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Acute renal failure critically ill

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https://www.readbyqxmd.com/read/30525838/-relationship-between-the-nutric-nutritional-risk-scale-and-protein-hypercatabolism-in-critically-ventilated-patients
#1
Dino Moretti, Melisa D Ré, Nicolás S Rocchetti, Daniel Horacio Bagilet, Claudio Jesus Settecase, Martin Gonzalo Buncuga, Marta Quaglino
INTRODUCTION: the Nutrition Risk in Critically Ill (NUTRIC) score does not include a variable that objectively estimates protein hypercatabolism (PHC), one of the main metabolic changes experienced by critical patients. OBJECTIVE: to evaluate the correlation of the NUTRIC score with PHC in critically ventilated patients. MATERIALS AND METHODS: prospective, observational study. Mixed ICU. It included ventilated patients ≥ 18 years old, without anuria or chronic renal failure...
October 17, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/30523563/when-kidneys-and-lungs-suffer-together
#2
REVIEW
Sorino Claudio, Scichilone Nicola, Pedone Claudio, Negri Stefano, Visca Dina, Spanevello Antonio
A significant interaction between kidneys and lungs has been shown in physiological and pathological conditions. The two organs can both be targets of the same systemic disease (eg., some vasculitides). Moreover, loss of normal function of either of them can induce direct and indirect dysregulation of the other one. Subjects suffering from COPD may have systemic inflammation, hypoxemia, endothelial dysfunction, increased sympathetic activation and increased aortic stiffness. As well as the exposure to nicotine, all the foresaid factors can induce a microvascular damage, albuminuria, and a worsening of renal function...
December 6, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/30505345/intensive-care-unit-physician-delivered-point-of-care-renal-tract-ultrasound-in-acute-kidney-injury-is-feasible
#3
Prashant Parulekar, Ed Neil-Gallacher, Alex Harrison
Acute kidney injury is common in critically ill patients, with ultrasound recommended to exclude renal tract obstruction. Intensive care unit clinicians are skilled in acquiring and interpreting ultrasound examinations. Intensive Care Medicine Trainees wish to learn renal tract ultrasound. We sought to demonstrate that intensive care unit clinicians can competently perform renal tract ultrasound on critically ill patients. Thirty patients with acute kidney injury were scanned by two intensive care unit physicians using a standard intensive care unit ultrasound machine...
November 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/30485886/kidney-injury-and-electrolyte-abnormalities-in-liver-failure
#4
Anthony Bonavia, Kai Singbartl
The liver and kidney are key organs of metabolic homeostasis in the body and display complex interactions. Liver diseases often have direct and immediate effects on renal physiology and function. Conversely, acute kidney injury (AKI) is a common problem in patients with both acute and chronic liver diseases. AKI in patients with acute liver failure is usually multifactorial and involves insults similar to those seen in the general AKI population. Liver cirrhosis affects and is directly affected by aberrations in systemic and renal hemodynamics, inflammatory response, renal handling of sodium and free water excretion, and additional nonvasomotor mechanisms...
October 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/30390876/higher-bmi-is-associated-with-reduced-mortality-but-longer-hospital-stays-following-icu-discharge-in-critically-ill-asian-patients
#5
Amartya Mukhopadhyay, Yanika Kowitlawakul, Jeyakumar Henry, Venetia Ong, Claudia Shu-Fen Leong, Bee Choo Tai
BACKGROUND & AIMS: Asians with similar body mass index (BMI) as the Caucasians are at higher health risk as compared to their counterparts. Although the mean weight of patients admitted to the intensive care unit (ICU) is increasing but the relation between BMI with 28-day mortality and length of stay (LOS) following ICU discharge in Asian patients is not well studied. METHODS: We included all adult patients admitted to the ICU of a tertiary hospital who received mechanical ventilation (MV) for at least 48 hours between October 2013 and September 2014...
December 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/30374606/augmented-renal-clearance-in-pediatric-intensive-care-are-we-undertreating-our-sickest-patients
#6
Evelyn Dhont, Tatjana Van Der Heggen, Annick De Jaeger, Johan Vande Walle, Peter De Paepe, Pieter A De Cock
Many critically ill patients display a supraphysiological renal function with enhanced renal perfusion and glomerular hyperfiltration. This phenomenon described as augmented renal clearance (ARC) may result in enhanced drug elimination through renal excretion mechanisms. Augmented renal clearance seems to be triggered by systemic inflammation and therapeutic interventions in intensive care. There is growing evidence that ARC is not restricted to the adult intensive care population, but is also prevalent in critically ill children...
October 29, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/30352414/vitamin-d-and-critical-illness-what-endocrinology-can-learn-from-intensive-care-and-vice-versa
#7
REVIEW
Karin Amrein, Alja Papinutti, Erwin Mathew, Greisa Vila, Dhruv Parekh
The prevalence of vitamin D deficiency in intensive care units ranges typically between 40 and 70 %. There are many reasons for being or becoming deficient in the ICU. Hepatic, parathyroid and renal dysfunction aditionally increase the risk for developing vitamin D deficiency. Moreover, therapeutic interventions like fluid resuscitation, dialysis, surgery, extracorporeal membrane oxygenation, cardiopulmonary bypass and plasma exchange may significantly reduce vitamin D levels. Many observational studies have consistently shown an association between low vitamin D levels and poor clinical outcomes in critically ill adults and children, including excess mortality and morbidity such as acute kidney injury, acute respiratory failure, duration of mechanical ventilation and sepsis...
October 1, 2018: Endocrine Connections
https://www.readbyqxmd.com/read/30342418/creation-of-an-empiric-tool-to-predict-ecmo-deployment-in-pediatric-respiratory-or-cardiac-failure
#8
Punkaj Gupta, Jeffrey M Gossett, Danny Kofos, Mallikarjuna Rettiganti
PURPOSE: To create a real-time prediction tool to predict probability of ECMO deployment in children with cardiac or pulmonary failure. MATERIALS AND METHODS: Patients ≤18 years old admitted to an ICU that participated in the Virtual Pediatric Systems database (2009-2015) were included. Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with ECMO use. RESULTS: A total of 538,202 ICU patients from 140 ICUs qualified for inclusion...
October 12, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30337758/-individualized-vancomycin-dosing-for-a-patient-diagnosed-as-severe-acute-pancreatitis-with-concurrent-extracorporeal-membrane-oxygenation-and-continuous-veno-venous-hemofiltration-therapy-a-case-report
#9
N He, Y Y Yan, Y Q Ying, M Yi, G Q Yao, Q G Ge, S D Zhai
Pharmacokinetic parameters can be significantly altered for acute kidney injury (AKI), extracorporeal membrane oxygenation (ECMO) and continuous veno-venous hemofiltration therapy (CVVH). Here we reported a case of individualized vancomycin dosing for a patient diagnosed as severe acute pancreatitis treated with concurrent ECMO and CVVH. A 65 kg 32-year-old woman was admitted to hospital presented with severe acute pancreatitis (SAP), respiratory failure, metabotropic acidosis and hyperkalemia. She was admitted to intensive care unit (ICU) on hospital day 1 and was initiated on CVVH...
October 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/30322739/prediction-of-major-adverse-kidney-events-in-critically-ill-burn-patients
#10
François Dépret, Louis Boutin, Jiří Jarkovský, Maité Chaussard, Sabri Soussi, Aurélien Bataille, Haikel Oueslati, Nabila Moreno, Christian de Tymowski, Jiří Parenica, Klára Benešová, Thomas Vauchel, Axelle Ferry, Mourad Benyamina, Alexandru Cupaciu, Maxime Coutrot, Jean-Pierre Garnier, Kevin Serror, Marc Chaouat, Alexandre Mebazaa, Matthieu Legrand
OBJECTIVE: We aimed at assessing the predictive value of plasmatic Neutrophil Gelatinase Associated Lipocalin (pNGAL) at admission and severity scores to predict major adverse kidney events (MAKE, defined as death and/or need for renal replacement therapy (RRT) and/or non-renal recovery at day 90) in critically ill burn patients. MATERIAL AND METHODS: Single-center cohort study in a burn critical care unit in a tertiary center, including all consecutive severely burn patients (total burned body surface >20%) from January 2012 until January 2015 with a pNGAL dosage at admission...
October 12, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/30293927/outcome-and-prognostic-factors-of-patients-treated-in-the-intensive-care-unit-for-carbon-monoxide-poisoning
#11
Wei-Chih Liao, Wen-Chien Cheng, Biing-Ru Wu, Wei-Chun Chen, Chih-Yu Chen, Chia-Hung Chen, Chih-Yen Tu, Te-Chun Hsia
BACKGROUND: Carbon monoxide (CO), a colorless and odorless gas, is one of the common causes of poisoning-related deaths worldwide. CO poisoning can result in hypoxic brain damage and death, but intensive care can improve the likely outcome for critically ill patients. However, there is a paucity of clinical data regarding the prognostic factors and association between organ dysfunction and clinical outcome of patients treated for CO poisoning in the intensive care unit (ICU). METHODS: We performed a retrospective study of patients admitted to a university affiliated hospital ICU between July 2001 and December 2010 following CO poisoning...
October 5, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/30238174/renal-failure-in-critically-ill-patients-beware-of-applying-central-venous-pressure-on-the-kidney
#12
REVIEW
Xiukai Chen, Xiaoting Wang, Patrick M Honore, Herbert D Spapen, Dawei Liu
The central venous pressure (CVP) is traditionally used as a surrogate of intravascular volume. CVP measurements therefore are often applied at the bedside to guide fluid administration in postoperative and critically ill patients. Pursuing high CVP levels has recently been challenged. A high CVP might impede venous return to the heart and disturb microcirculatory blood flow which may cause tissue congestion and organ failure. By imposing an increased "afterload" on the kidney, an elevated CVP will particularly harm kidney hemodynamics and promote acute kidney injury (AKI) even in the absence of volume overload...
September 20, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/30180125/consensus-recommendations-for-rbc-transfusion-practice-in-critically-ill-children-from-the-pediatric-critical-care-transfusion-and-anemia-expertise-initiative
#13
Stacey L Valentine, Melania M Bembea, Jennifer A Muszynski, Jill M Cholette, Allan Doctor, Phillip C Spinella, Marie E Steiner, Marisa Tucci, Nabil E Hassan, Robert I Parker, Jacques Lacroix, Andrew Argent, Jeffrey L Carson, Kenneth E Remy, Pierre Demaret, Guillaume Emeriaud, Martin C J Kneyber, Nina Guzzetta, Mark W Hall, Duncan Macrae, Oliver Karam, Robert T Russell, Paul A Stricker, Adam M Vogel, Robert C Tasker, Alexis F Turgeon, Steven M Schwartz, Ariane Willems, Cassandra D Josephson, Naomi L C Luban, Leslie E Lehmann, Simon J Stanworth, Nicole D Zantek, Timothy E Bunchman, Ira M Cheifetz, James D Fortenberry, Meghan Delaney, Leo van de Watering, Karen A Robinson, Sara Malone, Katherine M Steffen, Scot T Bateman
OBJECTIVES: To date, there are no published guidelines to direct RBC transfusion decision-making specifically for critically ill children. We present the recommendations from the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. DESIGN: Consensus conference series of multidisciplinary, international experts in RBC transfusion management of critically ill children. SETTING: Not applicable. INTERVENTION: None...
September 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/30116993/management-of-acute-on-chronic-liver-failure-an-algorithmic-approach
#14
Shiv Kumar Sarin, Ashok Choudhury
Acute-on-chronic liver failure (ACLF) is a distinct syndrome of liver failure in a patient with chronic liver disease presenting with jaundice, coagulopathy and ascites and/or hepatic encephalopathy, developing following an acute hepatic insult and associated with high 28-day mortality. The definition though lacks global consensus, excludes patients with known distinct entities such as acute liver failure and those with end-stage liver disease. The initial Systemic Inflammatory Response Syndrome (SIRS) because of cytokine storm in relation to acute insult and/or subsequent development of sepsis due to immunoparalysis leads to extrahepatic organ failure...
September 2018: Hepatology International
https://www.readbyqxmd.com/read/30116545/antibiotic-dosing-in-sustained-low-efficiency-dialysis-in-critically-ill-patients
#15
REVIEW
Sidharth Kumar Sethi, Vinod Krishnappa, Nisha Nangethu, Paul Nemer, Lawrence A Frazee, Rupesh Raina
Purpose of review: Sustained low-efficiency dialysis (SLED) is increasingly used as a renal replacement modality in critically ill patients with acute kidney injury (AKI) and hemodynamic instability. There is, therefore, a greater need for the understanding of the antibiotic dosage and pharmacokinetics in these patients, to provide them with optimal therapy. Sources of information: PubMed/Medline, Embase, and Google Scholar. Methods: PubMed/Medline, Embase, and Google Scholar databases were searched using a combination of key words: dialysis, end stage renal disease, renal failure, sustained low efficiency dialysis, extended daily dialysis, prolonged intermittent renal replacement therapy (PIRRT), and antibiotic dosing...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/30094785/successful-treatment-of-diabetic-ketoacidosis-and-hyperglycemic-hyperosmolar-status-in-an-infant-with-kcnj11-related-neonatal-diabetes-mellitus-via-continuous-renal-replacement-therapy
#16
Ting Chen, Dandan Zhang, Zhenjiang Bai, Shuiyan Wu, Haiying Wu, Rongrong Xie, Ying Li, Fengyun Wang, Xiuli Chen, Hui Sun, Xiaoyan Wang, Linqi Chen
Neonatal diabetes mellitus (NDM) is a rare monogenic disorder presenting as uncontrolled hyperglycemia during the first 6 months of life. Hyperglycemic hyperosmolar state (HHS) is quite rare in NDM patients, and reported experience with this condition is limited. Continuous renal replacement therapy (CRRT) is frequently used as a mode of dialytic treatment in critically ill patients with acute renal failure, but has seldom been used in patients with diabetic ketoacidosis (DKA) and HHS. We report the case of a 2-month-old infant admitted to our hospital presenting with dyspnea and lethargy...
October 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/30063639/potential-target-organ-protection-of-mineralocorticoid-receptor-antagonist-in-acute-kidney-disease
#17
Yu-Feng Lin, Likwang Chen, Shuei-Liong Lin, Yu-Chang Yeh, Tao-Min Huang, Yu-Hsiang Chou, Fan-Chi Chang, Yi-Ting Chen, Shao-Yu Yang, Tai-Shuan Lai, Vin-Cent Wu, Tzong-Shinn Chu, Kwan-Dun Wu
OBJECTIVES: Acute kidney disease (AKD), the transition of acute kidney injury to chronic kidney disease, has major clinical significance. Whether mineralocorticoid receptor antagonist will afford target organ protection during this critical stage remains ill-defined. METHODS: Using a population-based cohort database from January 1999 to July 2011, we identified 7252 AKD patients with hypertension, of whom 2255 were treated with mineralocorticoid receptor antagonist (user) and 4997 were treated by other antihypertensive medication (nonuser)...
July 30, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/30043276/extracorporeal-organ-support-ecos-in-critical-illness-and-acute-kidney-injury-from-native-to-artificial-organ-crosstalk
#18
REVIEW
Faeq Husain-Syed, Zaccaria Ricci, Daniel Brodie, Jean-Louis Vincent, V Marco Ranieri, Arthur S Slutsky, Fabio Silvio Taccone, Luciano Gattinoni, Claudio Ronco
The complex nature of single organ failure potentially leading to multiple organ dysfunction syndrome (MODS) in critically ill patients necessitates integrated supportive therapy. Rather than a primary disease, acute kidney injury (AKI) is considered a window to a potentially serious underlying systemic disease, which may partially explain the high morbidity and mortality rates associated with the condition. Renal replacement therapy (RRT) has been routinely used for more than a decade in various intensive care settings and there has also been an increase in the use of extracorporeal membrane oxygenation and extracorporeal carbon dioxide removal...
September 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/30041230/evidence-and-perspectives-on-the-use-of-polymyxin-b-immobilized-fiber-column-hemoperfusion-among-critically-ill-patients
#19
Chizuru Yamashita, Kazuhiro Moriyama, Daisuke Hasegawa, Yoshitaka Hara, Naohide Kuriyama, Tomoyuki Nakamura, Junpei Shibata, Hidefumi Komura, Osamu Nishida
BACKGROUND: Sepsis frequently leads to multiple organ failure due to the uncontrolled amplification and spread of inflammation, even if the infectious source is controlled. Lipopolysaccharide (LPS), a typical pathogen-associated molecular pattern (PAMP), is adsorbed by the polymyxin B-immobilized fiber column (PMX). PMX has been used for decades in Europe. Results of a North American randomized controlled trial (RCT) on PMX have recently been announced in a press release; results of large-scale observational studies and meta-analyses have also been reported in the last several years...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/30012641/circulating-proenkephalin-acute-kidney-injury-and-its-improvement-in-patients-with-severe-sepsis-or-shock
#20
Pietro Caironi, Roberto Latini, Joachim Struck, Oliver Hartmann, Andreas Bergmann, Valentina Bellato, Sandra Ferraris, Gianni Tognoni, Antonio Pesenti, Luciano Gattinoni, Serge Masson
BACKGROUND: Acute kidney injury (AKI) occurs in many critically ill patients and is associated with high mortality. We examined whether proenkephalin could predict incident AKI and its improvement in septic patients. METHODS: Plasma proenkephalin A 119-159 (penKid) was assayed in 956 patients with sepsis or septic shock enrolled in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial to test its association with incident AKI, improvement of renal function, need for renal replacement therapy (RRT), and mortality...
September 2018: Clinical Chemistry
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