Perfil clínico dos pacientes tratados com oxigenoterapia e hemodiálise: uma breve revisão de literatura

Abstract

Introduction: The administration of high concentrations of oxygen alone for long periods induces oxidative stress and lung inflammation. Conversely, both the worsening of chronic kidney disease and the use of hemodialysis are also associated with the production of free radicals. Understanding the profile of patients treated with both therapies allows us to identify the population most affected by the progression of pulmonary and renal dysfunction, in addition to analyzing clinical outcomes. The objective of this review is to answer the question: what is the clinical profile of patients undergoing concomitant oxygen therapy and hemodialysis? Methods: This systematic review was prepared according to the PRISMA 2020 methodological guidelines, with a search for scientific articles in the BVS, PUBMED, and SCIELO databases. The descriptors used were: oxygen therapy, hemodialysis, mechanical ventilation, invasive mechanical ventilation, noninvasive mechanical ventilation, renal replacement therapy, and dialysis. Results: Of the 246 studies identified in the initial search, 31 were included. Patients undergoing simultaneous hemodialysis and oxygen therapy represented 33.78% (n=4586) of the total. Ages ranged from 52 to 71 years, with a predominance of kidney injury and acute renal failure (62.9%), as well as respiratory failure (78.9%). Most patients underwent invasive mechanical ventilation (97.71%) and had a mortality rate higher than the overall mortality rate of the study (47.32% versus 37.80%). Conclusion: Patients with a mean age of 60.34 ± 3.11 years undergoing simultaneous hemodialysis and oxygen therapy have a higher prevalence of respiratory failure and acute renal dysfunction, in addition to widespread use of invasive mechanical ventilation and a higher mortality rate. The heterogeneity of the studies, including differences in methodological designs, hindered a more complete analysis. Future research is needed to better segment reviews and publications regarding the characterization of adult patients undergoing oxygen therapy and hemodialysis.

Introduction: The administration of high concentrations of oxygen alone for long periods induces oxidative stress and lung inflammation. Conversely, both the worsening of chronic kidney disease and the use of hemodialysis are also associated with the production of free radicals. Understanding the profile of patients treated with both therapies allows us to identify the population most affected by the progression of pulmonary and renal dysfunction, in addition to analyzing clinical outcomes. The objective of this review is to answer the question: what is the clinical profile of patients undergoing concomitant oxygen therapy and hemodialysis? Methods: This systematic review was prepared according to the PRISMA 2020 methodological guidelines, with a search for scientific articles in the BVS, PUBMED, and SCIELO databases. The descriptors used were: oxygen therapy, hemodialysis, mechanical ventilation, invasive mechanical ventilation, noninvasive mechanical ventilation, renal replacement therapy, and dialysis. Results: Of the 246 studies identified in the initial search, 31 were included. Patients undergoing simultaneous hemodialysis and oxygen therapy represented 33.78% (n=4586) of the total. Ages ranged from 52 to 71 years, with a predominance of kidney injury and acute renal failure (62.9%), as well as respiratory failure (78.9%). Most patients underwent invasive mechanical ventilation (97.71%) and had a mortality rate higher than the overall mortality rate of the study (47.32% versus 37.80%). Conclusion: Patients with a mean age of 60.34 ± 3.11 years undergoing simultaneous hemodialysis and oxygen therapy have a higher prevalence of respiratory failure and acute renal dysfunction, in addition to widespread use of invasive mechanical ventilation and a higher mortality rate. The heterogeneity of the studies, including differences in methodological designs, hindered a more complete analysis. Future research is needed to better segment reviews and publications regarding the characterization of adult patients undergoing oxygen therapy and hemodialysis.