Are Biomarkers Ready for Prime Time?

Kyle Enfield, MD, speaks with John A. Kellum, MD, MCCM, about his talk presented at the 46th Critical Care Congress in Honolulu, Hawaii entitled, "Are Biomarkers Ready for Prime Time?" Dr. Kellum works as an Intensivist in... read more

Platelets and Multi-Organ Failure in Sepsis

Platelets and Multi-Organ Failure in Sepsis

Platelets have received increasing attention for their role in the pathophysiology of infectious disease, inflammation, and immunity. In sepsis, a low platelet count is a well-known biomarker for disease severity and more... read more

Severe AKI in Young ICU Patients Predicts Higher Mortality

Severe AKI in Young ICU Patients Predicts Higher Mortality

Acute kidney injury (AKI) among critically ill children and young adults is common and is associated with higher mortality risk and other poor outcomes The condition also is associated with greater use of renal-replacement... read more

Can this patient be safely weaned from RRT?

Can this patient be safely weaned from RRT?

The timing of initiation of renal replacement therapy (RRT) in the critically ill with acute kidney injury (AKI) has been widely studied and discussed in detail recently. However, there is limited information and few recommendations... read more

Acute Kidney Injury Is Risk Factor for Delirium and Coma

Acute Kidney Injury Is Risk Factor for Delirium and Coma

For critically ill adults, acute kidney injury is a risk factor for delirium and coma. Stage 2 acute kidney injury was associated with increased risk of delirium and coma (odds ratios, 1.55 and 2.04, respectively), as was... read more

Risk of AKI After Intravenous Contrast Media Administration

Risk of AKI After Intravenous Contrast Media Administration

In the largest well-controlled study of acute kidney injury (AKI) following contrast administration in the ED to date, intravenous contrast was not associated with an increased frequency of acute kidney injury. Rates of acute... read more

Immunoglobulin G for patients with Necrotising Soft Tissue Infection

Immunoglobulin G for patients with Necrotising Soft Tissue Infection

The aim of the INSTINCT trial was to assess the effect of intravenous polyspecific immunoglobulin G (IVIG) compared with placebo on self-reported physical function in intensive care unit (ICU) patients with necrotising soft... read more

Biomarkers in AKI: That’s All the Story?

Biomarkers in AKI: That’s All the Story?

We would like to add to the recent editorial by McMahon on biomarkers of acute kidney injury (AKI), with a specific focus on biomarkers in the clinical setting of cardiac surgery-associated AKI (CSA-AKI). We agree with McMahon... read more

Most pediatric ICU physicians don’t use current guidelines to diagnose acute kidney injury

Most pediatric ICU physicians don’t use current guidelines to diagnose acute kidney injury

A study by University at Buffalo researchers has shown that physicians in pediatric intensive care units are not using the newest guidelines to diagnose acute kidney injury (AKI) in critically ill children, a practice that... read more

The Association of Early Combined Lactate and Glucose Levels with Subsequent Renal and Liver Dysfunction

The Association of Early Combined Lactate and Glucose Levels with Subsequent Renal and Liver Dysfunction

Abnormal combined lactate and glucose measurements may provide an early indication of organ dysfunction. In critically ill patients a 'normal' glucose with an elevated lactate should not be considered desirable, as this combination... read more

Optimal Timing of RRT in Patients with AKI in the Context of Sepsis

Optimal Timing of RRT in Patients with AKI in the Context of Sepsis

Among 620 patients enrolled in AKIKI, 494 (80%) had sepsis and 413 (67%) septic shock. This can help to suggest recommendations in septic patients with AKI. AKIKI showed no significant difference in mortality between early... read more

The Role of Oliguria and the Absence of Fluid Administration and Balance Information in Illness Severity Scores

The Role of Oliguria and the Absence of Fluid Administration and Balance Information in Illness Severity Scores

Urinary examination has formed part of patient assessment since the earliest days of medicine. Current definitions of oliguria are essentially arbitrary, but duration and intensity of oliguria have been associated with an... read more

Impact of End-Stage Renal Disease and Acute Kidney Injury on ICU Outcomes in Patients With Sepsis

Impact of End-Stage Renal Disease and Acute Kidney Injury on ICU Outcomes in Patients With Sepsis

Patients with sepsis having AKI have a higher mortality rate than those with ESRD and non-KI. Hospital and ICU mortality rates for patients with ESRD were similar to non-KI patients. Late AKI compared to early AKI had a higher... read more

Prevention of AKI and protection of renal function in ICU

Prevention of AKI and protection of renal function in ICU

Acute kidney injury (AKI) in the intensive care unit is associated with significant mortality and morbidity. The results of recent randomised controlled trials have allowed the formulation of new recommendations and/or increase... read more

Exosomes in Critical Illness

Exosomes in Critical Illness

Exosomes are small, cell-released vesicles (40–100 nm in size) with the potential to transfer proteins, lipids, small RNAs, messenger RNAs, or DNA between cells via interstitial fluids. Due to their role in tissue homeostasis,... read more

Generalizable Biomarkers in Critical Care

Generalizable Biomarkers in Critical Care

The sequencing of the human genome and the subsequent availability of inexpensive, robust methods for "omics" profiling (e.g., genome-wide association studies, gene expression microarrays, and metabolomics) have... read more

Diagnostic work-up and specific causes of acute kidney injury

Diagnostic work-up and specific causes of acute kidney injury

Acute kidney injury (AKI) is common in critically ill patients and associated with grim short- and long-term outcome. Although in the vast majority of cases AKI is multifactorial, with sepsis, shock and nephrotoxicity accounting... read more