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Fluid overload mortality

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https://www.readbyqxmd.com/read/29666156/circulating-bacterial-fragments-as-cardiovascular-risk-factors-in-ckd
#1
Cheuk-Chun Szeto, Christopher William McIntyre, Philip Kam-Tao Li
Cardiovascular disease (CVD) is a major cause of mortality and morbidity in patients with CKD. In the past decade, intestinal dysbiosis and altered gut epithelial barrier function are increasingly recognized in CKD. Uremic patients have slow intestinal transit time, impaired protein assimilation, and decreased consumption of dietary fiber. The use of multiple medications also may contribute to the proliferation of dysbiotic bacteria, which affect the barrier function of intestinal epithelium. In addition, fluid overload and uremic toxins per se directly reduce the gut barrier function...
April 17, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29657372/targeted-interventions-in-critically-ill-children-with-severe-dengue
#2
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29642696/periprocedural-and-perioperatory-management-of-patients-with-tricuspid-valve-disease
#3
Fabrizio Monaco, Ambra L DI Prima, Monica DE Luca, Gaia Barucco, Alberto Zangrillo
Tricuspid regurgitation (TR) is a common valvular lesion which may affect morbidity and mortality. It can be related to an intrinsic abnormality of the tricuspid valve leaflets (organic) or secondary to annular dilatation (functional). Often organic and functional TR coexist in the same patient. A long standing TR is associated with ascites, congestive hepatopathy, peripheral edema, renal failure, and abdominal fullness which significantly affect the outcome. In particular, the perioperative course may be complicated due to both the presence of comorbidities and the development of a severe postoperative right ventricle (RV) dysfunction...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29627971/how-to-tackle-congestion-in-acute-heart-failure
#4
Pieter Martens, Wilfried Mullens
Acute heart failure is a common complication of chronic heart failure and is associated with a high risk for subsequent mortality and morbidity. In 90% of case acute heart failure is the resultant of congestion, a manifestation of fluid build-up due to increased filling pressures. As residual congestion at discharge following an acute heart failure episodes is one of the strongest predictors of poor outcome, the goal of therapy should be to resolve congestion completely. Important to comprehend is that increased cardiovascular filling pressures are not solely the resultant of intravascular volume excess but can also be induced by a decreased venous capacitance...
April 11, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29621026/fluid-status-assessment-in-hemodialysis-patients-and-the-association-with-outcome-review-of-recent-literature
#5
Marijke J E Dekker, Jeroen P Kooman
PURPOSE OF REVIEW: In this review, we will discuss the most recent literature regarding fluids status assessment in hemodialysis patients, and the associations with outcome. RECENT FINDINGS: Research toward technique-assisted assessment of fluid status in hemodialysis patients has been going on for many years. However, there is no absolute agreement between techniques, such as bioimpedance, lung ultrasound, biochemical markers or vena caval diameter, likely because they reflect different fluid compartments with potentially altered distribution in hemodialysis patients...
May 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29615173/outcome-of-chronic-kidney-disease-patients-on-the-basis-of-referral-to-nephrologist-a-one-year-follow-up-study
#6
Muhammad Anees, Yasir Hussain, Muhammad Ibrahim, Irfan Ilahi, Sajjad Ahmad, Khushbakht Isma Asif, Amina Jameel
OBJECTIVE: To determine the outcome of chronic kidney disease (CKD) patients presenting for dialysis on the basis of referral to nephrologist. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Nephrology Department of King Edward Medical University/Mayo Hospital, Lahore, from January 2014 to January 2016. METHODOLOGY: All patients who were presented in nephrology outpatients department and with the indication of dialysis were included in study...
April 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29609642/a-comprehensive-characterization-of-myocardial-and-vascular-phenotype-in-pediatric-chronic-kidney-disease-using-cardiovascular-magnetic-resonance-imaging
#7
Mun Hong Cheang, Nathaniel J Barber, Abbas Khushnood, Jakob A Hauser, Gregorz T Kowalik, Jennifer A Steeden, Michael A Quail, Kjell Tullus, Daljit Hothi, Vivek Muthurangu
BACKGROUND: Children with chronic kidney disease (CKD) have increased cardiovascular mortality. Identifying high-risk children who may benefit from further therapeutic intervention is difficult as cardiovascular abnormalities are subtle. Although transthoracic echocardiography may be used to detect sub-clinical abnormalities, it has well-known problems with reproducibility that limit its ability to accurately detect these changes. Cardiovascular magnetic resonance (CMR) is the reference standard method for assessing blood flow, cardiac structure and function...
March 29, 2018: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29606266/-pulmonary-ultrasound-and-dialysis
#8
Alexandre Seidowsky, Ève Vilaine, Nicolas Mansencal, Alexandre Ébel, Cédric Villain, Lynda Cheddani, Ziad A Massy
Profound deficit of the body fluid composition regulation system is present at the end stage kidney disease, leading to the increase the risk of acute or chronic volume overload, which impacts the morbidity and mortality in these patients. Pulmonary ultrasound by its ability to estimate extrapulmonary water at an infraclinical stage has helped to make progress in this area. Line B is the element of fundamental semiology that reflects the presence of water in the pulmonary alveoli. The alteration of left ventricular function and the increase of pulmonary capillary permeability are the determining factors in the genesis of subclinical pulmonary congestion and are positively correlated with B-lines...
April 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29606256/-renal-toxicity-of-high-dose-methotrexate
#9
Hugo Garcia, Véronique Leblond, François Goldwasser, Didier Bouscary, Emmanuel Raffoux, Nicolas Boissel, Sophie Broutin, Dominique Joly
INTRODUCTION: High-dose methotrexate (at least 1g/m2 ) is used to treat haematologic malignancies and osteosarcomas. Acute kidney injury is a well-known adverse-event after high-dose methotrexate and may lead to delayed drug elimination. Besides usual therapeutics (hyperhydration, urine alkalinisation, leucovorin rescue, renal replacement therapy), a costly specific enzymatic treatment (glucarpidase) is now available but its clinical impact remains elusive. PATIENTS AND METHODS: We analysed high-dose methotrexate prescription charts in 11 clinical centres during the last 15 years to identify and describe adult patients who developed acute kidney injury (according to KDIGO classification)...
April 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29523958/assessment-and-management-of-fluid-overload-in-children-on-dialysis
#10
Wesley Hayes, Fabio Paglialonga
Dysregulation of intravascular fluid leads to chronic volume overload in children with end-stage kidney disease (ESKD). Sequelae include left ventricular hypertrophy and remodeling and impaired cardiac function. As a result, cardiovascular complications are the commonest cause of mortality in the pediatric dialysis population. The clinical need to optimize intravascular volume in children with ESKD is clear; however, its assessment and management is the most challenging aspect of the pediatric dialysis prescription...
March 9, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29512107/fluid-accumulation-during-acute-kidney-injury-in-the-intensive-care-unit
#11
R E Berthelsen, A Perner, A K Jensen, J-U Jensen, M H Bestle
INTRODUCTION: Fluid therapy is a ubiquitous intervention in patients admitted to the intensive care unit, but positive fluid balance may be associated with poor outcomes and particular in patients with acute kidney injury. Studies describing this have defined fluid overload either at specific time points or considered patients with a positive mean daily fluid balance as fluid overloaded. We wished to detail this further and performed joint model analyses of the association between daily fluid balance and outcome represented by mortality and renal recovery in patients admitted with acute kidney injury...
March 7, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29502930/a-comparison-of-compliance-in-the-estimation-of-body-fluid-status-using-daily-fluid-balance-charting-and-body-weight-changes-during-continuous-renal-replacement-therapy
#12
Hugh Davies, Gavin D Leslie, David Morgan, Geoff J Dobb
BACKGROUND: The risk of fluid overload and mortality is increased in patients with severe acute kidney injury. Charting of daily fluid balance is a key component of fluid assessment but not without problems affecting accuracy. The introduction of electronic bed scales has made routine patient-weighing easier and focused attention on monitoring fluid-related weight changes. OBJECTIVES: This paper investigated the frequency of compliance in weighing patients daily using electronic bed scales and evaluated the relationship between calculated fluid balance and body weight changes in patients receiving continuous renal replacement therapy (CRRT)...
March 1, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29482882/vasodilators-in-acute-heart-failure-evidence-based-on-new-studies
#13
REVIEW
André M Travessa, L Menezes Falcão
Acute heart failure (AHF) contributes largely to the worldwide burden of heart failure (HF) and is associated with high mortality, poor prognosis and high rehospitalization rate. The pharmacologic therapy of AHF includes diuretics and vasodilators, which are a keystone when fluid overload and congestion are present. However, vasodilators are mainly focused on controlling symptoms, and drugs that also improve long-term mortality and morbidity seem to be in high demand. In this review, we summarize the existing evidence on mortality benefits of IV vasodilators in AHF...
February 23, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29478864/management-of-acute-kidney-injury-core-curriculum-2018
#14
Peter K Moore, Raymond K Hsu, Kathleen D Liu
Acute kidney injury (AKI) is a heterogeneous disorder that is common in hospitalized patients and associated with short- and long-term morbidity and mortality. When AKI is present, prompt workup of the underlying cause should be pursued, with specific attention to reversible causes. Measures to prevent AKI include optimization of volume status and avoidance of nephrotoxic medications. Crystalloids are preferred over colloids for most patients, and hydroxyethyl starches should be avoided. Volume overload in the setting of AKI is associated with adverse outcomes, so attention should be paid to overall fluid balance...
February 22, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29478061/fluid-overload-and-inflammation-axis
#15
Marijke J E Dekker, Frank M van der Sande, Florence van den Berghe, Karel M L Leunissen, Jeroen P Kooman
Extracellular fluid overload (FO), which is assessed using bioimpedance technologies, is an important predictor of outcome in dialysis patients and in patients with early stages of chronic kidney disease. While traditional cardiovascular abnormalities are assumed to mediate this risk, recently also, the importance of noncardiovascular factors, such as systemic inflammation and malnutrition has been shown. While both FO and inflammation are independent risk factors for mortality, recent studies have shown that their combined presence can lead to a cumulative risk profile...
January 26, 2018: Blood Purification
https://www.readbyqxmd.com/read/29471301/repeated-bioimpedance-measurements-predict-prognosis-of-peritoneal-dialysis-patients
#16
Jwa-Kyung Kim, Young Rim Song, Hyung Seok Lee, Hyung Jik Kim, Sung Gyun Kim
BACKGROUND: Fluid overload is a major risk factor for mortality in patients undergoing peritoneal dialysis (PD). However, few studies have investigated the effect of chronic exposure to sustained fluid overload on long-term outcomes. METHOD: A total of 284 prevalent PD patients were included in this prospective study. Repeated multifrequency body composition analysis was performed 12 months apart, and 1-year cumulative chronic fluid overload were used to predict all-cause mortality and the risk for transfer to hemodialysis (HD) during the ensuing 15...
2018: American Journal of Nephrology
https://www.readbyqxmd.com/read/29454528/continuous-infusion-versus-intermittent-bolus-injection-of-furosemide-in-critically-ill-patients-a-systematic-review-and-meta-analysis
#17
REVIEW
Ka Ting Ng, Aslinah Velayit, Delton Kah Yeang Khoo, Amirah Mohd Ismail, Marzida Mansor
OBJECTIVE: Fluid overload is a common phenomenon seen in intensive care units (ICUs). However, there is no general consensus on whether continuous or bolus furosemide is safer or more effective in these hemodynamically unstable ICU patients. The aim of this meta-analysis was to examine the clinical outcomes of continuous versus bolus furosemide in a critically ill population in ICUs. DATA SOURCES: MEDLINE, EMBASE, PubMed, and the Cochrane Database of Systematic reviews were searched from their inception until June 2017...
January 10, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29447205/aggressive-fluid-accumulation-is-associated-with-acute-kidney-injury-and-mortality-in-a-cohort-of-patients-with-severe-pneumonia-caused-by-influenza-a-h1n1-virus
#18
Gustavo Alejandro Casas-Aparicio, Isabel León-Rodríguez, Rafael de Jesús Hernández-Zenteno, Manuel Castillejos-López, Claudia Alvarado-de la Barrera, Christopher E Ormsby, Gustavo Reyes-Terán
INTRODUCTION: Fluid accumulation is associated with adverse outcomes such as acute kidney injury (AKI) in critically ill patients. This study aimed to describe the factors associated with AKI in individuals with influenza A H1N1 severe pneumonia, and explore the relation of fluid accumulation with AKI and mortality. MATERIAL AND METHODS: We reviewed medical records of individuals with influenza A H1N1 severe pneumonia and no history of chronic kidney disease, attending a national referral center for respiratory diseases between November 2014 and May 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29439683/elevated-central-venous-pressure-is-associated-with-increased-mortality-in-pediatric-septic-shock-patients
#19
Seung Jun Choi, Eun-Ju Ha, Won Kyoung Jhang, Seong Jong Park
BACKGROUND: Central venous pressure (CVP) is an important factor affecting capillary blood flow, and it is associated with poor outcomes in adult septic shock patients. However, whether a similar association exists in pediatric patients remains unclear. METHODS: We retrospectively analyzed data from patients admitted to our pediatric intensive care unit (PICU) between February 2009 and July 2015. Patients were divided into two groups-survivors and nonsurvivors-according to 28-day mortality...
February 13, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29424017/perioperative-blood-management-strategies-for-total-knee-arthroplasty
#20
REVIEW
Qiang Lu, Hao Peng, Guan-Jin Zhou, Dong Yin
Total knee arthroplasty (TKA) often causes a significant amount of blood loss with an accompanying decline in hemoglobin and may increase the frequency of allogeneic blood transfusion rates. Unfortunately, allogeneic blood transfusions have associated risks including postoperative confusion, infection, cardiac arrhythmia, fluid overload, increased length of hospital stay, and increased mortality. Other than reducing the need for blood transfusions, reducing perioperative blood loss in TKA may also minimize intra-articular hemorrhage, limb swelling, and postoperative pain, and increase the range of motion during the early postoperative period...
February 9, 2018: Orthopaedic Surgery
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