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renal replacement therapy ICU

Nicola Vargas, Loredana Tibullo, Emanuela Landi, Giovanni Carifi, Alfonso Pirone, Antonio Pippo, Immacolata Alviggi, Renato Tizzano, Elisa Salsano, Francesco Di Grezia, Maria Vargas
Despite technological advances, the mortality rate for critically ill oldest old patients remains high. The intensive caring should be able to combine technology and a deep humanity considering that the patients are living the last part of their lives. In addition to the traditional goals of ICU of reducing morbidity and mortality, of maintaining organ functions and restoring health, caring for seriously oldest old patients should take into account their end-of-life preferences, the advance or proxy directives if available, the prognosis, the communication, their life expectancy and the impact of multimorbidity...
October 19, 2016: Aging Clinical and Experimental Research
Jun Lu, Xing Wang, Qiuhua Chen, Mingqi Chen, Lu Cheng, Hua Jiang, Zhiguang Sun
BACKGROUND AND AIMS: Continuous renal replacement therapy (CRRT) is an important treatment in the intensive care unit (ICU). Nevertheless, the outcome of CRRT remains unclear. It is important to find a useful and easy indicator to predict the prognosis in patients on CRRT treatment. We undertook this study to observe the association between serum D-dimer level and mortality of ICU patients in the treatment of CRRT. METHODS: A total of 149 patients who received CRRT were enrolled in our study...
July 2016: Archives of Medical Research
Jonathan A Silversides, Emmet Major, Andrew J Ferguson, Emma E Mann, Daniel F McAuley, John C Marshall, Bronagh Blackwood, Eddy Fan
BACKGROUND: It is unknown whether a conservative approach to fluid administration or deresuscitation (active removal of fluid using diuretics or renal replacement therapy) is beneficial following haemodynamic stabilisation of critically ill patients. PURPOSE: To evaluate the efficacy and safety of conservative or deresuscitative fluid strategies in adults and children with acute respiratory distress syndrome (ARDS), sepsis or systemic inflammatory response syndrome (SIRS) in the post-resuscitation phase of critical illness...
October 12, 2016: Intensive Care Medicine
Oleksa G Rewa, Pierre-Marc Villeneuve, Philippe Lachance, Dean T Eurich, Henry T Stelfox, R T Noel Gibney, Lisa Hartling, Robin Featherstone, Sean M Bagshaw
OBJECTIVES: Renal replacement therapy is increasingly utilized in the intensive care unit (ICU), of which continuous renal replacement therapy (CRRT) is most common. Despite CRRT being a relatively invasive and resource intensive technology, there remains wide practice variation in its application. This systematic review appraised the evidence for quality indicators (QIs) of CRRT care in critically ill patients. DESIGN: A comprehensive search strategy was developed and performed in five citation databases (Medline, Embase, CINAHL, Cochrane Library, and PubMed) and select grey literature sources...
October 11, 2016: Intensive Care Medicine
Gaël Piton, Claire Chaignat, Mikhael Giabicani, Jean-Paul Cervoni, Fabienne Tamion, Emmanuel Weiss, Catherine Paugam-Burtz, Gilles Capellier, Vincent Di Martino
BACKGROUND: The prognosis of cirrhotic patients admitted to the ICU is considered to be poor but has been mainly reported in liver ICU. We aimed to describe the prognosis of cirrhotic patients admitted to a general ICU, to assess the predictors of mortality in this population, and, finally, to identify a subgroup of patients in whom intensive care escalation might be discussed. RESULTS: We performed a retrospective monocentric study of all cirrhotic patients consecutively admitted between 2002 and 2014 in a general ICU in a regional university hospital...
December 2016: Annals of Intensive Care
Alicia I Fayad, Daniel G Buamscha, Agustín Ciapponi
BACKGROUND: Acute kidney injury (AKI) is a common condition among patients in intensive care units (ICU), and is associated with substantial morbidity and mortality. Continuous renal replacement therapy (CRRT) is a blood purification technique used to treat the most severe forms of AKI but its effectiveness remains unclear. OBJECTIVES: To assess the effects of different intensities (intensive and less intensive) of CRRT on mortality and recovery of kidney function in critically ill AKI patients...
October 4, 2016: Cochrane Database of Systematic Reviews
Joerg C Schefold
No abstract text is available yet for this article.
November 2016: Intensive Care Medicine
Kwadwo Kyeremanteng, Gianni D'Egidio, Cynthia Wan, Alan Baxter, Hans Rosenberg
Objective. To describe a single case of Systemic Capillary Leak Syndrome (SCLS) with a rare complication of compartment syndrome. Patient. Our patient is a 57-year-old male, referred to our hospital due to polycythemia (hemoglobin (Hgb) of 220 g/L), hypotension, acute renal failure, and bilateral calf pain. Measurements and Main Results. The patient required bilateral forearm, thigh, and calf fasciotomies during his ICU stay and continuous renal replacement therapy was instituted following onset of acute renal failure and oliguria...
2016: Case Reports in Critical Care
Catherine L Oberg, Robert J Hiensch, Hooman D Poor
OBJECTIVE: To report a case series of three patients with hepatitis C virus infection who all presented with severe type B lactic acidosis shortly after starting treatment with ombitasvir-paritaprevir-ritonavir-dasabuvir. DESIGN: Case series. SETTING: ICU. PATIENTS: Three patients, all who had HCV cirrhosis with mild hepatic impairment (Child-Pugh A) and had started taking ombitasvir-paritaprevir-ritonavir-dasabuvir within the preceding 2 weeks, presented with similar nonspecific symptoms of lethargy, fatigue, and nausea...
September 22, 2016: Critical Care Medicine
Charlotte Trumper
Continuous renal replacement therapy (CRRT) is widely used in the management of critically ill patients with acute kidney injury. It requires effective anticoagulation of the extracorporeal blood circuit. Although heparin is the most commonly prescribed anticoagulant, there are issues associated with heparin, and there has been increasing interest in regional citrate anticoagulation as an alternative. In 2013, The Leeds Teaching Hospitals NHS Trust switched from heparin to citrate anticoagulant for CRRT in intensive care units (ICUs) across the Trust...
September 8, 2016: British Journal of Nursing: BJN
Alessandro Capitanini, Luca Rosso, Laura Giannecchini, Ophelia Meniconi, Adamasco Cupisti
A 47-year old, Caucasian man underwent extracorporeal shock wave lithotripsy (ESWL) of a 14mm calcium stone in the right renal pelvis, without urinary tract obstruction or sepsis. 24 hours after ESWL septic shock occurred and the patient was admitted to the Intensive Care Unit (ICU). Escherichia coli emerged from the blood and urine culture. The patient developed acute renal failure and it was necessary to start a continuous renal replacement therapy (CRRT). Infection was successfully treated, patient recovered renal function and an improvement of general condition occurred...
September 1, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Amartya Mukhopadhyay, Jeyakumar Henry, Venetia Ong, Claudia Shu-Fen Leong, Ai Ling Teh, Rob M van Dam, Yanika Kowitlawakul
BACKGROUND & AIMS: For patients in the intensive care unit (ICU), nutritional risk assessment is often difficult. Traditional scoring systems cannot be used for patients who are sedated or unconscious since they are unable to provide information on their history of food intake and weight loss. We aim to validate the NUTRIC (NUTrition RIsk in Critically ill) score, an ICU-specific nutrition risk assessment tool in Asian patients. METHODS: This was an observational study in the medical ICU of a university-affiliated tertiary hospital...
August 12, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Perliveh Carrera, Charat Thongprayoon, Wisit Cheungpasitporn, Vivek N Iyer, Teng Moua
OBJECTIVE: To assess the incidence of new-onset atrial fibrillation (NOAF) in the medical intensive care unit setting and describe associated characteristics and implications for long-term outcomes. MATERIALS AND METHODS: A single-center, retrospective study of patients admitted to a medical intensive care unit from January 1, 2008, to December 31, 2013, was conducted. Atrial fibrillation (AF) diagnosis was categorized as NOAF or preexisting (PEAF). Intensive care unit characteristics along with in-hospital and long-term outcomes were compared...
July 9, 2016: Journal of Critical Care
Rebecca Fischler, Anne-Pascale Meert, Jean-Paul Sculier, Thierry Berghmans
INTRODUCTION: Acute renal failure (ARF) has a poor prognosis in patients with cancer requiring intensive care unit (ICU) admission. Our aim is finding prognostic factors for hospital mortality in patients with cancer with ARF requiring renal replacement therapy (RRT). METHODS: In this retrospective study, all patients with cancer with ARF treated with continuous venovenous filtration (CVVHDF) in the ICU of the Institut Jules Bordet, between January 1, 2003 and December 31, 2012, were included...
2016: Frontiers in Medicine
Wouter De Corte, Annemieke Dhondt, Raymond Vanholder, Jan De Waele, Johan Decruyenaere, Veerle Sergoyne, Joke Vanhalst, Stefaan Claus, Eric A J Hoste
BACKGROUND: In intensive care unit (ICU) patients, acute kidney injury treated with renal replacement therapy (AKI-RRT) is associated with adverse outcomes. The aim of this study was to evaluate variables associated with long-term survival and kidney outcome and to assess the composite endpoint major adverse kidney events (MAKE; defined as death, incomplete kidney recovery, or development of end-stage renal disease treated with RRT) in a cohort of ICU patients with AKI-RRT. METHODS: We conducted a single-center, prospective observational study in a 50-bed ICU tertiary care hospital...
August 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
Piotr Czempik, Daniel Cieśla, Piotr Knapik, Łukasz Krzych
INTRODUCTION: Acute kidney injury (AKI) remains a serious clinical problem in the intensive care unit (ICU). It constitutes an independent risk factor for mortality, especially when renal replacement therapy (RRT) is required. AIM: Due to limited evidence pertaining to timing, choice of RRT modality and lack of studies investigating AKI in Polish ICUs, we sought to analyse outcomes of adult AKI-RRT ICU patients in the Silesian Voivodeship. MATERIAL AND METHODS: We analysed data regarding 1,380 patients with AKI who required RRT (AKI-RRT) (9...
June 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Wuhua Jiang, Jie Teng, Jiarui Xu, Bo Shen, Yimei Wang, Yi Fang, Zhouping Zou, Jifu Jin, Yamin Zhuang, Lan Liu, Zhe Luo, Chunsheng Wang, Xiaoqiang Ding
BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common complication with a poor prognosis. In order to identify modifiable perioperative risk factors for AKI, which existing risk scores are insufficient to predict, a dynamic clinical risk score to allow clinicians to estimate the risk of CSA-AKI from preoperative to early postoperative periods is needed. METHODS AND RESULTS: A total of 7233 cardiac surgery patients in our institution from January 2010 to April 2013 were enrolled prospectively and distributed into 2 cohorts...
2016: Journal of the American Heart Association
Min Jee Han, Ki Hyun Park, Jung-Ho Shin, Su Hyun Kim
Positive fluid balance is a risk factor for mortality in critically ill patients, especially those requiring continuous renal replacement therapy (CRRT). However, the association between daily fluid balance and various organ impairments remains unclear. This study investigated the impacts of daily fluid balance prior to CRRT on organ dysfunction, as well as mortality in critically ill patients. We identified daily fluid balance between intensive care unit (ICU) admission and CRRT initiation. According to daily fluid balance, the time to CRRT initiation and the rate of organ failure based on the sequential organ failure assessment (SOFA) score were assessed...
August 2016: Journal of Korean Medical Science
Elisabeth Coupez, Jean-François Timsit, Stéphane Ruckly, Carole Schwebel, Didier Gruson, Emmanuel Canet, Kada Klouche, Laurent Argaud, Julien Bohe, Maïté Garrouste-Orgeas, Christophe Mariat, François Vincent, Sophie Cayot, Olivier Cointault, Alain Lepape, Michael Darmon, Alexandre Boyer, Elie Azoulay, Lila Bouadma, Alexandre Lautrette, Bertrand Souweine
BACKGROUND: Intensive care unit (ICU) patients require dialysis catheters (DCs) for renal replacement therapy (RRT). They carry a high risk of developing end-stage renal disease, and therefore their vascular access must be preserved. Guidewire exchange (GWE) is often used to avoid venipuncture insertion (VPI) at a new site. However, the impact of GWE on infection and dysfunction of DCs in the ICU is unknown. Our aim was to compare the effect of GWE and VPI on DC colonization and dysfunction in ICU patients...
July 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
Bhanu Prasad, Michelle Urbanski, Thomas W Ferguson, Erwin Karreman, Nav Tangri
BACKGROUND: Patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) have an increased short-term and long-term risk of mortality. In most North American intensive care units (ICUs), these patients receive continuous renal replacement therapy (CRRT). OBJECTIVE: We aim to identify clinical and demographic factors associated with mortality within 24 h of initiating CRRT. DESIGN: This paper is a prospective cohort study...
2016: Canadian Journal of Kidney Health and Disease
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