Update on Perioperative Acute Kidney Injury

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

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

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

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?

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

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

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

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?

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

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

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

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

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

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

Clinical Decision Support for In-Hospital AKI

Clinical Decision Support for In-Hospital AKI

AKI carries a significant mortality and morbidity risk. Use of a clinical decision support system (CDSS) might improve outcomes. We conducted a multicenter, sequential period analysis of 528,108 patients without ESRD before... read more

Ten Shortcomings of the Current Definition of AKI

Ten Shortcomings of the Current Definition of AKI

Acute kidney injury (AKI) is defined as an abrupt decline in kidney function. Although the kidney has many functions, this "abrupt decline" mostly refers to the glomerular filtration rate (GFR) that cannot... read more

Advances in Critical Care Management of Patients Undergoing Cardiac Surgery

Advances in Critical Care Management of Patients Undergoing Cardiac Surgery

Cardiac surgery has been evolving to include minimally invasive, hybrid and transcatheter techniques. Increas‑ing patient age and medical complexity means that critical care management needs to adapt and evolve. Recent... read more