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Krishna Mohan Gulla, Anil Sachdev, Dhiren Gupta, Neeraj Gupta, Kanav Anand, P K Pruthi
OBJECTIVE: Scanty literature is available regarding continuous renal replacement therapy (CRRT) utility in severe sepsis with multiorgan dysfunction syndrome (MODS) from developing countries. Author unit's experience in pediatric CRRT is described and outcome of early initiation of CRRT with sepsis and MODS is assessed. MATERIALS AND METHODS: Children aged <16 years with sepsis and MODS who required CRRT from September 2010 to February 2015 were analyzed on demographic factors, timing of initiation of CRRT, mode of CRRT, effect of CRRT onhemodynamics, oxygenation parameters, and outcome...
October 2015: Indian Journal of Critical Care Medicine
Maya Hites, Antonio Maria Dell'Anna, Sabino Scolletta, Fabio Silvio Taccone
The multiple organ dysfunction syndrome (MODS) is characterized by more than one organ system failing, especially during critical illness. MODS is the leading cause of morbidity and mortality in current ICU practice; moreover, multiple organ dysfunction, especially liver and kidneys, may significantly affect the pharmacokinetics (PKs) of different drugs that are currently administered in critically ill patients. These PK alterations may either result in insufficient drug concentrations to achieve the desired effects or in blood and tissue accumulation, with the development of serious adverse events...
November 20, 2014: Advanced Drug Delivery Reviews
Giuseppe Servillo, Maria Vargas, Antonio Pastore, Alfredo Procino, Michele Iannuzzi, Alfredo Capuano, Andrea Memoli, Eleonora Riccio, Bruno Memoli
INTRODUCTION: Severe sepsis and septic shock are the primary causes of multiple organ dysfunction syndrome (MODS), which is the most frequent cause of death in intensive care unit patients. Many pro- and anti-inflammatory mediators, such as interleukin-6 (IL-6), play a strategic role in septic syndrome. Continuous renal replacement therapy (CRRT) removes in a nonselective way pro- and anti-inflammatory mediators. OBJECTIVE: To investigate the effects of continuous venovenous hemofiltration (CVVH) as an immunomodulatory treatment of sepsis in a prospective clinical study...
2013: BioMed Research International
Gerardo Aguilar, José Antonio Carbonell, Carlos Ferrando, Rafael Badenes, Francisco Javier Belda
BACKGROUND: Critically ill patients with invasive candidiasis (IC) often suffer renal failure, which sometimes requires continuous renal replacement techniques (CRRT). Echinocandins are the first line treatment for IC in critically ill patients with mild or severe illness. Their elimination during CRRT should be negligible due to their pharmacokinetic and pharmacodynamic (PK/PD) profile, and dose adjustment are not needed, as suggested by the few reported clinical studies. CLINICAL CASE: This is the case of a 66 year old male who underwent surgery due to peritonitis secondary to intestinal suture dehiscence...
April 2012: Revista Iberoamericana de Micología
Li-qun Yao, Zhao-chen Jin, Mu-sen Ji, Chun-ying Xia, Zhi-xin Yu, Jing Liu, Xiu-lan Hu, Jun Yan
OBJECTIVE: To explore the effects of continuous renal replacement therapy (CRRT) on serum cytokines and prognosis in multiple organ dysfunction syndrome (MODS) patients based on different therapeutic opportunities. METHODS: A total of 34 MODS patients in the treatment of CRRT after admission to ICU of our hospital between July 2008 and October 2010 were recruited. Based on the time interval from the onset of MODS to the initiation of CRRT, the patients were stratified into early group (0 - 3 days, n = 16) and late group (4 - 10 days, n = 18)...
June 28, 2011: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Qin Wei, Su Baihai, Fu Ping, Chen Xiaolei, Li Jing, Zhen Rong
BACKGROUND: The M8.1 'Wenchuan' earthquake occurred on May 12th 2008 causing many injuries and casualties. We report a case with crush syndrome and multiple organ dysfunction syndrome (MODS) successfully treated with hybrid continuous renal replacement therapy (CRRT). METHOD: The patient is a 16-year-old female who was rescued from a collapsed building after 17 h. Emergency amputation was performed. Infections and crush syndrome caused sepsis, acute respiratory distress syndrome, acute renal failure, heart failure, liver dysfunction and disseminated intravascular coagulation in a short time...
2009: Blood Purification
Jian-wen Wang, You-ming Peng, Fu-you Liu, Hao Zhang
AIM: To elucidate the effects of serum of patients with multiple organ dysfunction syndrome (MODS) on tissue factor (TF) and Plasminogen activator inhibitor-1 (PAI-1) secretion of human vascular endothelial cells(HUVEC)during continuous renal replacement therapy (CRRT). METHODS: Sixteen patients who diagnosed MODS involved were divided into two groups randomly, eight patients treated with CRRT without heparin and the others with heparin for 8 hours. The blood was collected from patients at 0 min, 15 min, 60 min, 120 min and 480 min during CRRT...
June 2009: Xi Bao Yu Fen Zi Mian Yi Xue za Zhi, Chinese Journal of Cellular and Molecular Immunology
Jin-zhong YUAN, Qi-fa YE, Hao ZHANG, Ying-zi MING, Ming GUI, Ying JI, Jian Sun, Jian-wen WANG, Zu-hai REN, Ke CHENG, Yu-jun ZHAO, Pei-long SUN, Kun WU, Long-zhen JI
OBJECTIVE: To analyze the preoperative risk factors on liver transplant recipients with acute renal failure(ARF), and to evaluate renal replacement therapy (RRT) as a transitonary therapy before liver transplantation. METHODS: Liver transplant recipients with acute renal failure treated with renal replacement therapy between January 1st, 2001 and January 1st, 2008 in our center were retrospected. Clinical characteristics, the kinds of RRT and prognosis were analyzed; Logistic regression was applied to analyze the parameters that can forecast the motality of the liver transplant recipients with acute renal failure...
May 2009: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Leslie W Hayes, Robert A Oster, Nancy M Tofil, Ashita J Tolwani
PURPOSE: Acute kidney injury in the pediatric intensive care unit (PICU) is associated with significant morbidity, with continued mortality greater than 50%. Previous studies have described an association between percentage of fluid overload (%FO) less than 20% and improved survival. We reviewed our continuous renal replacement therapy (CRRT) experience to evaluate for factors associated with mortality as well as secondary outcomes. MATERIALS AND METHODS: This is a retrospective chart review of pediatric CRRT intensive care unit patients from January 2000 to September 2005...
September 2009: Journal of Critical Care
Qin Wei, Tan Chun Yu, Mi Xu Hua, Hu Zhang Xue, Li Zi, Fu Ping
Acute mountain sickness (AMS) is usually seen in unacclimatized individuals ascending to a high altitude within a short period of time. Severe cases may be complicated with multiorgan dysfunction syndrome (MODS), which results in very high mortality. We reported a case of a 20-year-old girl who developed AMS complicated with high altitude pulmonary edema (HAPE), high altitude cerebral edema (HACE), and acute renal failure. Continuous renal replacement therapy (CRRT) was successfully carried out in this patient and achieved satisfactory effects...
2009: Renal Failure
Hong Pu, Xiao-dong Jin, Yi-yun Deng, Yan Kang, Xiao-qi Xie, Xue-lian Liao, Ling Yang, Lan Wang, Cun-zhen Wang
OBJECTIVE: To analyze the characteristics and treatment of the multiple organ dysfunction syndrome (MODS) in patients in the Wenchuan earthquake on 12th May, 2008, in order to provide theoretical reference for future care for such patients. METHODS: Characteristics of MODS in these patients were analyzed, differences between survivors and non-survivors were compared, and therapeutic measures, and the time of the treatment for MODS in patients with earthquake related injury or illness who were admitted to West China Hospital from 12th May to 20th June, 2008, were retrospectively analyzed...
January 2009: Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, Chinese Critical Care Medicine, Zhongguo Weizhongbing Jijiuyixue
Francisco X Flores, Patrick D Brophy, Jordan M Symons, James D Fortenberry, Annabelle N Chua, Steven R Alexander, John D Mahan, Timothy E Bunchman, Douglas Blowey, Michael J G Somers, Michelle Baum, Richard Hackbarth, Deepa Chand, Kevin McBryde, Mark Benfield, Stuart L Goldstein
Pediatric stem cell transplant (SCT) recipients commonly develop acute renal failure (ARF). We report the demographic and survival data of pediatric SCT patients enrolled in the Prospective Pediatric Continuous Renal Replacement Therapy (ppCRRT) Registry. Since 1 January 2001, 51/370 (13.8%) patients entered in the ppCRRT Registry had received a SCT. Median age was 13.63 (0.53-23.52) years. The primary reasons for the initiation of continuous renal replacement therapy (CRRT) were treatment of fluid overload (FO) and electrolyte imbalance (49%), FO only (39%), electrolyte imbalance only (8%) and other reasons (4%)...
April 2008: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Anna Jander, Marcin Tkaczyk, Izabela Pagowska-Klimek, Witold Pietrzykowski, Jacek Moll, Wojciech Krajewski, Michał Nowicki
OBJECTIVE: Acute renal failure (ARF) is still a frequent complication following extensive cardiac surgery. Renal replacement therapy (RRT) modality preferences to treat critically ill children have shifted from peritoneal dialysis to continuous renal replacement therapy (CRRT), although the experience with the latter is still highly limited in the infants. METHODS: We describe our results with continuous veno-venous hemodiafiltration (CVVHDF) in 25 children (15 males, 10 females) who underwent CRRT from 2001 to 2006 and were retrospectively reviewed...
June 2007: European Journal of Cardio-thoracic Surgery
S Morabito, I Guzzo, E Vitaliano, L Muzi, A Solazzo, V Pistolesi, A Pierucci
In the critically ill, acute renal failure (ARF) and "Multiple Organ Dysfunction Syndrome" (MODS) can be associated with significant modifications of many pharmacokinetic parameters, such as protein binding, volume of distribution and total body clearance. The start of renal replacement therapy (RRT) represents an additional variable to take in consideration for drug-dosing adjustments. Drugs significantly eliminated by the kidney are likely to be removed during RRT and a supplemental dose or further dosing adjustments are required if extracorporeal clearance is more than 25-30% of total body clearance...
May 2006: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Xiao-miao Cheng, Qiao-ling Zhou, Sheng-li Deng, Li-ping Chen, Jun Zhang
OBJECTIVE: To investigate the effect of continuous renal replacement therapy (CRRT) on patients with emergency and serious diseases. METHODS: The patients were divided into 2 groups: Group A [71 patients with multiple organ dysfunction syndrome (MODS)] were treated by CRRT for 175 times. Group B (30 patients) were treated with common hematodialysis (HD). Blood urea nitrogen (BUN), serum creatinine (Scr), natrem (Na(+)), kalium (K(+)), chlorine (Clj), power of hydrogen (pH), bicarbonate (HCO3-), carbon dioxide partial pressure (PCO(2)), and oxygen pressure (PO(2)) were measured before and after the treatment...
August 2006: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
M B Iarustovskiĭ, E I Nazarova
Composite reparative cardiosurgical operations frequently lead to ischemia and hypoxia of vitally important organs and systems, which may be later a cause of the multiple organ dysfunction syndrome (MODS). Up to now, after operations on the heart and vessels, the incidence of this menacing complication remains rather high. In the postoperative period, isolated acute renal failure (ARF) occurs extremely rarely; its incidence is not greater than 5-8% whereas ARF is much more frequently (as high as 90%) a component of MODS and an indicator of a patient's status...
May 2006: Anesteziologiia i Reanimatologiia
Stuart L Goldstein, Michael J G Somers, Michelle A Baum, Jordan M Symons, Patrick D Brophy, Douglas Blowey, Timothy E Bunchman, Cheryl Baker, Theresa Mottes, Nancy McAfee, Joni Barnett, Gloria Morrison, Kristine Rogers, James D Fortenberry
BACKGROUND: Critical illness leading to multi-organ dysfunction syndrome (MODS) and associated acute renal failure (ARF) is less common in children compared to adult patients. As a result, many issues plague the pediatric ARF outcome literature, including a relative lack of prospective study, a lack of modality stratification in subject populations and inconsistent controls for patient illness severity in outcome analysis. METHODS: We now report data from the first multicenter study to assess the outcome of pediatric patients with MODS receiving continuous renal replacement therapy (CRRT)...
February 2005: Kidney International
Claudio Ronco, Ciro Tetta, Filippo Mariano, Mary Lou Wratten, Monica Bonello, Valeria Bordoni, Ximena Cardona, Paola Inguaggiato, Lidia Pilotto, Vince d'Intini, Rinaldo Bellomo
Severe sepsis and septic shock are the primary causes of multiple organ dysfunction syndrome (MODS), which is the most frequent cause of death in intensive care unit patients. Many water-soluble mediators with pro- and anti-inflammatory action such as TNF, IL-6, IL-8, and IL-10 play a strategic role in septic syndrome. In intensive care medicine, blocking any one mediator has not led to a measurable outcome improvement in patients with sepsis. CRRT is a continuously acting therapy, which removes in a nonselective way pro- and anti-inflammatory mediators; "the peak concentration hypothesis" is the concept of cutting peaks of soluble mediators through continuous hemofiltration...
September 2003: Artificial Organs
Sheng-yin Ma, Chao-yang Liu
OBJECTIVE: To investigate the clinical effect of continuous renal replacement therapy (CRRT) on patients of multiple organ dysfunction syndrome (MODS) with acute renal failure (ARF). METHODS: Twenty-two MODS cases with ARF underwent CRRT. Blood urea nitrogen (BUN), serum creatinine (SCr), hydrocarbons, serum potassium, and artery blood pH were detected in all patients every morning after hemopurification, in all patients volumes of infused fluid were recorded. The experience in 17 MODS cases with ARF treated with intermittent hemodialysis (IHD) in our hospital before October 1999 was present...
February 2003: Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, Chinese Critical Care Medicine, Zhongguo Weizhongbing Jijiuyixue
D Ji, D Gong, H Xie, B Xu, Y Liu, L Li
OBJECTIVE: To investigate the efficacy of continuous renal replacement therapy (CRRT) versus intermittent hemodialysis (IHD) in patients with severe acute renal failure (ARF). METHODS: One hundred and ninety-three severe ARF patients who received renal support between December 1978 and December 1998 were involved in this study. Of them, 101 (52.3%) were treated with CRRT (CRRT group), and 92 (47.7%) with IHD (IHD group). RESULTS: Sixty (59...
November 2001: Chinese Medical Journal
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