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"Renal replacement therapy"

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https://www.readbyqxmd.com/read/29676703/effect-of-intraoperative-single-shot-application-of-vancomycin-in-liver-transplant-recipients-on-postoperative-infections-with-enterococcus-faecium-and-enterococcus-faecalis
#1
Christian Siebers, Johannes Kinzinger, Ludwig C Hinske, Andreas Bauer, Patrick Scheiermann, Michael Zoller, Markus Guba, Martin Angele, Sebastian Pratschke, Thomas Weig
OBJECTIVES: Infections are major causes of morbidity and mortality in the early postoperative period after liver transplant. We observed a high rate of enterococcal infections at our center. Therefore, we added an intraoperative single shot of vancomycin to the standard regimen of meropenem given over 5 days. The aim of this study was to determine the prevalence of both Enterococcus faecium and Enterococcus faecalis infections during the first 28 days after surgery depending on the type of antibiotic prophylaxis and their implications on mortality and morbidity...
April 20, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29673370/early-versus-standard-initiation-of-renal-replacement-therapy-in-furosemide-stress-test-non-responsive-acute-kidney-injury-patients-the-fst-trial
#2
Nuttha Lumlertgul, Sadudee Peerapornratana, Thananda Trakarnvanich, Wanjak Pongsittisak, Kajbundit Surasit, Anan Chuasuwan, Pleumjit Tankee, Khajohn Tiranathanagul, Kearkiat Praditpornsilpa, Kriang Tungsanga, Somchai Eiam-Ong, John A Kellum, Nattachai Srisawat
BACKGROUND: The timing of initiation of renal replacement therapy (RRT) in severe acute kidney injury (AKI) remains controversial, with early initiation resulting in unnecessary therapy for some patients while expectant therapy may delay RRT for other patients. The furosemide stress test (FST) has been shown to predict the need for RRT and therefore could be used to exclude low-risk patients from enrollment in trials of RRT timing. We conducted this multicenter pilot study to determine whether FST could be used to screen patients at high risk for RRT and to determine the feasibility of incorporating FST into a trial of early initiation of RRT...
April 19, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29672685/surgical-and-early-outcomes-for-type-a-aortic-dissection-with-preoperative-renal-dysfunction-stratified-by-estimated-glomerular-filtration-rate
#3
Tianyu Zhou, Jun Li, Yongxin Sun, Jiawei Gu, Kai Zhu, Yulin Wang, Hao Lai, Chunsheng Wang
OBJECTIVES: The aim of this study was to analyse the effect of preoperative renal dysfunction on surgical and early outcomes for patients with Type A aortic dissection (AAD). METHODS: From January 2016 to December 2016, 140 patients with AAD who underwent surgical treatment at our institution were retrospectively analysed. According to the estimated glomerular filtration rate (eGFR), preoperative renal dysfunction was divided into 4 groups: normal (eGFR ≥90 ml/min/1...
April 17, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29672418/perioperative-use-of-levosimendan-improves-clinical-outcomes-in-patients-post-cardiac-surgery-a-systematic-review-and-meta-analysis
#4
Hua Qiang, Xiu Luo, Jian-Hua Huo, Zhi-Quan Wang
Severe postoperative complications can affect cardiac surgery patients. Levosimendan is a novel calcium sensitizer commonly administered after cardiac surgery. However, the patient benefits are controversial. PubMed, Embase, and the Cochrane library were systematically searched for randomized controlled trials (RCTs) comparing levosimendan with control in adult cardiac surgery patients. Twenty-five studies (3247 patients) were included. Pooled data indicated that levosimendan reduced mortality after cardiac surgery (OR 0...
April 3, 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29672307/extended-sessions-of-polymyxin-b-immobilized-fiber-column-hemoperfusion-ameliorate-renal-outcome-and-mortality-in-septic-shock-with-acute-kidney-injury
#5
Hiroshi Maekawa, Kousuke Negishi
BACKGROUND/AIMS: Polymyxin-B (PMX) treatment has been reported to decrease mortality in patients with septic shock and acute kidney injury (AKI). In this study, we aimed to evaluate whether extended sessions of PMX (Ext-PMX) immobilized fiber column hemoperfusion ameliorate clinical outcomes in patients complicated with septic shock and AKI without surgical control. METHODS: Twenty-two patients with nonsurgical septic shock and AKI who received PMX were included...
April 19, 2018: Blood Purification
https://www.readbyqxmd.com/read/29671865/diabetes-and-necrotizing-soft-tissue-infections-a-prospective-observational-cohort-study-statistical-analysis-plan
#6
A Rosén, P Arnell, M B Madsen, B G Nedrebø, A Norrby-Teglund, O Hyldegaard, V M Dos Santos, F Bergey, E Saccenti, S Skrede
BACKGROUND: Necrotizing soft tissue infections (NSTIs) are rare but carry a high morbidity and mortality. The multicenter INFECT project aims to improve the understanding of the pathogenesis, clinical characteristics, diagnosis, and prognosis of NSTIs. This article describes the study outline and statistical analyses that will be used. METHODS: Within the framework of INFECT project, patients with NSTI at 5 Scandinavian hospitals are enrolled in a prospective observational cohort study...
April 19, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29671040/preoperative-right-heart-hemodynamics-predict-postoperative-acute-kidney-injury-after-heart-transplantation
#7
Goksel Guven, Milos Brankovic, Alina A Constantinescu, Jasper J Brugts, Dennis A Hesselink, Sakir Akin, Ard Struijs, Ozcan Birim, Can Ince, Olivier C Manintveld, Kadir Caliskan
PURPOSE: Acute kidney injury (AKI) frequently occurs after heart transplantation (HTx), but its relation to preoperative right heart hemodynamic (RHH) parameters remains unknown. Therefore, we aimed to determine their predictive properties for postoperative AKI severity within 30 days after HTx. METHODS: From 1984 to 2016, all consecutive HTx recipients (n = 595) in our tertiary referral center were included and analyzed for the occurrence of postoperative AKI staged by the kidney disease improving global outcome criteria...
April 18, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29671035/-prognostic-relevance-of-tissue-oxygen-saturation-in-patients-in-the-early-stage-of-multiple-organ-dysfunction-syndrome
#8
D Huster, F Härtel, S Nuding, J Schroeder, Y Zhang, K Werdan, H Ebelt
BACKGROUND: Patients in circulatory shock exhibit insufficient peripheral perfusion to ensure adequate oxygenation of vital organs such as the heart and brain. Early detection of reduced tissue oxygen saturation (St O2 ) could be used for rapid therapeutic intervention and thus improve the prognosis of patients in the early stage of multiple organ dysfunction syndrome (MODS). MATERIALS AND METHODS: A total of 60 patients in the early stage of MODS (APACHE [Acute Physiology and Chronic Health Evaluation] II score ≥20) were investigated in a monocentric, prospective, randomized phase II study...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29670870/adjunctive-therapies-during-extracorporeal-membrane-oxygenation-to-enhance-multiple-organ-support-in-critically-ill-children
#9
REVIEW
Marguerite Orsi Canter, Jessica Daniels, Brian C Bridges
Since the advent of extracorporeal membrane oxygenation (ECMO) over 40 years ago, there has been increasing interest in the use of the extracorporeal circuit as a platform for providing multiple organ support. In this review, we will examine the evidence for the use of continuous renal replacement therapy, therapeutic plasma exchange, leukopheresis, adsorptive therapies, and extracorporeal liver support in conjunction with ECMO.
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29669237/current-practice-of-diagnosis-and-management-of-acute-kidney-injury-in-intensive-care-unit-in-resource-limited-settings
#10
Nattachai Srisawat, Nattaya Sintawichai, Win Kulvichit, Nuttha Lumlertgul, Patita Sitticharoenchai, Nicha Thamrongsat, Sadudee Peerapornratana
PURPOSE: In a resource limited settings, there is sparse information about the management of acute kidney injury (AKI) based on systemic data collection. This survey aimed to described the current management of AKI in intensive care units (ICUs) across Thailand. MATERIALS AND METHODS: Questionnaires were distributed to 160 physicians involved in the intensive care between January and December 2014 across Thailand. Distribution was done through an online survey platform or telephone interview...
April 11, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29665838/fungal-infections-in-adult-patients-on-extracorporeal-life-support
#11
Yiorgos Alexandros Cavayas, Hakeem Yusuff, Richard Porter
BACKGROUND: Patients on extracorporeal membrane oxygenation (ECMO) are often among the most severely ill in the intensive care unit. They are often receiving broad-spectrum antibiotics; they have multiple entry points for pathogens; and their immune system is impaired by blood circuit interaction. These factors are thought to predispose them to fungal infections. We thus aimed to evaluate the prevalence, risk factors, and prognosis of fungal infections in adults on ECMO. METHODS: We conducted a retrospective cohort study using the Extracorporeal Life Support Organization registry, which compiles data on ECMO use from hundreds of international centers...
April 17, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29665203/tolvaptan-alleviates-excessive-fluid-retention-of-nephrotic-diabetic-renal-failure-unresponsive-to-furosemide
#12
Tesshu Takada, Tsuguto Masaki, Ayako Hoshiyama, Takuya Toki, Yuji Kamata, Masayoshi Shichiri
Patients with diabetic nephropathy develop nephrotic syndrome, and may show limited response to conventional therapy. They often require earlier initiation of renal replacement therapy because they become refractory to diuretics, and experience excessive fluid retention. We aimed to investigate the efficacy of tolvaptan, an oral arginine vasopressin type 2 receptor antagonist, in a case series of 14 severe diabetic renal failure patients who were severely refractory to maximal doses of furosemide and had excessive fluid retention despite preserved cardiac function and residual renal function...
April 17, 2018: Nephrology
https://www.readbyqxmd.com/read/29664506/continuous-venovenous-hemofiltration-in-neonates-with-hyperammonemia-a-case-series
#13
Felipe Cavagnaro Santa María, Jorge Roque Espinosa, Pamela Guerra Hernández
INTRODUCTION: Neonatal hyperammonemia secondary due to inborn errors of metabolism is a rare condition with a high rate of neurological sequelae and mortality. Initial medical management is often insufficient to stop the progressive increase of ammonia, with the consequent deterioration of the patient. For this reason, depurative techniques have been implemented, including peritoneal dialysis, intermittent hemodialysis and continuous renal replacement therapy (CRRT). OBJECTIVE: To describe our experience with continuous extracorporeal dialysis in severely ill neonates with hyperammonemia...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29664109/forced-fluid-removal-in-intensive-care-patients-with-acute-kidney-injury-the-randomised-ffaki-feasibility-trial
#14
R E Berthelsen, A Perner, A K Jensen, B S Rasmussen, J U Jensen, J Wiis, M T Behzadi, M H Bestle
BACKGROUND: Accumulation of fluids is frequent in intensive care unit (ICU) patients with acute kidney injury and may be associated with increased mortality and decreased renal recovery. We present the results of a pilot trial assessing the feasibility of forced fluid removal in ICU patients with acute kidney injury and fluid accumulation of more than 10% ideal bodyweight. METHODS: The FFAKI-trial was a pilot trial of forced fluid removal vs standard care in adult ICU patients with moderate to high risk acute kidney injury and 10% fluid accumulation...
April 17, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29663999/-analysis-of-high-risk-factors-of-intensive-care-unit-acquired-weakness-in-patients-with-sepsis
#15
Xiaofan Yu, Xiaohong Wan, Linjun Wan, Qingqing Huang
OBJECTIVE: To investigate high risk factors of intensive care unit-acquired weakness (ICUAW) in patients with sepsis. METHODS: A retrospective study was conducted. 164 patients with mechanical ventilation (MV) who were diagnosed sepsis and multiple organ dysfunction syndrome (MODS), admitted to intensive care unit (ICU) of the Second Affiliated Hospital of Kunming Medical University from January 1st, 2015 to September 30th, 2017 were enrolled. The general situation, the basic diseases (hypertension, diabetes), body mass index (BMI), protopathy diseases, the level of albumin before ICU admission, the MV time, whether to use glucocorticoid and continuous renal replacement therapy (CRRT) or not, nutrition supply (nutritional way, nutrition initiation time, amino acid/protein supply, nutritional status on ICU 3 days and 7 days), myoglobin, the length of ICU stay, the length of hospital stay, and acute physiology and chronic health evaluation II (APACHE II) score were collected...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29661354/fatal-hypermagnesemia-due-to-laxative-use
#16
REVIEW
Syed Rizwan Bokhari, Ravi Siriki, Federico J Teran, Vecihi Batuman
We report a case of fatal hypermagnesemia in a 53-year-old woman admitted for acute exacerbation of chronic obstructive pulmonary disease and with a history of chronic constipation treated regularly with magnesium-containing laxatives. On admission, her magnesium level was 2.0mg/dL, which rose to a peak of 10.8mg/dL despite hydration and diuresis in the presence of a normal kidney function. Continuous renal replacement therapy was promptly initiated, which reduced her serum magnesium levels, but her condition continued to deteriorate precipitously progressing to shock leading to oligoanuric renal failure, and she died 2 days later...
April 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29657879/primary-hyperparathyroidism-and-gougerot-disease
#17
Toumader Bouziane, Nadia Belmahi, Hanan El Ouahabi
Primary hyperparathyroidism (PHPT) is a common endocrine disorder caused by the overactivation of the parathyroid glands due to the autonomous production of the parathyroid hormone (PTH). The resultant hypercalcemia leads to a myriad of symptoms. Here we report the case of a 54-year-old female with a previous diagnosis of Gougerot disease, in whom clinical (diffuse bone pain, asthenia polydipsia, and polyuria) and laboratory features (calcium level, 3.1 mmol/L; phosphate level, 0.55 mmol/L; alkaline phosphatase level, 70 U/L; and intact PTH level, 1028...
March 2018: European Journal of Rheumatology
https://www.readbyqxmd.com/read/29657198/scoring-systems-and-outcome-of-chronic-kidney-disease-patients-admitted-in-intensive-care-units
#18
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/29656901/different-rates-of-progression-and-mortality-in-patients-with-chronic-kidney-disease-at-outpatient-nephrology-clinics-across-europe
#19
Katharina Brück, Kitty J Jager, Carmine Zoccali, Aminu K Bello, Roberto Minutolo, Kyriakos Ioannou, Francis Verbeke, Henry Völzke, Johan Arnlöv, Daniela Leonardis, Pietro Manuel Ferraro, Hermann Brenner, Ben Caplin, Philip A Kalra, Christoph Wanner, Alberto Martinez Castelao, Jose Luis Gorriz, Stein Hallan, Dietrich Rothenbacher, Dino Gibertoni, Luca De Nicola, Georg Heinze, Wim Van Biesen, Vianda S Stel
The incidence of renal replacement therapy varies across countries. However, little is known about the epidemiology of chronic kidney disease (CKD) outcomes. Here we describe progression and mortality risk of patients with CKD but not on renal replacement therapy at outpatient nephrology clinics across Europe using individual data from nine CKD cohorts participating in the European CKD Burden Consortium. A joint model assessed the mean change in estimated glomerular filtration rate (eGFR) and mortality risk simultaneously, thereby accounting for mortality risk when estimating eGFR decline and vice versa, while also correcting for the measurement error in eGFR...
April 12, 2018: Kidney International
https://www.readbyqxmd.com/read/29652913/ventilator-associated-pneumonia-in-patients-assisted-by-veno-arterial-extracorporeal-membrane-oxygenation-support-epidemiology-and-risk-factors-of-treatment-failure
#20
Adrien Bouglé, Camille Bombled, Dimitri Margetis, Guillaume Lebreton, Charles Vidal, Marine Coroir, David Hajage, Julien Amour
INTRODUCTION: Ventilator-associated pneumonia (VAP) is frequent in Intensive Care Unit (ICU) patients. In the specific case of patients treated with Veno-Arterial Extracorporeal Membrane Oxygenation Support (VA-ECMO), VAP treatment failures (VAP-TF) have been incompletely investigated. METHODS: To investigate the risk factors of treatment failure (VAP-TF) in a large cohort of ICU patients treated with VA-ECMO, we conducted a retrospective study in a Surgical ICU about patients assisted with VA-ECMO between January 1, 2013, and December 31, 2014...
2018: PloS One
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