Journal of critical care
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Journal of critical care · Aug 2021
Multicenter Study Observational StudyFluid management in patients with acute kidney injury - A post-hoc analysis of the FINNAKI study.
Whether positive fluid balance among patients with acute kidney injury (AKI) stems from decreased urine output, overzealous fluid administration, or both is poorly characterized. ⋯ AKI patients received more fluids albeit having lower fluid output compared to matched critically ill non-AKI patients. Smaller volumes of fluid input and higher fluid output were associated with better AKI recovery.
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Journal of critical care · Aug 2021
Cardio-pulmonary-renal interactions in ICU patients. Role of mechanical ventilation, venous congestion and perfusion deficit on worsening of renal function: Insights from the MIMIC-III database.
Background Mechanical ventilation (MV) in ICU patients may impact hemodynamics and renal function. We aimed to describe the interactions of MV settings, hemodynamic parameters and worsening of renal function (WRF). Methods We included adult patients admitted for the first time in the ICU from the MIMIC-III database. ⋯ Conclusion In this large cohort of ICU patients, we observed a strong relationship between MV and WRF. PEEP was associated with WRF in MV patients. This association relied at least partly on renal venous congestion.
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Journal of critical care · Aug 2021
Acute Respiratory Distress Syndrome (ARDS) after trauma: Improving incidence, but increasing mortality.
Acute Respiratory Distress Syndrome (ARDS) is an infrequent, yet morbid inflammatory complication in injury victims. With the current project we sought to estimate trends in incidence, determine outcomes, and identify risk factors for ARDS and related mortality. ⋯ Although the incidence of ARDS after trauma appears to be declining, mortality is on the rise.
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Journal of critical care · Aug 2021
Impact of sterile leukocyturia on outcome of critically ill patients with severe acute kidney injury.
The role of immunological mechanisms on renal regeneration and functional recovery after an episode of Acute Kidney Injury (AKI) is still understudied. We aim to evaluate the impact of sterile leukocyturia on outcomes of critically-ill AKI patients. ⋯ Sterile leukocyturia was associated with different patient baseline and AKI characteristics and more persistent AKI by both KDIGO criteria. Sterile leukocyturia may represent a surrogate marker of renal inflammation during AKI.
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Journal of critical care · Aug 2021
Review Meta AnalysisA systematic review and meta-analysis of propofol versus midazolam sedation in adult intensive care (ICU) patients.
Compare outcomes of adult patients admitted to ICU- length of ICU stay, length of mechanical ventilation (MV), and time until extubation- according to the use of propofol versus midazolam. ⋯ Sedation with propofol compared to midazolam is associated with improved clinical outcomes in ICU, with reduced ICU stay MV time and extubation time in acute surgical patients and reduced extubation time in critically-ill patients.