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acute renal failure intensive care

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https://www.readbyqxmd.com/read/28298367/incidence-risk-factors-and-clinical-outcomes-of-acute-kidney-injury-associated-with-scrub-typhus-a-retrospective-study-of-510-consecutive-patients-in-south-korea-2001-2013
#1
Kyungo Hwang, Ha Nee Jang, Tae Won Lee, Hyun Seop Cho, Eunjin Bae, Se-Ho Chang, Dong Jun Park
OBJECTIVES: Renal involvement in scrub typhus ranges from simple urinary abnormalities to acute kidney injury (AKI) leading to death. This study evaluated the incidence, predictors and prognosis of AKI associated with scrub typhus according to the RIFLE (risk, injury, failure, loss, end-stage kidney disease) criteria. METHODS: We retrospectively evaluated the medical records of patients diagnosed with scrub typhus from January 2001 to November 2013 in Gyeongsang National University Hospital...
March 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28275227/halogenated-volatile-anesthetics-in-the-intensive-care-unit-current-knowledge-on-an-upcoming-practice
#2
Pascal L Langlois, Frederick D'Aragon, William Manzanares
The aim of this narrative review was to highlight key points of volatile anesthetics administration in the intensive care unit (ICU), including AnaConDa® and Mirus® devices characteristics and the reported findings on clinical outcomes in critically ill patients. Intravenous sedation in the ICU is associated with issues, such as over- and under-sedation. Halogenated compounds, which can be safely administered by inserting a device in any ICU ventilation circuit, have interesting pharmacodynamic and pharmacokinetic profiles for patients with multi-organ failure...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28264675/sequential-organ-failure-assessment-score-predicts-mortality-after-coronary-artery-bypass-grafting
#3
Chih-Hsiang Chang, Shao-Wei Chen, Pei-Chun Fan, Cheng-Chia Lee, Huang-Yu Yang, Su-Wei Chang, Heng-Chih Pan, Feng-Chun Tsai, Chih-Wei Yang, Yung-Chang Chen
BACKGROUND: Mortality after coronary artery bypass grafting (CABG) is generally associated with underlying disease and surgical factors overlooked in preoperative prognostic models. Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE II) scores are widely used in intensive care units for outcome prediction. This study investigated the accuracy of these models in predicting mortality. METHODS: Between January 2010 and April 2013, 483 patients who underwent isolated CABG were enrolled...
March 6, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28260481/incidence-and-patient-outcomes-in-renal-replacement-therapy-after-orthotopic-liver-transplant
#4
Asude Ayhan, Zeynep Ersoy, Aydin Ulas, Pinar Zeyneloglu, Arash Pirat, Mehmet Haberal
OBJECTIVES: Our objective was to evaluate the incidence of renal replacement therapy after orthotopic liver transplant and to evaluate and analyze patient outcomes. MATERIALS AND METHODS: We performed a retrospective analysis of 177 consecutive patients at a tertiary care unit who underwent orthotopic liver transplant between January 2010 and June 2016. Patients who were admitted to the intensive care unit after orthotopic liver transplant and who required renal replacement therapy were included...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28257549/analysis-of-intensive-care-unit-admission-and-sequelae-in-patients-intravenously-abusing-extended-release-oral-oxymorphone
#5
Matthew W Wilson, Alex K Bonnecaze, Ajay Dharod, Peter J Miller
OBJECTIVES: Prescription drug abuse is a major public health problem in the United States, with the rate of opioid-related deaths nearly quadrupling between 2000 and 2014. Extended-release oral oxymorphone hydrochloride (Opana ER) is a long-acting opioid prescribed for chronic pain; however, it also has the potential to be abused via intravenous injection. This retrospective review sought to analyze specific complications and sequelae requiring intensive care unit resources for patients intravenously abusing extended-release oral oxymorphone...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28250986/severe-tuberculosis-requiring-intensive-care-a-descriptive-analysis
#6
Raquel Pacheco Duro, Paulo Figueiredo Dias, Alcina Azevedo Ferreira, Sandra Margarida Xerinda, Carlos Lima Alves, António Carlos Sarmento, Lurdes Campos Dos Santos
Background. This study aims to describe the characteristics of tuberculosis (TB) patients requiring intensive care and to determine the in-hospital mortality and the associated predictive factors. Methods. Retrospective cohort study of all TB patients admitted to the ICU of the Infectious Diseases Department of Centro Hospitalar de São João (Porto, Portugal) between January 2007 and July 2014. Comorbid diagnoses, clinical features, radiological and laboratory investigations, and outcomes were reviewed. Univariate analysis was performed to identify risk factors for death...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/28237894/early-continuous-renal-replacement-therapy-in-septic-acute-kidney-injury-could-be-defined-by-its-initiation-within-24-hours-of-vasopressor-infusion
#7
Seung Don Baek, Hoon Yu, Seulgi Shin, Hyang-Sook Park, Mi-Soon Kim, So Mi Kim, Eun Kyoung Lee, Jai Won Chang
PURPOSE: The optimal timing for the initiation of early continuous renal replacement therapy (CRRT) is uncertain and requires a practically feasible definition with acceptable evidence. MATERIALS AND METHODS: We investigated the clinical impacts of 3-time interval parameters on the morbidity and mortality of 177 patients with septic shock-induced acute kidney injury: (1) time from vasopressor initiation to CRRT initiation (Tvaso-CRRT), (2) time from intensive care unit (ICU) admission to CRRT initation (TICU-CRRT), and (3) time from endotracheal intubation to CRRT initiation (Tendo-CRRT)...
December 27, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#8
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28222690/ngal-expression-during-cardiopulmonary-bypass-does-not-predict-severity-of-postoperative-acute-kidney-injury
#9
Martin G Friedrich, Ioannis Bougioukas, Johanna Kolle, Christian Bireta, Fawad A Jebran, Marius Placzek, Theodor Tirilomis
BACKGROUND: Renal injury is a serious complication after cardiac surgery and therefore, early detection and much more prediction of postoperative kidney injury is desirable. Neutrophil gelatinase-associated lipocalin (NGAL) is a predictive biomarker of acute kidney injury and may increase after cardiopulmonary bypass (CPB). However, time correlation of NGAL expression and severity of renal injury is still unclear. The aim of our study was to investigate CPB-related urine NGAL (uNGAL) secretion in correlation to postoperative renal function...
February 21, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28219188/-change-of-prognosis-and-pathogens-in-adult-patients-with-severe-community-acquired-pneumonia-during-different-periods
#10
L Zhang, P Ning, F Rong, Z C Gao
Objective: To compare the change of prognosis and pathogens of adult patients with severe community-acquired pneumonia (CAP) requiring admission to Respiratory Intensive Care Unit (RICU) during different period, and estimate the risk factors of severe CAP. Methods: The clinical data of 186 patients with severe CAP admission to RICU was collected and assessed the trend in outcomes of these patients during three time periods: Period Ⅰ (January 1 2000 to October 31 2006), Period Ⅱ (November 1 2006 to December 31 2010), and Period Ⅲ (January 1 2011 to December 31 2015), analyzed the risk factors by Cox Proportional Hazards regression, and compared the pathogens detection...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28217064/a-simple-technique-to-achieve-vascular-access-for-continuous-venous-venous-ultrafiltration-in-a-toddler
#11
Joseph Drew Tobias
Acute renal failure is associated with increased mortality in the Pediatric Intensive Care Unit. When anuric or oliguric renal failure occurs, the associated fluid overload may compromise respiratory function and has been shown to be associated with worse outcomes. Renal replacement therapy using continuous venous-venous hemofiltration (CVVH) allows for fluid, solute, and nitrogenous waste removal. However, large bore vascular access with placement of a double-lumen dialysis catheter is necessary to ensure effective flow rates to allow for CVVH...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28208022/protein-requirements-for-critically-ill-patients-with-renal-and-liver-failure
#12
Jayshil J Patel, Craig J McClain, Menaka Sarav, Jill Hamilton-Reeves, Ryan T Hurt
Diseases leading to critical illness induce proteolysis resulting in muscle wasting and negative nitrogen balance. Muscle wasting has been associated with poor intensive care unit (ICU)-related outcomes, including an increased risk for mortality. Acute kidney injury (AKI) represents a common organ dysfunction associated with ICU-related disorders, such as sepsis, trauma, and respiratory failure. AKI and renal replacement therapy lead to amino acid loss. Decompensated liver cirrhosis (DLC) and acute liver failure (ALF) represent more severe forms of liver dysfunction leading to ICU admission...
February 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28196107/fluid-overload-and-survival-in-critically-ill-patients-with-acute-kidney-injury-receiving-continuous-renal-replacement-therapy
#13
Il Young Kim, Joo Hui Kim, Dong Won Lee, Soo Bong Lee, Harin Rhee, Eun Young Seong, Ihm Soo Kwak, Sang Heon Song
BACKGROUND: Fluid overload is known to be associated with increased mortality in patients with acute kidney injury (AKI) who are critically ill. In this study, we intended to uncover whether the adverse effect of fluid overload on survival could be applied to all of the patients with AKI who received continuous renal replacement therapy (CRRT). METHODS: We analyzed 341 patients with AKI who received CRRT in our intensive care units. The presence of fluid overload was defined as a minimum 10% increase in body weight from the baseline...
2017: PloS One
https://www.readbyqxmd.com/read/28190602/prevention-of-acute-kidney-injury-in-intensive-care-units
#14
S Mas-Font, J Ros-Martinez, C Pérez-Calvo, P Villa-Díaz, S Aldunate-Calvo, E Moreno-Clari
Acute kidney injury (AKI) is a growing concern in Intensive Care Units. The advanced age of our patients, with the increase in associated morbidity and the complexity of the treatments provided favor the development of AKI. Since no effective treatment for AKI is available, all efforts are aimed at prevention and early detection of the disorder in order to establish secondary preventive measures to impede AKI progression. In critical patients, the most frequent causes are sepsis and situations that result in renal hypoperfusion; preventive measures are therefore directed at securing hydration and correct hemodynamics through fluid perfusion and the use of inotropic or vasoactive drugs, according to the underlying disease condition...
March 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28190431/posterior-reversible-encephalopathy-in-the-intensive-care-unit
#15
M Toledano, J E Fugate
Posterior reversible encephalopathy syndrome (PRES) is increasingly diagnosed in the emergency department, and medical and surgical intensive care units. PRES is characterized by acute onset of neurologic symptoms in the setting of blood pressure fluctuations, eclampsia, autoimmune disease, transplantation, renal failure, or exposure to immunosuppressive or cytotoxic drugs, triggers known to admit patients to the intensive care unit (ICU). Although the exact pathophysiology remains unknown, there is growing consensus that PRES results from endothelial dysfunction...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28151948/model-for-end-stage-liver-disease-excluding-inr-meld-xi-score-in-critically-ill-patients-easily-available-and-of-prognostic-relevance
#16
Bernhard Wernly, Michael Lichtenauer, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Uta C Hoppe, Malte Kelm, Christian Jung
PURPOSE: MELD-XI, an adapted version of Model for End-stage Liver Disease (MELD) score excluding INR, was reported to predict outcomes e.g. in patients with acute heart failure. We aimed to evaluate MELD-XI in critically ill patients admitted to an intensive care unit (ICU) for prognostic relevance. METHODS: A total of 4381 medical patients (66±14 years, 2862 male) admitted to a German ICU between 2004 and 2009 were included and retrospectively investigated. Admission diagnoses were e...
2017: PloS One
https://www.readbyqxmd.com/read/28144728/-acute-pancreatitis-in-intensive-care-medicine-which-risk-score-is-useful
#17
A J Fischer, F Andreottola, P Lenz, P Lebiedz
INTRODUCTION: Acute pancreatitis is a disease with an increasing incidence in the Western countries associated with a high mortality depending on severity of disease. Etiology is often biliary or due to alcoholism. Incidence of etiology varies between regions depending on risk-factor prevalence. Several risk scores are available to estimate mortality. The aim of the study is to identify the risk factors most relevant for patients being treated for severe acute pancreatitis in an ICU of a tertiary medical center...
January 31, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28142264/annals-express-neutrophil-gelatinase-associated-lipocalin-is-a-better-biomarker-than-cystatin-c-for-predicting-imminent-acute-kidney-injury-in-critically-ill-patients
#18
Itir Yegenaga, Fatih Kamis, Canan Baydemir, Elizade Erdem, Koray Celebi, Necmi Eren, Nur Baykara
AIMS: The prevention of acute kidney injury (AKI) can be lifesaving for intensive care unit (ICU) patients. However, conventional methods are not sufficient for predicting the risk for approaching AKI. In this study, the promising biomarker NGAL(neutrophil gelatinase-associated lipocalin) was compared to CysC (Cystatin C ) for indicating risk of future AKI. METHODS: One hundred eighty-three adult patients without chronic kidney disease or renal replacement therapy were included in this study...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28142133/perioperative-hemodynamic-instability-and-fluid-overload-are-associated-with-increasing-acute-kidney-injury-severity-and-worse-outcome-after-cardiac-surgery
#19
Anja Haase-Fielitz, Michael Haase, Rinaldo Bellomo, Paolo Calzavacca, Anke Spura, Hassina Baraki, Ingo Kutschka, Christian Albert
PURPOSE: The study aimed to investigate patients' characteristics, fluid and hemodynamic management, and outcomes according to the severity of cardiac surgery-associated acute kidney injury (CSA-AKI). METHODS: In a single-center, prospective cohort study, we enrolled 282 adult cardiac surgical patients. In a secondary analysis, we assessed preoperative patients' characteristics, physiological variables, and medication for intra- and postoperative fluid and hemodynamic management and outcomes according to CSA-AKI stages by the Renal risk, Injury, Failure, Loss, End-stage renal disease (RIFLE) classification...
January 31, 2017: Blood Purification
https://www.readbyqxmd.com/read/28138736/the-intensive-care-medicine-agenda-on-acute-kidney-injury
#20
REVIEW
Peter Pickkers, Marlies Ostermann, Michael Joannidis, Alexander Zarbock, Eric Hoste, Rinaldo Bellomo, John Prowle, Michael Darmon, Joseph V Bonventre, Lui Forni, Sean M Bagshaw, Miet Schetz
Acute kidney injury (AKI) is a common complication in the critically ill. Current standard of care mainly relies on identification of patients at risk, haemodynamic optimization, avoidance of nephrotoxicity and the use of renal replacement therapy (RRT) in established AKI. The detection of early biomarkers of renal tissue damage is a recent development that allows amending the late and insensitive diagnosis with current AKI criteria. Increasing evidence suggests that the consequences of an episode of AKI extend long beyond the acute hospitalization...
January 30, 2017: Intensive Care Medicine
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