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Renal replacement therapy sepsis

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https://www.readbyqxmd.com/read/27900737/three-year-mortality-in-30-day-survivors-of-critical-care-with-acute-kidney-injury-data-from-the-prospective-observational-finnaki-study
#1
Henriikka Mildh, Ville Pettilä, Anna-Maija Korhonen, Sari Karlsson, Tero Ala-Kokko, Matti Reinikainen, Suvi T Vaara
BACKGROUND: The role of an episode of acute kidney injury (AKI) in long-term mortality among initial survivors of critical illness is controversial. We aimed to determine whether AKI is independently associated with decreased survival at 3 years among 30-day survivors of intensive care. RESULTS: We included 2336 30-day survivors of intensive care enrolled in the FINNAKI study conducted in seventeen medical-surgical ICUs in Finland during a 5-month period in 2011-2012...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27875571/short-and-long-term-mortality-rates-of-elderly-acute-kidney-injury-patients-who-underwent-continuous-renal-replacement-therapy
#2
Harin Rhee, Keum Sook Jang, Jong Man Park, Jin Suk Kang, Na Kyoung Hwang, Il Young Kim, Sang Heon Song, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak
BACKGROUND: The world's population is aging faster and the incidence of acute kidney injury (AKI) needing continuous renal replacement therapy (CRRT) is increasing in elderly population. The outcome of AKI needing CRRT in elderly patients is known to be poor. However, the definitions of elderly used in the previous literatures were diverse and, there were few data that compared the long-term mortality rates of these patients with middle aged patients. This study was aimed to evaluate this issue...
2016: PloS One
https://www.readbyqxmd.com/read/27862103/pharmacokinetics-of-imipenem-cilastatin-burn-intensive-care-unit-patients-undergoing-high-dose-continuous-venovenous-hemofiltation
#3
Bradley A Boucher, Joanna Q Hudson, David M Hill, Joseph M Swanson, G Christopher Wood, S Casey Laizure, Angela Arnold-Ross, Zhe-Yi Hu, William L Hickerson
STUDY OBJECTIVE: High dose continuous venovenous hemofiltration (CVVH) is a continuous renal replacement therapy (CRRT) used frequently inpatients with burns. However, antibiotic dosing is based on inference from studies assessing substantially different methods of CRRT. To address this knowledge gap for imipenem/cilastatin (I-C) we evaluated the systemic and extracorporeal clearances (CL) of I-C in patients with burns undergoing high dose CVVH. DESIGN: Prospective clinical pharmacokinetic study...
November 9, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27858178/proteome-analysis-of-hemofilter-adsorbates-to-identify-novel-substances-of-sepsis-a-pilot-study
#4
Tomoaki Hashida, Taka-Aki Nakada, Mamoru Satoh, Keisuke Tomita, Rui Kawaguchi, Fumio Nomura, Shigeto Oda
Blood purification therapy using hemofilters with high adsorbing capabilities has been reported to remove excessive humoral mediators from the blood of patients with sepsis. However, there are insufficient studies of the adsorbates bound to hemofilter membranes. We hypothesized that these adsorbates in acute kidney injury (AKI) patients with sepsis were different from those in patients without sepsis and that proteome analysis of the adsorbates would identify novel substances of sepsis. This study included 20 patients who had AKI upon admission to intensive care units (ICUs) and who received continuous renal replacement therapy using polymethyl methacrylate hemofilters...
November 17, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27857914/continuous-renal-replacement-therapy-for-acute-renal-failure-in-patients-with-traumatic-brain-injury
#5
Chang-Yong Park, Hyun-Yong Choi, Nam-Kyu You, Tae Hoon Roh, Sook Jin Seo, Se-Hyuk Kim
OBJECTIVE: The purpose of this study was to investigate the impact of continuous renal replacement therapy (CRRT) on survival and relevant factors in patients who underwent CRRT after traumatic brain injury (TBI). METHODS: We retrospectively reviewed the laboratory, clinical, and radiological data of 29 patients who underwent CRRT among 1,190 TBI patients treated at our institution between April 2011 and June 2015. There were 20 men and 9 women, and the mean age was 60...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27854517/acute-kidney-injury-as-a-risk-factor-for-delirium-and-coma-during-critical-illness
#6
Edward D Siew, William H Fissell, Christina M Tripp, Jeffrey D Blume, Matthew D Wilson, Amanda J Clark, Andrew J Vincz, E Wesley Ely, Pratik P Pandharipande, Timothy D Girard
RATIONALE: Acute kidney injury may contribute to distant organ dysfunction. Few studies have examined kidney injury as a risk factor for delirium and coma. OBJECTIVE: To examine whether acute kidney injury is associated with delirium and coma in critically ill adults. METHODS: In a prospective cohort study of ICU patients with respiratory failure and/or shock, we examined the association between acute kidney injury and daily mental status using multinomial transition models adjusting for demographics, non-renal organ failure, sepsis, prior mental status, and sedative exposure...
November 17, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27803084/severe-soft-tissue-infection-masquerading-as-necrotising-fasciitis-in-a-31-year-old-woman-with-a-background-of-right-thigh-arteriovenous-malformation
#7
Pennylouise Hever, Naveen Cavale, Paul Harnett
A 31-year-old woman with a history of a right thigh arteriovenous malformation presented with an acute history of right thigh pain and swelling. This rapidly progressed to gross sepsis. She was intubated, requiring inotropic support and renal replacement therapy. She was considered disproportionately unwell, with the impression one of necrotising fasciitis (NF). She was taken to theatre for emergency exploration and debridement. There was no evidence of NF to note in theatre. Tissue samples cultured group C Streptococcus, with histopathological examination confirming group C Streptococcal soft tissue infection...
November 1, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27760529/the-effect-of-continuous-venovenous-hemofiltration-on-neutrophil-gelatinase-associated-lipocalin-plasma-levels-in-patients-with-septic-acute-kidney-injury
#8
Xingui Dai, Tao Li, Zhenhua Zeng, Chunlai Fu, Shengbiao Wang, Yeping Cai, Zhongqing Chen
BACKGROUND: It is known that continuous venonenous hemofiltration (CVVH) does not affect the plasma level of neutrophil gelatinase-associated lipocalin (pNGAL) in acute kidney injury (AKI) patients. However, because of the unique pathophysiology underlying AKI caused by sepsis, the effect of CVVH on pNGAL in this clinical setting is less certain. The purpose of this study was to determine the effect of CVVH on pNGAL in sepsis-induced AKI patients. METHODS: Between August 1, 2014, and December 31, 2014, 42 patients with sepsis-induced AKI underwent CVVH in the general intensive care unit of our institution and were consecutively enrolled in this study...
October 19, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27734109/conservative-fluid-management-or-deresuscitation-for-patients-with-sepsis-or-acute-respiratory-distress-syndrome-following-the-resuscitation-phase-of-critical-illness-a-systematic-review-and-meta-analysis
#9
Jonathan A Silversides, Emmet Major, Andrew J Ferguson, Emma E Mann, Daniel F McAuley, John C Marshall, Bronagh Blackwood, Eddy Fan
BACKGROUND: It is unknown whether a conservative approach to fluid administration or deresuscitation (active removal of fluid using diuretics or renal replacement therapy) is beneficial following haemodynamic stabilisation of critically ill patients. PURPOSE: To evaluate the efficacy and safety of conservative or deresuscitative fluid strategies in adults and children with acute respiratory distress syndrome (ARDS), sepsis or systemic inflammatory response syndrome (SIRS) in the post-resuscitation phase of critical illness...
October 12, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27719676/nomenclature-for-renal-replacement-therapy-and-blood-purification-techniques-in-critically-ill-patients-practical-applications
#10
Gianluca Villa, Mauro Neri, Rinaldo Bellomo, Jorge Cerda, A Raffaele De Gaudio, Silvia De Rosa, Francesco Garzotto, Patrick M Honore, John Kellum, Anna Lorenzin, Didier Payen, Zaccaria Ricci, Sara Samoni, Jean-Louis Vincent, Julia Wendon, Marta Zaccaria, Claudio Ronco
This article reports the conclusions of the second part of a consensus expert conference on the nomenclature of renal replacement therapy (RRT) techniques currently utilized to manage acute kidney injury and other organ dysfunction syndromes in critically ill patients. A multidisciplinary approach was taken to achieve harmonization of definitions, components, techniques, and operations of the extracorporeal therapies. The article describes the RRT techniques in detail with the relevant technology, procedures, and phases of treatment and key aspects of volume management/fluid balance in critically ill patients...
October 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27698480/mode-of-renal-replacement-therapy-determines-endotoxemia-and-neutrophil-dysfunction-in-chronic-kidney-disease
#11
Sandra Lemesch, Werner Ribitsch, Gernot Schilcher, Walter Spindelböck, Hildegard Hafner-Gießauf, Gunther Marsche, Lisa Pasterk, Doris Payerl, Bianca Schmerböck, Monika Tawdrous, Alexander R Rosenkranz, Philipp Stiegler, Gerd Kager, Seth Hallström, Karl Oettl, Katharina Eberhard, Angela Horvath, Bettina Leber, Vanessa Stadlbauer
Bacterial infection and sepsis are common complications of chronic kidney disease (CKD). A vicious cycle of increased gut permeability, endotoxemia, inadequate activation of the innate immune system and resulting innate immune dysfunction is hypothesized. We assessed endotoxemia, neutrophil function and its relation to oxidative stress, inflammation and gut permeability in patients with CKD grade 3-5 without renal replacement therapy (CKD group, n = 57), patients with CKD stage 5 undergoing haemodialysis (HD, n = 32) or peritoneal dialysis (PD, n = 28) and patients after kidney transplantation (KT, n = 67) in a cross-sectional observational study...
October 4, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27678541/study-protocol-for-a-multicentre-randomised-controlled-trial-safety-tolerability-efficacy-and-quality-of-life-of-a-human-recombinant-alkaline-phosphatase-in-patients-with-sepsis-associated-acute-kidney-injury-stop-aki
#12
Esther Peters, Ravindra L Mehta, Patrick T Murray, Jürgen Hummel, Michael Joannidis, John A Kellum, Jacques Arend, Peter Pickkers
INTRODUCTION: Acute kidney injury (AKI) occurs in 55-60% of critically ill patients, and sepsis is the most common underlying cause. No pharmacological treatment options are licensed to treat sepsis-associated AKI (SA-AKI); only supportive renal replacement therapy (RRT) is available. One of the limited number of candidate compounds in clinical development to treat SA-AKI is alkaline phosphatase (AP). The renal protective effect of purified bovine intestinal AP has been demonstrated in critically ill sepsis patients...
2016: BMJ Open
https://www.readbyqxmd.com/read/27661862/ombitasvir-paritaprevir-ritonavir-dasabuvir-viekira-pak-induced-lactic-acidosis
#13
Catherine L Oberg, Robert J Hiensch, Hooman D Poor
OBJECTIVE: To report a case series of three patients with hepatitis C virus infection who all presented with severe type B lactic acidosis shortly after starting treatment with ombitasvir-paritaprevir-ritonavir-dasabuvir. DESIGN: Case series. SETTING: ICU. PATIENTS: Three patients, all who had HCV cirrhosis with mild hepatic impairment (Child-Pugh A) and had started taking ombitasvir-paritaprevir-ritonavir-dasabuvir within the preceding 2 weeks, presented with similar nonspecific symptoms of lethargy, fatigue, and nausea...
September 22, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27651589/return-to-the-operation-theatre-an-analysis-of-repeat-surgeries-in-operative-obstetrics
#14
Maimoona Ahmed, Sunil T Pandya, Tarakeswari Supraneni
PURPOSE: To determine the risk factors and associated comorbidities with a relaparotomy after primary surgery in pregnant mothers and to identify preventable causes. METHODS: A retrospective observational study was done at a tertiary care centre from January 2009 till August 2014. All records of exploratory laparotomy following primary surgery in the obstetric population during this period were retrieved from the hospital database and analysed. RESULTS: The incidence of relaparotomy was 0...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27583356/sepsis-complicated-by-brain-abscess-following-eswl-of-a-caliceal-kidney-stone-a-case-report
#15
Alessandro Capitanini, Luca Rosso, Laura Giannecchini, Ophelia Meniconi, Adamasco Cupisti
A 47-year old, Caucasian man underwent extracorporeal shock wave lithotripsy (ESWL) of a 14mm calcium stone in the right renal pelvis, without urinary tract obstruction or sepsis. 24 hours after ESWL septic shock occurred and the patient was admitted to the Intensive Care Unit (ICU). Escherichia coli emerged from the blood and urine culture. The patient developed acute renal failure and it was necessary to start a continuous renal replacement therapy (CRRT). Infection was successfully treated, patient recovered renal function and an improvement of general condition occurred...
September 1, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27562206/role-of-technology-for-the-management-of-aki-in-critically-ill-patients-from-adoptive-technology-to-precision-continuous-renal-replacement-therapy
#16
J Cerdá, I Baldwin, P M Honore, G Villa, John A Kellum, Claudio Ronco
This paper reports on the continuous renal replacement therapy (CRRT) technology group recommendations and research proposals developed during the 17th Acute Dialysis Quality Initiative Meeting in Asiago, Italy. The group was tasked to address questions related to the impact of technology on acute kidney injury management. We discuss technological aspects of the decision to initiate CRRT and the components of the treatment prescription and delivery, the integration of information technology (IT) on overall patient management, the incorporation of CRRT into other 'non-renal' extracorporeal technologies such as ECMO and ECCO2R and the use of sorbents in sepsis and propose new areas for future research...
2016: Blood Purification
https://www.readbyqxmd.com/read/27526933/early-initiation-of-continuous-renal-replacement-therapy-improves-survival-of-elderly-patients-with-acute-kidney-injury-a-multicenter-prospective-cohort-study
#17
Jae Yoon Park, Jung Nam An, Jong Hyun Jhee, Dong Ki Kim, Hyung Jung Oh, Sejoong Kim, Kwon Wook Joo, Yun Kyu Oh, Chun-Soo Lim, Shin-Wook Kang, Yon Su Kim, Jung Tak Park, Jung Pyo Lee
BACKGROUND: Continuous renal replacement therapy (CRRT) is essential in the management of critically ill patients with acute kidney injury (AKI). However, the optimal timing for initiating CRRT remains controversial, especially in elderly patients. Therefore, we investigated the outcomes of early CRRT initiation in elderly patients with AKI. METHODS: A total of 607 patients ≥65 years of age who started CRRT due to AKI between August 2009 and December 2013 were prospectively enrolled...
August 16, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27524405/cost-of-nosocomial-pneumonia-the-example-of-vancomycin-versus-linezolid-shorter-stay-or-fewer-complications
#18
Jordi Rello, Cao Bin
Hospital and national committees often focus on drug acquisition costs when taking decisions on the use of new drugs, but antimicrobial agent costs represent a minor part of the bill compared with the indirect costs of hospitalization or loss in days of productivity in working people. Although reducing the length of stay should be a main priority in the USA due to the indirect costs associated with hospitalization, adverse events, such as renal failure, have a major impact on healthcare resource use and costs...
August 11, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27513541/increased-ratio-of-visceral-to-subcutaneous-adipose-tissue-in-septic-patients-is-associated-with-adverse-outcome
#19
Chawika Pisitsak, Joseph G H Lee, John H Boyd, Harvey O Coxson, James A Russell, Keith R Walley
OBJECTIVES: Visceral and subcutaneous adipose tissue may contribute differentially to the septic inflammatory response. Accordingly, we tested the hypothesis that the ratio of visceral to subcutaneous adipose tissue is associated with altered sepsis outcome. DESIGN: A retrospective analysis from a cohort of sepsis patients admitted between 2004 and 2009. SETTING: A mixed medical-surgical ICU at St. Paul's Hospital in Vancouver, Canada. PATIENTS: Patients older than 16 years old who had sepsis and underwent abdominal CT scan (n = 257) for clinical reasons...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27512163/anaesthesia-and-intensive-care-for-simultaneous-liver-kidney-transplantation-a-single-centre-experience-with-12-recipients
#20
Akila Rajakumar, Shiwalika Gupta, Selvakumar Malleeswaran, Joy Varghese, Ilankumaran Kaliamoorthy, Mohamed Rela
BACKGROUND AND AIMS: The perioperative management of patients presenting for simultaneous liver and kidney transplantation (SLKT) is a complex process. We analysed SLKTs performed in our institution to identify preoperative, intraoperative and post-operative challenges encountered in the management. METHODS: We retrospectively studied the case records of 12 patients who underwent SLKT between 2009 and 2014 and analysed details of pre-operative evaluation and optimisation, intraoperative anaesthetic management and the implications of use of perioperative continuous renal replacement therapy (CRRT) and the post-operative course of these patients...
July 2016: Indian Journal of Anaesthesia
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