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Acute kidney injury in critical care setting

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https://www.readbyqxmd.com/read/29140969/risk-factors-for-ventilator-associated-events-in-a-picu
#1
Raeley Guess, Jarin Vaewpanich, Jorge A Coss-Bu, Siriporn Phongjitsiri, Curtis Kennedy, Jeffrey Starke, Satid Thammasitboon
OBJECTIVE: The term ventilator-associated events includes ventilator-associated condition, infection-related ventilator-associated complication, and ventilator-associated pneumonia. We sought to identify potential new risk factors for ventilator-associated condition and infection-related ventilator-associated complication in the PICU population. DESIGN: Matched case control study. SETTING: Children's hospital at a tertiary care academic medical center...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29123653/chloride-in-intensive-care-units-a-key-electrolyte
#2
REVIEW
Ghassan Bandak, Kianoush B Kashani
Over the past few years, chloride has joined the league of essential electrolytes for critically ill patients. Dyschloremia can occur secondary to various etiologic factors before and during patient admission in the intensive care unit. Some cases are disease-related; others, treatment-related. Chloride abnormalities were shown in animal models to have adverse effects on arterial blood pressure, renal blood flow, and inflammatory markers, which have led to several clinical investigations. Hyperchloremia was studied in several settings and correlated to different outcomes, including death and acute kidney injury...
2017: F1000Research
https://www.readbyqxmd.com/read/29104728/oxidative-stress-and-acute-kidney-injury-in-critical-illness-pathophysiologic-mechanisms-biomarkers-interventions-and-future-perspectives
#3
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/29100016/urinary-versus-plasma-neutrophil-gelatinase-associated-lipocalin-ngal-as-a-predictor-of-mortality-for-acute-kidney-injury-in-intensive-care-unit-patients
#4
Ata Mahmoodpoor, Hadi Hamishehkar, Vahid Fattahi, Sarvin Sanaie, Pradeep Arora, Nader D Nader
OBJECTIVE: To examine urinary and plasma neutrophil gelatinase-associated lipocalin (NGAL) levels in predicting ICU mortality. DESIGN: Prospective observational. SETTING: University Critical Care setting. PARTICIPANTS: 50 patients with acute kidney injury (AKI). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Serial urinary and plasma concentrations of NGAL were measured...
October 26, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28946897/undetectable-haptoglobin-is-associated-with-major-adverse-kidney-events-in-critically-ill-burn-patients
#5
François Dépret, Chloé Dunyach, Christian De Tymowski, Maïté Chaussard, Aurélien Bataille, Axelle Ferry, Nabila Moreno, Alexandru Cupaciu, Sabri Soussi, Mourad Benyamina, Alexandre Mebazaa, Kevin Serror, Marc Chaouat, Jean-Pierre Garnier, Romain Pirracchio, Matthieu Legrand
BACKGROUND: Intravascular haemolysis has been associated with acute kidney injury (AKI) in different clinical settings (cardiac surgery, sickle cell disease). Haemolysis occurs frequently in critically ill burn patients. The aim of this study was to assess the predictive value of haptoglobin at admission to predict major adverse kidney events (MAKE) and AKI in critically ill burn patients. METHODS: We conducted a retrospective, single-centre cohort study in a burn critical care unit in a tertiary centre, including all consecutive severely burned patients (total burned body surface > 20% and/or shock and/or mechanical ventilation at admission) from January 2012 to April 2017 with a plasmatic haptoglobin dosage at admission...
September 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28906422/increased-risk-of-acute-kidney-injury-in-critically-ill-children-treated-with-vancomycin-and-piperacillin-tazobactam
#6
Maya R Holsen, Calvin J Meaney, Amanda B Hassinger, Nicholas M Fusco
OBJECTIVES: Compare the rates of acute kidney injury in critically ill children treated with vancomycin and piperacillin-tazobactam versus vancomycin and ceftriaxone. DESIGN: Retrospective cohort study. SETTING: A large tertiary care children's hospital in an urban setting. PATIENTS: Children greater than or equal to 2 months old admitted to the PICU who received greater than or equal to 48 consecutive hours of vancomycin and piperacillin-tazobactam or vancomycin and ceftriaxone...
September 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28669380/acute-kidney-injury-in-critically-ill-adult-patients-with-seasonal-influenza-infection
#7
Ana Dovč, Vladimir Premru, Blaž Pečavar, Rafael Ponikvar
BACKGROUND: Acute kidney injury (AKI) occurs in 22.4 - 100% of critically-ill hospitalized patients with influenza infection. In up to 2/3, it is severe enough to necessitate renal replacement therapy. We aimed to document the incidence of AKI among patients with influenza-related critical illness and its relation to clinical outcomes. METHODS: We conducted a retrospective observational study of all adult patients with acute respiratory illness and laboratory-confirmed influenza infection admitted to non-surgical intensive care units at the University Medical Centre Ljubljana between January 1, 2016, and March 31, 2016...
July 2, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28643487/proenkephalin-neutrophil-gelatinase-associated-lipocalin-and-estimated-glomerular-filtration-rates-in-patients-with-sepsis
#8
Hanah Kim, Mina Hur, Seungho Lee, Rossella Marino, Laura Magrini, Patrizia Cardelli, Joachim Struck, Andreas Bergmann, Oliver Hartmann, Salvatore Di Somma
BACKGROUND: Proenkephalin (PENK) has been suggested as a novel biomarker for kidney function. We investigated the diagnostic and prognostic utility of plasma PENK in comparison with neutrophil gelatinase-associated lipocalin (NGAL) and estimated glomerular filtration rates (eGFR) in septic patients. METHODS: A total of 167 septic patients were enrolled: 99 with sepsis, 37 with septic shock, and 31 with suspected sepsis. PENK and NGAL concentrations were measured and GFR was estimated by using the isotope dilution mass spectrometry traceable-Modification of Diet in Renal Disease (MDRD) Study and three Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations: CKD-EPI(Cr), CDK-EPI(CysC), and CKD-EPI(Cr-CysC)...
September 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/28625248/-core-knowledge-and-skill-based-approach-to-subspecialty-construction-in-critical-intensive-care-medicine-with-distinct-chinese-peculiarity
#9
Lijun Wang, Fang Tian
With the rapid development of critical care medicine (CCM) in China, there are increases in the number of intensive care units (ICUs), the scale of one center ICU and the team. Subspecialty construction of CCM is of great concerns for personnel training as well as discipline development, and is currently one of the urgent problems that need to be resolved. Experience of CCM subspecialty construction from Europe and the United States is lacking and it is necessary to propose some opinions on innovation to construct CCM subspecialties with Chinese characteristics...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28560615/effect-of-continuous-dialysis-on-blood-ph-in-acidemic-hypercapnic-animals-with-severe-acute-kidney-injury-a-randomized-experimental-study-comparing-high-vs-low-bicarbonate-affluent
#10
Thiago Gomes Romano, Luciano Cesar Pontes Azevedo, Pedro Vitale Mendes, Eduardo Leite Vieira Costa, Marcelo Park
BACKGROUND: Controlling blood pH during acute ventilatory failure and hypercapnia in individuals suffering from severe acute kidney injury (AKI) and undergoing continuous renal replacement therapy (CRRT) is of paramount importance in critical care settings. In this situation, the optimal concentration of sodium bicarbonate in the dialysate is still an unsolved question in critical care since high concentrations may worsen carbon dioxide levels and low concentrations may not be as effective in controlling pH...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28487870/volume-related-weight-gain-as-an-independent-indication-for-renal-replacement-therapy-in-the-intensive-care-units
#11
REVIEW
Tibor Fülöp, Lajos Zsom, Mihály B Tapolyai, Miklos Z Molnar, László Rosivall
Attempts to identify specific therapies to reverse acute kidney injury (AKI) have been unsuccessful in the past; only modifying risk profile or addressing the underlying disease processes leading to AKI proved efficacious. The current thinking on recognizing AKI is compromised by a "kidney function percent-centered" viewpoint, a paradigm further reinforced by the emergence of serum creatinine-based automated glomerular filtration reporting over the last two decades. Such thinking is, however, grossly corrupted for AKI and poorly applicable in critically ill patients in general...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28427496/mortality-risk-factors-in-intensive-care-unit-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-a-retrospective-cohort-study%C3%A2
#12
Michael Schmitz, Frank P Tillmann, Ausra Paluckaite, Erich A Laufer, Brian Rayner, Lars C Rump, Peter J Heering
BACKGROUND: Mortality of critically-ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) in an intensive-care setting continues to remain high. There is still uncertainty as to which factors should guide clinical judgement. METHODS: A cohort of 155 patients admitted to an intensive-care unit and necessitating RRT due to AKI were retrospectively analyzed. Demographic and clinical parameters at the time of RRT initiation were retrieved...
April 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28407811/saline-versus-balanced-crystalloids-for-intravenous-fluid-therapy-in-the-emergency-department-study-protocol-for-a-cluster-randomized-multiple-crossover-trial
#13
Wesley H Self, Matthew W Semler, Jonathan P Wanderer, Jesse M Ehrenfeld, Daniel W Byrne, Li Wang, Leanne Atchison, Matthew Felbinger, Ian D Jones, Stephan Russ, Andrew D Shaw, Gordon R Bernard, Todd W Rice
BACKGROUND: Prior studies in critically ill patients suggest the supra-physiologic chloride concentration of 0.9% ("normal") saline may be associated with higher risk of renal failure and death compared to physiologically balanced crystalloids. However, the comparative effects of 0.9% saline and balanced fluids are largely unexamined among patients outside the intensive care unit, who represent the vast majority of patients treated with intravenous fluids. METHODS/DESIGN: This study, entitled Saline Against Lactated Ringer's or Plasma-Lyte in the Emergency Department (SALT-ED), is a pragmatic, cluster, multiple-crossover trial at a single institution evaluating clinical outcomes of adults treated with 0...
April 13, 2017: Trials
https://www.readbyqxmd.com/read/28375502/pro-prevention-of-acute-kidney-injury-time-for-teamwork-and-new-biomarkers
#14
REVIEW
Claudio Ronco, Lilia Rizo-Topete, Mara Serrano-Soto, Kianoush Kashani
Acute kidney injury (AKI) is a common condition in critically ill patients. Multiple studies have identified AKI as a strong independent risk factor for higher morbidity and mortality. AKI is often multifactorial, asymptomatic and difficult to predict. In recent years, the discovery of several AKI biomarkers, including the recent validation and approval of cell cycle arrest biomarkers (NephroCheck, Astute Medical, San Diego, CA, USA), has provided additional tools to detect patients at high risk of AKI and improve their outcomes...
March 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28296663/acute-decompensation-in-pediatric-cardiac-patients-outcomes-after-rapid-response-events
#15
Aarti C Bavare, Kimia S Rafie, Patricia X Bastero, Joseph L Hagan, Paul A Checchia
OBJECTIVE: We studied rapid response events after acute clinical instability outside ICU settings in pediatric cardiac patients. Our objective was to describe the characteristics and outcomes after rapid response events in this high-risk cohort and elucidate the cardiac conditions and risk factors associated with worse outcomes. DESIGN: A retrospective single-center study was carried out over a 3-year period from July 2011 to June 2014. SETTING: Referral high-volume pediatric cardiac center located within a tertiary academic pediatric hospital...
May 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28257549/analysis-of-intensive-care-unit-admission-and-sequelae-in-patients-intravenously-abusing-extended-release-oral-oxymorphone
#16
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/28153190/acute-pd-evidence-guidelines-and-controversies-%C3%A2
#17
REVIEW
Daniela Ponce, Andre Balbi, Brett Cullis
Peritoneal dialysis (PD) may be a feasible, safe, and complementary alternative to hemodialysis not only in the chronic setting, but also in the acute setting. It previously was widely accepted for acute kidney injury (AKI) treatment, but its practice decreased in favor of other types of extracorporeal therapies. The interest in PD to manage AKI patients has been reignited and PD now frequently is used in developing countries because of its lower cost and minimal infrastructural requirements. Studies from these countries have shown that, with careful thought and planning, critically ill patients can be treated successfully using PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28114140/peritoneal-dialysis-treatment-modality-option-in-acute-kidney-injury
#18
REVIEW
Daniela Ponce, Mariele Gobo-Oliveira, Andre Luís Balbi
BACKGROUND: Peritoneal dialysis (PD) may be a feasible and safe alternative to haemodialysis not only in the chronic but also in the acute setting. It was previously widely accepted as a modality for acute kidney injury (AKI) treatment, but its practice declined in favor of other types of extracorporeal therapies. SUMMARY: The interest in PD to manage AKI patients has been increased and PD is now frequently used in developing countries because of its lower cost and minimal infrastructural requirements...
2017: Blood Purification
https://www.readbyqxmd.com/read/27951537/association-between-obstructive-sleep-apnea-and-acute-kidney-injury-in-critically-ill-patients-a-propensity-matched-study
#19
Lin Dou, Haitao Lan, Daniel J Reynolds, Tina M Gunderson, Rahul Kashyap, Ognjen Gajic, Sean Caples, Guangxi Li, Kianoush B Kashani
BACKGROUND/AIMS: Obstructive sleep apnea (OSA) is a known risk factor for chronic kidney disease (CKD); however, its association with acute kidney injury (AKI) is not well documented. We aimed to study whether OSA is associated with the risk of AKI in the intensive care unit (ICU) setting. METHODS: All consecutive adult Olmsted County, MN residents who were admitted in Mayo Clinic ICUs from January 1, 2010 to December 31, 2010 were screened. Chronic and acute risk factors were collected within the first 48 h of ICU admission...
2017: Nephron
https://www.readbyqxmd.com/read/27877096/a-prospective-pilot-study-on-the-systemic-absorption-of-oral-vancomycin-in-children-with-colitis
#20
James W Antoon, Margaret Hall, Diana Metropulos, Michael J Steiner, Ravi Jhaveri, Jacob A Lohr
BACKGROUND: Oral vancomycin is used to treat refractory colitis due to Clostridium dificile infection. Traditionally, oral vancomycin was thought to not be absorbed systemically, but recent adult studies have demonstrated detectable serum levels in over half of patients with severe colitis. This has not been studied in children. OBJECTIVE: To determine the absorption of oral vancomycin and the renal safety profile of oral vancomycin in children hospitalized with colitis. METHODS: We performed a prospective, observational, pilot proof of principle study at the North Carolina Children's Hospital in patients 2 years to 18 years of age receiving oral vancomycin for the treatment of C dificile colitis...
September 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
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