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https://www.readbyqxmd.com/read/29775554/outcomes-and-predictors-of-early-infection-after-heart-transplantation
#1
Kendall C Shultes, Jerrica E Shuster, Scott Micek, Justin M Vader, Keki Balsara, Akinobu Itoh, Bethany R Tellor
BACKGROUND: Limited data exist on the incidence and outcome of early infection after orthotopic heart transplantation (OHT). The purpose of this study was to describe characteristics and outcomes of OHT recipients with an early infection and to identify predictors of such infections. METHODS: This retrospective, single-center study included patients greater than 18 years of age who underwent OHT from February 2009 to May 2014 and had an infection within 30 days of transplantation...
May 18, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29750039/impact-of-an-inline-extracorporeal-membrane-oxygenation-hemofilter-system-in-neonatal-acute-kidney-injury
#2
Mohammed Azar, Abdulrahman Alamir, Abdullah Thabet Al Qahtani, Al Mokali Khamisa, Khalid Alfakeeh
Extracorporeal membrane oxygenation (ECMO) is considered a recognized lifesaving support for patients with cardiorespiratory failure. Acute kidney injury (AKI) and fluid overload are significant morbidity factors resulting in serious complications. The inline hemofilter system (IHS) and the continuous renal replacement therapy (CRRT) machine are different methods of renal replacement therapy for patients with ECMO. IHS is the alternate, safe dialysis modality of choice because it is user-friendly, inexpensive, and efficiently removes fluid overload and renal diffusive clearance...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29737106/-predictors-of-long-term-mortality-and-health-related-quality-of-life-for-elderly-patients-with-sepsis
#3
Xing Cao, Xue-Lian Liao, Xiao-Li He, Zhi-Chao Xie, Mei-Zu Lu, Yan Kang
OBJECTIVE: To explore the predictors of long-term mortality and healthy related quality of life (HR-QoL) for elderly patients with sepsis. METHODS: Two hundred and thirty-eight septic patients older than 60 years old admitted to intensive care unit (ICU) were enrolled in the study,and were followed up by telephone interview one year after ICU discharge. The hospital mortality and cumulative one-year mortality were analyzed,single and multiple factors analysis were used to for the risk factors of 1-year mortality...
January 2018: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29717547/kinetic-estimated-glomerular-filtration-rate-as-a-predictor-of-successful-continuous-renal-replacement-therapy-discontinuation
#4
Teruhiko Yoshida, Ryo Matsuura, Yohei Komaru, Yoshihisa Miyamoto, Kohei Yoshimoto, Yoshifumi Hamasaki, Eisei Noiri, Naoto Morimura, Masaomi Nangaku, Kent Doi
AIM: No standardised criteria for continuous renal replacement therapy (CRRT) discontinuation have been established so far. Kinetic estimated glomerular filtration rate (eGFR) is a newly developed estimation method based on dynamic changes of serum creatinine expected to reflect the true GFR. This study aimed to evaluate the predictive role of kinetic eGFR for CRRT discontinuation. METHODS: A retrospective single-centre cohort study was conducted. Acute kidney injury (AKI) patients who received CRRT between May 2015 and April 2016 were enrolled...
May 1, 2018: Nephrology
https://www.readbyqxmd.com/read/29702997/recovery-of-renal-function-in-a-heart-transplantation-recipient-with-over-300-days-of-iatrogenic-anuria-a-case-report
#5
Yong-Hua Peng, Xiao-Min Yu, Chen Yan, Lan Luo, Tao-Sheng Li, Jie Xiao
RATIONALE: Anuria is a severe symptom indicating severe kidney damage. Patient recovery from prolonged anuria is rarely reported. PATIENT CONCERNS: A 15-year-old boy received gender- and weight-mismatch heart transplantation (HT) due to dilated cardiomyopathy. He developed severe hypotension, and heart failure 24 hours after surgery, which were relieved by preload reduction treatments. Although, routine examinations did not show any abnormalities in renal function before surgery, anuria occurred 4 days after preload reduction treatments (24-hour urine volume was 23 mL)...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29693303/sofa-coagulation-score-and-changes-in-platelet-counts-in-severe-acute-kidney-injury-analysis-from-the-randomised-evaluation-of-normal-versus-augmented-level-renal-study
#6
Jin Lin, Martin Gallagher, Rinaldo Bellomo, Meili Duan, Konlawi Trongtrakul, Amanda Ying Wang
AIM: To evaluate the prognostic value of baseline SOFA coagulation score (SOFA-CS) and change in platelet counts in patients with severe acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). METHODS: We performed a secondary analysis from the Randomised Evaluation of Normal versus Augmented Level of RRT (RENAL) study. The primary endpoint was all-cause mortality at 90 days after randomisation. The association between baseline SOFA-CS, changes in platelet counts, process of care, and clinical outcomes were analysed using multivariate Cox model adjusted for baseline variables...
April 24, 2018: Nephrology
https://www.readbyqxmd.com/read/29669237/current-practice-of-diagnosis-and-management-of-acute-kidney-injury-in-intensive-care-unit-in-resource-limited-settings
#7
Nattachai Srisawat, Nattaya Sintawichai, Win Kulvichit, Nuttha Lumlertgul, Patita Sitticharoenchai, Nicha Thamrongsat, Sadudee Peerapornratana
PURPOSE: In a resource limited settings, there is sparse information about the management of acute kidney injury (AKI) based on systemic data collection. This survey aimed to described the current management of AKI in intensive care units (ICUs) across Thailand. MATERIALS AND METHODS: Questionnaires were distributed to 160 physicians involved in the intensive care between January and December 2014 across Thailand. Distribution was done through an online survey platform or telephone interview...
April 11, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29664506/continuous-venovenous-hemofiltration-in-neonates-with-hyperammonemia-a-case-series
#8
Felipe Cavagnaro Santa María, Jorge Roque Espinosa, Pamela Guerra Hernández
INTRODUCTION: Neonatal hyperammonemia secondary due to inborn errors of metabolism is a rare condition with a high rate of neurological sequelae and mortality. Initial medical management is often insufficient to stop the progressive increase of ammonia, with the consequent deterioration of the patient. For this reason, depurative techniques have been implemented, including peritoneal dialysis, intermittent hemodialysis and continuous renal replacement therapy (CRRT). OBJECTIVE: To describe our experience with continuous extracorporeal dialysis in severely ill neonates with hyperammonemia...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29663999/-analysis-of-high-risk-factors-of-intensive-care-unit-acquired-weakness-in-patients-with-sepsis
#9
Xiaofan Yu, Xiaohong Wan, Linjun Wan, Qingqing Huang
OBJECTIVE: To investigate high risk factors of intensive care unit-acquired weakness (ICUAW) in patients with sepsis. METHODS: A retrospective study was conducted. 164 patients with mechanical ventilation (MV) who were diagnosed sepsis and multiple organ dysfunction syndrome (MODS), admitted to intensive care unit (ICU) of the Second Affiliated Hospital of Kunming Medical University from January 1st, 2015 to September 30th, 2017 were enrolled. The general situation, the basic diseases (hypertension, diabetes), body mass index (BMI), protopathy diseases, the level of albumin before ICU admission, the MV time, whether to use glucocorticoid and continuous renal replacement therapy (CRRT) or not, nutrition supply (nutritional way, nutrition initiation time, amino acid/protein supply, nutritional status on ICU 3 days and 7 days), myoglobin, the length of ICU stay, the length of hospital stay, and acute physiology and chronic health evaluation II (APACHE II) score were collected...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29627837/combination-of-mean-platelet-volume-platelet-count-ratio-and-the-apache-ii-score-better-predicts-the-short-term-outcome-in-patients-with-acute-kidney-injury-receiving-continuous-renal-replacement-therapy
#10
Junhui Li, Yingchuan Li, Xiaohua Sheng, Feng Wang, Dongsheng Cheng, Guihua Jian, Yongguang Li, Liang Feng, Niansong Wang
BACKGROUND/AIMS: Both the Acute physiology and Chronic Health Evaluation (APACHE II) score and mean platelet volume/platelet count Ratio (MPR) can independently predict adverse outcomes in critically ill patients. This study was aimed to investigate whether the combination of them could have a better performance in predicting prognosis of patients with acute kidney injury (AKI) who received continuous renal replacement therapy (CRRT). METHODS: Two hundred twenty-three patients with AKI who underwent CRRT between January 2009 and December 2014 in a Chinese university hospital were enrolled...
March 29, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29597227/from-continuous-renal-replacement-therapies-to-multiple-organ-support-therapy
#11
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco, Gaetano La Manna
The incidence of the multiple organ dysfunction syndrome (MODS) is rapidly increasing in intensive care units (ICU). It usually combines with sepsis and is the most frequent cause of death in the ICU patients. The nature of the ICU patients has changed in the last years. It includes a variety of patients with severe cases due to major surgical interventions, trauma, hemodynamic instability, sepsis, and so on but also older people than previous times. All these situations can easily lead to MODS. In the prior years, the only available and efficient therapy was renal replacement therapy (RRT) for treating acute renal failure, but the development of technology also gives us devices to support the other systems...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597226/pediatric-continuous-renal-replacement-therapy-for-40-years-of-continuous-renal-replacement-therapy
#12
Stuart L Goldstein
The provision of continuous renal replacement therapy (CRRT) to pediatric patients presents numerous clinical and technical challenges that have been addressed over the past 40 years. Children provide an informative population for acute kidney injury and CRRT study, as pediatric subspecialists practice with a preventive perspective and children often do not have the multiple severe chronic comorbidities that confound adult studies. In addition, the relatively small number of patients treated at any one pediatric center has engendered successful multicenter collaboration to advance the clinical and technical studies of CRRT provision...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597225/continuous-renal-replacement-therapy-quality-control-and-performance-measures
#13
Bo Shen, Jiarui Xu, Yimei Wang, Wuhua Jiang, Jie Teng, Xiaoqiang Ding
Continuous renal replacement therapy (CRRT) is one of the most predominant forms of renal replacement therapy (RRT) currently in use now, this therapy being the initial RRT modality in most critically ill patients. However, in general, the quality of CRRT is still suboptimal. The quality of CRRT is affected by many factors, including the optimal prescription and precision delivery, the CRRT providers' professional level, and the CRRT device used. Establishment of a comprehensive quality control system covering all the aspects and procedures of CRRT is essential...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597224/ensuring-quality-of-care-through-monitoring-of-continuous-renal-replacement-therapies
#14
Mitchell H Rosner
The continuous renal replacement therapy (CRRT) has offered life-saving treatment for kidney failure. Technological advances coupled with findings from clinical trials have allowed for refinements both in the therapy and in the way it is applied to patients. However, outcomes for patients requiring CRRT remain suboptimal. The use of information technology coupled with structured quality improvement programs offers a methodology for studying the delivery of CRRT with an eye toward improving outcomes. Furthermore, integration of information from the CRRT treatment can be combined with real-time data from other patient-monitoring sources to create "feedback" loops where more timely changes in the CRRT prescription can occur...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597222/clinical-complications-of-continuous-renal-replacement-therapy
#15
Florent Sigwalt, Axelle Bouteleux, François Dambricourt, Théo Asselborn, Florent Moriceau, Thomas Rimmelé
The various complications of continuous renal replacement therapy (CRRT) are mostly preventable. Hemodynamic disturbances are dominated by hypotension due to the modification of volume status, myocardial dysfunction, cardiac arrhythmia, or modification of systemic vascular resistances, which are correlated with body temperature changes. Metabolic complications remain at the forefront and have profoundly changed with the use of regional citrate anticoagulation (RCA). RCA may lead to two distinct situations: citrate overload and citrate accumulation, respectively, responsible for metabolic alkalosis and metabolic acidosis...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597221/technical-complications-of-continuous-renal-replacement-therapy
#16
Zaccaria Ricci, Stefano Romagnoli
Continuous renal replacement therapy (CRRT) is commonly applied in critically ill patients affected by severe acute kidney injury for solute and volume control and to optimize acid-base and electrolytes balance. Although CRRT represents a life-saving procedure for these patients, it is a representation of a non-physiologic artificial kidney and the potential benefits of the treatment could be hampered by clinical and technical side effects. Different parts of the CRRT system can be a source of technical complications...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597220/extra-renal-indications-for-continuous-renal-replacement-therapy
#17
Suvi T Vaara, Rinaldo Bellomo
Continuous renal replacement therapy (CRRT) has many potential indications that extend beyond the traditional removal of uremic waste products. Many of these stem from the capacity of CRRT to remove middle-sized molecules and its suitability for haemodynamically unstable patients. Using CRRT for immunomodulation to remove circulating plasma cytokines has created great enthusiasm and, in the past, immunomodulation was a frequently reported indication for commencing CRRT. Unfortunately, recent evidence from randomized controlled trials has been discouraging, and CRRT cannot be recommended for immunomodulation...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597219/advances-in-machine-technology
#18
William R Clark, Gianluca Villa, Mauro Neri, Claudio Ronco
Continuous renal replacement therapy (CRRT) machines have evolved into devices specifically designed for critically ill over the past 40 years. In this chapter, a brief history of this evolution is first provided, with emphasis on the manner in which changes have been made to address the specific needs of the critically ill patient with acute kidney injury. Subsequently, specific examples of technology developments for CRRT machines are discussed, including the user interface, pumps, pressure monitoring, safety features, and anticoagulation capabilities...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597218/membranes-and-sorbents
#19
William R Clark, Dayong Gao, Anna Lorenzin, Claudio Ronco
For continuous renal replacement therapy (CRRT), the extracorporeal filter provides solute depuration, fluid removal, and control of electrolyte and acid-base balance in critically ill patients with acute kidney injury (AKI). The membranes comprising CRRT filters are almost exclusively based on hollow fiber designs and, while adapted from the chronic hemodialysis field, have features that are specific to the requirements of CRRT nevertheless. In addition, these devices have evolved through the 40 years of CRRT in response to changes in clinical practice and the desire to extend the solute removal spectrum...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597217/prescription-and-delivery-of-the-right-continuous-renal-replacement-therapies-dose
#20
Gianluca Villa, Mauro Neri, Claudio Ronco, Jorge Cerdá
This chapter focuses on the definitions and impact of prescription and delivery of the right dose of treatment in patients on continuous renal replacement therapy (CRRT). We define "dose" and the concepts of efficiency, intensity, and efficacy; differentiate their multiple components; and describe the practical application of those concepts to direct patient care. In the article, we emphasize the effects of delivered dose variation on solute control, and list the main factors affecting CRRT dose delivery...
2018: Contributions to Nephrology
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