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REVIEW
Yan-Ting Sun, Wei Wu, Yun-Tai Yao
BACKGROUND: The objective of this study is to conduct a systematic review and meta-analysis examining the relationship between the vasoactive-inotropic score (VIS) and patient outcomes in surgical settings. METHODS: Two independent reviewers searched PubMed, Web of Science, EMBASE, Scopus, Cochrane Library, Google Scholar, and CNKI databases from November 2010, when the VIS was first published, to December 2022. Additional studies were identified through hand-searching the reference lists of included studies...
January 6, 2024: Systematic Reviews
#22
REVIEW
Rita Gaspari, Giorgia Spinazzola, Paola Aceto, Alfonso Wolfango Avolio, Manuel Delli Compagni, Stefania Postorino, Teresa Michi, Daniele Cosimo Fachechi, Anna Modoni, Massimo Antonelli
Intensive Care Unit (ICU)-Acquired Weakness (ICU-AW) is a generalized muscle weakness that is clinically detected in critical patients and has no plausible etiology other than critical illness. ICU-AW is uncommon in patients undergoing orthotopic liver transplantation (OLT). Our report sheds light on the highest number of ICU-AW cases observed in a single center on OLT patients with early allograft dysfunction. Out of 282 patients who underwent OLT from January 2015 to June 2023, 7 (2.5%) developed generalized muscle weakness in the ICU and underwent neurophysiological investigations...
December 6, 2023: Journal of Clinical Medicine
#23
JOURNAL ARTICLE
Gazi Md Salahuddin Mamun, Monira Sarmin, Aklima Alam, Farzana Afroze, Lubaba Shahrin, Abu Sadat Mohammad Sayeem Bin Shahid, Shamsun Nahar Shaima, Nadia Sultana, Mohammod Jobayer Chisti, Tahmeed Ahmed
Despite having essential roles in maintaining human body physiology, magnesium has gained little attention. We sought to evaluate the prevalence and predictors of magnesium imbalance in diarrheal children admitted to an intensive care unit. This retrospective data analysis was conducted among children admitted between January 2019 and December 2019. Eligible children were categorized by serum magnesium levels that were extracted from the hospital database. Among 557 participants, 29 (5.2%) had hypomagnesemia, 344 (61...
2023: PloS One
#24
JOURNAL ARTICLE
Justin C Magin, Jacob R Wrobel, Xinming An, Jacob Acton, Alexander Doyal, Shawn Jia, James C Krakowski, Jay Schoenherr, Ricardo Serrano, David Flynn, Duncan McLean, Stuart A Grant
Objectives: Perioperative fluid administration impacts the rate of complications following surgery. VExUS grading system is a standardized point of care ultrasound (POCUS)-based, comprehensive method to assess volume status. VExUS could serve as a tool to guide fluid management, if validated perioperatively. The primary aim was to assess the success rate of obtaining required windows for VExUS grading , as well as the feasibility within a perioperative setting among noncardiac surgery. Further, this study describes the incidence of perioperative venous congestion and associations with 30-day postoperative complications...
2023: POCUS J
#25
JOURNAL ARTICLE
Inger Persson, Adam Grünwald, Ludivine Morvan, David Becedas, Martin Arlbrandt
BACKGROUND: Acute kidney injury (AKI) represents a significant global health challenge, leading to increased patient distress and financial health care burdens. The development of AKI in intensive care unit (ICU) settings is linked to prolonged ICU stays, a heightened risk of long-term renal dysfunction, and elevated short- and long-term mortality rates. The current diagnostic approach for AKI is based on late indicators, such as elevated serum creatinine and decreased urine output, which can only detect AKI after renal injury has transpired...
December 14, 2023: JMIR Formative Research
#26
JOURNAL ARTICLE
Summra Siddiq, Zakia Hussain, Janmohamed Mubarakali, Anam Nazir
Background Cancer patients are at increased risk of multi-organ failure due to either the primary disease burden or certain non-cancer-related risk factors. Among the most common complications is acute kidney injury (AKI), which is frequently seen in cancer settings. Among patients with cancer, the incidence of renal injury reaches up to 12.5%. However, critical care units have a much higher incidence, up to 50%. This study aimed to describe the characteristics of Asian populations with AKI with a background of malignancy, along with risk factors and outcomes...
November 2023: Curēus
#27
JOURNAL ARTICLE
Xinyao Luo, Dingyuan Wan, Ruoxin Xia, Ruoxi Liao, Baihai Su
(1) Background: Inflammation plays an important role in the onset and progression of acute kidney injury (AKI). Despite this, evidence regarding the prognostic effect of the monocyte-to-lymphocyte ratio (MLR), a novel systemic inflammation marker, among patients with AKI is scarce. This study sets out to investigate the prognostic potential of both baseline and early changes in MLR for short-term mortality among critically ill patients with AKI. (2) Method: Eligible patients with AKI from the Medical Information Mart for Intensive Care IV database were retrospectively analyzed...
November 28, 2023: Journal of Clinical Medicine
#28
JOURNAL ARTICLE
Li-Chun Lin, Min-Hsiang Chuan, Jung-Hua Liu, Hung-Wei Liao, Leong L Ng, Martin Magnusson, Amra Jujic, Heng-Chih Pan, Vin-Cent Wu, Lui G Forni
BACKGROUND: Proenkephalin A 119-159 (PENK) is freely filtered in the glomerulus with plasma levels correlating with glomerular filtration rate. Therefore, PENK has been proposed as an early indicator of acute kidney injury (AKI) although its performance is dependent on the clinical setting. This meta-analysis aimed to investigate the correlation between PENK levels and the development of AKI. METHODS: We conducted a comprehensive search on the PubMed, Embase, Cochrane databases, the website ClinicalTrials...
December 7, 2023: Critical Care: the Official Journal of the Critical Care Forum
#29
JOURNAL ARTICLE
Julie Helms, Hamid Merdji, Sébastien Loewert, François Severac, Alexandra Monnier, Julian Kaurin, Anaïs Curtiaud, Ferhat Meziani, Julien Demiselle
BACKGROUND: Disseminated intravascular coagulation (DIC) worsens the prognosis of septic shock and contributes to multiple organ failure. To date, no data linking DIC and acute kidney injury (AKI) occurrence, severity, and evolution in this setting are available. We aimed at analyzing the association between AKI occurrence, severity and evolution in patients with septic shock-induced DIC. In a prospective monocentric cohort study, consecutive patients, 18 years and older, admitted in the ICU of Strasbourg University Hospital in the setting of systemic hypotension requiring vasopressor related to an infection, without history of terminal chronic kidney disease were eligible...
December 1, 2023: Annals of Intensive Care
#30
REVIEW
Gerard Cortina, Marco Daverio, Demet Demirkol, Rahul Chanchlani, Akash Deep
Continuous renal replacement therapy (CRRT) is the preferred method for renal support in critically ill and hemodynamically unstable children in the pediatric intensive care unit (PICU) as it allows for gentle removal of fluids and solutes. The most frequent indications for CRRT include acute kidney injury (AKI) and fluid overload (FO) as well as non-renal indications such as removal of toxic metabolites in acute liver failure, inborn errors of metabolism, and intoxications and removal of inflammatory mediators in sepsis...
February 2024: European Journal of Pediatrics
#31
JOURNAL ARTICLE
Autumn M Spyhalsky, Se Jin Kim, Calvin J Meaney, Nicholas M Smith, Dhaval K Shah, Amanda B Hassinger, Nicholas M Fusco
INTRODUCTION: The standard of care for detecting acute kidney injury (AKI) is change in serum creatinine (SCr) and urine output, which are limited. This study aimed to compare urinary biomarkers neutrophil gelatinase-associated lipocalin (uNGAL) with kidney injury molecule-1 (uKIM-1) in critically ill children exposed to vancomycin who did and did not develop AKI as defined by changes in SCr. METHODS: This was a single-center, prospective, clinical, observational cohort study at a large tertiary care children's hospital in an urban setting...
November 16, 2023: Pharmacotherapy
#32
JOURNAL ARTICLE
Kunmei Lai, Guo Lin, Caiming Chen, Yanfang Xu
BACKGROUND: Sepsis-associated acute kidney injury (SA-AKI) is a critical condition with significant clinical implications, yet there is a need for a predictive model that can reliably assess the risk of its development. This study is undertaken to bridge a gap in healthcare by creating a predictive model for SA-AKI with the goal of empowering healthcare providers with a tool that can revolutionize patient care and ultimately lead to improved outcomes. METHODS: A cohort of 615 patients afflicted with sepsis, who were admitted to the intensive care unit, underwent random stratification into 2 groups: a training set (n = 435) and a validation set (n = 180)...
November 15, 2023: Journal of Intensive Care Medicine
#33
REVIEW
Iman Karimzadeh, Erin F Barreto, John A Kellum, Linda Awdishu, Patrick T Murray, Marlies Ostermann, Azra Bihorac, Ravindra L Mehta, Stuart L Goldstein, Kianoush B Kashani, Sandra L Kane-Gill
Drug-induced kidney disease (DIKD) accounts for about one-fourth of all cases of acute kidney injury (AKI) in hospitalized patients, especially in critically ill setting. There is no standard definition or classification system of DIKD. To address this, a phenotype definition of DIKD using expert consensus was introduced in 2015. Recently, a novel framework for DIKD classification was proposed that incorporated functional change and tissue damage biomarkers. Medications were stratified into four categories, including "dysfunction without damage," "damage without dysfunction," "both dysfunction and damage," and "neither dysfunction nor damage" using this novel framework along with predominant mechanism(s) of nephrotoxicity for drugs and drug classes...
November 9, 2023: Critical Care: the Official Journal of the Critical Care Forum
#34
JOURNAL ARTICLE
Theresa Mottes, Shina Menon, Andrea Conroy, Jennifer Jetton, Kristin Dolan, Ayse Akcan Arikan, Rajit K Basu, Stuart L Goldstein, Jordan M Symons, Rashid Alobaidi, David J Askenazi, Sean M Bagshaw, Matthew Barhight, Erin Barreto, Benan Bayrakci, O N Bignall Ray, Erica Bjornstad, Patrick Brophy, Jennifer Charlton, Rahul Chanchlani, Andrea L Conroy, Akash Deep, Prasad Devarajan, Dana Fuhrman, Katja M Gist, Stephen M Gorga, Jason H Greenberg, Denise Hasson, Emma Heydari, Arpana Iyengar, Catherine Krawczeski, Leslie Meigs, Catherine Morgan, Jolyn Morgan, Tara Neumayr, Zaccaria Ricci, David T Selewski, Danielle Soranno, Natalja Stanski, Michelle Starr, Scott M Sutherland, Jordan Symons, Marcelo Tavares, Molly Vega, Michael Zappitelli, Claudio Ronco, Ravindra L Mehta, John Kellum, Marlies Ostermann
BACKGROUND: Acute kidney injury (AKI) is independently associated with increased morbidity and mortality across the life course, yet care for AKI remains mostly supportive. Raising awareness of this life-threatening clinical syndrome through education and advocacy efforts is the key to improving patient outcomes. Here, we describe the unique roles education and advocacy play in the care of children with AKI, discuss the importance of customizing educational outreach efforts to individual groups and contexts, and highlight the opportunities created through innovations and partnerships to optimize lifelong health outcomes...
November 7, 2023: Pediatric Nephrology
#35
REVIEW
Sara Samoni, Silvia De Rosa, Claudio Ronco, Giuseppe Castellano
Acute kidney injury (AKI) affects about half of patients admitted to the intensive care unit (ICU), and worsens their short- and long-term outcomes. Apparently self-limiting AKI episodes initiate a progression toward chronic kidney disease (CKD) through cellular and molecular mechanisms that are yet to be explained. In particular, persistent AKI, defined in 2016 by the Acute Dialysis Quality Initiative as an AKI which lasts more than 48 h from its onset, has been correlated with higher morbidity and mortality, and with a higher progression to acute kidney disease (AKD) and CKD than transient AKI (i...
November 2023: Clinical Kidney Journal
#36
REVIEW
H David Humes, Stuart L Goldstein, Lenar T Yessayan, David A Catanzaro, Emily C Scribe, Sai Prasad N Iyer, Kevin K Chung
OBJECTIVES: Acute kidney injury (AKI) requiring continuous kidney replacement therapy is a significant complication in ICU patients with mortality rates exceeding 50%. A dysregulated immune response can lead to systemic inflammation caused by hyperactivity of pro-inflammatory neutrophils and monocytes leading to tissue damage. The selective cytopheretic device (SCD) is an investigational medical device in a new class of cell-directed extracorporeal therapies distinct from cytokine adsorbers or filters, as it targets activated leukocytes...
October 2023: Critical care explorations
#37
REVIEW
Kianoush B Kashani, Jay L Koyner
PURPOSE OF REVIEW: Acute kidney injury (AKI) is a highly prevalent clinical syndrome that substantially impacts patient outcomes. It is accepted by the clinical communities that the management of AKI is time-sensitive. Unfortunately, despite growing proof of its preventability, AKI management remains suboptimal in community, acute care, and postacute care settings. Digital health solutions comprise various tools and models to improve care processes and patient outcomes in multiple medical fields...
December 1, 2023: Current Opinion in Critical Care
#38
REVIEW
Louis Baeseman, Samantha Gunning, Jay L Koyner
Abstract: Background: Sepsis associated Acute kidney injury (AKI) is a leading comorbidity in admissions to the intensive care unit. While a gold standard definition exists, it remains imperfect and does not allow for the timely identification of patients in the setting of critical illness. This review will discuss the use of biochemical and electronic biomarkers to allow for prognostic and predictive enrichment of patients with sepsis associated AKI over and above the use of serum creatinine and urine output...
October 16, 2023: American Journal of Nephrology
#39
JOURNAL ARTICLE
Zhi-Tao Li, Da-Bing Huang, Jian-Feng Zhao, Hui Li, Shui-Qiao Fu, Wei Wang
BACKGROUND: Venous congestion has been demonstrated to increase the risk of acute kidney injury (AKI) after cardiac surgery. Although many surrogate markers for venous congestion are currently used in clinical settings, there is no consensus on which marker is most effective in predicting AKI. METHODS: We evaluated various markers of venous congestion, including central venous pressure (CVP), inferior vena cava (IVC) diameter, portal pulsatility fraction (PPF), hepatic vein flow pattern (HVF), intra-renal venous flow pattern (IRVF), and venous excess ultrasound grading score (VExUS) in adult patients undergoing cardiac surgery to compare their ability in predicting AKI...
February 2024: Journal of Critical Care
#40
JOURNAL ARTICLE
Akhil Vaid, Ashwin Sawant, Mayte Suarez-Farinas, Juhee Lee, Sanjeev Kaul, Patricia Kovatch, Robert Freeman, Joy Jiang, Pushkala Jayaraman, Zahi Fayad, Edgar Argulian, Stamatios Lerakis, Alexander W Charney, Fei Wang, Matthew Levin, Benjamin Glicksberg, Jagat Narula, Ira Hofer, Karandeep Singh, Girish N Nadkarni
BACKGROUND: Substantial effort has been directed toward demonstrating uses of predictive models in health care. However, implementation of these models into clinical practice may influence patient outcomes, which in turn are captured in electronic health record data. As a result, deployed models may affect the predictive ability of current and future models. OBJECTIVE: To estimate changes in predictive model performance with use through 3 common scenarios: model retraining, sequentially implementing 1 model after another, and intervening in response to a model when 2 are simultaneously implemented...
October 2023: Annals of Internal Medicine
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