Abstract:
PURPOSE OF REVIEW:The present article reviews the recent literature on the main aspects of perioperative acute kidney injury (AKI). RECENT FINDINGS:AKI occurs in 1 in every 10 surgical patients, with cardiac, orthopedic, and major abdominal surgeries being the procedures associated with the highest risk. Overall, complex operations, bleeding, and hemodynamic instability are the most consistent procedure-related risk factors for AKI. AKI increases hospital stay, mortality, and chronic kidney disease, gradually with severity. Furthermore, delayed renal recovery negatively impacts on patients' outcomes. Cell cycle arrest biomarkers seem promising to identify high-risk patients who may benefit from the bundles recommended by the Kidney Disease: Improving Global Outcomes guidelines. Hemodynamic management using protocol-based administration of fluids and vasopressors helps reducing AKI. Recent studies have highlighted the benefit of personalizing the blood pressure target according to the patient's resting reference, and avoiding both hypovolemia and fluid overload. Preliminary research has reported encouraging renoprotective effects of angiotensin II and nitric oxide, which need to be confirmed. Moreover, urinary oxygenation monitoring appears feasible and a fair predictor of postoperative AKI. SUMMARY:AKI remains a frequent and severe postoperative complication. A personalizedmulticomponent approach might help reducing the risk of AKI and improving patients' outcomes.
journal_name
Curr Opin Crit Carejournal_title
Current opinion in critical careauthors
Canet E,Bellomo Rdoi
10.1097/MCC.0000000000000560subject
Has Abstractpub_date
2018-12-01 00:00:00pages
568-574issue
6eissn
1070-5295issn
1531-7072journal_volume
24pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Glutamine (GLN) is a versatile amino acid, long believed to have important implications in ICU and surgical patients. An extensive body of data examining GLN supplementation of TPN demonstrated a consistent signal of improved outcomes. However, recently signals of risk have come from two large-scale m...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000633
更新日期:2019-08-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide an update on the progress of the multicenter, randomized, controlled trial of corticosteroids after significant head injury (CRASH). RECENT FINDINGS:After a successful pilot phase, the main phase of the CRASH Trial began in March 2001. By June 2002, 107 hospitals from 31 countries were par...
journal_title:Current opinion in critical care
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00075198-200304000-00003
更新日期:2003-04-01 00:00:00
abstract:PURPOSE OF REVIEW:We report on recent advances and achievements on the use of extracorporeal gas exchange for long-term application in the therapy of critically ill patients with various forms of respiratory failure. RECENT FINDINGS:The most important results regarding the use of extracorporeal gas exchange are expect...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283220e1f
更新日期:2009-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Postoperative sepsis is a major cause of surgical associated morbidity and mortality. Our goal is to describe its incidence, pathophysiology, and contributing factors. In addition, we will review preventive measures and treatment options that may possibly reduce its healthcare burden. RECENT FINDINGS...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328348bee2
更新日期:2011-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Management of the patient with traumatic brain injury is a rapidly advancing field, characterized in recent years by an improved understanding of intracranial pathophysiology and ways in which outcomes can be improved. Many traditional therapies, such as fluid restriction and hyperventilation, have be...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200312000-00007
更新日期:2003-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The ultimate goal of cardiopulmonary resuscitation is long-term neurologically intact survival. Despite numerous well-designed studies, the medications currently used in advanced cardiac life support have not demonstrated success in this regard. This review describes the novel therapeutics under inves...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328364d7b1
更新日期:2013-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To examine recent developments in preventing and treating postoperative acute renal dysfunction. To review contemporary issues concerning perioperative fluid and electrolyte management. RECENT FINDINGS:Renal dysfunction remains a major postoperative morbidity despite the advent of intermittent and co...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328348bef5
更新日期:2011-08-01 00:00:00
abstract:PURPOSE OF REVIEW:From an elderly patient's perspective, acute and chronic cognitive disturbances are among the most harmful complications that can occur following surgery. For elderly patients, these complications often mean the end of an independent life. This article focuses on this serious aspect, which is increasi...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000327
更新日期:2016-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Severe acute respiratory syndrome (SARS) is a new disease that caused large outbreaks in several countries in the first half of 2003, resulting in infection in more than 8000 people and more than 900 deaths. During that time, a large body of literature rapidly emerged describing the clinical disease, ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200402000-00009
更新日期:2004-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Acute liver failure (ALF) is associated with significant mortality. Although specific therapies may be available, the evidence base for these and for many aspects of supportive therapy has been slow to emerge. Liver transplantation continues to be a cornerstone of treatment, and the management of ALF,...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000073
更新日期:2014-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive damage control procedure for life-threatening abdominal or pelvic haemorrhage. The purpose of this review is to summarize the current understanding and experience with REBOA, outline potential future applications...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000367
更新日期:2016-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To investigate the impact of critical illness polyneuropathy and critical illness myopathy on short-term and long-term patient outcome. RECENT FINDINGS:In the acute-care setting, critical illness polyneuropathy and critical illness myopathy are important causes of acute paralysis in critically ill co...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000168530.30702.3e
更新日期:2005-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Fluid removal and relief of congestion are central to treatment of acute heart failure. Diuretics have been the decongestive mainstay but their known limitations have led to the exploration of alternative strategies. This review compares diuretics with ultrafiltration and examines the recent evidence ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000134
更新日期:2014-10-01 00:00:00
abstract:PURPOSE OF REVIEW:This article reviews the current literature dealing with pathophysiology, diagnostics, bleeding management, and thromboprophylaxis in patients with acute and chronic liver dysfunction. RECENT FINDINGS:Routine coagulation tests such as prothrombin time and International Normalized Ratio (INR) are not ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32835ebb52
更新日期:2013-04-01 00:00:00
abstract:PURPOSE OF REVIEW:We sought to review the evidence supporting neurocritical care as a distinct specialty of medicine. RECENT FINDINGS:Over the past 20 years, neuro-intensive care units have evolved from neurosurgical units focused primarily on postoperative monitoring to units that provide comprehensive medical and sp...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32808255c6
更新日期:2007-04-01 00:00:00
abstract::Increased knowledge of the mechanisms that determine respiratory failure has led to the development of new technologies aimed at improving ventilatory treatment. Proportional assist ventilation and neurally adjusted ventilatory assist have been designed with the goal of improving patient-ventilator interaction by matc...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200302000-00010
更新日期:2003-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Continuous electroencephalography (cEEG) is being used more frequently in intensive care units to detect epileptic activity and ischemia. This review analyzes clinical applications and limitations of cEEG as a routine neuromonitoring tool. RECENT FINDINGS:cEEG is primarily used to detect nonconvulsiv...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3283294947
更新日期:2009-04-01 00:00:00
abstract::Cardiac arrest survival rates remain low despite increased access to advanced cardiac life support. Survival from cardiac arrest is, at least in part, related to the perfusion pressures and blood flow achieved during cardiopulmonary resuscitation (CPR). A number of alternative CPR devices have been developed that aim ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200206000-00004
更新日期:2002-06-01 00:00:00
abstract:PURPOSE OF REVIEW:The pulmonary artery catheter is one of the most scrutinized monitors used in intensive care today. Pulmonary artery catheter use is declining due to limited demonstrated beneficial outcomes and the advancement of less invasive monitoring. This study discusses the current use of the pulmonary artery c...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32832b302b
更新日期:2009-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Statins are effective lipid-lowering agents used extensively in medical practice. This review summarizes the evidence for statin treatment of cardiovascular patients in the intensive care unit and briefly discusses the role of statins in prevention and treatment of sepsis as a potential future applica...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000235207.00322.96
更新日期:2006-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Although providing palliative care in the ICU has become a priority, the success of different methods to integrate palliative care into the ICU has varied. This review examines the current evidence supporting the different models of palliative care delivery and highlights areas for future study. RECE...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000149
更新日期:2014-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review is to provide an update of recent developments pertaining to the use of percutaneous tracheostomy. Percutaneous tracheostomy has been established as an alternative to open surgical tracheostomy, but many key questions about the optimal use of this procedure remain unanswered...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000170680.09759.f2
更新日期:2005-08-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide a summary of the recent literature on extracorporeal membrane oxygenation (ECMO) in adults with severe acute respiratory distress syndrome (ARDS), focusing on advances in equipment, current conventional and unconventional indications, complications, and future applications. RECENT FINDINGS...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000170
更新日期:2015-02-01 00:00:00
abstract:PURPOSE OF REVIEW:When classic examinations such as bronchoalveolar lavage are not contributory in the etiologic diagnosis of unresolving acute respiratory distress syndrome, surgical lung biopsy would appear to be useful to determine the specific cause, particularly infection or postaggressive fibrosis, which could be...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3282f33e42
更新日期:2008-02-01 00:00:00
abstract:PURPOSE OF REVIEW:This article reviews current concepts in perioperative pulmonary management. RECENT FINDINGS:Preoperative risk assessment tools for perioperative pulmonary complications (POPCs) are evolving for both children and adults. Intraoperative management strategies have a demonstrable effect on outcomes. Lat...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328348bfc8
更新日期:2011-08-01 00:00:00
abstract:PURPOSE OF REVIEW:To describe recent data about Acinetobacter baumannii pneumonia epidemiology and the therapeutic options including adjunctive nebulized therapy. RECENT FINDINGS:A. baumannii is a major cause of nosocomial pneumonia in certain geographic areas affecting mainly debilitated patients, with prolonged hosp...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000649
更新日期:2019-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Securing the airway to provide sufficient oxygenation and ventilation is of paramount importance in the management of all types of emergency patients. Particularly in severely injured patients, strategies should be adapted according to useful recent literature findings. RECENT FINDINGS:The role of ou...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000160
更新日期:2014-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite the improvements in its management, community-acquired pneumonia (CAP) still exhibits high global morbidity and mortality rates, especially in elderly patients. This review focuses on the most recent findings on the epidemiology, cause, diagnosis and management of CAP. RECENT FINDINGS:There i...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000550
更新日期:2018-12-01 00:00:00
abstract::The purpose of this report is to provide information regarding preparation for disaster management from the perspective of ICU physicians. Both a framework toward ICU preparation for disaster management and a guide to the relevant literature are presented. Our objective is to show that the understanding of disaster pr...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200212000-00021
更新日期:2002-12-01 00:00:00
abstract:PURPOSE OF REVIEW:In light of emerging data from clinical trials, the place of high-frequency oscillatory ventilation (HFOV) in the management of acute respiratory distress syndrome (ARDS) is uncertain. This review provides an overview of these new clinical data and also explores new areas of investigation for HFOV in ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000387
更新日期:2017-04-01 00:00:00