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renal replacement therapy ICU

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https://www.readbyqxmd.com/read/29216937/-significance-of-peripheral-perfusion-index-in-early-diagnosis-and-goal-directed-therapy-of-septic-shock-patients-a-prospective-single-blind-randomized-controlled-trial
#1
Yuanfeng Shi, Ruihong Yin, Yanli Wang, Jiguang Li, Xiaobing Chen, Yongpeng Xie, Caihong Gu, Xiuzhen Zou, Kexi Liu
OBJECTIVE: To investigate the application of peripheral perfusion index (PPI) in early diagnosis and goal-directed therapy of septic shock, and to provide reference for the early clinical diagnosis and treatment of septic shock. METHODS: A prospective single-blind randomized controlled trial (RCT) was conducted. Adult patients with sepsis admitted to emergency medical department and intensive care unit (ICU) of the First People's Hospital of Lianyungang City in Jiangsu Province from January 2013 to December 2016 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29216644/prognostic-factors-and-efficacy-for-continuous-renal-replacement-therapy-in-critically-ill-patients-a-chinese-single-center-retrospective-study
#2
Jing Zhang, Yiming Li, Zhiyong Peng
BACKGROUND: There is controversy about the efficacy and prognostic factors for continuous renal replacement therapy (CRRT) in China due to practice variation. Our aim is to investigate these questions. METHOD: A total of 613 adult patients receiving CRRT in last 3 years from one Chinese ICU were enrolled. The analysis of demographic data, vital signs, and laboratory tests prior to CRRT and outcomes were performed. The data between pre- and post-CRRT were compared for efficacy analysis...
December 7, 2017: Blood Purification
https://www.readbyqxmd.com/read/29212080/clinical-evaluation-of-continuous-renal-replacement-therapy-in-combination-with-ultrasound-guided-percutaneous-transhepatic-gallbladder-drainage-for-acute-severe-biliary-pancreatitis-a-retrospective-study
#3
Qingyun Zhu, Xinting Pan, Yongxian Cao, Hongqiao Wang, Ning Yu, Fuguo Liu, Shigang Yang, Yunlong Wang, Yunbo Sun, Zhengbin Wang
BACKGROUND/AIMS: This study aimed to report the clinical efficacy of continuous renal replacement therapy (CRRT) in combination with ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) (CRRT+PTGD) in the treatment of acute severe biliary pancreatitis (ASBP). METHODS: Between January 2010 and January 2016, 40 cases of patients with ASBP who received routine CRRT (CRRT group) and 40 of those who received CRRT+PTGD (CRRT+PTGD group) at the Affiliated Hospital of Qingdao University (Qingdao, China) were retrospectively reviewed...
November 30, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29210058/development-and-internal-validation-of-the-simplified-mortality-score-for-the-intensive-care-unit-sms-icu
#4
A Granholm, A Perner, M Krag, P B Hjortrup, N Haase, L B Holst, S Marker, M O Collet, A K G Jensen, M H Møller
BACKGROUND: Intensive care unit (ICU) mortality prediction scores deteriorate over time, and their complexity decreases clinical applicability and commonly causes problems with missing data. We aimed to develop and internally validate a new and simple score that predicts 90-day mortality in adults upon acute admission to the ICU: the Simplified Mortality Score for the Intensive Care Unit (SMS-ICU). METHODS: We used data from an international cohort of 2139 patients acutely admitted to the ICU and 1947 ICU patients with severe sepsis/septic shock from 2009 to 2016...
December 6, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29199512/long-term-renal-and-overall-survival-of-critically-ill-patients-with-acute-renal-injury-who-received-continuous-renal-replacement-therapy
#5
Lingping Wu, Ping Zhang, Yi Yang, Hua Jiang, Yongchun He, Chunping Xu, Huijuan Yan, Qi Guo, Qun Luo, Jianghua Chen
BACKGROUND: Acute kidney injury (AKI) is associated with the increased short-term mortality of critically ill patients on continuous renal replacement therapy (CRRT). The aim of this research was to evaluate the association of kidney function at discharge with the long-term renal and overall survival of critically ill patients with AKI who were on CRRT in an intensive care unit (ICU). METHODS: We retrospectively collected data for critically ill patients with AKI who were admitted to ICU on CRRT at a tertiary metropolitan hospital in China between 2008 and 2013...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/29198634/intraoperative-administration-of-4-factor-prothrombin-complex-concentrate-reduces-blood-requirements-in-cardiac-transplantation
#6
Gina H Sun, Visal Patel, Ingrid Moreno-Duarte, Farhad Zahedi, Eric Ursprung, Greg Couper, Fred Y Chen, Ian J Welsby, Raymond Comenzo, Grace Kao, Frederick C Cobey
OBJECTIVE: Assessing the efficacy of intraoperative 4-factor prothrombin complex concentrate (4F-PCC) use in blood product utilization, time to chest closure, intensive care unit (ICU) and hospital length of stay (LOS), thromboembolic complications, renal injury and mortality in left ventricular assist device (LVAD) patients on home anticoagulation therapy with warfarin, undergoing orthotopic heart transplantation (OHT). DESIGN: Retrospective analysis of OHT patients at Tufts Medical Center from May 2013 to October 2016...
August 3, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29197350/effect-of-hyperchloremia-on-acute-kidney-injury-in-critically-ill-septic-patients-a-retrospective-cohort-study
#7
Lenar Yessayan, Javier A Neyra, Fabrizio Canepa-Escaro, George Vasquez-Rios, Michael Heung, Jerry Yee
BACKGROUND: Hyperchloremia is common in critically ill septic patients. The impact of hyperchloremia on the incidence of acute kidney injury (AKI) is not well studied. We investigated the association between hyperchloremia and AKI within the first 72 h of intensive care unit (ICU) admission. METHODS: 6490 ICU adult patients admitted with severe sepsis or septic shock were screened for eligibility. Exclusion criteria included: AKI on admission, baseline estimated glomerular filtration rate (eGFR) <15 ml/min/1...
December 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29176794/capillary-refill-time-during-fluid-resuscitation-in-patients-with-sepsis-related-hyperlactatemia-at-the-emergency-department-is-related-to-mortality
#8
Barbara Lara, Luis Enberg, Marcos Ortega, Paula Leon, Cristobal Kripper, Pablo Aguilera, Eduardo Kattan, Ricardo Castro, Jan Bakker, Glenn Hernandez
INTRODUCTION: Acute circulatory dysfunction in patients with sepsis can evolve rapidly into a progressive stage associated with high mortality. Early recognition and adequate resuscitation could improve outcome. However, since the spectrum of clinical presentation is quite variable, signs of hypoperfusion are frequently unrecognized in patients just admitted to the emergency department (ED). Hyperlactatemia is considered a key parameter to disclose tissue hypoxia but it is not universally available and getting timely results can be challenging in low resource settings...
2017: PloS One
https://www.readbyqxmd.com/read/29149864/kinetic-estimated-glomerular-filtration-rate-in-critically-ill-patients-beyond-the-acute-kidney-injury-severity-classification-system
#9
Flávio de Oliveira Marques, Saulo Aires Oliveira, Priscila Ferreira de Lima E Souza, Wandervânia Gomes Nojoza, Maiara da Silva Sena, Taynara Muniz Ferreira, Bruno Gabriele Costa, Alexandre Braga Libório
BACKGROUND: Although significant advances have been achieved in acute kidney injury (AKI) research following its classification, potential pitfalls can be identified in clinical practice. The nonsteady-state (kinetic) estimated glomerular filtration rate (KeGFR) could add clinical and prognostic information in critically ill patients beyond the current AKI classification system. METHODS: This was a retrospective analysis using data from the Multiparameter Intelligent Monitoring in Intensive Care II project...
November 18, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29137024/effect-of-different-surgical-type-of-coronary-artery-bypass-grafting-on-kidney-injury-a-propensity-score-analysis
#10
Ming-Jen Chan, Cheng-Chia Lee, Shao-Wei Chen, Feng-Chun Tsai, Pyng-Jing Lin, Pei-Chun Fan, Hsiang-Hao Hsu, Ming-Yang Chang, Yung-Chang Chen, Chih-Hsiang Chang
Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with a less favorable outcome. Off-pump surgery results in lower kidney dysfunction than conventional on-pump arrest surgery. On-pump arrest surgery results in a lower revascularization rate compared with off-pump surgery. On-pump beating heart (OPBH) CABG combines the advantages of beating heart surgery and cardiopulmonary bypass. This study compared the renal outcomes of 3 cardiac surgical methods. From January 2010 to December 2012, 373 patients who underwent on-pump CABG were enrolled...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29132411/an-isolated-elevation-in-blood-urea-level-is-not-uraemia-and-not-an-indication-for-renal-replacement-therapy-in-the-icu
#11
EDITORIAL
Jack Mackenzie, Bobby Chacko
The decision to initiate renal replacement therapy (RRT) and the optimal timing for commencement is a difficult decision faced by clinicians when treating acute kidney injury (AKI) in the intensive care setting. Without clinically significant ureamic symptoms or emergent indications (electrolyte abnormalities, volume overload) the timing of RRT initiation remains contentious and inconsistent across health providers. Current trends of initiating RRT in the ICU are often based on isolated blood urea levels without clear guidelines demonstrating an upper limit for treatment...
November 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29132321/the-role-of-the-specialized-team-in-the-operation-of-continuous-renal-replacement-therapy-a-single-center-experience
#12
Harin Rhee, Gum Sook Jang, Miyeun Han, In Seong Park, Il Young Kim, Sang Heon Song, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak
BACKGROUND: The requirement of continuous renal replacement therapy (CRRT) is increasing with the growing incidence of acute kidney injury (AKI). The decision to initiate CRRT is not difficult if an adequate medical history is obtained. However, the handling and maintenance of CRRT constitute a labor-intensive intervention that requires specialized skills. For these reasons, our center organized a specialized CRRT team in March 2013. The aim of this study is to report on the role of a specialized CRRT team and to evaluate the team's outcome...
November 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29116996/leptospirosis-in-icu-a-retrospective-study-of-134-consecutive-admissions
#13
Benjamin Delmas, Julien Jabot, Paul Chanareille, Cyril Ferdynus, Jérôme Allyn, Nicolas Allou, Loïc Raffray, Bernard-Alex Gaüzere, Olivier Martinet, David Vandroux
OBJECTIVES: Leptospirosis causes reversible multiple organ failure, and its mortality remains high. The aim of this study was to determine the mortality rate of leptospirosis in an ICU offering all types of organ support available nowadays and to compare it with mortality in bacterial sepsis. DESIGN: Retrospective, descriptive, and single-center cohort study. SETTINGS: The largest ICU of Reunion Island (Indian Ocean) in a teaching hospital...
November 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29112632/prediction-of-60-day-case-fatality-in-critically-ill-patients-receiving-renal-replacement-therapy-external-validation-of-a-prediction-model
#14
Gloria Maria Custodio de Carvalho, Tacyano Tavares Leite, Alexandre Braga Libório
BACKGROUND: A recent prognostic model, predicting 60-day case fatality in critically-ill patients requiring RRT has been developed (Acute Renal Failure Trial Network - ATN study). Because many prognostic models are suggested in literature, but just a few have found its way into clinical practice, we aimed to externally validate this prediction model in an independent cohort. METHODS: 1,053 critically-ill patients requiring RRT from the MIMIC-III database were analyzed...
November 6, 2017: Shock
https://www.readbyqxmd.com/read/29104728/oxidative-stress-and-acute-kidney-injury-in-critical-illness-pathophysiologic-mechanisms-biomarkers-interventions-and-future-perspectives
#15
REVIEW
Paraskevi Pavlakou, Vassilios Liakopoulos, Theodoros Eleftheriadis, Michael Mitsis, Evangelia Dounousi
Acute kidney injury (AKI) is a multifactorial entity that occurs in a variety of clinical settings. Although AKI is not a usual reason for intensive care unit (ICU) admission, it often complicates critically ill patients' clinical course requiring renal replacement therapy progressing sometimes to end-stage renal disease and increasing mortality. The causes of AKI in the group of ICU patients are further complicated from damaged metabolic state, systemic inflammation, sepsis, and hemodynamic dysregulations, leading to an imbalance that generates oxidative stress response...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29092737/oxalate-nephropathy-following-vitamin-c-intake-within-intensive-care-unit%C3%A2
#16
Eloïse Colliou, Arnaud Mari, Audrey Delas, Antoine Delarche, Stanislas Faguer
OBJECTIVE: To report a case of acute oxalate nephropathy related to vitamin C intake within the intensive care unit (ICU). DESIGN: Case report. SETTING: ICU and nephrology department of a French university hospital. PATIENT: A 57-year-old woman with septic shock related to <italic>Legionella pneumophila</italic> pneumonia complicated by acute respiratory distress syndrome and acute kidney injury who required renal replacement therapy for 75 days...
December 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29061597/high-dose-versus-low-dose-haemofiltration-for-the-treatment-of-critically-ill-patients-with-acute-kidney-injury-an-updated-systematic-review-and-meta-analysis
#17
Peng Li, Li-Ping Qu, Dong Qi, Bo Shen, Yi-Mei Wang, Jia-Rui Xu, Wu-Hua Jiang, Hao Zhang, Xiao-Qiang Ding, Jie Teng
OBJECTIVE: The purpose of this study was to perform a systematic review and meta-analysis to evaluate the effect of high-dose versus low-dose haemofiltration on the survival of critically ill patients with acute kidney injury (AKI). We hypothesised that high-dose treatments are not associated with a higher risk of mortality. DESIGN: Meta-analysis. SETTING: Randomised controlled trials and two-arm prospective and retrospective studies were included...
October 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29041948/effect-of-levosimendan-on-prognosis-in-adult-patients-undergoing-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#18
Qi-Hong Chen, Rui-Qiang Zheng, Hua Lin, Jun Shao, Jiang-Quan Yu, Hua-Ling Wang
BACKGROUND: Small trials suggest that levosimendan is associated with a favorable outcome in patients undergoing cardiac surgery. However, recently published larger-scale trials did not provide evidence for a similar benefit from levosimendan. We performed a meta-analysis to assess the survival benefits of levosimendan in patients undergoing cardiac surgery and to investigate its effects in subgroups of patients with preoperative low-ejection fraction (EF). METHODS: We identified randomized clinical trials through 20 April 2017 that investigated levosimendan therapy versus control in patients undergoing cardiac surgery...
October 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29022532/hiv-positive-patients-in-the-intensive-care-unit-a-retrospective-audit
#19
P Mkoko, R I Raine
BACKGROUND: The indications for and outcomes of intensive care unit (ICU) admission of HIV-positive patients in resource-poor settings such as sub-Saharan Africa are unknown. OBJECTIVE: To identify indications for ICU admission and determine factors associated with high ICU and hospital mortality in HIV-positive patients. METHODS: We reviewed case records of HIV-positive patients admitted to the medical and surgical ICUs at Groote Schuur Hospital, Cape Town, South Africa, from 1 January 2012 to 31 December 2012...
September 22, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28978157/the-optimal-time-of-initiation-of-renal-replacement-therapy-in-acute-kidney-injury-a-meta-analysis
#20
Kaiping Luo, Shufang Fu, Weidong Fang, Gaosi Xu
BACKGROUND: The impact on the timing of renal replacement therapy (RRT) initiation on clinical outcomes for patients with acute kidney injury (AKI) remains controversial. MATERIALS AND METHODS: We searched the Cochrane Library, EMBASE, Global Health, MEDLINE, PubMed, the International Clinical Trials Registry Platform, and Web of Science. RESULTS: We included 49 studies involving 9698 patients. Pooled analysis of 5408 critically ill patients with AKI showed that early RRT was significantly associated with reduced mortality compared to late RRT [odds ratio (OR), 0...
September 15, 2017: Oncotarget
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