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aki and ards/ali

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June 2016: Annals of Intensive Care
Chang Li, Dong Yun
OBJECTIVE: To evaluate the effect of the early goal-directed therapy (EGDT) on mortality in patients with septic shock, and to analyze the risk factors of mortality. METHODS: A retrospective controlled study was conducted. Complete clinical data of patients with septic shock admitted to emergency intensive care unit (EICU) of Sichuan Provincial People's Hospital from May 1994 to December 2014 were recorded and analyzed. According to the International Guidelines for Management of Severe Sepsis and Septic Shock ( SSC ) with the time of promulgation as dividing point, the patients were divided into two groups as before and after the publication of the guideline, i...
November 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Sana R Akbar, Dustin M Long, Kashif Hussain, Ahmad Alhajhusain, Umair S Ahmed, Hafiz I Iqbal, Ailia W Ali, Rachel Leonard, Cheryl Dalton
Background. Uric acid can acutely activate various inflammatory transcription factors. Since high levels of oxyradicals and lower antioxidant levels in septic patients are believed to result in multiorgan failure, uric acid levels could be used as a marker of oxidative stress and poor prognosis in patients with sepsis. Design. We conducted a prospective cohort study on Medical Intensive Care Unit (MICU) patients and hypothesized that elevated uric acid in patients with sepsis is predictive of greater morbidity...
2015: International Journal of Nephrology
ShanShan Shi, Chi Chen, DongYan Zhao, XiWang Liu, BaoLi Cheng, ShuiJing Wu, Ru Lin, LinHua Tan, XiangMing Fang, Qiang Shu
BACKGROUND: Acute lung injury (ALI) induced by cardiopulmonary bypass (CPB, CPB-ALI) is a common and serious complication after cardiac surgery. And infants and young children are more prone to CPB-ALI. The purpose of this study was to investigate the perioperative changes of plasma gelsolin (pGSN) in patients below 3 years of age with cardiac surgeries and CPB, and determine whether pGSN are associated with the occurrence and severity of CPB-ALI. METHODS: Seventy-seven consecutive patients ≤3 years of age with congenital heart diseases (CHD) performed on open heart surgery with CPB were finally enrolled, and assigned to ALI and non-ALI groups according to the American-European Consensus Criteria...
2014: BMC Anesthesiology
Vikas Loomba, Anna Mani, Mary John, Aroma Oberoi
Scrub typhus is an important cause of acute febrile illness. This observational study describes the clinical features and complications of the patients diagnosed to have scrub typhus in Christian Medical College & Hospital, Ludhiana, Punjab, India. The diagnosis of scrub typhus was made by using Bioline SD Tsutsugamushi test kit which detects IgM, IgG or IgA antibodies to Orientia tsutsugamushi. Sixty-two patients of scrub typhus were seen during the study period of 1 year. The mean age of the study group was 39...
July 2014: Tropical Doctor
Rhea Bhargava, William Janssen, Christopher Altmann, Ana Andrés-Hernando, Kayo Okamura, R William Vandivier, Nilesh Ahuja, Sarah Faubel
INTRODUCTION: Serum and bronchoalveolar fluid IL-6 are increased in patients with acute respiratory distress syndrome (ARDS) and predict prolonged mechanical ventilation and poor outcomes, although the role of intra-alveolar IL-6 in indirect lung injury is unknown. We investigated the role of endogenous and exogenous intra-alveolar IL-6 in AKI-mediated lung injury (indirect lung injury), intraperitoneal (IP) endotoxin administration (indirect lung injury) and, for comparison, intratracheal (IT) endotoxin administration (direct lung injury) with the hypothesis that IL-6 would exert a pro-inflammatory effect in these causes of acute lung inflammation...
2013: PloS One
Antonio Carlos Seguro, Lúcia Andrade
Leptospirosis is an acute septicemic illness that affects humans in all parts of the world. Approximately 10% of patients with leptospirosis develop severe disease, the Weil syndrome, with jaundice, acute kidney injury (AKI), and pulmonary hemorrhage. Leptospirosis-induced AKI is typically nonoliguric with a high frequency of hypokalemia. Experimental and clinical studies demonstrated that tubular function alterations precede a drop in the glomerular filtration rate and are mainly in the proximal tubule. Studies in humans and animals have demonstrated a decrease in the expression of proximal sodium (NHE3) and water tubular transporter, aquaporin 1 (AQP1) together with higher renal expression of the Na-K-2Cl cotransporter NKCC2...
May 2013: Shock
Eric J Seeley
Acute respiratory distress syndrome (ARDS) is a major cause of hypoxemic respiratory failure in adults and can result from several predisposing factors, such as sepsis and trauma, which also predispose patients to acute kidney injury (AKI). Animal models of AKI and ARDS suggest that AKI increases inflammatory cytokines in the circulation such that IL-6 may be a direct mediator of AKI induced lung injury. When ARDS and AKI overlap, intensive care unit length of stay, resource utilization, and mortality increase dramatically...
January 2013: Advances in Chronic Kidney Disease
Mohan Gurjar, Saurabh Saigal, Arvind K Baronia, Afzal Azim, Banani Poddar, Ratender K Singh
Though both malaria and leptospirosis are frequent in the tropics, co-infections are under-recognized due to overlapping of clinical features. Here, we reviewed clinical manifestations of published co-infection along with our three cases. Out of a total of 18 patients, nine patients (50%) required ICU admission. Almost all patients had prodromal symptoms in the form of fever, headache and myalgia. Seven patients (37%) had altered sensorium, three patients (17%) had hypotension at admission, and 11 patients (61%) had acute kidney injury (AKI)...
July 2011: Tropical Doctor
Kent Doi, Tomoko Ishizu, Toshiro Fujita, Eisei Noiri
The mortality of acute kidney injury (AKI) remains unacceptably high, especially associated with acute respiratory failure. Lung injury complicated with AKI was previously considered as "uremic lung", which is characterized by volume overload and increased vascular permeability. New experimental data using rodent models of renal ischemia-reperfusion and bilateral nephrectomy have emerged recently focusing on kidney-lung crosstalk in AKI, and have highlighted the pathophysiological significance of increased cytokine concentration, enhanced inflammatory responses, and neutrophil activation...
August 2011: Clinical and Experimental Nephrology
Zaccaria Ricci, Claudio Ronco
Critically ill patients are subject to several risk factors for organ injury: surgical intervention, trauma, rhabdomyolysis, hemodynamic instability, organ hypoperfusion, bacteremia and endotoxemia, sepsis and septic shock. These conditions may cause acute kidney injury (AKI), myocardial dysfunction, liver failure, coagulation abnormalities, acute lung injury (ALI), adult respiratory distress syndrome (ARDS), bone marrow depression, loss of acid/base homeostasis, and finally, brain dysfunction. The resulting picture of multiple organ dysfunction syndrome (MODS) is a lethal clinical entity that is refractory to all therapies in the majority of cases...
March 2011: Seminars in Dialysis
Morgan E Grams, Michelle M Estrella, Josef Coresh, Roy G Brower, Kathleen D Liu
BACKGROUND AND OBJECTIVES: Management of volume status in patients with acute kidney injury (AKI) is complex, and the role of diuretics is controversial. The primary objective was to elucidate the association between fluid balance, diuretic use, and short-term mortality after AKI in critically ill patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using data from the Fluid and Catheter Treatment Trial (FACTT), a multicenter, randomized controlled trial evaluating a conservative versus liberal fluid-management strategy in 1000 patients with acute lung injury (ALI), we evaluated the association of post-renal injury fluid balance and diuretic use with 60-day mortality in patients who developed AKI, as defined by the AKI Network criteria...
May 2011: Clinical Journal of the American Society of Nephrology: CJASN
Saeed Safari, Iraj Najafi, Mostafa Hosseini, Houshang Sanadgol, Ali Sharifi, Mostafa Alavi Moghadam, Ali Abdulvand, Farin Rashid Farrokhi, Behrooz Borumand
INTRODUCTION. Fasciotomy may increase the morbidity and mortality in patients with crush-induced acute kidney injury (AKI), by creating an open wound, increasing the risk of bleeding, coagulopathy, and potentially fatal sepsis. This study evaluates the outcomes of fasciotomy in these patients after Bam earthquake in Iran. MATERIALS AND METHODS. We reviewed medical records of victims of Bam earthquake complicated with crush-induced AKI. Demographic, biochemical, and clinical data of patients who underwent fasciotomy were evaluated and compared with other patients with AKI...
January 2011: Iranian Journal of Kidney Diseases
Rinaldo Bellomo, Ville Pettilä, Steven A R Webb, Michael Bailey, Belinda Howe, Ian M Seppelt
The year 2009 was characterized by a pandemic with a new virus, the 2009 H1N1 influenza virus. This pandemic was responsible for thousands of deaths worldwide, many more hospital admissions, and thousands of admissions to intensive care units (ICUs). Among those admitted to ICUs, the pandemic was associated with a mortality of approximately 16%, a high incidence of acute lung injury and, in some cases, acute respiratory distress syndrome severe enough to require support with extracorporeal membrane oxygenation...
2010: Contributions to Nephrology
Kevin K Chung, Jonathan B Lundy, James R Matson, Evan M Renz, Christopher E White, Booker T King, David J Barillo, John A Jones, Leopoldo C Cancio, Lorne H Blackbourne, Steven E Wolf
INTRODUCTION: Acute kidney injury (AKI) is a common and devastating complication in critically ill burn patients with mortality reported to be between 80 and 100%. We aimed to determine the effect on mortality of early application of continuous venovenous hemofiltration (CVVH) in severely burned patients with AKI admitted to our burn intensive care unit (BICU). METHODS: We performed a retrospective cohort study comparing a population of patients managed with early and aggressive CVVH compared with historical controls managed conservatively before the availability of CVVH...
2009: Critical Care: the Official Journal of the Critical Care Forum
E A J Hoste, W De Corte
Up to a little while ago there was no uniform definition for acute kidney injury (AKI). Recently, the Acute Dialysis Quality Initiative proposed the RIFLE consensus classification for AKI. This classification was adapted and modified by the Acute Kidney Injury Network into the AKI staging system. This classification defines 3 stages of severity of AKI, including less severe AKI. The incidence of AKI in ICU patients is increasing; severe AKI, treated by renal replacement therapy (RRT), has now an incidence comparable to that of acute lung injury/acute respiratory distress syndrome (ALI/ARDS), and less severe AKI has an incidence comparable to that of sepsis...
2007: Acta Clinica Belgica
José M Vieira, Isac Castro, Américo Curvello-Neto, Sérgio Demarzo, Pedro Caruso, Laerte Pastore, Marina H Imanishe, Regina C R M Abdulkader, Daniel Deheinzelin
OBJECTIVES: Acute kidney injury (AKI) worsens outcome in various scenarios. We sought to investigate whether the occurrence of AKI has any effect on weaning from mechanical ventilation. DESIGN AND SETTING: Observational, retrospective study in a 23-bed medical/surgical intensive care unit (ICU) in a cancer hospital from January to December 2003. PATIENTS: The inclusion criterion was invasive mechanical ventilation for > or =48 hrs. AKI was defined as at least one measurement of serum creatinine of > or =1...
January 2007: Critical Care Medicine
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