Tag: RRT
Outcomes in Patients with Vasodilatory Shock and RRT Treated with Intravenous Angiotensin II
Acute kidney injury (AKI) requiring renal replacement therapy in severe vasodilatory shock is associated with an unfavorable prognosis. Angiotensin II treatment may help these patients by potentially restoring renal function... read more
Too Much SALT on the ICU?
There has a been a little flutter of activity in the #FOAMed world this week about two trials published in the NEJM on the subject of balanced fluids in the care of critically ill patients, and also on admitted patients in... read more
Acute Kidney Injury in Sepsis
Acute kidney injury (AKI) and sepsis carry consensus definitions. The simultaneous presence of both identifies septic AKI. Septic AKI is the most common AKI syndrome in ICU and accounts for approximately half of all such... read more
Renal Recovery – RRT Modality
Renal recovery - does the choice of renal replacement therapy matter?... read more
Spotlight Interview: The World of Fluids
Looking at the data from a new perspective, the article "Both Positive and Negative Fluid Balance May Be Associated With Reduced Long-Term Survival in the Critically Ill" published in Critical Care Medicine in August 2017,... read more
Kinetic Estimated Glomerular Filtration Rate in Critically Ill Patients
Both the Acute kidney injury (AKI) classification system and the nonsteady-state (kinetic) estimated glomerular filtration rate (KeGFR) are complementary to each other. Assessing both AKI stage and KeGFR can help to identify... read more
RRT Modality in the ICU and Renal Recovery at Hospital Discharge
In this large retrospective study, intermittent hemodialysis as an initial modality was associated with lower renal recovery at hospital discharge among patients with acute kidney injury, although the difference seems somewhat... read more
Can this patient be safely weaned from RRT?
The timing of initiation of renal replacement therapy (RRT) in the critically ill with acute kidney injury (AKI) has been widely studied and discussed in detail recently. However, there is limited information and few recommendations... read more
Levosimendan in high-risk patients undergoing cardiac surgery
Levosimendan reduces mortality in patients with preoperative severely reduced LVEF but does not affect overall mortality. Levosimendan reduces the need for RRT after high-risk cardiac surgery. Six RCTs were included in the... read more
Early Oseltamivir Therapy Improves the Outcome in Critically Ill with Influenza
This real-life study emphasizes oseltamivir efficacy on in-hospital outcome when administrated within 2 days of the onset of symptoms. Even if physicians' awareness of the influenza disease has been undeniably enhanced... read more
Association Between Survival and Time of Day for RRT Calls
Rapid response team activation is less frequent during the early morning and is followed by a spike in mortality in the 7 AM hour. These findings suggest that failure to rescue deteriorating patients is more common overnight.... read more
Optimal Timing of RRT in Patients with AKI in the Context of Sepsis
Among 620 patients enrolled in AKIKI, 494 (80%) had sepsis and 413 (67%) septic shock. This can help to suggest recommendations in septic patients with AKI. AKIKI showed no significant difference in mortality between early... read more
Both Positive and Negative Fluid Balance May Be Associated With Reduced Long-Term Survival in the Critically Ill
Among critically ill patients with acute kidney injury, exposure to positive fluid balance, compared with negative fluid balance, has been associated with mortality and impaired renal recovery. However, it is unclear whether... read more
Effect of an automated notification system for deteriorating ward patients on clinical outcomes
We performed a prospective before-and-after study in all patients admitted to two clinical ward areas in a district general hospital in the UK. We examined the effect on clinical outcomes of deploying an electronic automated... read more
A patient and family initiated rapid response system
Rapid response teams (RRTs) help in delivering safe, timely care. Typically they are activated by clinicians using specific parameters. Allowing patients and families to activate RRTs is a novel intervention. 240 patients/family... read more
Earlier Renal Replacement Therapy for AKI? Not So Fast, Says Dr Berns
The AKIKI study was published in the New England Journal of Medicine; ELAIN was published in JAMA. If you have not read them, you should, if for no other reason than that your colleagues are likely to ask about them.... read more
Is Timing Really Everything With RRT?
For years we have been told that early interventions result in better patient outcomes. Early cardiac catheterization results in more preserved myocardial function.... read more
