Articles: critical-illness.
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Ann Acad Med Singap · Aug 2023
Multicenter Study Observational StudyAssociation of anticoagulation use during continuous kidney replacement therapy and 90-day outcomes: A multicentre study.
Anticoagulation is recommended during continuous kidney replacement therapy (CKRT) to prolong the filter lifespan for optimal filter performance. We aimed to evaluate the effect of anticoagulation during CKRT on dialysis dependence and mortality within 90 days of intensive care unit (ICU) admission. ⋯ Among critically ill patients with AKI, anticoagulation use during CKRT was associated with reduced dialysis or death at 90 days post-ICU admission, which was statistically significant for regional citrate anticoagulation and trended in the same direction of benefit for systemic heparin anticoagulation. Anticoagulation during CKRT should be considered whenever possible.
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Resilient prescribing is an approach to the use of psychotropics that considers the significance of the treatment beyond the direct effects of the medication. Within this strengths-based approach, those who are prescribed medications must retain a sense of self-efficacy, understand the importance of their own actions in their recovery, have reasonable expectations of what a medication can and cannot do, and avoid the adoption of a disempowering illness identity. ⋯ In this manuscript, we explore these principles with consideration for how they may be applied in deployed settings where the ability of service members to recover from behavioral health concerns is mission critical. These principles offer a roadmap to prescribing that builds upon the service members' own strengths and has the potential to amplify the positive impacts of mental health treatment.