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kidney transplantation in picu

Pilar Velasco, Andrés J Alcaraz, Niki Oikonomopoulou, Marina Benito, Raquel Moya, Álvaro Sánchez
INTRODUCTION: The objective of this study was to evaluate the association between the type of initial fluid therapy used (isotonic or hypotonic solutions) and the development of hyponatremia, the plas ma chlorine values and the tolerance of venous access. PATIENTS AND METHOD: Retrospective cohort study in a Pediatric Intensive Care Unit (PICU) of a high complexity hospital. There were included children younger than 15 years old hospitalized during the first semester of 2010 and 2013 who recei ved intravenous maintenance fluid therapy, excluding patients undergoing cardiac surgery, kidney transplant and admissions that lasted less than 24 hours...
February 2018: Revista Chilena de Pediatría
Morgan B Slater, Andrea Gruneir, Paula A Rochon, Andrew W Howard, Gideon Koren, Christopher S Parshuram
OBJECTIVES: Acute kidney injury may be promoted by critical illness, preexisting medical conditions, and treatments received both before and during ICU admission. We aimed to estimate the frequency of acute kidney injury during ICU treatment and to determine factors, occurring both before and during the ICU stay, associated with the development of acute kidney injury. DESIGN: Cohort study of critically ill children. SETTING: University-affiliated PICU...
September 2016: Pediatric Critical Care Medicine
Christine MacDonald, Colleen Norris, Gwen Y Alton, Simon Urschel, Ari R Joffe, Catherine J Morgan
BACKGROUND: Critical illness following heart transplantation can include acute kidney injury (AKI). Study objectives were to define the epidemiology of, risk factors for, or impact on outcomes of AKI after pediatric heart transplant. METHODS: Using data from a prospective study of 66 young children, we evaluated: (1) post-operative AKI rate (by pediatric modified RIFLE criteria); (2) pre, intra, and early post-operative AKI risk factors using stepwise logistic regression (3) effect of AKI on short-term outcomes (ventilation and length of pediatric intensive care unit (PICU) stay) using stepwise multiple regression...
April 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Carol Pineda, Tristan Grogan, James A Lin, Joshua J Zaritsky, Robert Venick, Douglas G Farmer, Robert B Kelly
Outcomes for pediatric SBT patients requiring perioperative RRT in the PICU remain unknown. The objectives were to document our center's experience with PICU SBT patients receiving perioperative RRT and to identify variables predictive of survival to discharge. A retrospective chart review of patients (ages, 0-18 yr) between January 1, 2000 and December 31, 2011 that received RRT within a SBT perioperative period and were transplanted at our university-affiliated, tertiary care children's hospital was performed...
June 2015: Pediatric Transplantation
David T Selewski, Timothy T Cornell, Michael Heung, Jonathan P Troost, Brett J Ehrmann, Rebecca M Lombel, Neal B Blatt, Kera Luckritz, Sue Hieber, Robert Gajarski, David B Kershaw, Thomas P Shanley, Debbie S Gipson
PURPOSE: Acute kidney injury (AKI) occurs commonly in critically ill children and has been associated with increased mortality of up to 50 %. The Kidney Disease: Improving Global Outcomes (KDIGO) AKI working group has proposed a standardized definition of AKI. Utilizing routinely available clinical data, we evaluated the KDIGO AKI criteria and the relationship of AKI with relevant outcomes in a single center tertiary pediatric intensive care (PICU) and cardiac intensive care unit (CICU) population...
October 2014: Intensive Care Medicine
Brett J Ehrmann, David T Selewski, Jonathan P Troost, Susan M Hieber, Debbie S Gipson
OBJECTIVES: Reports of the burden of hypertension in hospitalized children are emerging, but the prevalence and significance of this condition within the PICU are not well understood. The aims of this study were to validate a definition of hypertension in the PICU and assess the associations between hypertension and acute kidney injury, PICU length of stay, and mortality. DESIGN AND SETTING: Single-center retrospective study using a database of PICU discharges between July 2011 and February 2013...
June 2014: Pediatric Critical Care Medicine
J C Gómez Polo, A J Alcaraz Romero, M A Gil-Ruíz Gil-Esparza, J López-Herce Cid, M García San Prudencio, S N Fernández Lafever, Á Carrillo Álvarez
AIM: To describe the morbimortality associated to the development of acute kidney injury (AKI) defined by the pediatric adaptation of the RIFLE criteria in a Pediatric Intensive Care Unit (PICU). DESIGN: A retrospective cohort study was carried out. SETTING: Children admitted to a PICU in a tertiary care hospital. Patients or participants A total of 320 children admitted to a tertiary care hospital PICU during the year 2011. Neonates and renal transplant patients were excluded...
October 2014: Medicina Intensiva
Nabil E Hassan, Aly S Mageed, Dominic J Sanfilippo, Dianne Reischman, Ulrich A Duffner, Surender Rajasekaran
BACKGROUND: Hematopoietic stem-cell transplant (HSCT) is associated with many risk factors for life-threatening complications. Post-transplant critical illness often requires admission to the pediatric intensive care unit (PICU). METHODS: A retrospective analysis was made on the risk factors associated with PICU admission and mortality of all HSCT patients at Helen DeVos Children's Hospital from October 1998 to November 2008. RESULTS: One hundred and twenty-four patients underwent HSCT, with 19 (15...
May 2013: World Journal of Pediatrics: WJP
Rebecca M Lombel, Mallika Kommareddi, Theresa Mottes, David T Selewski, Yong Y Han, Debbie S Gipson, Katherine L Collins, Michael Heung
PURPOSE: In critically ill pediatric patients, fluid overload (FO) >10% has been identified as a threshold for possible interventions, including initiation of continuous renal replacement therapy (CRRT). However, multiple definitions have been reported, and there remains no consensus method for FO calculation. The goal of this study was to compare different methods of FO determination and to assess their relative value in predicting outcomes. METHODS: This is a retrospective single-center review of 21 pediatric stem cell transplant patients (PSCT) that required CRRT from 2004 to 2009...
April 2012: Intensive Care Medicine
Paul M Shore, Rong Huang, Lonnie Roy, Cindy Darnell, Heather Grein, Tammy Robertson, Lisa Thompson
OBJECTIVE: To determine the potential effect of organ donation after circulatory death (DCD) on the number of kidney and liver donors in a PICU. PATIENTS AND METHODS: All deaths in the PICU of an academic, tertiary care children's hospital from May 1996 to April 2007 were retrospectively reviewed. Patient demographics, premortem physiology, and end-of-life circumstances were recorded and compared with basic criteria for potential organ donation. A sensitivity analysis was performed to examine the effect of more strict physiologic and time criteria as well as 3 different rates of consent for donation...
September 2011: Pediatrics
Omar Alkandari, K Allen Eddington, Ayaz Hyder, France Gauvin, Thierry Ducruet, Ronald Gottesman, Véronique Phan, Michael Zappitelli
INTRODUCTION: In adults, small (< 50%) serum creatinine (SCr) increases predict mortality. It is unclear whether different baseline serum creatinine (bSCr) estimation methods affect findings of acute kidney injury (AKI)-outcome associations. We characterized pediatric AKI, evaluated the effect of bSCr estimation approaches on AKI-outcome associations and evaluated the use of small SCr increases to predict AKI development. METHODS: We conducted a retrospective cohort database study of children (excluding postoperative cardiac or renal transplant patients) admitted to two pediatric intensive care units (PICUs) for at least one night in Montreal, QC, Canada...
2011: Critical Care: the Official Journal of the Critical Care Forum
Egmont Harps, Florian Brinkert, Rainer Ganschow, Andrea Briem-Richter, Michael van Husen, Susanne Schmidtke, Uta Herden, Björn Nashan, Lutz Fischer, Markus J Kemper
BACKGROUND: Studies reporting the immediate pediatric intensive care unit (PICU) treatment after combined liver-kidney transplantation (CLKT) are scarce, although this period is pivotal for survival and long-term outcome. METHODS: We retrospectively analyzed all pediatric CLKT performed in our center between 1998 and 2010. RESULTS: Sixteen patients underwent 17 CLKT at a median age of 5.3 years (range, 1.3-15.9 years). Median body weight at CLKT was 17...
May 27, 2011: Transplantation
Denise Miyuki Kusahara, Patricia Kuerten Rocha, Maria Angélica S Peterlini, Mavilde L G Pedreira, Werther Brunow de Carvalho
Renal transplantation has been described as the main treatment for children with end-stage renal disease. Traditionally, infants and small children represented a high-risk group with poor allograft survival. However, studies conducted mainly in developed countries have been demonstrated improvements in allograft survival rates. The aim of this study was to identify demographic characteristics of recipients and kidney donors and to analyse the outcomes of children who received postoperative care following renal transplantation in one Paediatric Intensive Care Unit (PICU)...
November 2006: Nursing in Critical Care
Geneviève Benoit, Véronique Phan, Michel Duval, Martin Champagne, Catherine Litalien, Aicha Merouani
Fluid administration is essential in patients undergoing hematopoietic stem cell transplant (HSCT). Admission to pediatric intensive care unit (PICU) is required for 11-29% of pediatric HSCT recipients and is associated with high mortality. The objective of this study was to determine if a positive fluid balance acquired during the HSCT procedure is a risk factor for PICU admission. The medical records of 87 consecutive children who underwent a first HSCT were reviewed retrospectively for the following periods: from admission for HSCT to PICU admission for the first group (PICU group), and from admission for HSCT to hospital discharge for the second group (non-PICU group)...
March 2007: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
A Medina Villanueva, J López-Herce Cid, Y López Fernández, M Antón Gamero, A Concha Torre, C Rey Galán, F Santos Rodríguez
OBJECTIVE: To analyze the characteristics of acute renal failure (ARF) in critically-ill children and develop a protocol for a multicenter study. METHODS: A prospective, descriptive study was performed in four pediatric intensive care units (PICU) over 5 months. Epidemiological, clinical and laboratory data from children aged between 7 days and 16 years with ARF were analyzed. Premature neonates were excluded. RESULTS: There were 16 episodes of ARF in 14 patients and 62...
December 2004: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
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