Serum Creatinine in the Critically Ill Patient With Sepsis

Serum Creatinine in the Critically Ill Patient With Sepsis

A 73-year-old man underwent esophageal resection for cancer. He had a history of hypertension that was treated with an angiotensin receptor blocker. Preoperative estimated glomerular filtration rate (GFR) was 98 mL/min/1.73... read more

Sepsis Surveillance Using Adult Sepsis Events Simplified eSOFA Criteria Versus Sepsis-3 Sequential Organ Failure Assessment Criteria

Sepsis Surveillance Using Adult Sepsis Events Simplified eSOFA Criteria Versus Sepsis-3 Sequential Organ Failure Assessment Criteria

Sepsis-3 defines organ dysfunction as an increase in the Sequential Organ Failure Assessment score by greater than or equal to 2 points. However, some Sequential Organ Failure Assessment score components are not routinely... read more

Variation in Identifying Sepsis and Organ Dysfunction Using Administrative Versus Electronic Clinical Data and Impact on Hospital Outcome Comparisons

Variation in Identifying Sepsis and Organ Dysfunction Using Administrative Versus Electronic Clinical Data and Impact on Hospital Outcome Comparisons

Variation in the accuracy of claims data for identifying sepsis and organ dysfunction limits their use for comparing hospitals' sepsis rates and outcomes. Using objective clinical data may facilitate more meaningful hospital... read more

Positive Outcomes, Mortality Rates, and Publication Bias in Septic Shock Trials

Positive Outcomes, Mortality Rates, and Publication Bias in Septic Shock Trials

Out of 65 eligible septic shock trials, 14 did not have a clearly defined control group (two standards of care were compared) and were excluded. For the 51 remaining trials, control-group mortality ranged between 15.9%... read more

Oliguria and AKI in Critically Ill Children

Oliguria and AKI in Critically Ill Children

Nearly one in five critically ill children with acute kidney injury (AKI) do not experience increase in serum creatinine. These acute kidney injury events, which are only identified by urine output criteria, are associated... read more

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

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

Machine Learning Can Reduce Tests, Improve Treatments for ICU Patients

Machine Learning Can Reduce Tests, Improve Treatments for ICU Patients

Researchers from Princeton University are using machine learning to design a system that could reduce the frequency of tests and improve the timing of critical treatments for ICU patients. To create the system, the researchers... read more

Predicting Mortality in Patients Undergoing VA-ECMO After CABG

Predicting Mortality in Patients Undergoing VA-ECMO After CABG

Prediction scoring systems for coronary artery bypass grafting (CABG) patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) have not yet been reported. This study was designed to develop a predictive score... read more

Effect of Human Recombinant Alkaline Phosphatase on 7-Day Creatinine Clearance in Patients With Sepsis-Associated AKI

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

No Requirement for Targeted Theophylline Levels for Diuretic Effect of Aminophylline in Critically Ill Children

No Requirement for Targeted Theophylline Levels for Diuretic Effect of Aminophylline in Critically Ill Children

Aminophylline administration provided a measure of increased diuresis, regardless of dosage, and theophylline trough levels. Therefore, achieving a prescribed therapeutic trough level may not be necessary for full diuretic... 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

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

Risk of AKI After Intravenous Contrast Media Administration

Risk of AKI After Intravenous Contrast Media Administration

In the largest well-controlled study of acute kidney injury (AKI) following contrast administration in the ED to date, intravenous contrast was not associated with an increased frequency of acute kidney injury. Rates of acute... read more

The Role of Oliguria and the Absence of Fluid Administration and Balance Information in Illness Severity Scores

The Role of Oliguria and the Absence of Fluid Administration and Balance Information in Illness Severity Scores

Urinary examination has formed part of patient assessment since the earliest days of medicine. Current definitions of oliguria are essentially arbitrary, but duration and intensity of oliguria have been associated with an... read more