An assessment of repeat computed tomography utilization in the emergency department in the setting of blunt trauma

An assessment of repeat computed tomography utilization in the emergency department in the setting of blunt trauma

Two CT scans performed during blunt trauma encounters demonstrated mixed benefit and were associated with an increased hospital LOS. Additionally, IV contrast was associated with lower rates of AKI. Of 5787 patient encounters,... read more

Preoperative Risk and the Association between Hypotension and Postoperative AKI

Preoperative Risk and the Association between Hypotension and Postoperative AKI

Adult patients undergoing noncardiac surgery demonstrate varying associations with distinct levels of hypotension when stratified by preoperative risk factors. Specific levels of absolute hypotension, but not relative... read more

Association Between Intravenous Contrast Media Exposure and Non-recovery From Dialysis-requiring Septic AKI

Association Between Intravenous Contrast Media Exposure and Non-recovery From Dialysis-requiring Septic AKI

This large observational study did not support an association between intravenous contrast media and adverse in-hospital outcomes in patients with septic dialysis-requiring acute kidney injury (AKI-D). Further studies are... read more

Risk for Mortality in Critically Ill Children Needing RRT

Risk for Mortality in Critically Ill Children Needing RRT

Margaret M. Parker, MD, MCCM, speaks with Danny Hames, MD, on his article titled "Risk Factors for Mortality in Critically Ill Children Requiring Renal Replacement Therapy" published in the November 2019 issue of Pediatric... read more

Renal Outcomes of Vasopressin and Its Analogs in Distributive Shock

Renal Outcomes of Vasopressin and Its Analogs in Distributive Shock

In patients with distributive shock, vasopressin and its analogs use is associated with a reduced need for renal replacement therapy and lower acute kidney injury (AKI) incidence. These results are supported by high risk... read more

Low-dose Atrial Natriuretic Peptide for Prevention or Treatment of AKI

Low-dose Atrial Natriuretic Peptide for Prevention or Treatment of AKI

Theoretically, atrial natriuretic peptide (ANP), especially low-dose ANP, is beneficial in acute kidney injury (AKI). In this study, we examined whether low-dose ANP is effective in preventing or treating AKI by conducting... read more

The Effect of Vitamin C on Clinical Outcome in Critically Ill Patients

The Effect of Vitamin C on Clinical Outcome in Critically Ill Patients

In a mixed population of ICU patients, vitamin C administration is associated with no significant effect on survival, length of ICU or hospital stay. In cardiac surgery, beneficial effects on postoperative atrial fibrillation,... read more

AKI in Critically Ill Patients After Noncardiac Major Surgery

AKI in Critically Ill Patients After Noncardiac Major Surgery

Acute kidney injury (AKI) is a common complication of major surgery. However, acute kidney injury occurring within the first 48 hours after surgery (early acute kidney injury) and therefore likely related to the surgery itself... read more

Association Between Mean Arterial Pressure and AKI and a Composite of Myocardial Injury and Mortality in Postoperative Critically Ill Patients

Association Between Mean Arterial Pressure and AKI and a Composite of Myocardial Injury and Mortality in Postoperative Critically Ill Patients

Hypotension thresholds that provoke renal injury, myocardial injury, and mortality in critical care patients remain unknown. We primarily sought to determine the relationship between hypotension and a composite of myocardial... read more

Derivation and Validation of Plasma Endostatin for Predicting Renal Recovery from AKI

Derivation and Validation of Plasma Endostatin for Predicting Renal Recovery from AKI

Plasma endostatin shows a useful value for predicting failure to recover from acute kidney injury (AKI). The predictive ability can be greatly improved when endostatin is combined with the Sequential Organ Failure Assessment... read more

Estimated Effects of Early Diuretic Use in Critical Illness

Estimated Effects of Early Diuretic Use in Critical Illness

The main objectives of this study was to estimate the effects of diuretic use during the first 24 hours of an ICU stay on in-hospital mortality and other clinical outcomes including acute kidney injury (AKI) and duration... read more

The Spleen: The Forgotten Organ in AKI of Critical Illness

The Spleen: The Forgotten Organ in AKI of Critical Illness

Acute kidney injury (AKI) is an increasing medical burden and is independently associated with mortality. AKI is a common comorbidity in the intensive care unit (ICU), with sepsis-associated AKI seen in almost a quarter of... read more

Fluid Resuscitation with PPD Attenuates Crush Injury-related AKI and Improves Survival

Fluid Resuscitation with PPD Attenuates Crush Injury-related AKI and Improves Survival

In-hospital renal replacement therapy (RRT) is widely used for the treatments of acute kidney injury (AKI) in crush injury (CI) victims. This study was designed to investigate whether preventive peritoneal dialysis (PPD)... read more

Ideas for Future Intensive Care

Ideas for Future Intensive Care

Progress toward determining the true worth of ongoing practices or value of recent innovations can be glacially slow when we insist on following the conventional stepwise scientific pathway. Moreover, a widely accepted but... read more

Acute Kidney Injury in Postoperative Shock

Acute Kidney Injury in Postoperative Shock

Is hyperoncotic albumin administration an unrecognized resuscitation risk factor? The use of hyperoncotic albumin (HA) for shock resuscitation is controversial given concerns about its cost, effectiveness, and potential for... read more

Effects of Baseline Thrombocytopenia and Platelet Decrease Following RRT Initiation in Patients With Severe AKI

Effects of Baseline Thrombocytopenia and Platelet Decrease Following RRT Initiation in Patients With Severe AKI

Baseline thrombocytopenia and platelet decrease following renal replacement therapy initiation were associated with increased mortality, and baseline thrombocytopenia was associated with decreased rates of renal recovery.... read more

Perioperative Kidney Injury: Principles of Risk Assessment, Diagnosis and Treatment

Perioperative Kidney Injury: Principles of Risk Assessment, Diagnosis and Treatment

The kidneys participate in all vital processes of the body to maintain overall homeostasis and health. When kidneys are injured during surgical interventions, metabolic and hemodynamic control is disrupted, leading to dysfunction... read more