR = 2.40 (1.122\u20135.147), p = 0.024]. Kaplan-Meier survival curves were calculated and the log rank statistic was highly significant. Conclusions: Acute kidney injury combined with respiratory failure is associated with high mortality. High mean arterial pressure and normal blood pH might improve these outcomes. Therefore, the acid\u2013base status and MAP should be considered when attempting to predict outcome. Moreover, the blood pressure targets for acute kidney injury in critical care should not be similar to those recommended for the general population and might prevent mortality.<\/jats:p>","DOI":"10.3390\/medicina57111243","type":"journal-article","created":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T20:51:53Z","timestamp":1636923113000},"page":"1243","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Effects of Mean Artery Pressure and Blood pH on Survival Rate of Patients with Acute Kidney Injury Combined with Acute Hypoxic Respiratory Failure: A Retrospective Study"],"prefix":"10.3390","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6437-8473","authenticated-orcid":false,"given":"Chi-Hua","family":"Ko","sequence":"first","affiliation":[{"name":"Department of Life Sciences, and Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan"},{"name":"Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Yunlin 638, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying-Wei","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, and Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying-Chou","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tien-Tsai","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan-Fu","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulkadir","family":"Cidem","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, and Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan"},{"name":"Department of Molecular Biology and Genetics, Erzurum Technical University, Erzurum 25250, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Hsien","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, and Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan"},{"name":"Department of Nephrology, Jen-Ai Hospital, Dali, Taichung 412, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia-Wen","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, and Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan"},{"name":"Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung 411, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Ching","family":"Yen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, China Medical University Hospital, and College of Health Care, China Medical University, Taichung 404, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4152-4949","authenticated-orcid":false,"given":"Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, Chiayi 600, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2461-9150","authenticated-orcid":false,"given":"Chuan-Mu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, and Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan"},{"name":"The iEGG and Animal Biotechnology Center, and the Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"R222","DOI":"10.1186\/cc11868","article-title":"Patterns and early evolution of organ failure in the intensive care unit and their relation to outcome","volume":"16","author":"Sakr","year":"2012","journal-title":"Crit. 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