Tag: AKI
Insidious Harm of Medication Diluents as a Contributor to Cumulative Volume and Hyperchloremia
This study identified that medication diluents contribute substantially to the total IV volume received by critically ill patients. Saline as the primary medication diluent compared with dextrose 5% in water is associated... read more
Personalization of Arterial Pressure in the Perioperative Period
This review aims to discuss recent findings on the relationship between intraoperative arterial hypotension and organ dysfunction in surgical patients and examines the available evidence for personalizing blood pressure (BP)... read more
Association of Vasopressin Plus Catecholamine Vasopressors vs Catecholamines Alone With Atrial Fibrillation in Patients With Distributive Shock
In this meta-analysis, the addition of vasopressin to catecholamine vasopressors compared with catecholamines alone was associated with a lower risk of atrial fibrillation. However, findings for secondary outcomes varied.... read more
Complications of Regional Citrate Anticoagulation: Accumulation or Overload?
Based on recent recommendations, the use of Regional Citrate Anticoagulation (RCA) is likely to increase dramatically throughout the world. RCA protocols should aim to minimize the amount of net citrate load delivered to... read more
Dosing Adjuvant Vitamin C in Critically Ill Patients Undergoing CRRT
We read with great interest the recent letter to Critical Care by Marik and Hooper. Vitamin C is increasingly recognized as a crucial compound to alleviate morbidity in critically ill patients. Vitamin C concentrations, however,... read more
Fluid Responsiveness in a Hemodynamically Unstable Patient
Only half of patients who are hemodynamically unstable will respond to a fluid bolus. There are no historical or physical examination findings that can help us decide whether a patient is a fluid responder, but we must treat... read more
Postoperative Renal Dysfunction After Noncardiac Surgery
Acute kidney injury (AKI) is a frequent postoperative complication with a substantial risk for both short and long-term adverse events, and its incidence is likely to rise because of increasing major surgical procedures.... read more
Effect of Human Recombinant Alkaline Phosphatase on 7-Day Creatinine Clearance in Patients With Sepsis-Associated AKI
In this randomized, double-blind, placebo-controlled, dose-finding adaptive phase 2a/2b trial enrolling 301 adults, the optimal therapeutic dose of recombinant alkaline phosphatase was 1.6 mg/kg. Treatment with this dose... read more
Update on Perioperative Acute Kidney Injury
Acute kidney injury (AKI) in the perioperative period is a common complication and is associated with increased morbidity and mortality. A standard definition and staging system for AKI has been developed, incorporating a... read more
Effect of Early vs Delayed Initiation of RRT on Mortality in Critically Ill Patients With AKI
Among critically ill patients with Acute Kidney Injury (AKI), early Renal Replacement Therapy (RRT) compared with delayed initiation of RRT reduced mortality over the first 90 days. Further multicenter trials of this intervention... read more
Predicting AKI using urinary liver-type fatty-acid binding protein and serum N-terminal pro-B-type natriuretic peptide levels in patients treated at medical cardiac ICUs
Urinary L-FABP and serum NT-proBNP levels on admission are independent predictors of acute kidney injury (AKI), and when used in combination, improve early prediction of AKI in patients hospitalized at medical cardiac intensive... read more
Predicting the Requirement for RRT in Intensive Care Patients with Sepsis
Sepsis is one of the most frequent causes of acute kidney injury (AKI) in critically ill patients, with initial organ impairment often followed by dysfunction in other systems. Renal dysfunction may therefore represent one... read more
Natriuretic Peptides: A Role in Early Septic Acute Kidney Injury?
Acute kidney injury (AKI) is a common complication of critical illness and is associated with significant morbidity, mortality, and financial cost. Sepsis is the leading association of acute kidney injury in the intensive... read more
Moving Albumin Into the Small Volume Resuscitation Era
Physicians have an intense 70-year history of enthusiasm, skepticism, fear, and reconciliation with albumin products since their market introduction in the late 1940s. Despite its cumbersome production method and costs, albumin... read more
Effect of Decompressive Laparotomy on Organ Function in Patients with Abdominal Compartment Syndrome
Decompressive laparotomy has been advised as potential treatment for abdominal compartment syndrome (ACS) when medical management fails; yet, the effect on parameters of organ function differs markedly in the published literature.... read more
AKI and Electrolyte Disorders in the Critically Ill Patient with Cancer
This review outlines key knowledge areas for critical care physicians and nephrologists caring for patients with cancer and associated kidney issues such as acute kidney injury (AKI) and electrolyte disorders. Specifically,... read more
MAP of 65: Target of the Past?
Septic shock is defined as sepsis with hypotension refractory to fluid challenge and requiring vasopressor support combined with an increase in arterial lactate reflecting impaired cellular energy metabolism and dysoxia.... read more
Sodium Bicarbonate Therapy for Patients with Severe Metabolic Acidaemia in the ICU
In patients with severe metabolic acidaemia, sodium bicarbonate had no effect on the primary composite outcome. However, sodium bicarbonate decreased the primary composite outcome and day 28 mortality in the a-priori defined... read more
Timing of Renal Support and Outcome of Septic Shock and ARDS
Early RRT initiation strategy was not associated with any improvement of 60-day mortality in patients with severe acute kidney injury and septic shock or Acute Respiratory Distress Syndrome (ARDS). Unnecessary and potentially... read more
The Fluid Debate: Balanced or Unbalanced
Consider using balanced fluids in your ED unless you are treating a patient at risk for cerebral edema, or a patient with a chloride responsive metabolic alkalosis, e.g. from gastric losses. Although the superiority of balanced... read more
AKI and Mild Therapeutic Hypothermia in Patients After Cardiopulmonary Resuscitation
The aim of this study was to investigate the influence of mild therapeutic hypothermia (MTH) on the incidence of and recovery from acute kidney injury (AKI). Mild therapeutic hypothermia seems to have a protective effect... read more
In vitro comparison of the adsorption of inflammatory mediators by blood purification devices
Septic shock, a leading cause of acute kidney injury, induces release of pro-/anti-inflammatory mediators, leading to increased mortality and poor renal recovery. This is the first in vitro study directly comparing three... read more
