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Renal replacement therapy sepsis

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https://www.readbyqxmd.com/read/29132515/acute-kidney-injury-in-the-critically-ill
#1
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/29123901/respiratory-extracorporeal-membrane-oxygenation-for-severe-sepsis-and-septic-shock-in-adults-a-propensity-score-analysis-in-a-multicenter-retrospective-observational-study
#2
Shuhei Takauji, Mineji Hayakawa, Kota Ono, Hiroshi Makise
Aim: This multicenter retrospective observational study aimed to evaluate the efficacy of extracorporeal membrane oxygenation (ECMO) support for septic patients with severe respiratory failure using propensity score analyses. Methods: The data of severe sepsis patients from 42 intensive care units between January 2011 and December 2013 were retrospectively collected. Propensity score matching analyses were undertaken for severe respiratory failure patients with/without veno-venous ECMO support...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29116996/leptospirosis-in-icu-a-retrospective-study-of-134-consecutive-admissions
#3
Benjamin Delmas, Julien Jabot, Paul Chanareille, Cyril Ferdynus, Jérôme Allyn, Nicolas Allou, Loïc Raffray, Bernard-Alex Gaüzere, Olivier Martinet, David Vandroux
OBJECTIVES: Leptospirosis causes reversible multiple organ failure, and its mortality remains high. The aim of this study was to determine the mortality rate of leptospirosis in an ICU offering all types of organ support available nowadays and to compare it with mortality in bacterial sepsis. DESIGN: Retrospective, descriptive, and single-center cohort study. SETTINGS: The largest ICU of Reunion Island (Indian Ocean) in a teaching hospital...
November 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29112080/%C3%AE-lactam-therapeutic-drug-management-in-the-picu
#4
Jeffrey J Cies, Wayne S Moore, Adela Enache, Arun Chopra
OBJECTIVES: To determine whether contemporary β-lactam anti-infective dosing recommendations in critically ill children achieve concentrations associated with maximal anti-infective activity. The secondary objective was to describe the microbiological and clinical outcomes associated with β-lactam therapeutic drug management. DESIGN: Electronic Medical Record Review. SETTING: A 189-bed, freestanding children's tertiary care teaching hospital in Philadelphia, PA...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29104728/oxidative-stress-and-acute-kidney-injury-in-critical-illness-pathophysiologic-mechanisms-biomarkers-interventions-and-future-perspectives
#5
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/29084247/the-effect-of-a-novel-extracorporeal-cytokine-hemoadsorption-device-on-il-6-elimination-in-septic-patients-a-randomized-controlled-trial
#6
Dirk Schädler, Christine Pausch, Daniel Heise, Andreas Meier-Hellmann, Jörg Brederlau, Norbert Weiler, Gernot Marx, Christian Putensen, Claudia Spies, Achim Jörres, Michael Quintel, Christoph Engel, John A Kellum, Martin K Kuhlmann
OBJECTIVE: We report on the effect of hemoadsorption therapy to reduce cytokines in septic patients with respiratory failure. METHODS: This was a randomized, controlled, open-label, multicenter trial. Mechanically ventilated patients with severe sepsis or septic shock and acute lung injury or acute respiratory distress syndrome were eligible for study inclusion. Patients were randomly assigned to either therapy with CytoSorb hemoperfusion for 6 hours per day for up to 7 consecutive days (treatment), or no hemoperfusion (control)...
2017: PloS One
https://www.readbyqxmd.com/read/29072871/disseminated-intravascular-coagulation-in-an-under-recognised-zoonotic-infection
#7
Sarah Lawrence, Andrew Claxton, Mark Holland, Jack Hodd
A 51 year old man presented with severe sepsis, disseminated intravascular coagulation (DIC) and multiorgan dysfunction after a 24 hour history of diarrhoea and malaise. Despite fluid resuscitation and receiving a platelet transfusion, freshfrozen plasma and intravenous broad-spectrum antibiotics, he remained anuric with a worsening metabolic acidosis. He was transferred to critical care for organ support including renal replacement therapy. He subsequently developed purpura fulminans. Blood cultures were positive for Captocytophaga carnimorsis, a gram-negative canine zoonosis that is an underdiagnosed cause of severe sepsis, for which DIC at presentation is characteristic...
2017: Acute Medicine
https://www.readbyqxmd.com/read/29068858/outcomes-of-ventilated-patients-with-sepsis-who-undergo-interhospital-transfer-a-nationwide-linked-analysis
#8
Barret Rush, Patrick D Tyler, David J Stone, Benjamin P Geisler, Keith R Walley, Leo Anthony Celi
OBJECTIVES: The outcomes of critically ill patients who undergo interhospital transfer are not well understood. Physicians assume that patients who undergo interhospital transfer will receive more advanced care that may translate into decreased morbidity or mortality relative to a similar patient who is not transferred. However, there is little empirical evidence to support this assumption. We examined country-level U.S. data from the Nationwide Readmissions Database to examine whether, in mechanically ventilated patients with sepsis, interhospital transfer is associated with a mortality benefit...
October 24, 2017: Critical Care Medicine
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
#9
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
https://www.readbyqxmd.com/read/29044341/the-use-of-antimicrobials-in-septic-patients-with-acute-kidney-injury
#10
Fernanda Moreira de Freitas, Welder Zamoner, Durval Sampaio de Souza Garms, Mariele Gobo de Oliveira, André Luis Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and it may be associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administrate antimicrobials in dosis to achieve adequate serum levels, preventing overdosis and drug toxicity or underdosing and risk for resistance to antibiotics and higher mortality. To date, there aren't validated guidelines on antibiotic dosis adjustment in septic patients with AKI and the recommendations are extrapolated from studies conducted in non-critical patients with chronic kidney disease in end stage receiving chronic renal replacement therapy...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29022532/hiv-positive-patients-in-the-intensive-care-unit-a-retrospective-audit
#11
P Mkoko, R I Raine
BACKGROUND: The indications for and outcomes of intensive care unit (ICU) admission of HIV-positive patients in resource-poor settings such as sub-Saharan Africa are unknown. OBJECTIVE: To identify indications for ICU admission and determine factors associated with high ICU and hospital mortality in HIV-positive patients. METHODS: We reviewed case records of HIV-positive patients admitted to the medical and surgical ICUs at Groote Schuur Hospital, Cape Town, South Africa, from 1 January 2012 to 31 December 2012...
September 22, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28958185/targeting-the-endothelial-glycocalyx-in-acute-critical-illness-as-a-challenge-for-clinical-and-laboratory-medicine
#12
Vladimir Cerny, David Astapenko, Florian Brettner, Jan Benes, Radomir Hyspler, Christian Lehmann, Zdenek Zadak
The purpose of this manuscript is to review the role of endothelial glycocalyx (EG) in the field of critical and perioperative medicine and to discuss possible future directions for investigations in this area. Under physiological conditions, EG has several well-defined functions aimed to prevent the disruption of vessel wall integrity. Under pathological conditions, the EG represent one of the earliest sites of injury during inflammation. EG structure and function distortion contribute to organ dysfunction related to sepsis, trauma, or global ischemia of any origin...
August 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28937077/practice-pattern-of-hemodialysis-among-end-stage-renal-disease-patients-in-rural-south-india-a-single-center-experience
#13
R Hemachandar
Hemodialysis (HD) is the most common mode of renal replacement therapy for end-stage renal disease (ESRD) patients in India. However, the practice and pattern of dialysis in a hospital serving rural population is largely unknown. A prospective study of 127 ESRD patients initiated on HD between January 2013 and December 2014 was done. The study included 101 males and 26 females, with a mean age of 50.05 ± 13.80 years. Native kidney disease was unknown in 45.67% of patients as they presented very late in their disease course...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28926489/high-levels-of-morbidity-and-mortality-among-pediatric-hematopoietic-cell-transplant-recipients-with-severe-sepsis-insights-from-the-sepsis-prevalence-outcomes-and-therapies-international-point-prevalence-study
#14
Robert B Lindell, Shira J Gertz, Courtney M Rowan, Jennifer McArthur, Florian Beske, Adrian Plunkett, Scott L Weiss, Neal J Thomas, Vinay M Nadkarni, Julie C Fitzgerald
OBJECTIVES: Pediatric severe sepsis is a major cause of morbidity and mortality worldwide, and hematopoietic cell transplant patients represent a high-risk population. We assessed the epidemiology of severe sepsis in hematopoietic cell transplant patients, describing patient outcomes compared with children with no history of hematopoietic cell transplant. DESIGN: Secondary analysis of the Sepsis PRevalence, OUtcomes, and Therapies point prevalence study, comparing demographics, sepsis etiology, illness severity, organ dysfunction, and sepsis-related treatments in patients with and without hematopoietic cell transplant...
September 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28923303/an-extremely-high-bioavailability-of-orally-administered-vancomycin-in-a-patient-with-severe-colitis-and-renal-insufficiency
#15
Shingo Yamazaki, Takaaki Suzuki, Tatsuya Suzuki, Hirokazu Takatsuka, Masayuki Ishikawa, Noriyuki Hattori, Takeshi Fujishiro, Hideaki Miyauchi, Takehiko Oami, Noritaka Ariyoshi, Shigeto Oda, Hisahiro Matsubara, Itsuko Ishii
Because there is little absorption of orally administered vancomycin hydrochloride (VCM) through the normal intestinal microvillus membrane, the pharmacokinetics of VCM absorbed from the digestive tract are mostly unknown. Here we report a case of severe colitis and renal insufficiency in which the serum concentration of VCM reached the supratherapeutic range after oral administration. A 54-year-old man receiving outpatient chemotherapy for rectal cancer was admitted to our hospital for severe sepsis and acute renal failure...
September 8, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28918911/mortality-of-severe-septic-patients-between-physician-s-high-and-low-care-volumes
#16
Chun-Yao Lin, Jo-Chi Tseng, Chih-Yu Huang, Chien-Ming Chu, Huang-Pin Wu
BACKGROUND: Patients with severe sepsis frequently require intensive care unit (ICU) admission and different ICU care models may influence their outcomes. The mortality of severe septic patients between physician's high and low care volume remains unclear. METHODS: We analyzed the data from a three-year prospective observation study, which was performed in an adult medical ICU of Chung Gung Memorial Hospital, Keelung. The data included initial bundle therapies based on the Surviving Sepsis Campaign (SSC) guidelines for patients with severe sepsis...
August 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28894043/immune-disorders-in-sepsis-and-their-treatment-as-a-significant-problem-of-modern-intensive-care
#17
Lidia Łysenko, Patrycja Leśnik, Kamil Nelke, Hanna Gerber
Despite the great advances in the treatment of sepsis over the past 20 years, sepsis remains the main cause of death in intensive care units. In the context of new possibilities of treating sepsis, a comprehensive response of the immune system to the infection, immunosuppression, in particular, has in recent years gained considerable interest. There is vast evidence pointing to the correlation between comorbid immunosuppression and an increased risk of recurrent infections and death. Immune disorders may impact the clinical course of sepsis...
August 22, 2017: Postȩpy Higieny i Medycyny Doświadczalnej
https://www.readbyqxmd.com/read/28878224/mild-intracellular-acidification-by-dexamethasone-attenuates-mitochondrial-dysfunction-in-a-human-inflammatory-proximal-tubule-epithelial-cell-model
#18
T J J Schirris, J Jansen, M Mihajlovic, L P van den Heuvel, R Masereeuw, F G M Russel
Septic acute kidney injury (AKI) associates with poor survival rates and often requires renal replacement therapy. Glucocorticoids may pose renal protective effects in sepsis via stimulation of mitochondrial function. Therefore, we studied the mitochondrial effects of dexamethasone in an experimental inflammatory proximal tubule epithelial cell model. Treatment of human proximal tubule epithelial cells with lipopolysaccharide (LPS) closely resembles pathophysiological processes during endotoxaemia, and led to increased cytokine excretion rates and cellular reactive oxygen species levels, combined with a reduced mitochondrial membrane potential and respiratory capacity...
September 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28868069/urinary-neutrophil-gelatinase-associated-lipocalin-as-a-predictor-of-acute-kidney-injury-severe-kidney-injury-and-the-need-for-renal-replacement-therapy-in-the-intensive-care-unit
#19
Fatma I Albeladi, Haifa M Algethamy
BACKGROUND: Recent attempts were made to identify early indicators of acute kidney injury (AKI) in order to accelerate treatment and hopefully improve outcomes. This study aims to assess the value of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a predictor of AKI, severe AKI, and the need for renal replacement therapy (RRT). METHODS: We conducted a prospective study and included adults admitted to our intensive care unit (ICU) at King Abdulaziz University Hospital (KAUH), between May 2012 and June 2013, who had at least 1 major risk factor for AKI...
May 2017: Nephron Extra
https://www.readbyqxmd.com/read/28857121/assessment-of-plasma-endostatin-to-predict-acute-kidney-injury-in-critically-ill-patients
#20
J Mårtensson, S T Vaara, V Pettilä, T Ala-Kokko, S Karlsson, O Inkinen, A Uusaro, A Larsson, M Bell
BACKGROUND: We evaluated whether plasma endostatin predicts acute kidney injury (AKI), need for renal replacement therapy (RRT), or death. METHODS: Prospective, observational, multicenter study from 1 September 2011 to 1 February 2012 with data from 17 intensive care units (ICUs) in Finland. RESULTS: A total of 1112 patients were analyzed. We measured plasma endostatin within 2 h of ICU admission. Early AKI (KDIGO stage within 12 h of ICU admission) was found in 20% of the cohort, and 18% developed late AKI (KDIGO criteria > 12 h from ICU admission)...
November 2017: Acta Anaesthesiologica Scandinavica
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