Abstract:
PURPOSE:Acute kidney injury (AKI) frequently occurs in critically ill patients and often precipitates use of renal replacement therapy (RRT). However, the ideal circumstances for whether and when to start RRT remain unclear. We performed evidence synthesis of the available literature to evaluate the value of biomarkers to predict receipt of RRT for AKI. METHODS:We conducted a PRISMA-guided systematic review and meta-analysis including all trials evaluating biomarker performance for prediction of RRT in AKI. A systematic search was applied in MEDLINE, Embase, and CENTRAL databases from inception to September 2017. All studies reporting an area under the curve (AUC) for a biomarker to predict initiation of RRT were included. RESULTS:Sixty-three studies comprising 15,928 critically ill patients (median per study 122.5 [31-1439]) met eligibility. Forty-one studies evaluating 13 different biomarkers were included. Of these biomarkers, neutrophil gelatinase-associated lipocalin (NGAL) had the largest body of evidence. The pooled AUCs for urine and blood NGAL were 0.720 (95% CI 0.638-0.803) and 0.755 (0.706-0.803), respectively. Blood creatinine and cystatin C had pooled AUCs of 0.764 (0.732-0.796) and 0.768 (0.729-0.807), respectively. For urine biomarkers, interleukin-18, cystatin C, and the product of tissue inhibitor of metalloproteinase-2 and insulin growth factor binding protein-7 showed pooled AUCs of 0.668 (0.606-0.729), 0.722 (0.575-0.868), and 0.857 (0.789-0.925), respectively. CONCLUSION:Though several biomarkers showed promise and reasonable prediction of RRT use for critically ill patients with AKI, the strength of evidence currently precludes their routine use to guide decision-making on when to initiate RRT.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Klein SJ,Brandtner AK,Lehner GF,Ulmer H,Bagshaw SM,Wiedermann CJ,Joannidis Mdoi
10.1007/s00134-018-5126-8subject
Has Abstractpub_date
2018-03-01 00:00:00pages
323-336issue
3eissn
0342-4642issn
1432-1238pii
10.1007/s00134-018-5126-8journal_volume
44pub_type
杂志文章,评审abstract:PURPOSE:Early central venous catheter (CVC) insertion in Ebola virus disease (EVD) is a novel approach and has not previously been described. This report delineates the safety, feasibility and clinical implications of early CVC insertion as the optimum means of vascular access in patients with EVD, in the setting of a ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-015-3736-y
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:Atracurium besylate and laudanosine cause excitement and seizures when introduced into the central nervous system of laboratory animals. We examined the modulation of lipid-protein interaction in the lipid environment of rat brain synaptosomal plasma membrane (SPM)-bound enzymes as a possible mechanism leadin...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050605
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVE:To examine the usefulness of preload indices obtained by transoesophageal echocardiography (TOE) for estimating stroke volume at various levels of cardiac index. DESIGN:Prospective clinical study. SETTING:Intensive care unit with surgical patients. PATIENTS:16 ventilated patients monitored via Swan-Ganz ca...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050349
更新日期:1997-04-01 00:00:00
abstract:PURPOSE:To investigate the relationship between hemoglobin (Hgb) and brain tissue oxygen tension (PbtO(2)) after severe traumatic brain injury (TBI) and to examine its impact on outcome. METHODS:This was a retrospective analysis of a prospective cohort of severe TBI patients whose PbtO(2) was monitored. The relationsh...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2593-1
更新日期:2012-09-01 00:00:00
abstract:PURPOSE:Acute kidney injury (AKI) frequently occurs after heart transplantation (HTx), but its relation to preoperative right heart hemodynamic (RHH) parameters remains unknown. Therefore, we aimed to determine their predictive properties for postoperative AKI severity within 30 days after HTx. METHODS:From 1984 to 20...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-018-5159-z
更新日期:2018-05-01 00:00:00
abstract:PURPOSE:To compare the concentration conformity of infusion solutions manually prepared on intensive care units (ICU) with solutions from pharmacy-based, automated production. METHODS:A prospective observational study conducted in a university hospital in Germany. Drug concentrations of 100 standardised infusion solut...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2230-4
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:Biomarkers allowing accurate early staging of septic shock patients are lacking despite their obvious interest for patient management. Experimental models of septic shock in mouse previously noted a decrease in dendritic cell numbers. The aim of the study was to find a rapid reproducible biological test for a...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0436-7
更新日期:2007-01-01 00:00:00
abstract::In the past two years several guidelines for suggested components of emergency medical systems for children have been suggested, and for the first time, specific standards of pediatric trauma care have also been formulated. The American Academy of Pediatrics new Provisional Committee on Emergency Medicine has been cha...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00260888
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the physiological effects of decannulation on breathing patterns and respiratory mechanics by comparing mouth breathing (MB) to tracheal breathing (TB) in tracheostomized patients. DESIGN AND SETTING:Prospective cross-over study in a critical and neuromuscular care unit. PATIENTS AND METHODS:Nin...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1545-6
更新日期:2002-12-01 00:00:00
abstract::The process of surgical decision making is based on both general principles that are amenable to evaluation using rigorous techniques of clinical research and the intangible element of surgical judgment that seeks to apply those principles to the care of an individual patient. The role of surgical judgment is inescapa...
journal_title:Intensive care medicine
pub_type: 指南,杂志文章,实务指引,评审
doi:10.1007/pl00003797
更新日期:2001-01-01 00:00:00
abstract::Marked respiratory insufficiency was established in 20 of 91 patients with acute pancreatitis. 16 of them died, 12 from uncontrollable hypoxaemia. At postmortem the most prominent finding was microatelectasis, the occurrence of which correlated highly with the serum amylase activity. ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01683069
更新日期:1977-08-01 00:00:00
abstract::Meta-analyses and several large cohort studies have demonstrated that antiseptic mouthwashes are associated with mortality in hospitalized patients. A clear pathogenic mechanism is lacking, leading to controversy and a reluctance to abandon or limit the use of antiseptic mouthwashes. Here, we generate the hypothesis t...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-020-06276-z
更新日期:2021-01-01 00:00:00
abstract:PURPOSE:To determine the incidence of and risk factors for adverse cardiac events during catecholamine vasopressor therapy in surgical intensive care unit patients with cardiovascular failure. METHODS:The occurrence of any of seven predefined adverse cardiac events (prolonged elevated heart rate, tachyarrhythmia, myoc...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2531-2
更新日期:2012-06-01 00:00:00
abstract:PURPOSE:A retrieval program was developed in New South Wales (NSW), Australia to provide extracorporeal membrane oxygenation support (ECMO) for the safe transport of adults with severe, acute respiratory or cardiac failure. We describe the development and results of this program and the impact of the 2009 H1N1 epidemic...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-011-2158-8
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:Evaluating the prevalence, risk factors and prevention of pressure ulcers in Dutch intensive care units (ICUs). DESIGN:Cross-sectional design. SETTING:ICUs of acute care hospitals that participated in the 1998 and 1999 national prevalence surveys. Data were collected on 1 day in each year. PATIENTS:Eight h...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340101061
更新日期:2001-10-01 00:00:00
abstract:PURPOSE:The clinical significance of septic myocardial dysfunction is controversial, a fact that may be explained by the influence of loading conditions. Many indices may be useful to characterize cardiac function during septic shock, but their feasibility and physiological coherence in the clinical setting are unknown...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-017-4698-z
更新日期:2017-05-01 00:00:00
abstract::A randomized study of 30 patients undergoing uncomplicated surgery under spinal anesthesia was conducted to assess the influence of colloids on the kinetics of plasma fibronectin and complement. Both are opsonins of the reticuloendothelial system; moreover fibronectin is concerned with host resistance against septic c...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01691428
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the incidence and the circumstances of a moderate increase in serum creatinine early after elective abdominal aortic surgery. DESIGN:Prospective clinical observational study. SETTING:Surgical intensive care unit in a university hospital. PATIENTS:Two hundred and fifteen consecutive adult patien...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1958-x
更新日期:2003-10-01 00:00:00
abstract::Arrhythmias are extremely common early after AMI. An arrhythmia is defined by exclusion, either because the sequence of myocardial depolarisation is other than normal or because certain arbitrary limits are exceeded. It follows that the term "arrhythmia" encompasses a complex heterogenous group. Although arrhythmias a...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01683131
更新日期:1978-01-01 00:00:00
abstract:BACKGROUND:Limiting the duration of invasive ventilation is an important goal in caring for critically ill patients. Several clinical trials have shown that compared to traditional care, protocols can reduce the total duration of mechanical ventilation. Computerized or automated weaning has the potential to improve wea...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-008-1154-0
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To measure water balance and changes in distribution, and the effect of giving supplementary albumin, early after a burn injury. DESIGN:Consecutive patients (matched groups) and healthy controls. SETTING:National burn unit in a Swedish university hospital. PATIENTS AND SUBJECTS:Eighteen patients with 18%-9...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340100935
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Dislocation of the heart is a rare complication of thoracic blunt trauma. A high index of suspicion of pericardium rupture is necessary to formulate an early diagnosis to reduce morbidity and mortality. PATIENTS:A 23-year-old man suffered a blunt thoracoabdominal trauma and was admitted 3 days later to a un...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1328-0
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE:To assess the ability of the Clinical Risk Index for Babies (CRIB) to predict long-term neurodevelopmental impairment in very low birth weight (VLBW) infants. DESIGN:Single-center cohort study. SETTING:Tertiary neonatal care hospital and follow-up clinic. PATIENTS:Four hundred fifty-five VLBW infants conse...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051157
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To explore the consequences of helium/oxygen (He/O(2)) inhalation on respiratory mechanics, gas exchange, and ventilation-perfusion (VA/Q) relationships in an animal model of severe induced bronchospasm during mechanical ventilation. DESIGN:Prospective, interventional study. SETTING:Experimental animal labo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1779-y
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:Aspiration of dead space (ASPIDS) improves carbon dioxide (CO2) elimination by replacing dead space air rich in CO2 with fresh gas during expiration. The hypothesis was that ASPIDS allows normocapnia to be maintained at low tidal volumes (VT). DESIGN:Prospective study. SETTING:Adult intensive care unit in a...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050929
更新日期:1999-07-01 00:00:00
abstract:PURPOSE:Assessing feasibility and physiological effects of sedation with sevoflurane, administered with the anesthetic conserving device (AnaConDa), in comparison with propofol and remifentanil. METHODS:Seventeen patients undergoing mechanical ventilation underwent sedation with sevoflurane delivered with AnaConDa (ph...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-009-1414-7
更新日期:2009-07-01 00:00:00
abstract::In critically ill patients, it is frequently challenging to identify who will benefit from admission to the intensive care unit and life-sustaining interventions when the chances of a meaningful outcome are unclear. In addition, the acute illness not only affects the patients but also family members or surrogates who ...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-018-5339-x
更新日期:2018-09-01 00:00:00
abstract:PURPOSE:To assess the utility of two in situ techniques, differential time to positivity (DTP) and semiquantitative superficial cultures (SQSC) for diagnosing catheter-related bloodstream infection (CR-BSI) in critically ill adults. METHODS:This was a prospective cohort study in patients with suspected CR-BSI arising ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2689-7
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVES:To compare the effects of norepinephrine and dobutamine to epinephrine on hemodynamics, lactate metabolism, and gastric tonometric variables in hyperdynamic dopamine-resistant septic shock. DESIGN:A prospective, intervention, randomized clinical trial. SETTING:Adult medical/surgical intensive care unit in ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s001340050329
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:It remains uncertain why immunocompetent patients with bacterial community-acquired pneumonia (CAP) die, in spite of adequate antibiotics. METHODS:This is a secondary analysis of the CAPUCI database which was a prospective observational multicentre study. Two hundred and twelve immunocompetent patients admi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1363-6
更新日期:2009-03-01 00:00:00