Sepsis-Associated AKI Risks in the PICU

Sepsis-Associated AKI Risks in the PICU

In children with severe sepsis, the degree of hemodynamic support as measured by the VIS and the presence of fluid overload may identify patients at increased risk of developing severe acute kidney injury (AKI). Children... read more

Optimizing the Design and Analysis of Future AKI Trials

Optimizing the Design and Analysis of Future AKI Trials

Acute kidney injury (AKI) is a complex clinical syndrome associated with an increased risk of morbidity and mortality, particularly in critically ill and perioperative patient populations. Most AKI clinical trials have... read more

Acute Kidney Injury Related to Intoxication From Synthetic Cannabis

Acute Kidney Injury Related to Intoxication From Synthetic Cannabis

Acute kidney injury (AKI) occurs infrequently in young patients and often raises concern for irreversible or deadly etiologies. However, AKI related to synthetic marijuana, colloquially known as K2, is an increasingly common... read more

Reducing Mortality in Acute Kidney Injury

Reducing Mortality in Acute Kidney Injury

This book describes the techniques, strategies, and drugs that have been demonstrated by at least one paper published in a peer-reviewed journal to significantly influence survival in patients with or at risk for acute kidney... read more

Multi-Organ Point-Of-Care Ultrasound in AKI

Multi-Organ Point-Of-Care Ultrasound in AKI

Acute kidney injury (AKI) is a clinical syndrome caused by a multitude of hemodynamic, toxic, and structural insults to the kidney, and portends worse patient outcomes. Despite careful history taking, physical examination,... read more

Balanced Crystalloids Probably Reduce Mortality in the Critically-Ill

Balanced Crystalloids Probably Reduce Mortality in the Critically-Ill

As remarked by the authors of the recent PLUS trial, a systematic review and meta-analysis of randomized controlled trials comparing balanced resuscitation fluid to 0.9% saline was reported in the New England Journal of Medicine... read more

Balanced vs. Unbalanced Fluid in Critically Ill Children

Balanced vs. Unbalanced Fluid in Critically Ill Children

Our systematic review found some evidence of improvement in blood pH and bicarbonate values in critically ill children after 4–12 hours of fluid bolus therapy with balanced fluid compared with the unbalanced fluid. However,... read more

Balanced Fluid Resuscitation for the Critically-Ill: the PLUS study mirrors the BaSICS

Balanced Fluid Resuscitation for the Critically-Ill: the PLUS study mirrors the BaSICS

Intravenous fluid therapy is one of the most commonly-performed interventions in all of critical care medicine. Numerous trials over the last 20 years have attempted to identify the ideal fluid for those in the intensive... read more

Assessment of Patiromer Monotherapy for Hyperkalemia in an Acute Care Setting

Assessment of Patiromer Monotherapy for Hyperkalemia in an Acute Care Setting

In this cohort study of patients with acute, non–life-threatening hyperkalemia, a single dose of patiromer was associated with a significant decrease in serum potassium levels and a low incidence of hypokalemia. These... read more

The Ongoing Saga of Normal Saline vs. Balanced Fluids

The Ongoing Saga of Normal Saline vs. Balanced Fluids

I have discussed the ongoing battle between normal saline and ‘balanced fluids’ many times in the past. First, there was the SPLIT trial, a double blind cluster RCT of 2200 ICU patients that showed no difference between... read more

Prolonged Blood Storage and Risk of Posttransfusion AKI

Prolonged Blood Storage and Risk of Posttransfusion AKI

In a population of patients without severely impaired baseline renal function receiving fewer than 10 erythrocyte units, duration of blood storage had no effect on the incidence of posttransfusion acute kidney injury (AKI). The... read more

Chlorthalidone Improves Blood Pressure Control in Advanced Chronic Kidney Disease with Hypertension

Chlorthalidone Improves Blood Pressure Control in Advanced Chronic Kidney Disease with Hypertension

Among patients with advanced chronic kidney disease and poorly controlled hypertension, chlorthalidone therapy improved blood-pressure control at 12 weeks as compared with placebo. A total of 160 patients underwent randomization,... read more

Intraoperative Hypotension and AKI after Noncardiac Surgery in Infants and Children

Intraoperative Hypotension and AKI after Noncardiac Surgery in Infants and Children

In distinct contrast to adults, the authors did not find any association between intraoperative hypotension and postoperative renal injury. Avoiding short periods of hypotension should not be the clinician’s primary concern... read more

Obesity, Inflammatory and Thrombotic Markers, and Major Clinical Outcomes in Critically Ill Patients with COVID-19 in the US

Obesity, Inflammatory and Thrombotic Markers, and Major Clinical Outcomes in Critically Ill Patients with COVID-19 in the US

In critically ill patients with COVID-19, higher BMI was not associated with death or thrombotic events but was associated with a greater risk of ARDS and AKI-RRT. The lack of an association between BMI and circulating... read more

Critical Care Pediatric Nephrology and Dialysis

Critical Care Pediatric Nephrology and Dialysis

This book covers all key aspects of critical care in pediatric nephrology, including acute dialysis in sick children. It also provides detailed protocols for managing fluid and electrolyte balance and dialysis in children... read more

Longitudinal Respiratory Subphenotypes in COVID-19 Patients with ARDS

Longitudinal Respiratory Subphenotypes in COVID-19 Patients with ARDS

COVID-19-related ARDS has no consistent respiratory subphenotype. Patients diverged from a fairly homogenous to a more heterogeneous population, with trajectories of ventilatory ratio and mechanical power being the most discriminatory.... read more

Optimizing the Timing of RRT in AKI

Optimizing the Timing of RRT in AKI

The optimal timing of renal replacement therapy (RRT) in critically ill patients with acute kidney injury (AKI) has been much debated. Over the past five years several studies have provided new guidance for evidence-based... read more