Journal of critical care
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Journal of critical care · Feb 2025
LetterElectrical impedance tomography to set high pressure in time-controlled adaptive ventilation.
TCAV (Time controlled adaptive ventilation), a combination of settings applied to the APRV (airway pressure release ventilation) mode, provides personalized ventilation tailored to the lung condition in ARDS (acute respiratory distress syndrome). The objective was to evaluate whether electrical impedance tomography (EIT) could serve as a tool for guiding Phigh level in TCAV for ARDS patients. ⋯ EIT enabled detection of regional ventilation distribution on TCAV during a decremental Phigh trial and thus enabled the determination of a best EIT-derived-Phigh through an individualized approach, achieving best compromise between overdistension and collapse. The observed overdistention variability highlights the necessity of Phigh level personalization on TCAV.
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Journal of critical care · Feb 2025
Meta AnalysisProtective effect of intravenous amino acid on kidney function: A systematic review and meta-analysis of randomized controlled trials.
Acute kidney injury (AKI) is a common complication in critically ill and cardiac surgery patients. Intravenous amino acids can increase renal perfusion and replenish renal functional reserves. However, the exact therapeutic efficacy of intravenous amino acids in reducing the incidence of AKI remains uncertain. Therefore, this study aims to comprehensively review the existing evidence to assess the potential of intravenous amino acids in kidney protection. ⋯ Intravenous amino acids protect renal function in patients at high risk of AKI, particularly after cardiac surgery. It reduces the incidence of AKI and increases urine output, but has no significant effect on KRT and mortality.