IRRT

Purpose: We assessed long-term outcomes in intensive care unit (ICU) survivors with acute kidney injury (AKI) submitted to intermittent or continuous renal replacement therapy (RRT) for comparisons between groups. Methods: The multicenter prospective cohort study included 195 adult ICU survivors with an ICU stay >72 h in 10 ICUs that had at least one episode of AKI treated with intermittent RRT (IRRT) or continuous RRT (CRRT) during ICU stay. The main outcomes were mortality and health-related quality of life (HRQoL)...

UNLABELLED: Acute kidney injury (AKI) and fluid overload (FO) are among the top reasons to initiate intermittent hemodialysis (IHD) or continuous renal replacement therapy (CRRT). Prior research suggests CRRT provides more precise volume control, but whether CRRT is cost-effective remains unclear. We assessed the cost-effectiveness of CRRT for volume control compared with IHD from a U.S. healthcare payer perspective. DESIGN: Decision analytical model comparing health outcomes and healthcare costs of CRRT versus IHD initiation for AKI patients with FO...

INTRODUCTION: Online hemodiafiltration (HDF) has been increasingly used for improved clearance of middle molecular weight toxins. The impact of this mode of clearance is unknown in critically ill patients. We aimed to determine whether the use of HDF in acute kidney injury (AKI) is associated with lower mortality and improved kidney recovery up to 90 days after initiation of therapy. METHODS: Single-center retrospective cohort study using data from 2017 to 2020 of adults with AKI who initiated intermittent renal replacement therapy (IRRT) in the intensive care unit (ICU), using either hemodialysis (HD) or HDF depending on the maintenance status of the water system without regards for patient characteristics...

The route planning problem for rotary-wing UAV formation is studied in discrete urban environments. First, a discrete-space consensus algorithm (DSCA) integrating asynchronous planning and grouping mechanism is developed to make the rotary-wing UAVs converge to the desired formation. Then the DSCA is combined with the improved rapidly-exploring random tree (IRRT) algorithm to enable the rotary-wing UAV formation to avoid the obstacles. Finally, the time information of waypoints is complemented by resolving the conflicts among multiple rotary-wing UAVs, thus reducing the rotary-wing UAVs' time gap of reaching the destinations...

Background: Avulsion fracture of the lesser tuberosity (AFLT) of the humerus has traditionally been treated with open reduction internal fixation using screw fixation. The clinical outcomes of arthroscopic repair with suture anchors remains unknown. Hypothesis: It was hypothesized that arthroscopic fixation with suture anchors would result in good clinical outcomes for the treatment of AFLT. Study Design: Case series; Level of evidence, 4...

BACKGROUND: Transition from continuous renal replacement therapy (CRRT) to intermittent renal replacement therapy (IRRT) can be associated with intra-dialytic hypotension (IDH) although data to inform the definition of IDH, its incidence and clinical implications, are lacking. We aimed to describe the incidence and factors associated with IDH during the first IRRT session following transition from CRRT and its association with hospital mortality. This was a retrospective single-center cohort study in patients with acute kidney injury for whom at least one CRRT-to-IRRT transition occurred while in intensive care...

INTRODUCTION: Though cost-effectiveness analyses (CEAs) have evaluated continuous renal replacement therapy (RRTs) and intermittent RRTs in acute kidney injury (AKI) patients; it is yet to establish which RRT technique is most cost-effective. We systematically reviewed the current evidence from CEAs of CRRT versus IRRT in patients with AKI. AREAS COVERED: PubMed, EMBASE, and Cochrane databases searched for CEAs comparing two RRTs. Overall, seven CEAs, two from Brazil and one from US, Canada, Colombia, Belgium, and Argentina were included...

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BACKGROUND: Intermittent renal replacement therapy (IRRT) is prescribed across intensive care units (ICU) worldwide. While research regarding the prescribed dialysis dose has not yielded results concerning mortality, it is still unknown whether the same applies to the actual delivered dose. METHODS: We retrospectively analyzed two different cohorts of patients (562 IRRT sessions) who were admitted to the intensive care units at Hospital Clínic of Barcelona and required renal replacement therapy with IRRT...

Background and O bjectives: Hemodynamic stress during resistance training is often a reason why this training method is not used in cardiac patients. A lifting protocol that imposes rests between repetitions (IRRT) may provide less hemodynamic stress compared to traditional resistance training (TT). The aim of this study was to verify differences between set configurations on hemodynamic stress responses in resistance training. Materials and Methods: We compared hemodynamic (heart rate (HR), systolic blood pressure (SBP), and rate pressure product (RPP)) responses assessed with the auscultatory method in elderly (age = 75...

This study aimed at validating the anatomical sites for the measurement of infrared (IR) body surface temperature as a tool to monitor the pigs' response to handling and transport stress. The selected anatomical sites were the neck (infrared neck temperature-IRNT), rump (infrared rump temperature-IRRT), orbital (infrared orbital temperature-IROT) and behind ears (infrared behind ears temperature-IRBET) regions. A total of 120 pigs were handled from the finishing pen to the loading dock through a handling test course...

BACKGROUND: We aimed to examine recent trends in patient characteristics and mortality in patients with acute kidney injury (AKI) receiving renal replacement therapy (RRT), including continuous RRT (CRRT) and intermittent RRT (IRRT), in intensive care units (ICUs). METHODS: From the Diagnosis Procedure Combination database in Japan during 6 months (July-December) from 2007 to 2016, we identified patients with AKI who received RRT in ICUs. We restricted the study participants to those admitted to hospitals (in which both CRRT and IRRT were available) that participated in the Diagnosis Procedure Combination database for all 10 years...

PURPOSE OF REVIEW: Severe acute kidney injury in the ICU setting often requires renal replacement therapy (RRT). Intermittent hemodialysis (IHD), hybrid forms of RRT such as sustained low-efficiency dialysis (SLED), as well as continuous renal replacement therapy (CRRT) are the three common modalities of extracorporeal RRT used in the adult ICU setting in developed countries. This review summarizes recently published data regarding comparisons of these three RRT modalities on clinical outcomes (e...

BACKGROUND: Studies reporting renal and overall survival after acute kidney injury (AKI) treated exclusively with intermittent modalities of renal replacement therapy (IRRT) are rare. This study focused on outcomes of AKI patients treated with IRRT both in intensive care units (ICUs) and non-ICU dialysis units. METHODS: This prospective observational study was carried on during a 5-month period in 17 ICUs and 17 non-ICUs. ICU and non-ICU patients (total n = 138; 65 ICU, 73 non-ICU) requiring RRT for AKI and chosen to receive IRRT were included...

BACKGROUND: Microembolism is a frequent pathological event during extracorporeal renal replacement therapy (RRT). Some previous data indicate that microemboli are generated in patients who are undergoing RRT and that these may contribute to increased cerebrovascular and neurocognitive morbidity in patients with end-stage renal disease. The current trial aims to quantify the microembolic load and respective qualitative composition that effectively reaches the intracerebral circulation in critically ill patients treated with different RRT modalities for acute kidney injury (AKI)...

Hyperammonemia has been associated with intracranial hypertension and mortality in patients with acute liver failure (ALF). We evaluated the effect of renal replacement therapy (RRT) on serum ammonia level and outcomes in ALF. This was a multicenter cohort study of consecutive ALF patients from the United States ALF Study Group registry between January 1998 and December 2016. First, we studied the association of ammonia with hepatic encephalopathy (HE) and 21-day transplant-free survival (TFS; n = 1,186). Second, we studied the effect of RRT on ammonia for the first 3 days post study admission (n = 340) and on 21-day TFS (n = 1,186)...

Background: Dialysis-dependent acute kidney injury (AKI) can be treated using continuous (CRRT) or intermittent renal replacement therapies (IRRT). Although some studies suggest that CRRT may have advantages over IRRT, study findings are inconsistent. This study assessed differences between CRRT and IRRT regarding important clinical outcomes (such as mortality and renal recovery) and cost-effectiveness. Additionally, ethical aspects that are linked to renal replacement therapies in the intensive care setting are considered...

PURPOSE: This study compared the effects of resistance training (RT) and RT with instability (RTI) on neuromuscular and total training volume (TTV) outcomes obtained as part of the Instability Resistance Training Trial in Parkinson's disease. It also used a linear multiple regression (forward stepwise method) to identify the contribution of neuromuscular outcomes to previously published improvements in the timed-up-and-go test and the Unified Parkinson's Disease Rating Scale, motor subscale score...

BACKGROUND: The consideration of specific trauma-associated emotions poses a challenge for the differential treatment planning in trauma therapy. Soldiers experiencing deployment-related posttraumatic stress disorder often struggle with emotions of guilt and shame as a central component of their PTSD. OBJECTIVE: The purpose of this study was to examine the extent to which soldiers' PTSD symptoms and their trauma-related guilt and shame may be affected as a function of their ability to develop compassionate imagery between their CURRENT SELF (today) and their TRAUMATIZED SELF (back then)...

From the initial version of an extended renal replacement therapy, the initiative to provide safer, more efficient means for detoxification and volume removal in comparison with intermittent renal replacement therapies (IRRT) has been evaluated. As a result, the Kidney Disease Improving Global Outcomes guidelines for acute kidney injury recommend the preferential use of continuous renal replacement therapy (CRRT) in patients who are hemodynamically unstable or who suffer from intracranial hypertension. The choice of dialysis modality is also influenced by other factors including clinical expertise, and the availability of each treatment option in individual medical centers...