Spotlight Interview: The World of Fluids

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

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

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?

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 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

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

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

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

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

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

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

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?

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