The Great Debate Between Balanced and Unbalanced Crystalloids Continues

This meta-analysis contributes very little to the current discussion mainly because of the heterogeneity of included studies. The use of fluid type in different pathologies isn't really what we need, but rather tailored use... read more

Long-term survival in patients with septic acute kidney injury is strongly influenced by renal recovery

In patients with sepsis, recovery by hospital discharge is associated with long-term survival similar to patients without AKI. Of the 1742 patients who survived to hospital discharge, stage 2–3 AKI occurred in 262 (15%),... read more

A Pilot Study Evaluating the Effect of Cooler Dialysate Temperature on Hemodynamic Stability During Prolonged Intermittent RRT in AKI

Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is associated with high morbidity and mortality. Complications of renal replacement therapy include hemodynamic instability with ensuing shortened treatments,... read more

CRRT for Sepsis-induced Acute Kidney Injury

Sepsis-induced acute kidney injury (SI-AKI) represents the first cause of AKI in ICUs, and renal replacement therapy (RRT) is frequently applied in advanced AKI stages. The debate between 'rescue' indications for RRT start... read more

Machine Learning for the Prediction of Volume Responsiveness in Patients with Oliguric AKI in Critical Care

Excess fluid balance in acute kidney injury (AKI) may be harmful, and conversely, some patients may respond to fluid challenges. This study aimed to develop a prediction model that can be used to differentiate between volume-responsive... read more

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