Intensive care medicine
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Intensive care medicine · Jan 2025
Role of major cardiovascular surgery-induced metabolic reprogramming in acute kidney injury in critical care.
Major cardiovascular surgery imposes high physiologic stress, often causing severe organ dysfunction and poor outcomes. The underlying mechanisms remain unclear. This study investigated metabolic changes induced by major cardiovascular surgery and the potential role of identified metabolic signatures in postoperative acute kidney injury (AKI). ⋯ Major cardiovascular surgery, particularly with CPB, induces significant changes in protein metabolism. Patients developing postoperative AKI exhibited specific metabolic signatures. These findings may be critical for designing interventions to minimize organ dysfunction, including AKI, and improve outcomes in major cardiovascular surgery.
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Intensive care medicine · Jan 2025
The association between pain, analgesia, and delirium among critically ill adults: a systematic review and meta-analysis.
We performed a systematic review with meta-analysis examining the relationship between pain or pain medications and delirium occurence, duration, and severity. ⋯ We observed an association between pain and incident delirium among critically ill adults. Exposure to morphine or fentanyl (but no other pain medications) was associated with increased risk of delirium occurrence.