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acute renal failure in the icu patient

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https://www.readbyqxmd.com/read/29777456/distal-bowel-re-feeding-in-patients-with-proximal-jejunostomy
#1
Anand Nagar, Siddharth Mehrotra, Amitabh Yadav, Vivek Mangla, Shailendra Lalwani, Naimish Mehta, Samiran Nundy
BACKGROUND: Patients who have a proximal jejunostomy are difficult to manage because of their high stoma output which results in fluid and electrolyte imbalance with repeated hospital admissions and the necessity for expensive parenteral nutrition (PN). There are few reports on the use of re-feeding of the proximal effluents in this situation. METHODS: We here relate our experience with this manoeuvre in 35 patients between Jan 2010 and Feb 2016 who had stomas less than 120 cm away from the duodenojejunal flexure...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29771702/pathogenesis-of-cerebral-edema-in-patients-with-acute-renal-and-liver-failure-and-the-role-of-the-nephrologist-in-the-management
#2
Tamim Hamdi
PURPOSE OF REVIEW: Acute liver failure (ALF) is a severe and complex illness and one of the most daunting conditions managed in the ICU. Because the renal care is intertwined with multiple disciplines, the aim of this review is to examine the multifactorial pathogenesis of cerebral edema in ALF, covering basic established facts as well as recent advances in our understanding of this condition. RECENT FINDINGS: Acetaminophen remains the most common cause of ALF in the United States and many European countries...
May 15, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29766216/impact-of-angiotensin-converting-enzyme-inhibitors-or-receptor-blockers-on-post-icu-discharge-outcome-in-patients-with-acute-kidney-injury
#3
Etienne Gayat, Alexa Hollinger, Alain Cariou, Nicolas Deye, Antoine Vieillard-Baron, Samir Jaber, Benjamin G Chousterman, Qin Lu, Pierre François Laterre, Xavier Monnet, Michael Darmon, Marc Leone, Bertrand Guidet, Romain Sonneville, Jean-Yves Lefrant, Marie-Céline Fournier, Matthieu Resche-Rigon, Alexandre Mebazaa, Matthieu Legrand
PURPOSE: Acute kidney injury (AKI) is associated with the activation of the renin-angiotensin system. Whether angiotensin-converting enzyme inhibitors (ACEi) or angiotensin-receptor blockers (ARB) improve outcome in patients recovering from AKI remains unexplored. The purpose was to investigate the association between prescription of ACEi/ARB at intensive care unit (ICU) discharge and 1-year outcome in patients recovering from AKI. METHODS: Association between ACEi/ARB and 1-year mortality rate was explored in 1551 patients discharged from 21 European ICUs in an observational cohort...
May 15, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29750814/one-year-mortality-after-recovery-from-critical-illness-a-retrospective-cohort-study
#4
Sharukh Lokhandwala, Ned McCague, Abdullah Chahin, Braiam Escobar, Mengling Feng, Mohammad M Ghassemi, David J Stone, Leo Anthony Celi
RATIONALE: Factors associated with one-year mortality after recovery from critical illness are not well understood. Clinicians generally lack information regarding post-hospital discharge outcomes of patients from the intensive care unit, which may be important when counseling patients and families. OBJECTIVE: We sought to determine which factors among patients who survived for at least 30 days post-ICU admission are associated with one-year mortality. METHODS: Single-center, longitudinal retrospective cohort study of all ICU patients admitted to a tertiary-care academic medical center from 2001-2012 who survived ≥30 days from ICU admission...
2018: PloS One
https://www.readbyqxmd.com/read/29727370/effect-of-a-perioperative-intra-aortic-balloon-pump-in-high-risk-cardiac-surgery-patients-a-randomized-clinical-trial
#5
Graziela Santos Rocha Ferreira, Juliano Pinheiro de Almeida, Giovanni Landoni, Jean Louis Vincent, Evgeny Fominskiy, Filomena Regina Barbosa Gomes Galas, Fabio A Gaiotto, Luís Oliveira Dallan, Rafael Alves Franco, Luiz Augusto Lisboa, Luis Roberto Palma Dallan, Julia Tizue Fukushima, Stephanie Itala Rizk, Clarice Lee Park, Tânia Mara Strabelli, Silvia Helena Gelas Lage, Ligia Camara, Suely Zeferino, Jaquelline Jardim, Elisandra Cristina Trevisan Calvo Arita, Juliana Caldas Ribeiro, Silvia Moreira Ayub-Ferreira, Jose Otavio Costa Auler, Roberto Kalil Filho, Fabio Biscegli Jatene, Ludhmila Abrahao Hajjar
OBJECTIVES: The aim of this study was to evaluate the efficacy of perioperative intra-aortic balloon pump use in high-risk cardiac surgery patients. DESIGN: A single-center randomized controlled trial and a meta-analysis of randomized controlled trials. SETTING: Heart Institute of São Paulo University. PATIENTS: High-risk patients undergoing elective coronary artery bypass surgery. INTERVENTION: Patients were randomized to receive preskin incision intra-aortic balloon pump insertion after anesthesia induction versus no intra-aortic balloon pump use...
April 30, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29722889/double-arterial-cannulation-a-strategy-for-whole-body-perfusion-during-aortic-arch-reconstruction
#6
Michaela Kreuzer, Eva Sames-Dolzer, Laura Schausberger, Andreas Tulzer, Thomas Ratschiller, Bettina Haizinger, Gerald Tulzer, Rudolf Mair
OBJECTIVES: Double-arterial cannulation enables cerebral perfusion and lower body perfusion during aortic arch reconstruction. The aim of this study was to analyse and report our experience of using this cannulation and perfusion technique on paediatric patients. METHODS: A retrospective single-centre study was carried out on 407 consecutive paediatric patients who underwent an aortic arch reconstruction under double-arterial cannulation between 2003 and 2015. The median age of the patients at surgery was 8 (range 2-5570) days, and body weight was 3...
May 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29703972/critically-ill-allogenic-hsct-patients-in-the-intensive-care-unit-a-systematic-review-and-meta-analysis-of-prognostic-factors-of-mortality
#7
Colombe Saillard, Michael Darmon, Magali Bisbal, Antoine Sannini, Laurent Chow-Chine, Marion Faucher, Etienne Lengline, Norbert Vey, Didier Blaise, Elie Azoulay, Djamel Mokart
Outcome of patients undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT) has improved. To investigate if this improvement can be transposed to the ICU setting, we conducted a systematic review and meta-analysis to assess short-term mortality of critically ill allo-HSCT patients admitted to the ICU and to identify prognostic factors of mortality. Public-domain electronic databases, including Medline via PubMed and the Cochrane Library were searched. All full-text articles written-English studies published from 2006 to 2016, including allo-HSCT adults transferred to the ICU were included...
April 27, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29696106/evaluation-of-the-effect-of-aminophylline-in-reducing-the-incidence-of-acute-kidney-injury-after-cardiac-surgery
#8
Shahrbanoo Shahbazi, Peyman Alishahi, Elham Asadpour
Objectives: Acute renal failure is a common complication of major cardiovascular surgeries (One-third of patients). Adenosine release as a vascular vasodilator increases after cardiac surgery, which reduces renal and glomerular blood flow and subsequently causes kidney ischemic damage. The present study aimed at evaluating the impact of aminophylline as an adenosine receptor antagonist on renal function after cardiac surgery hoping to find an appropriate method to reduce acute kidney injury...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29690893/inclusion-and-definition-of-acute-renal-dysfunction-in-critically-ill-patients-in-randomized-controlled-trials-a-systematic-review
#9
Rogerio da Hora Passos, Joao Gabriel Rosa Ramos, André Gobatto, Juliana Caldas, Etienne Macedo, Paulo Benigno Batista
BACKGROUND: In evidence-based medicine, multicenter, prospective, randomized controlled trials (RCTs) are the gold standard for evaluating treatment benefits and ensuring the effectiveness of interventions. Patient-centered outcomes, such as mortality, are most often the preferred evaluated outcomes. While there is currently agreement on how to classify renal dysfunction in critically ill patients , the application frequency of this new classification system in RCTs has not previously been evaluated...
April 24, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29671145/nephrotoxicity-of-ciprofloxacin-five-cases-and-a-review-of-the-literature
#10
Meriam Hajji, Hela Jebali, Aymen Mrad, Yassine Blel, Nozha Brahmi, Rania Kheder, Soumaya Beji, Lilia Ben Fatma, Wided Smaoui, Madiha Krid, Fethi Ben Hmida, Lamia Rais, Mohammed Karim Zouaghi
Fluoroquinolones are usually well tolerated with a minimum of serious adverse effects; renal toxicity is uncommon. Apart from the renal side effects of ciprofloxacin, we aimed to highlight the renal impact of a ciprofloxacin overdose, and thus conducted a prospective study in the Department of Nephrology at La Rabta Hospital between 2010 and 2015. The cohort database was continually updated until the inclusion of five patients who were subjected to an overdose and who were initially admitted to the medical intensive care unit and then transferred to our department for acute renal failure (ARF) due to ciprofloxacin ingestion requiring urgent hemodialysis...
April 18, 2018: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/29663995/-risk-factors-of-atrial-fibrillation-in-critical-ill-patients
#11
Jianyu Fu, Hongying Bi, Yunsong Xia, Hui Fang, Xu Liu, Yan Tang, Difen Wang
OBJECTIVE: To observe the clinical features of atrial fibrillation (AF) patients, and to explore the correlation between the routine detection index and the new-onset AF and to find out risk factors for new AF in critically ill patients. METHODS: A prospective observational study was conducted. The patients with AF admitted to intensive care unit (ICU) of the Affiliated Hospital of Guizhou Medical University from March 2016 to June 2017 were enrolled. The patients were divided into new-onset AF group and past-existed AF group according to their past history of AF (including persistent AF, paroxysmal AF or permanent AF)...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29657198/scoring-systems-and-outcome-of-chronic-kidney-disease-patients-admitted-in-intensive-care-units
#12
Jitendra Goswami, Manish R Balwani, Vivek Kute, Manoj Gumber, Mohan Patel, Umesh Godhani
The outcome of chronic kidney disease (CKD) patients admitted to the Intensive Care Unit (ICU) is difficult to predict. This study assessed the outcome of CKD patients admitted to the ICU and evaluated prediction of 30-day mortality using the Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Score (SAPS II), and Sequential Organ Failure Assessment (SOFA) score. One hundred consecutive CKD patients admitted to the ICU at a tertiary care hospital, Ahmedabad between 2011 and 2013 were included prospectively...
March 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29656714/epidemiology-of-sepsis-in-intensive-care-units-in-turkey-a-multicenter-point-prevalence-study
#13
Nur Baykara, Halis Akalın, Mustafa Kemal Arslantaş, Volkan Hancı, Çiğdem Çağlayan, Ferda Kahveci, Kubilay Demirağ, Canan Baydemir, Necmettin Ünal
BACKGROUND: The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms, and outcome of sepsis in intensive care units (ICUs) in Turkey. METHODS: A total of 132 ICUs from 94 hospitals participated. All patients (aged > 18 years) present at the participating ICUs or admitted for any duration within a 24-h period (08:00 on January 27, 2016 to 08:00 on January 28, 2016) were included...
April 16, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29619336/risk-of-acute-kidney-injury-in-critically-ill-surgical-patients-with-presumed-pneumonia-is-not-impacted-by-choice-of-methicillin-resistant-staphylococcus-aureus-therapy
#14
Kelsey B Billups, Erica E Reed, Gary S Phillips, Kurt B Stevenson, Steven M Steinberg, Claire V Murphy
Background: Vancomycin and linezolid are standard treatment options for nosocomial methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. While acute kidney injury (AKI) is commonly attributed to vancomycin, existing data has not definitely confirmed vancomycin as an independent risk factor for AKI. Aims: This study aimed to quantify the incidence of AKI in Surgical Intensive Care Unit (ICU) patients receiving empiric vancomycin or linezolid for nosocomial pneumonia and to identify risk factors for AKI with a focus on MRSA antibiotic therapy...
January 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29617495/early-clinical-results-of-perceval-sutureless-aortic-valve-in-139-patients-freeman-experience
#15
Syed Saleem Mujtaba, Simon Ledingham, Asif Raza Shah, Stephen Clark, Thasee Pillay, Stephan Schueler
OBJECTIVE: The aim of this retrospective study is to evaluate the safety and performance of the Perceval sutureless valve in patients undergoing aortic valve replacement. We report the 30-day clinical outcomes of 139 patients. METHODS: From January 2014 to December 2016, 139 patients underwent sutureless aortic valve replacement. Their operation notes, National Adult Cardiac Surgery Database and perioperative transoesophageal echocardiography findings were studied retrospectively...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29614507/renoprotective-postoperative-monitoring-what-is-the-best-method-for-computing-renal-perfusion-pressure-an-observational-prospective-multicentre-study
#16
Csaba Kopitko, Laszlo Medve, Tibor Gondos
BACKGROUND: Low mean arterial pressure (MAP) is a well-known risk factor for postoperative acute kidney injury (AKI), but probably it is not the sole hemodynamic parameter that can influence the development of renal failure. There are data in cardiac patients supporting the role of renal venous congestion in the development of AKI. The aim of our study was to determine a combination of factors best predicting the development of AKI. METHODS: Data were collected prospectively for adult patients admitted after major abdominal surgery to 9 Hungarian intensive care units...
April 3, 2018: Nephron
https://www.readbyqxmd.com/read/29597227/from-continuous-renal-replacement-therapies-to-multiple-organ-support-therapy
#17
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco, Gaetano La Manna
The incidence of the multiple organ dysfunction syndrome (MODS) is rapidly increasing in intensive care units (ICU). It usually combines with sepsis and is the most frequent cause of death in the ICU patients. The nature of the ICU patients has changed in the last years. It includes a variety of patients with severe cases due to major surgical interventions, trauma, hemodynamic instability, sepsis, and so on but also older people than previous times. All these situations can easily lead to MODS. In the prior years, the only available and efficient therapy was renal replacement therapy (RRT) for treating acute renal failure, but the development of technology also gives us devices to support the other systems...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29596092/the-impact-of-postreperfusion-syndrome-on-acute-kidney-injury-in-living-donor-liver-transplantation-a-propensity-score-analysis
#18
In-Gu Jun, Hye-Mee Kwon, Kyeo-Woon Jung, Young-Jin Moon, Won-Jung Shin, Jun-Gol Song, Gyu-Sam Hwang
BACKGROUND: Postreperfusion syndrome (PRS) has been shown to be related to postoperative morbidity and graft failure in orthotopic liver transplantation. To date, little is known about the impact of PRS on the prevalence of postoperative acute kidney injury (AKI) and the postoperative outcomes after living donor liver transplantation (LDLT). The purpose of our study was to determine the impact of PRS on AKI and postoperative outcomes after LDLT surgery. METHODS: Between January 2008 and October 2015, we retrospectively collected and evaluated the records of 1865 patients who underwent LDLT surgery...
March 27, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29596073/the-development-of-a-machine-learning-inpatient-acute-kidney-injury-prediction-model
#19
Jay L Koyner, Kyle A Carey, Dana P Edelson, Matthew M Churpek
OBJECTIVES: To develop an acute kidney injury risk prediction model using electronic health record data for longitudinal use in hospitalized patients. DESIGN: Observational cohort study. SETTING: Tertiary, urban, academic medical center from November 2008 to January 2016. PATIENTS: All adult inpatients without pre-existing renal failure at admission, defined as first serum creatinine greater than or equal to 3.0 mg/dL, International Classification of Diseases, 9th Edition, code for chronic kidney disease stage 4 or higher or having received renal replacement therapy within 48 hours of first serum creatinine measurement...
March 28, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29588066/life-threatening-everolimus-associated-pneumonitis-a-case-report-and-a-review-of-the-literature
#20
F Almeida, S Amorim, A Sarmento, L Santos
INTRODUCTION: Noninfective pneumonitis is a class-related effect within mammalian target of rapamycin (mTOR) inhibitors, including everolimus, and can occasionally be severe. CASE REPORT: A 62-year-old man, medicated with everolimus due to a heart transplantation 17 years previously and with chronic kidney disease, was admitted to the intensive care unit (ICU) with acute respiratory failure, cardiovascular shock, and impaired renal function requiring dialysis. Computed tomography (CT) scan revealed right upper lobe consolidation...
March 24, 2018: Transplantation Proceedings
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