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Continuous renal replacement therapy

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https://read.qxmd.com/read/30887109/dialysis-modalities-for-the-management-of-pediatric-acute-kidney-injury
#1
Lara de Galasso, Stefano Picca, Isabella Guzzo
Acute kidney injury (AKI) is an increasingly frequent complication among hospitalized children. It is associated with high morbidity and mortality, especially in neonates and children requiring dialysis. The different renal replacement therapy (RRT) options for AKI have expanded from peritoneal dialysis (PD) and intermittent hemodialysis (HD) to continuous RRT (CRRT) and hybrid modalities. Recent advances in the provision of RRT in children allow a higher standard of care for increasingly ill and young patients...
March 18, 2019: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://read.qxmd.com/read/30885623/aortic-arch-surgery-with-hypothermic-circulatory-arrest-and-unilateral-antegrade-cerebral-perfusion-perioperative-outcomes
#2
Xiaomeng Wang, Feng Yang, Junming Zhu, Yongmin Liu, Lizhong Sun, Xiaotong Hou
OBJECTIVE: The study objective was to determine the effects of surgical procedures, circulatory management strategies, and cerebral protection strategies on the short-term outcomes of aortic arch surgery based on the 7-year clinical experience of a single center. METHODS: We analyzed the data of 1708 patients who underwent aortic arch surgery with definite hypothermic circulatory arrest and unilateral antegrade cerebral perfusion at Beijing Anzhen Hospital between 2009 and 2015...
February 14, 2019: Journal of Thoracic and Cardiovascular Surgery
https://read.qxmd.com/read/30885139/lower-rate-of-delayed-graft-function-is-observed-when-epidural-analgesia-for-living-donor-nephrectomy-is-administered
#3
Wolfgang Baar, Ulrich Goebel, Hartmut Buerkle, Bernd Jaenigen, Kai Kaufmann, Sebastian Heinrich
BACKGROUND: The beneficial effects of epidural analgesia (EDA) in terms of pain control and postoperative convalescence are widely known and led to a frequent use for patients who underwent living donor kidney nephrectomy. The objective of this study was to determine whether general anesthesia (GA) plus EDA compared to GA only, administered for living donor nephrectomy has effects on postoperative graft function in recipients. METHODS: In this monocentric, retrospective cohort analysis we analyzed the closed files of all consecutive donor- recipient pairs who underwent living donor kidney transplantations from 2008 to 2017...
March 18, 2019: BMC Anesthesiology
https://read.qxmd.com/read/30872071/clinical-predictors-of-mortality-of-middle-east-respiratory-syndrome-mers-infection-a-cohort-study
#4
Sarah H Alfaraj, Jaffar A Al-Tawfiq, Ayed Y Assiri, Nojoom A Alzahrani, Amal A Alanazi, Ziad A Memish
BACKGROUND: Since the emergence of the Middle East Respiratory Syndrome (MERS) in 2012, the virus had caused a high case fatality rate. The clinical presentation of MERS varied from asymptomatic to severe bilateral pneumonia, depending on the case definition and surveillance strategies. There are few studies examining the mortality predictors in this disease. In this study, we examined clinical predictors of mortality of Middle East Respiratory Syndrome (MERS) infection. METHODS: This is a retrospective analysis of symptomatic admitted patients to a large tertiary MERS-CoV center in Saudi Arabia over the period from April 2014 to March 2018...
March 11, 2019: Travel Medicine and Infectious Disease
https://read.qxmd.com/read/30864363/the-effect-of-continuous-renal-replacement-therapy-with-the-an69st-membrane-on-inflammatory-markers-and-the-level-of-consciousness-of-hemodialysis-patients-with-stroke-comparison-with-hemodialysis-with-low-blood-flow-rate
#5
Tomohiro Matsui, Takafumi Nakagawa, Hitomi Kikuchi, Hiroyuki Horio, Kazuhiko Hashimura
INTRODUCTION: Hemodialysis (HD) with low blood flow rate, continuous renal replacement therapy (CRRT), and peritoneal dialysis are recommended for patients with stroke complications to prevent intracranial hypertension because of the low diffusion capacity of the brain barrier. However, detailed guidelines are not currently available; thus, there is an urgent need to establish such guidelines. MATERIAL AND METHODS: We developed a novel protocol for performing CRRT with the AN69ST membrane, which has excellent adsorption capacity for various cytokines...
December 1, 2018: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://read.qxmd.com/read/30863646/-clostridium-difficile-enteritis-after-total-abdominal-colectomy-for-ulcerative-colitis
#6
Hassan Nasser, Semeret Munie, Dania Shakaroun, Tommy Ivanics, Surya Nalamati, Keith Killu
Introduction: Isolated Clostridium difficile small bowel enteritis is a rare condition with significant morbidity and mortality. Presentation of Case: An 83-year-old female with refractory ulcerative colitis underwent a total proctocolectomy and end ileostomy. Her postoperative course was complicated with return to the operating room for repair of an incarcerated port site hernia. Subsequently, she developed septic shock and multiorgan failure requiring intubation and mechanical ventilation, renal replacement therapy, and high dose vasopressors...
2019: Case Reports in Critical Care
https://read.qxmd.com/read/30863267/prognostic-value-of-admission-blood-glucose-level-in-critically-ill-patients-admitted-to-cardiac-intensive-care-unit-according-to-the-presence-or-absence-of-diabetes-mellitus
#7
Sua Kim, Soo Jin Na, Taek Kyu Park, Joo Myung Lee, Young Bin Song, Jin-Oh Choi, Joo-Yong Hahn, Jin-Ho Choi, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Chi Ryang Chung, Kyeongman Jeon, Gee Young Suh, Jeong Hoon Yang
Background: Admission blood glucose (BG) level is a predictor of mortality in critically ill patients with various conditions. However, limited data are available regarding this relationship in critically ill patients with cardiovascular diseases according to diabetic status. Methods: A total of 1,780 patients (595 with diabetes) who were admitted to cardiac intensive care unit (CICU) were enrolled from a single center registry. Admission BG level was defined as maximal serum glucose level within 24 hours of admission...
March 11, 2019: Journal of Korean Medical Science
https://read.qxmd.com/read/30858974/triple-bridge-of-mechanical-circulatory-support-to-heart-transplantation-listing-a-case-report
#8
Magdy Mohamed El-Sayed Ahmed, Mathew Thomas, Samuel Jacob, Ian A Makey, Kevin P Landolfo, Si M Pham, Erol V Belli
A 60-year-old male patient presented to an outside hospital with severe cardiogenic shock. A triple bridge of mechanical circulatory support was utilized to transition him to heart transplantation listing. Initially, coronary artery disease was percutaneously treated and Impella 2.5 was used as mechanical circulatory support for 5 days followed by the second Impella 2.5 for 4 days. Veno-arterial extracorporeal membrane oxygenation support was deployed for 16 days. This was exchanged for HeartWare ventricular assist device support as the third stage of mechanical circulatory support to heart transplantation listing...
2019: SAGE open medical case reports
https://read.qxmd.com/read/30857514/a-protocol-for-a-phase-3-multicentre-randomised-controlled-trial-of-continuous-versus-intermittent-%C3%AE-lactam-antibiotic-infusion-in-critically-ill-patients-with-sepsis-bling-iii
#9
Jeffrey Lipman, Stephen J Brett, Jan J De Waele, Menino O Cotta, Joshua S Davis, Simon Finfer, Parisa Glass, Serena Knowles, Shay McGuinness, John Myburgh, David L Paterson, Sandra Peake, Dorrilyn Rajbhandari, Andrew Rhodes, Jason A Roberts, Charudatt Shirwadkar, Therese Starr, Colman Taylor, Laurent Billot, Joel M Dulhunty
BACKGROUND AND RATIONALE: β-Lactam antibiotics display a time-dependent mechanism of action, with evidence suggesting improved outcomes when administering these drugs via continuous infusion compared with standard intermittent infusion. However, there is no phase 3 randomised controlled trial (RCT) evidence to support one method of administration over another in critically ill patients with sepsis. DESIGN AND SETTING: The β-Lactam Infusion Group (BLING) III study is a prospective, multicentre, open, phase 3 RCT to compare continuous infusion with standard intermittent infusion of β-lactam antibiotics in critically ill patients with sepsis...
March 2019: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://read.qxmd.com/read/30855330/evaluation-of-medication-errors-at-the-transition-of-care-from-an-icu-to-non-icu-location
#10
Andrea P Tully, Drayton A Hammond, Chenghui Li, Andrew S Jarrell, Rachel M Kruer
OBJECTIVES: To determine the point prevalence of medication errors at the time of transition of care from an ICU to non-ICU location and assess error types and risk factors for medication errors during transition of care. DESIGN: This was a multicenter, retrospective, 7-day point prevalence study. SETTING: Fifty-eight ICUs within 34 institutions in the United States and two in the Netherlands. PATIENTS: Nine-hundred eighty-five patients transferred from an ICU to non-ICU location...
January 11, 2019: Critical Care Medicine
https://read.qxmd.com/read/30852030/energy-expenditure-and-caloric-targets-during-continuous-renal-replacement-therapy-under-regional-citrate-anticoagulation-a-viewpoint
#11
REVIEW
J Jonckheer, H Spapen, M L N G Malbrain, T Oschima, E De Waele
BACKGROUND: Indirect calorimetry (IC) is the gold standard for measuring energy expenditure in critically ill patients However, continuous renal replacement therapy (CRRT) is a formal contraindication for IC use. AIMS: To discuss specific issues that hamper or preclude an IC-based assessment of energy expenditure and correct caloric prescription in CRRT-treated patients. METHODS: Narrative review of current literature. RESULTS: Several relevant pitfalls for validation of IC during CRRT were identified...
February 23, 2019: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://read.qxmd.com/read/30851258/impact-of-bleeding-revision-on-outcomes-after-left-ventricular-assist-device-implantation
#12
Philipp Angleitner, Paul Simon, Alexandra Kaider, Dominik Wiedemann, Kamen Dimitrov, Thomas Schlöglhofer, Maria Angela Rajek, Julia Riebandt, Günther Laufer, Daniel Zimpfer
BACKGROUND: Few reports have described associations between a bleeding revision and outcomes following implantation of a continuous-flow left-ventricular assist device (LVAD). METHODS: We retrospectively analyzed all adult recipients of a continuous-flow LVAD that underwent surgery between January 2006 and December 2016 at the Division of Cardiac Surgery, Medical University of Vienna (n = 257; LVAD types: Medtronic [Heartware® ] HVAD® , Abbott [Thoratec® ] Heartmate 2® , Abbott [Thoratec® ] Heartmate 3TM )...
March 6, 2019: Annals of Thoracic Surgery
https://read.qxmd.com/read/30850912/eliminating-endotoxin-by-polymyxin-b-hemoperfusion-and-or-continuous-renal-replacement-therapy-should-the-focus-be-on-timing-dosing-and-type-of-renal-epuration
#13
EDITORIAL
Patrick M Honore, David De Bels, Sebastien Redant, Herbert D Spapen
No abstract text is available yet for this article.
March 8, 2019: Annals of Intensive Care
https://read.qxmd.com/read/30848433/therapeutic-hypernatremia-management-during-continuous-renal-replacement-therapy-with-elevated-intracranial-pressures-and-respiratory-failure
#14
REVIEW
Tibor Fülöp, Lajos Zsom, Rafael D Rodríguez, Jorge O Chabrier-Rosello, Mehrdad Hamrahian, Christian A Koch
Cerebral edema and elevated intracranial pressure (ICP) are common complications of acute brain injury. Hypertonic solutions are routinely used in acute brain injury as effective osmotic agents to lower ICP by increasing the extracellular fluid tonicity. Acute kidney injury in a patient with traumatic brain injury and elevated ICP requiring renal replacement therapy represents a significant therapeutic challenge due to an increased risk of cerebral edema associated with intermittent conventional hemodialysis...
March 8, 2019: Reviews in Endocrine & Metabolic Disorders
https://read.qxmd.com/read/30844791/the-effect-of-serum-neutrophil-gelatinase-associated-lipocalin-on-the-discontinuation-of-continuous-renal-replacement-therapy-in-critically-ill-patients-with-acute-kidney-injury
#15
Xiaohan Chen, Zhiwen Chen, Tiantian Wei, Peiyun Li, Ling Zhang, Ping Fu
BACKGROUND: To determine the optimal time for discontinuing continuous renal replacement therapy (CRRT) by evaluating serum neutrophil gelatinase-associated lipocalin (NGAL) in critically ill patients with acute kidney injury (AKI). METHODS: A prospective observational study was conducted from September 2015 to March 2018. AKI patients treated with CRRT for at least 24 h were divided into "success" and "failure" groups according to their RRT requirement within 7 days after the initial discontinuation of CRRT...
March 7, 2019: Blood Purification
https://read.qxmd.com/read/30843338/vascular-access-in-patients-treated-with-continuous-renal-replacement-therapy-a-report-from-a-single-center-in-china
#16
Hongqi Ren, Yongchun Ge, Xu He, Chuan Li, Bin Xu, Dehua Gong, Zhihong Liu
OBJECTIVE: To analyze the practice pattern of vascular access use and complication rates in patients receiving continuous renal replacement therapy from a large Chinese urban medical center. METHODS: Patients who had received CRRT from April to October, 2014 in our center were included in this study. Demographic data, primary disease, department for hospitalization, blood pressure, heart rate, SOFA score, APACHE II score, presence of mechanical ventilation, CRRT modalities, choice of functioning vascular access, site and duration of catheter insertion, presence of recatheterization, cumulative catheter indwelling time, catheter malfunction and catheter-related infections, as well as laboratory test results, were collected...
March 7, 2019: Therapeutic Apheresis and Dialysis
https://read.qxmd.com/read/30843114/feeding-modality-is-a-barrier-to-adequate-protein-provision-in-children-receiving-continuous-renal-replacement-therapy-crrt
#17
Molly Wong Vega, Marisa Juarez Calderon, Naile Tufan Pekkucuksen, Poyyapakkam Srivaths, Ayse Akcan Arikan
BACKGROUND: Critically ill children have a high prevalence of malnutrition. Children with acute kidney injury experience high rates of protein debt. Previous research has indicated that protein provision is positively associated with survival. METHODS: This was a prospective observational study of all patients receiving CRRT for greater than 48 h at our tertiary care institution. Patients with inborn errors of metabolism were excluded. Data collection included energy, protein, and fluid volume intakes, anthropometrics, feeding modality, and route of nutrition intake...
March 6, 2019: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://read.qxmd.com/read/30842962/therapeutic-plasma-exchange-and-continuous-renal-replacement-therapy-for-severe-hyperthyroidism-and-multi-organ-failure-a-case-report
#18
Jun-Hui Ba, Ben-Quan Wu, Yan-Hong Wang, Yun-Feng Shi
BACKGROUND: Severe hyperthyroidism is a life-threatening exacerbation of thyrotoxicosis, characterized by high fever and multiorgan failure. The most common medical treatments are administration of antithyroid drugs and radioactive iodine, and thyroidectomy. In some patients, antithyroid therapy is limited due to serious adverse effects or failure to control disease progression. In some extreme cases, such as thyroid storm, conventional therapy alone does not yield effective and rapid improvement before the development of multiorgan failure...
February 26, 2019: World Journal of Clinical Cases
https://read.qxmd.com/read/30820972/experience-of-extracorporeal-cardiopulmonary-resuscitation-in-a-refractory-cardiac-arrest-patient-at-the-emergency-department
#19
Kap Su Han, Su Jin Kim, Eui Jung Lee, Jae Seung Jung, Jae Hyoung Park, Sung Woo Lee
INTRODUCTION: Extracorporeal cardiopulmonary resuscitation (ECPR) is a method to improve survival outcomes in refractory cardiac arrest. HYPOTHESIS: This study aimed to determine the associated factors related to outcome and to analyse the post-ECPR management in patients who received ECPR due to non-response to advanced cardiac life support (ACLS). METHODS: This was a retrospective analysis based on a prospective cohort. Cardiac arrest patients who received ECPR in our emergency department from May 2006 to December 2017 were selected from the prospective cohort...
February 28, 2019: Clinical Cardiology
https://read.qxmd.com/read/30819019/the-relationship-and-threshold-of-serum-phosphate-with-regard-to-the-28-day-mortality-risk-in-sepsis-patients-undergoing-continuous-renal-replacement-therapy
#20
Hai Wang, Zheng-Hai Bai, Jun-Hua Lv, Jiang-Li Sun, Yu Shi, Zheng-Liang Zhang, Hong-Hong Pei
OBJECTIVE: To investigate the association between serum phosphate levels and the risk of 28-day mortality in critically-ill patients with septic acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT). METHODS: This retrospective cohort study analysed data from critically-ill patients with septic AKI who underwent CRRT between January 2009 and September 2016. Demographic, clinical and routine biochemical data were retrieved from a database and analysed to identify risk factors for 28-day mortality...
February 28, 2019: Journal of International Medical Research
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