Akutes Nierenversagen bei Brandverletzten – Ursachen, Konsequenzen und Vermeidungstrategien

Zusammenfassung

Das akute Nierenversagen stellt eine häufige und bedrohliche Komplikation in der Intensivmedizin dar. Gerade brandverletzte Patienten haben durch das thermische Trauma und durch die damit verbundenen Veränderungen (z.B. Verbrennungskrankheit) ein hohes Risiko für die Entwicklung eines ANV. Aber auch andere Faktoren, wie z.B. therapeutische Interventionen und Flüssigkeitsersatz spielen eine wichtige Rolle. Durch das Entstehen eines ANV wird die Morbidität und Mortalität des Brandverletzten noch zusätzlich erhöht. Die vorliegende Übersichtsarbeit soll die Ursachen und Konsequenzen dieser schwerwiegenden Komplikation aufzeigen und auf Strategien zur Vermeidung des ANV beim kritisch brandverletzten Patienten eingehen.

Abstract

Acute renal failure (ARF) is a common and dangerous complication in intensive care medicine. Especially critical ill patients, who are suffering from major burns, have a high risk to develop ARF as a consequence of their trauma. Many factors, including the trauma itself, the damage of soft tissue and consecutive rhabdomyolysis, the development of the burn illness and therapeutic interventions play also a major role in this context. These circumstances have a major impact on the morbidity and mortality of severely burned patients. The aim of this manuscript is to review the reasons for the development of an ARF in burn patients as well as its consequences; moreover it highlights potential strategies to avoid ARF in critically ill burned patients.

Schlüsselwörter:

Akutes Nierenversagen - Brandverletzung - patientenadaptiertes Flüssigkeitsregime - Prävention des ANV

Keywords

acute renal failure - burns - volume management - prevention of ARF

Kernaussagen

• Die Verbrennungskrankheit ist ein komplexes Zustandsbild und tritt bereits kurz nach dem Trauma auf.

• Schwerbrandverletzte Patienten sind nicht nur durch das Trauma selbst, sondern auch durch die Folgen der Verbrennungskrankheit bedroht.

• Eine schwerwiegende Komplikation in der Therapie brandverletzter Patienten stellt das akute Nierenversagen dar.

• Das akute Nierenversagen verschlechtert die Prognose von brandverletzten Patienten deutlich.

• Massive Flüssigkeitszufuhr kann Komplikationen wie erhöhten intraabdominellen Druck und in weiterer Folge ein akutes Nierenversagen auslösen.

• Durch gezielte patientenadaptierte Therapie und ein hämodynamisches Monitoring kann Infusionsvolumen eingespart werden.

Literatur

• 1 Druml W. Prognosis of acute renal failure.  Nephron. 1996;  73 8-15
• 2 Metnitz PhGH, Krenn CG, Steltzer H, Lang Th, Ploder J, Lenz K, Le JR Gall, Druml W. Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients.  Crit Care Med. 2002;  30 2051-2058
• 3 Maher ER, Robinson KN, Scoble JE, Farrimond JG, Browne DRG, Sweny P, Moorhead JF. Prognosis of critically ill patients with acute renal failure: APACHE II score and other predictive factors.  Quart J Med. 1989;  269 857-866
• 4 Spiegel DM, Ullian ME, Zerbe GO, Berl T. Determinants of survival and recovery in acute renal failure patients dialyzed in intensive care units.  Am J Nephrol. 1991;  11 44-47
• 5 Bellomo R, Farmer M, Boyce N. The outcome of critically ill elderly patients with severe acute renal failure treated by continuous hemodiafiltration.  Art Kid Dialysis. 1994;  17 466-472
• 6 van Bommel EFH, Bouvy ND, So KL, Vincent HH, Zietse E, Bruining HA, Weimar W. High risk surgical acute renal failure treated by continuous arteriovenous hemofiltration: metabolic control and outcome in sixty patients.  Nephron. 1995;  70 185-192
• 7 Brivet FG, Kleinknecht DJ, Loirat P, Landais PJM. French Study Group on Acute Renal Failure . Acute renal failure in intensive care units – causes, outcome, and prognostic factors of hospital mortality: a prospective, multicenter study.  Crit Care Med. 1996;  24 192-198
• 8 McCarthy JT. Prognosis of patients with acute renal failure in the intensive care unit: a tale of two eras.  Mayo Clin Proc. 1996;  71 117-126
• 9 Schwilk B, Wiedeck H, Stein B, Reinelt H, Treibner H, Bothner U. Epidemiology of acute renal failure and outcome of haemodiafiltration in intensive care.  Intensive Care Med. 1997;  23 1204-1211
• 10 Parker RA, Himmelfarb J, Tolkoff-Rubin N, Chandran P, Wingard RL, Hakim RM. Prognosis of patients with acute renal failure requiring dialysis: results of a multicenter study.  Am J Kidney Dis. 1998;  32 432-443
• 11 Levy EM, Viscoli CM, Horwitz RI. The effect of acute renal failure on mortality. A cohort analysis.  JAMA. 1996;  275 1489-1494
• 12 de Mendonca A, Vincent JL, Suter PM, Moreno R, Dearden NM, Antonelli M, Takala J, Sprung C, Cantraine F. Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score.  Intensive Care Med. 2000;  26 915-921
• 13 Mustonen KM, Vuola J. Acute renal failure in intensive care burn patients (ARF in burn patients).  J Burn Care Res. 2008;  29 227-237
• 14 Schiavon M, Di Landro D, Baldo M, De Silvestro G, Chiarelli A. A study of renal damage in seriously burned patients.  Burns Incl Therm Inj. 1988;  14 107-112
• 15 Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients.  J Am Soc Nephrol. 2005;  16 3365-3370
• 16 Herold G , et al.. Innere Medizin 2004 – Eine vorlesungsorientierte Darstellung. Köln; 2004
• 17 Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute Dialysis Quality Initiative workgroup . Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the second international consensus conference of the Acute Dialysis Quality Initiative (ADQI) Group.  Crit Care. 2004;  8 204-212
• 18 Abosaif NY, Tolba YA, Heap M. The outcome of acute renal failure in the intensive care unit according to RIFLE: model application, sensitivity, and predictability.  Am J Kidney Dis. 2005;  46 1038-1048
• 19 Hoste EA, Clermont G, Kersten A. RIFLE-criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis.  Crit Care. 2006;  10
• 20 Kuitunen A, Vento A, Suojaranta-Ylinen R. Acute renal failure after cardiac surgery: evaluation of the RIFLE-classification.  Ann Thorac Surg. 2006;  81 542-546
• 21 Lin CY, Chen YC, Tsai FC. RIFLE-classification is predictive of short-term prognosis in critically ill patients with acute renal failure supported by extracorporeal membrane oxygenation.  Nephrol Dia Transplant. 2006;  21 2867-2873
• 22 Lopes JA, Jorge S, Neves FC. An assessment of the rifle criteria for acute renal failure in severely burned patients.  Nephrol Dial Transplant. 2007;  22 285
• 23 Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin A. Acute Kidney Injury Network . Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury.  Crit Care. 2007;  11
• 24 Bagshaw SM, George C, Bellomo R. ANZICS Database Management Committe . A comparison of the RIFLE- and AKIN-criteria for acute kidney injury in critically ill patients.  Nephrol Dial Transplant. 2008;  23 1569-1574
• 25 Joannidis M, Metnitz B, Bauer P, Schusterschitz N, Moreno R, Druml W, Metnitz PG. Acute kidney injury in critically ill patients classified by AKIN versus RIFLE using the SAPS-3-database.  Intensive Care Med. 2009;  35 192-1702
• 26 Statistik Austria. Spitalsentlassungsstatistik 2007.  Erstellt am. 24;  06 2009
• 27 Statistisches Bundesamt Hrsg.. Die Todesursachenstatistik – Methodik und Ergebnisse 2004, Wiesenbaden.  2006; 
• 28 Keller CK. Praxis der Nephrologie. Berlin, Heidelberg: Springer; 2002
• 29 Mehta RL, Pascual MT, Soroko S, Savage BR, Himmelfarb J, Ikizler TA, Paganini EP, Chertow GM. Program to Improve Care in Acute Renal Disease . Spectrum of acute renal failure in the intensive care unit: the PICARD-experience.  Kidney Int. 2004;  66 1613-1621
• 30 Hoste EA, Lameire NH, Vanholder RC, Benoit DD, Decruyenaere JM, Colardyn FA. Acute renal failure in patients with sepsis in a surgical ICU: predictive factors, incidence, comorbidity, and outcome.  J Am Soc Nephrol. 2003;  14 1022-1030
• 31 Norman RW, Mack FG, Awad SA, Belitsky P, Schwarz RD, Lannon SG. Acute renal failure secondary to bilateral ureteric obstruction: review of 50 cases.  Can Med Assoc J. 1982;  127 601-604
• 32 Hsu CY, Ordoñez JD, Chertow GM, Fan D, McCulloch CE, Go AS. The risk of acute renal failure in patients with chronic kidney disease.  Kidney Int. 2008;  74 101-107
• 33 Cope O, Moore FD. The redistribution of body water and the fluid therapy of the burned patient.  Ann Surg. 1947;  126 1010-1045
• 34 Cioffi Jr WG, Vaughan GM, Heironimus JD, Jordan BS, Mason Jr AD, Pruitt Jr BA. Dissociation of blood volume and flow in regulation of salt and water balance in burn patients.  Ann Surg. 1991;  214 213-218
• 35 Kao CC, Garner WL. Acute Burns.  Plast Reconstr Surg. 2000;  101 2482-2493
• 36 Carleton SC. Cardiac problems associated with burns.  Cardiol Clin. 1995;  13 257-262
• 37 Kawai K, Kawai T, Sambol JT, Xu D, Yuan Z, Caputo FJ, Badami CD, Deitch EA, Yatani A. Cellular mechanisms of burn-related changes in contractility and its prevention by mesenteric lymph ligation.  Am J Physiol Heart Circ Physiol. 2007;  292 2475-2484
• 38 Carlson DL, Horton JW. Cardiac molecular signaling after burn trauma.  J Burn Care Res. 2006;  27 669-675
• 39 Baylis C, Brenner BM. Modulation by prostaglandin synthesis inhibitors of the action of exogenous angiotensin II on glomerular ultrafiltration in the rat.  Circ Res. 1978;  43 889-898
• 40 De Nicola L, Blantz RC, Gabbai FB. Nitric oxide and angiotensinII: glomerular and tubular interaction in the rat.  J Clin Invest. 1992;  89 1248-1256
• 41 Badr KF, Ichikawa I. Prerenal failure: a deleterious shift from renalcompensation to decompensation.  N Engl J Med. 1988;  319 623-629
• 42 O'Mara MS, Slater H, Godfarb W. A prospective, randomized evaluation of intra-abdominal pressures with crystalloid and colloid resuscitation in burn patients.  J Trauma. 2005;  58 1011-1018
• 43 Oda J, Ueyama M, Yamashita K. Hypertonic lactated saline resuscitation reduces the risk of abdominal compartment syndrome in severely burned patients.  J Trauma. 2006;  60 64-71
• 44 Daugherty EL, Hongyan L, Taichman D. Abdominal compartment syndrome is common in medical intensive care unit patients receiving large-volume resuscitation.  J Intensive Care Med. 2007;  22 294-299
• 45 Slater M, Mullins R. Rhabdomyolysis and myoglobinuric acute renal failure in trauma and surgical patients: a review.  J Am Coll Surg. 1998;  186 693-716
• 46 Huerta-Alardín AL, Varon J, Marik PE. Bench-to-bedside review: rhabdomyolysis – an overview for clinicians.  Crit Care. 2005;  9 158-169
• 47 Chatzizisis YS, Misirli G, Hatzitolios AI, Giannoglou GD. The syndrome of rhabdomyolysis: complications and treatment.  Eur J Intern Med. 2008;  19 568-574
• 48 Zager RA. Studies of mechanisms and protective maneuvers in myoglobinuric acute renal injury.  Lab Invest. 1989;  60 619-629
• 49 Beetham R. Biochemical investigation of suspected rhabdomyolysis.  Ann Clin Biochem. 2000;  37 581-587
• 50 Piccolo NS, Piccolo MS, Piccolo PD, Piccolo-Daher R, Piccolo ND, Piccolo MT. Escharotomies, fasciotomies and carpal tunnel release in burn patients – review of the literature and presentation of an algorithm for surgical decision making.  Handchir Mikrochir Plast Chir. 2007;  39 161-167
• 51 Gauglitz GG, Song J, Herndon DN, Finnerty CC, Boehning D, Barral JM, Jeschke MG. Characterization of the inflammatory response during acute and post-acute phases after severe burn.  Shock. 2008;  30 503-507
• 52 Zhang B, Huang YH, Chen Y, Yang Y, Hao ZL, Xie SL. Plasma tumor necrosis factor-alpha, its soluble receptors and interleukin-1beta levels in critically burned patients.  Burns. 1998;  24 599-603
• 53 Vindenes HA, Ulvestad E, Bjerknes R. Concentrations of cytokines in plasma of patients with large burns: their relation to time after injury, burn size, inflammatory variables, infection, and outcome.  Eur J Surg. 1998;  164 647-656
• 54 Carlson DL, Horton JW. Cardiac molecular signaling after burn trauma.  J Burn Care Res. 2006;  27 669-675
• 55 Lee MA, Yatani A, Sambol JT, Deitch EA. Role of gut-lymph factors in the induction of burn-induced and trauma-shock-induced acute heart failure.  Int J Clin Exp Med. 2008;  1 171-180
• 56 Ronco C, Haapio M, House AA, Anavekar N, Bellomo R. cardiorenal syndrome.  J AmColl Cardiol. 2008;  52 1527-1539
• 57 Wencker D. Acute cardio-renal syndrome: progression from congestive heart failure to congestive kidney failure.  Curr Heart Fail Rep. 2007;  4 134-138
• 58 Vinsonneau C, Benyamina M. Effects of candidaemia on outcome of burns.  Burns. 2009;  35 561-564
• 59 Greenhalgh DG, Saffle JR, Holmes 4th JH, Gamelli RL, Palmieri TL, Horton JW, Tompkins RG, Traber DL, Mozingo DW, Deitch EA, Goodwin CW, Herndon DN, Gallagher JJ, Sanford AP, Jeng JC, Ahrenholz DH, Neely AN, O'Mara MS, Wolf SE, Purdue GF, Garner WL, Yowler CJ, Latenser BA. American Burn Association Consensus Conference on Burn Sepsis and Infection Group . American Burn Association consensus conference to define sepsis and infection in burns.  J Burn Care Res. 2007;  28 776-790
• 60 Kierdorf HP. Sepsis und Akutes Nierenversagen.  Intensivmed. 2006;  43 175-188
• 61 Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS, Wenzel RP. The natural history of the systemic inflammatory response syndrome (SIRS): a prospective study.  JAMA. 1995;  273 117-123
• 62 Schrier RW, Wang W. Acute renal failure and sepsis.  N Engl J Med. 2004;  351 159-169
• 63 Steinvall I, Bak Z, Sjoberg F. Acute kidney injury is common, parallels organ dysfunction or failure, and carries appreciable mortality in patients with major burns: a prospective exploratory cohort study.  Crit Care. 2008;  12
• 64 Doi K, Leelahavanichkul A, Hu X, Sidransky KL, Zhou H, Qin Y, Eisner C, Schnermann J, Yuen PS, Star RA. Pre-existing renal disease promotes sepsis-induced acute kidney injury and worsens outcome.  Kidney Int. 2008;  74 1017-1025
• 65 Bakhtiari K, Meijers JC, de Jonge E, Levi M. Prospective validation of the international society of thrombosis and haemostasis scoring system for disseminated intravascular coagulation.  Crit Care Med. 2004;  32 2416-2421
• 66 Amaral A, Opal SM, Vincent JL. Coagulation in sepsis.  Intensive Care Med. 2004;  30 1032-1040
• 67 Lavrentieva A, Kontakiotis T, Bitzani M, Papaioannou-Gaki G, Parlapani A, Thomareis O, Tsotsolis N, Giala MA. Early coagulation disorders after severe burn injury: impact on mortality.  Intensive Care Med. 2008;  34 700-706
• 68 Sugrue M, Jones F, Deane SA. Intraabdominal hypertension is an independent cause of postoperative renal impairment.  Arch Surg. 1999;  134 1082-1085
• 69 Shear W, Rosner MH. Acute kidney dysfunction secondary to the abdominal compartment syndrome.  J Nephrol. 2006;  19 556-565
• 70 Ryan CM, Yarmush ML, Burke JF, Tompkins RG. Increased gut permeability early after burns correlates with the extent of burn injury.  Crit Care Med. 1992;  20 1508-1512
• 71 Turnage RH, Nwariaku F, Murphy J, Schulman C, Wright K, Yin H. Mechanisms of pulmonary microvascular dysfunction during severe burn injury.  World J Surg. 2002;  26 848-853
• 72 De Waele JJ, De Laet I. Intra-abdominal hypertension and the effect on renal function.  Acta Clin Belg Suppl. 2007;  2 371-374
• 73 Reske AP, Schreiter D, Höhne C. Intraabdominelle Hypertonie und abdominelles Kompartmentsyndrom.  Anästhesiol Intensivmed Notfallmed Schmerzther. 2009;  44 336-342
• 74 Baxter CR, Shires T. Physiological response to crystalloid resuscitation of severe burns.  Ann N Y Acad Sci. 1968;  150 874-894
• 75 Adams HA, Vogt PM. Mitglieder der Sektion "Schock" der Deutschen Interdisziplinären Vereinigung für Intensivmedizin und Notfallmedizin (DIVI). Circulation therapy for severe burn injuries.  Unfallchirurg. 2009;  112 462-471
• 76 Friedrich JB, Sullivan SR, Engrav LH, Round KA, Blayney CB, Carrougher GJ, Heimbach DM, Honari S, Klein MB, Gibran NS. Is supra-Baxter resuscitation in burn patients a new phenomenon?.  Burns. 2004;  30 464-466
• 77 Mitra B, Fitzgerald M. Fluid resuscitation in major burns.  ANZ J Surg. 2006;  76 35-38
• 78 Saffle JI. The phenomenon of "fluid creep" in acute burn resuscitation.  J Burn Care Res. 2007;  28 382-395
• 79 Blumetti J, Hunt JL, Arnoldo BD. The Parkland formula under fire: is the criticism justified?.  J Burn Care Res. 2008;  29 180-186
• 80 Klein MB, Hayden D, Elson C. The association between fluid administration and outcome following major burn: a multicenter study.  Annals of Surgery. 2007;  245 622-628
• 81 Azzopardi EA, McWilliams B, Iyer S, Whitaker IS. Fluid resuscitation in adults with severe burns at risk of secondary abdominal compartment syndrome – an evidence based systematic review.  Burns. 2009;  35 911-920
• 82 Tuggle D, Skinner S, Garza J, Vandijck D, Blot S. The abdominal compartment syndrome in patients with burn injury.  Acta Clin Belg Suppl. 2007;  1 136-140
• 83 Ivy ME, Atweh NA, Palmer J. Intra-abdominal hypertension and abdominal compartment syndrome in burn patients.  J Trauma. 2000;  49 387-391
• 84 Schachtrupp A. Influence of volume increase on intra-abdominal pressure.  Anaesthesist. 2009;  58 532-536
• 85 Bednar B. OTC medication-induced nephrotoxicity in the elderly and CKD patient.  Nephrol News Issues. 2009;  23 43-44
• 86 John R, Herzenberg AM. Renal toxicity of therapeutic drugs.  J Clin Pathol. 2009;  62 505-515
• 87 Xu B, Murray M. Flucloxacillin induced acute renal failure.  Aust Fam Physician. 2008;  37 1009-1011
• 88 Bennett WM, Wood CA, Houghton DC. Modification of experimental aminoglycoside nephrotoxicity.  Am J Kidney Dis. 1986;  8 292-296
• 89 Pannu N, Nadim MK. An overview of drug-induced acute kidney injury.  Crit Care Med. 2008;  36 216-223
• 90 Huerta C, Castellsague J, Varas- C Lorenzo, Garcia LA Rodriguez. Non-steroidal antiinflamatory drugs and risk of acute renal failure in the general population.  Am J Kidney Dis. 2005;  45 531-539
• 91 Whelton A. Nephrotoxicity of nonsteroidal anti-inflammatory drugs: physiologic foundations and clinical implications.  Am J Med. 1999;  106
• 92 Heinrich MC, Häberle L, Müller V, Bautz W, Uder M. Nephrotoxicity of iso-osmolar iodixanol compared with nonionic low-osmolar contrast media: meta-analysis of randomized controlled trials.  Radiology. 2009;  250 68-86
• 93 Meschi M, Detrenis S. Facts and fallacies concerning the prevention of contrast medium–induced nephropathy.  Crit Care Med. 2006;  34 2060-2068
• 94 Reddan D, Laville M, Garovic VD. Contrast-induced nephropathy and its prevention: what do we really know from evidence-based findings?.  J Nephrol. 2009;  22 333-351
• 95 Tepel M, Zidek W. N-acetylcysteine in nephrology; contrast nephropathy and beyond.  Curr Opin Nephrol Hypertens. 2004;  13 649-654
• 96 Baskurt M, Okcun B. N-acetylcysteine versus N-acetylcysteine + theophylline for the prevention of contrast nephropathy.  Eur J Clin Invest. 2009;  39 793-799
• 97 Hörl WH. Contrast induced nephropathy.  Wien Klin Wochenschr. 2009;  121 (S 01) (S 02) 15-32
• 98 Soni SS, Ronco C, Katz N, Cruz DN. Early diagnosis of acute kidney injury: the promise of novel biomarkers.  Blood Purif. 2009;  28 165-174
• 99 Haase M, Bellomo R, Devarajan P, Ma Q, Bennett MR, Möckel M, Matalanis G, Dragun D, Haase-Fielitz A. Novel biomarkers early predict the severity of acute kidney injury after cardiac surgery in adults.  Ann Thorac Surg. 2009;  88 124-130
• 100 Haase-Fielitz A, Bellomo R, Devarajan P, Story D, Matalanis G, Dragun D, Haase M. Novel and conventional serum biomarkers predicting acute kidney injury in adult cardiac surgery: a prospective cohort study.  Crit Care Med. 2009;  37 553-560
• 101 Bell M, Granath F, Mårtensson J, Löfberg E, Ekbom A, Martling CR. KING (Karolinska Intensive care Nephrology Group) . Cystatin C is correlated with mortality in patients with and without acute kidney injury.  Nephrol Dial Transplant. 2009;  24 3096-3102
• 102 Nickolas TL. Biomarkers in acute and chronic kidney disease.  Current Opinion in Nephrology and Hypertension. 2008;  17 127-132
• 103 Holm C, Melcer B, Hörbrand F, Henckel von Donnersmarck G, Mühlbauer W. Arterial thermodilution: an alternative to pulmonary artery catheter for cardiac output assessment in burn patients.  Burns. 2001;  27 161-166
• 104 Bein B, Worthmann F, Tonner PH, Paris A, Steinfath M, Hedderich J, Scholz J. Comparison of esophageal doppler, pulse contour analysis and real-time pulmonary artery thermodilution for the continuous measurement of cardiac output.  J Cardiothorac Vasc Anesth. 2004;  18 185-159
• 105 Reid RD, Jayamaha J. The use of a cardiac output monitor to guide the initial fluid resuscitation in a patient with burns.  Emerg Med J. 2007;  24
• 106 Küntscher MV, Blome-Eberwein S, Pelzer M, Erdmann D, Germann G. Transcardiopulmonary vs. pulmonary arterial thermodilution methods for hemodynamic monitoring of burned patients.  J Burn Care Rehabil. 2002;  23 21-26
• 107 Compton F, Wittrock M, Schaefer JH, Zidek W, Tepel M, Scholze A. Noninvasive cardiac output determination using applanation tonometry-derived radial artery pulse contour analysis in critically ill patients.  Anesth Analg. 2008;  106 171-174
• 108 Brown LM, Liu KD, Matthay MA. Measurement of extravascular lung water using the single indicator method in patients: research and potential clinical value.  Am J Physiol Lung Cell Mol Physiol. 2009;  297 547-558
• 109 Faybik P, Metnitz PhGH. Volumenmanagement bei Brandverletzten.  OEGARI News. 2008;  58 23-25
• 110 O'Mara MS, Slater H, Goldfarb IW, Caushaj PF. A prospective, randomized evaluation of intra-abdominal pressures with crystalloid and colloid resuscitation in burn patients.  J Trauma. 2005;  58 1011-1018
• 111 Chung KK, Juncos LA, Wolf SE, Mann EE, Renz EM, White CE, Barillo DJ, Clark RA, Jones JA, Edgecombe HP, Park MS, Albrecht MC, Cancio LC, Wade CE, Holcomb JB. Continuous renal replacement therapy improves survival in severely burned military casualties with acute kidney injury.  J Trauma. 2008;  64 (S 02) 179-185
• 112 Ronco C, Bellomo R, Homel P, Brendolan A, Dan M, Piccinni P, La Greca G. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial.  Lancet. 2000;  356 26-30
• 113 Saudan P, Niederberger M, De Seigneux S, Romand J, Pugin J, Perneger T, Martin PY. Adding a dialysis dose to continuous hemofiltration increases survival in patients with acute renal failure.  Kidney Int. 2006;  70 1312-1317
• 114 Schiffl H, Land SM, Fischer R. Daily hemodialysis and the outcome of acute renal failure.  N Engl J Med. 2002;  346 305-310
• 115 Morgera S, Schneider M, Slowinski T, Vargas-Hein O, Zuckermann-Becker H, Peters H, Kindgen-Milles D, Neumayer HH. A safe citrate anticoagulation protocol with variable treatment efficacy and excellent control of the acid-base status.  Crit Care Med. 2009;  37 2018-2024
• 116 Oudemans-van Straaten HM, Bosman RJ, Koopmans M, van der Voort PH, Wester JP, van der Spoel JI, Dijksman LM, Zandstra DF. Citrate anticoagulation for continuous venovenous hemofiltration.  Crit Care Med. 2009;  37 545-552
• 117 Kim GH, Oh KH, Yoon JW, Koo JW, Kim HJ, Chae DW, Noh JW, Kim JH, Park YK. Impact of burn size and initial serum albumin level on acute renal failure occurring in major burn.  Am J Nephrol. 2003;  23 55-60
• 118 Saffle JR, Sullivan JJ, Tuohig GM, Larson CM. Multiple organ failure in patients with thermal injury.  Crit Care Med. 1993;  21 1673-1683
• 119 Chrysopoulo MT, Jeschke MG, Dziewulski P, Barrow RE, Herndon DN. Acute renal dysfunction in severely burned adults.  J Trauma. 1999;  46 141-144
• 120 Holm C, Horbrand F, von Donnersmarck GH. Acute renal failure in severely burned patients.  Burns. 1999;  25 171-178