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Intensive Care Medicine
Published in: Intensive Care Medicine 4/2020

Open Access 01-04-2020 | Acute Kidney Injury | Conference Reports and Expert Panel

Lung–kidney interactions in critically ill patients: consensus report of the Acute Disease Quality Initiative (ADQI) 21 Workgroup

Authors: Michael Joannidis, Lui G. Forni, Sebastian J. Klein, Patrick M. Honore, Kianoush Kashani, Marlies Ostermann, John Prowle, Sean M. Bagshaw, Vincenzo Cantaluppi, Michael Darmon, Xiaoqiang Ding, Valentin Fuhrmann, Eric Hoste, Faeq Husain-Syed, Matthias Lubnow, Marco Maggiorini, Melanie Meersch, Patrick T. Murray, Zaccaria Ricci, Kai Singbartl, Thomas Staudinger, Tobias Welte, Claudio Ronco, John A. Kellum

Published in: Intensive Care Medicine | Issue 4/2020

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Abstract

Background

Multi-organ dysfunction in critical illness is common and frequently involves the lungs and kidneys, often requiring organ support such as invasive mechanical ventilation (IMV), renal replacement therapy (RRT) and/or extracorporeal membrane oxygenation (ECMO).

Methods

A consensus conference on the spectrum of lung–kidney interactions in critical illness was held under the auspices of the Acute Disease Quality Initiative (ADQI) in Innsbruck, Austria, in June 2018. Through review and critical appraisal of the available evidence, the current state of research, and both clinical and research recommendations were described on the following topics: epidemiology, pathophysiology and strategies to mitigate pulmonary dysfunction among patients with acute kidney injury and/or kidney dysfunction among patients with acute respiratory failure/acute respiratory distress syndrome. Furthermore, emphasis was put on patients receiving organ support (RRT, IMV and/or ECMO) and its impact on lung and kidney function.

Conclusion

The ADQI 21 conference found significant knowledge gaps about organ crosstalk between lung and kidney and its relevance for critically ill patients. Lung protective ventilation, conservative fluid management and early recognition and treatment of pulmonary infections were the only clinical recommendations with higher quality of evidence. Recommendations for research were formulated, targeting lung–kidney interactions to improve care processes and outcomes in critical illness.
Appendix
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Metadata
Title
Lung–kidney interactions in critically ill patients: consensus report of the Acute Disease Quality Initiative (ADQI) 21 Workgroup
Authors
Michael Joannidis
Lui G. Forni
Sebastian J. Klein
Patrick M. Honore
Kianoush Kashani
Marlies Ostermann
John Prowle
Sean M. Bagshaw
Vincenzo Cantaluppi
Michael Darmon
Xiaoqiang Ding
Valentin Fuhrmann
Eric Hoste
Faeq Husain-Syed
Matthias Lubnow
Marco Maggiorini
Melanie Meersch
Patrick T. Murray
Zaccaria Ricci
Kai Singbartl
Thomas Staudinger
Tobias Welte
Claudio Ronco
John A. Kellum
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 4/2020
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-019-05869-7

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