Articles: urine-output.
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Excess fluid balance in acute kidney injury (AKI) may be harmful, and conversely, some patients may respond to fluid challenges. This study aimed to develop a prediction model that can be used to differentiate between volume-responsive (VR) and volume-unresponsive (VU) AKI. ⋯ The XGBoost model was able to differentiate between patients who would and would not respond to fluid intake in urine output better than a traditional logistic regression model. This result suggests that machine learning techniques have the potential to improve the development and validation of predictive modeling in critical care research.
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Chin. J. Traumatol. · Apr 2019
Effectiveness of Parkland formula in the estimation of resuscitation fluid volume in adult thermal burns.
Acute burn resuscitation in initial 24 h remains a challenge to plastic surgeons. Though various formulae for fluid infusion are available but consensus is still lacking, resulting in under resuscitation or over resuscitation. Parkland formula is widely used but recently its adequacy is questioned in studies. This study was conducted to see how closely the actual volume of fluid given in our center matches with that of calculated volume by Parkland formula. ⋯ The study showed a significant difference in the fluid infused based on urine output and the fluid calculated by Parkland formula. This probably is because fluid infused based on end point of resuscitation was more physiological than fluid calculated based on formulae.
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Acute kidney injury (AKI) is a frequent complication after living donor liver transplantation (LDLT), and is associated with increased mortality. However, the association between intraoperative oliguria and the risk of AKI remains uncertain for LDLT. We sought to determine the association between intraoperative oliguria alone and oliguria coupled with hemodynamic derangement and the risk of AKI after LDLT. ⋯ AUC with neither oliguria nor SvO₂ reduction 0.68; 95% CI 0.64⁻0.72; p < 0.0001). Intraoperative oliguria coupled with a decrease in SvO₂ may suggest the risk of AKI after LDLT more reliably than oliguria alone or decrease in SvO₂ alone. Intraoperative oliguria should be interpreted in conjunction with SvO₂ to predict AKI in patients with normal preoperative renal function and who did not receive hydroxyethyl starch during surgery.
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Journal of critical care · Dec 2017
Randomized Controlled TrialThe effect of low-dose furosemide in critically ill patients with early acute kidney injury: A pilot randomized blinded controlled trial (the SPARK study).
Furosemide is commonly prescribed in acute kidney injury (AKI). Prior studies have found conflicting findings on whether furosemide modifies the course and outcome of AKI. ⋯ In this pilot trial, furosemide did not reduce the rate of worsening AKI, improve recovery or reduce RRT; however, was associated with greater electrolyte abnormalities.
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Journal of critical care · Aug 2017
Multicenter StudyClinical variables associated with poor outcome from sepsis-associated acute kidney injury and the relationship with timing of initiation of renal replacement therapy.
Identify clinical variables associated with mortality in patients with sepsis-associated acute kidney injury (SA-AKI) receiving continuous renal replacement therapy (CRRT) and examine timing of initiation of CRRT in reference to those variables identified. ⋯ In patients with SA-AKI, survival is lower when CRRT is started in the setting of low urine output.