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Acute kidney injury and sepsis

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https://www.readbyqxmd.com/read/29133918/fast-simultaneous-assessment-of-renal-and-liver-function-using-polymethine-dyes-in-animal-models-of-chronic-and-acute-organ-injury
#1
A T Press, M J Butans, T P Haider, C Weber, S Neugebauer, M Kiehntopf, U S Schubert, M G Clemens, M Bauer, A Kortgen
Simultaneous assessment of excretory liver and kidney function is still an unmet need in experimental stress models as well as in critical care. The aim of the study was to characterize two polymethine-dyes potentially suitable for this purpose in vivo. Plasma disappearance rate and elimination measurements of simultaneously injected fluorescent dyes DY-780 (hepato-biliary elimination) and DY-654(renal elimination) were conducted using catheter techniques and intravital microscopy in animals subjected to different organ injuries, i...
November 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29132978/intensive-care-in-severe-malaria-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#2
REVIEW
Dilip R Karnad, Mohd Basri Mat Nor, Guy A Richards, Tim Baker, Pravin Amin
Severe malaria is common in tropical countries in Africa, Asia, Oceania and South and Central America. It may also occur in travelers returning from endemic areas. Plasmodium falciparum accounts for most cases, although P vivax is increasingly found to cause severe malaria in Asia. Cerebral malaria is common in children in Africa, manifests as coma and seizures, and has a high morbidity and mortality. In other regions, adults may also develop cerebral malaria but neurological sequelae in survivors are rare...
November 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29132515/acute-kidney-injury-in-the-critically-ill
#3
REVIEW
Robert A Maxwell, Christopher Michael Bell
Acute kidney injury (AKI) occurs frequently in the surgical intensive care unit and results in significant morbidity and mortality. AKI needs to be identified early and underlying causes treated or eliminated. Sepsis, major surgery such as coronary artery bypass, and hypovolemia are the most common causes and patients with underlying comorbidities have increased susceptibility. Treatment should begin by ensuring that patients are adequately resuscitated and all contributing causes are replaced or eliminated...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29117994/role-of-adenosine-1a-receptor-signaling-on-gfr-early-after-the-induction-of-sepsis
#4
Jonathan M Street, Erik H Koritzinsky, Tiffany R Bellomo, Xuzhen Hu, Peter S T Yuen, Robert A Star
Sepsis and acute kidney injury (AKI) synergistically increase morbidity and mortality in the ICU. How sepsis reduces GFR and causes AKI is poorly understood; one proposed mechanism includes tubuloglomerular feedback (TGF). When sodium reabsorption by the proximal tubules is reduced in normal animals, the macula densa senses increased luminal sodium chloride, then adenosine 1a receptor (A1aR) signaling triggers tubuloglomerular feedback, reducing GFR through afferent arteriole vasoconstriction. We measured GFR and systemic hemodynamics early during cecal ligation and puncture-induced sepsis in wild-type and A1aR knockout mice...
November 8, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29112541/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-cardiovascular-and-thoracic-surgery
#5
Aamer B Ahmed, Andreas Koster, Marcus Lance, David Faraoni
: None of the predictive models for venous thromboembolism (VTE) prophylaxis have been designed for and validated in patients undergoing cardiothoracic and vascular surgery. The presence of one or more risk factors [age over 70 years old, transfusion of more than 4 U of red blood cells/fresh frozen plasma/cryoprecipitate, mechanical ventilation lasting more than 24 h, postoperative complication (e.g. acute kidney injury, infection/sepsis, neurological complication)] should place the cardiac population at high risk for VTE...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112081/predictors-prevalence-and-outcomes-of-early-crystalloid-responsiveness-among-initially-hypotensive-patients-with-sepsis-and-septic-shock
#6
Daniel E Leisman, Martin E Doerfler, Sandra M Schneider, Kevin D Masick, Jason A D'Amore, John K D'Angelo
OBJECTIVES: The prevalence of responsiveness to initial fluid challenge among hypotensive sepsis patients is unclear. To avoid fluid overload, and unnecessary treatment, it is important to differentiate these phenotypes. We aimed to 1) determine the proportion of hypotensive sepsis patients sustaining favorable hemodynamic response after initial fluid challenge, 2) determine demographic and clinical risk factors that predicted refractory hypotension, and 3) assess the association between timeliness of fluid resuscitation and refractoriness...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29111542/a-call-to-action-to-develop-integrated-curricula-in-cardiorenal-medicine
#7
Claudio Ronco, Federico Ronco, Peter A McCullough
With the adoption of the new definition and classification of cardiorenal syndrome (CRS) and its relevant subtypes, much attention has been placed on elucidating the mechanisms of heart and kidney interactions. The pathophysiologic pathways are of great interest by which acute heart failure may result in acute kidney injury (AKI; type 1), chronic heart failure accelerates the progression of chronic kidney disease (CKD; type 2), AKI provokes cardiac events (type 3), and CKD increases the risk and severity of cardiovascular disease (type 4)...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29104728/oxidative-stress-and-acute-kidney-injury-in-critical-illness-pathophysiologic-mechanisms-biomarkers-interventions-and-future-perspectives
#8
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/29098010/mesenchymal-stem-cells-in-sepsis-and-associated-organ-dysfunction-a-promising-future-or-blind-alley
#9
REVIEW
Jan Horák, Lukáš Nalos, Vendula Martínková, Jan Beneš, Milan Štengl, Martin Matějovič
Sepsis, newly defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection, is the most common cause of death in ICUs and one of the principal causes of death worldwide. Although substantial progress has been made in the understanding of fundamental mechanisms of sepsis, translation of these advances into clinically effective therapies has been disappointing. Given the extreme complexity of sepsis pathogenesis, the paradigm "one disease, one drug" is obviously flawed and combinations of multiple targets that involve early immunomodulation and cellular protection are needed...
2017: Stem Cells International
https://www.readbyqxmd.com/read/29095750/the-use-of-regional-or-neuraxial-anesthesia-for-below-knee-amputations-may-reduce-the-need-for-perioperative-blood-transfusions
#10
Obaid Malik, Ethan Y Brovman, Richard D Urman
BACKGROUND AND OBJECTIVES: Amputations of the lower extremity remain a common procedure in a high-risk population. Perioperative morbidity and mortality reach as high as 14.1% in below-knee amputations. We aimed to determine whether regional, or neuraxial, anesthesia, when compared with general anesthesia (GA), would be associated with reduced perioperative morbidity and mortality. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program data set...
November 1, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29092740/preoperative-aldosterone-receptor-blockade-and-outcomes-of-cardiac-surgery-in-patients-with-chronic-kidney-disease%C3%A2
#11
Linda Shavit, Shuli Silberman, Rachel Tauber, Ofer Merin, Daniel Bitran, Daniel Fink
BACKGROUND AND AIMS: Recent clinical evidence demonstrates that chronic low-dose mineralocorticoid receptor antagonists (MRA), when added to optimal treatment, result in reductions in cardiovascular mortality. However, continuation of MRAs before cardiac surgery in patients with CKD has never been evaluated and its potential benefit or harm in this specific clinical setting is largely unknown. MATERIALS AND METHODS: This is an observational study that included adult CKD patients undergoing cardiac surgery...
October 26, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29089579/transfemoral-transcatheter-aortic-valve-implantation-in-patients-with-end-stage-renal-disease-and-kidney-transplant-recipients
#12
Fadi Al-Rashid, Anja Bienholz, Heike Annelie Hildebrandt, Polycarpos-Christos Patsalis, Matthias Totzeck, Andreas Kribben, Daniel Wendt, Heinz Jakob, Alexander Lind, Rolf Alexander Jánosi, Tienush Rassaf, Philipp Kahlert
Transcatheter aortic valve implantation (TAVI) has evolved to a treatment of choice in high-risk patients and is therefore ideal for patients with advanced chronic kidney disease, as patients with end-stage renal disease and kidney transplant recipients. Especially, outcome of this special patient group is very important. 22 patients with chronic kidney disease stage 5 undergoing intermittent hemodialysis treatment (CKD 5D) and 8 kidney transplant recipients (KT) with severe aortic valve stenosis underwent transfemoral TAVI...
October 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29080804/blockade-of-cd38-diminishes-lipopolysaccharide-induced-macrophage-classical-activation-and-acute-kidney-injury-involving-nf-%C3%AE%C2%BAb-signaling-suppression
#13
Bingyan Shu, Ye Feng, Yuan Gui, Qingmiao Lu, Wei Wei, Xian Xue, Xiaoli Sun, Weichun He, Junwei Yang, Chunsun Dai
The CD38, possessing ADP-ribosyl cyclase (ADPR-cyclase) and cyclic ADP-ribose hydrolase (cADPR-hydrolase), is able to regulate a variety of cellular activities. However, the role and mechanisms for CD38 in macrophage activation and sepsis-induced acute kidney injury (AKI) remain to be determined. Here we report that in cultured macrophages, Lipopolysaccharide (LPS) could upregulate CD38 expression in time and dose dependent manner. Knocking down or blockade of CD38 in macrophages could inhibit LPS-induced macrophage M1 polarization accompanied by diminished NF-κB signaling activation...
November 11, 2017: Cellular Signalling
https://www.readbyqxmd.com/read/29077618/urinary-oxygenation-as-a-surrogate-measure-of-medullary-oxygenation-during-angiotensin-ii-therapy-in-septic-acute-kidney-injury
#14
Yugeesh R Lankadeva, Junko Kosaka, Roger G Evans, Rinaldo Bellomo, Clive N May
OBJECTIVES: Angiotensin II is an emerging therapy for septic acute kidney injury, but it is unknown if its vasoconstrictor action induces renal hypoxia. We therefore examined the effects of angiotensin II on intrarenal PO2 in ovine sepsis. We also assessed the validity of urinary PO2 as a surrogate measure of medullary PO2. DESIGN: Interventional study. SETTING: Research Institute. SUBJECTS: Sixteen adult Merino ewes (n = 8/group)...
October 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29076682/outcomes-of-intensive-care-patients-having-septic-shock-at-a-tertiary-care-hospital-of-islamabad
#15
Azmat Ali, Awais Saeed Abbasi, Maliha Sheikh
BACKGROUND: Septic shock is defined as sepsis with circulatory, cellular and metabolic abnormalities which are associated with greater mortality more than 40%. The objective of this study was to identify shortcomings and act promptly and adequately. METHODS: This case series included 32 patients over a period of 03 months, September to November 2016 done at ICU of KRL Hospital Islamabad. RESULTS: The study only enrolled patients who fulfilled the criteria of septic shock...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29074644/extracellular-signal-regulated-kinase-1-2-regulates-kidney-injury-molecule-1-expression-physiologically-and-following-ischemic-and-septic-renal-injury
#16
Justin B Collier, Rick G Schnellmann
The upregulation of kidney injury molecule-1 (KIM-1) has been extensively studied in various renal diseases and following acute injury; however, the initial mechanisms controlling KIM-1 expression remain limited. In this study, KIM-1 expression was examined in mouse renal cell cultures and in two different models of acute kidney injury (AKI), ischemia-reperfusion (IR) and lipopolysaccharide (LPS)-induced sepsis. KIM-1 mRNA increased in both AKI models and pharmacological inhibition of extracellular signal-regulated kinase 1/2 (ERK1/2) signaling attenuated injury induced KIM-1 expression in the renal cortex...
October 26, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/29074099/efficacy-and-safety-of-long-acting-pasireotide-or-everolimus-alone-or-in-combination-in-patients-with-advanced-carcinoids-of-the-lung-and-thymus-luna-an-open-label-multicentre-randomised-phase-2-trial
#17
Piero Ferolla, Maria Pia Brizzi, Tim Meyer, Wasat Mansoor, Julien Mazieres, Christine Do Cao, Hervé Léna, Alfredo Berruti, Vincenzo Damiano, Wieneke Buikhuisen, Henning Grønbæk, Catherine Lombard-Bohas, Christian Grohé, Vincenzo Minotti, Marcello Tiseo, Javier De Castro, Nicholas Reed, Gabriella Gislimberti, Neha Singh, Miona Stankovic, Kjell Öberg, Eric Baudin
BACKGROUND: There are no data from prospective studies focused exclusively on patients with advanced lung and thymic carcinoids. We aimed to assess the efficacy and safety of long-acting pasireotide and everolimus, administered alone or in combination, in patients with advanced carcinoids of the lung or thymus. METHODS: LUNA was a prospective, multicentre, randomised, open-label, phase 2 trial of adult patients (aged >18 years) with advanced (unresectable or metastatic), well differentiated carcinoid tumours of the lung or thymus, with radiological progression within 12 months before randomisation, and a WHO performance status of 0-2...
October 23, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/29065398/a-call-to-action-to-develop-integrated-curricula-in-cardiorenal-medicine
#18
Claudio Ronco, Federico Ronco, Peter A McCullough
With the adoption of the new definition and classification of cardiorenal syndrome (CRS) and its relevant subtypes, much attention has been placed on elucidating the mechanisms of heart and kidney interactions. Of great interest are the pathophysiological pathways by which acute heart failure may result in acute kidney injury (AKI; type 1), chronic heart failure accelerating the progression of chronic kidney disease (CKD; type 2), AKI provoking cardiac events (type 3), and CKD increasing the risk and severity of cardiovascular disease (type 4)...
October 25, 2017: Blood Purification
https://www.readbyqxmd.com/read/29065350/which-one-is-a-better-predictor-of-icu-mortality-in-septic-patients-comparison-between-serial-serum-lactate-concentrations-and-its-removal-rate
#19
Ata Mahmoodpoor, Kamran Shadvar, Seied Hadi Saghaleini, Evin Koleini, Hadi Hamishehkar, Zohre Ostadi, Nader D Nader
PURPOSE: To predict 28-day mortality with serum lactate and oxygenation profile in sepsis. METHODS: 82 patients were admitted to the ICU with sepsis. Comorbid disease, hemodynamic and oxygenation parameters were recorded. Serum lactate was measured at T0, T6, T12 and T24 hours of admission. Arterial and venous oxygen saturation levels were also measured. Regression and ROC analyses were used to predict death within 28days. RESULTS: Out of 82 patients, 32 died within 28days of ICU admission...
October 17, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29061597/high-dose-versus-low-dose-haemofiltration-for-the-treatment-of-critically-ill-patients-with-acute-kidney-injury-an-updated-systematic-review-and-meta-analysis
#20
Peng Li, Li-Ping Qu, Dong Qi, Bo Shen, Yi-Mei Wang, Jia-Rui Xu, Wu-Hua Jiang, Hao Zhang, Xiao-Qiang Ding, Jie Teng
OBJECTIVE: The purpose of this study was to perform a systematic review and meta-analysis to evaluate the effect of high-dose versus low-dose haemofiltration on the survival of critically ill patients with acute kidney injury (AKI). We hypothesised that high-dose treatments are not associated with a higher risk of mortality. DESIGN: Meta-analysis. SETTING: Randomised controlled trials and two-arm prospective and retrospective studies were included...
October 22, 2017: BMJ Open
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