Abstract:
BACKGROUND:Changes in mean perfusion pressure (MPP) from premorbid resting values may contribute to the progression of septic acute kidney injury (AKI). OBJECTIVES:In patients with septic shock, we aimed to investigate the association of changes from premorbid values with AKI severity and progression. METHODS:We obtained premorbid resting mean arterial pressure (MAP), central venous pressure (CVP), and MPP, and then recorded data from intensive care unit admission 2 hourly for the first 24 hours to calculate hemodynamic deficits. We recorded 4-hourly creatinine measurements for 96 hours. The association of hemodynamic variables with progression of AKI by Kidney Disease: Improving Global Outcomes ≥2 stages was explored by multivariate logistic regression. RESULTS:Of 107 patients, 55 (51.4%) had severe AKI. Median MAP deficit was similar for patients with or without severe AKI. Median MPP deficit was 29% in patients with severe AKI and 24% in those without (P = .04), a difference determined by greater CVP levels. Central venous pressure was independently associated with worsening AKI (odds ratio, 1.26 [95% confidence interval, 1.01-1.58]; P = .04). CONCLUSIONS:Mean arterial pressure and MPP deficits were substantial in septic shock patients, with patients with severe AKI having a greater MPP deficit. However, only CVP was independently associated with AKI progression. These findings suggest a possible role for venous congestion in septic AKI.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Wong BT,Chan MJ,Glassford NJ,Mårtensson J,Bion V,Chai SY,Oughton C,Tsuji IY,Candal CL,Bellomo Rdoi
10.1016/j.jcrc.2015.05.003subject
Has Abstractpub_date
2015-10-01 00:00:00pages
975-81issue
5eissn
0883-9441issn
1557-8615pii
S0883-9441(15)00270-1journal_volume
30pub_type
杂志文章abstract:INTRODUCTION:Percutaneous dilational tracheostomy (PDT) is routinely performed in the intensive care unit with bronchoscopic guidance. Recently, ultrasound (US) has emerged as a new safety adjunct tool to increase the efficacy of PDT. However, the available data are limited to case series without any control group. Hen...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.09.011
更新日期:2015-02-01 00:00:00
abstract:PURPOSE:To identify early mortality-associated clinical risk factors preceding, during, and after cardiac surgery in children. MATERIALS AND METHODS:Of the 722 children admitted to our pediatric intensive care unit (PICU) from January 1992 to January 1997 after repair of congenital heart defects, 70 required 48 hours ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1053/jcrc.2002.36760
更新日期:2002-12-01 00:00:00
abstract::A qualitative research design can provide unique contributions to research in the intensive care unit. Qualitative research includes the entire process of research: the methodology (conceptualization of the research question, choosing the appropriate qualitative strategy, designing the protocol), methods (conducting t...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2007.03.001
更新日期:2007-06-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.08.034
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:The purpose of this study is to investigate the accuracy of currently used scoring systems in differentiating transient and persistent organ failure in patients with acute pancreatitis (AP). MATERIALS AND METHODS:In this retrospective study, 127 consecutive patients with AP and organ failure were included. Pat...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.01.011
更新日期:2014-08-01 00:00:00
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journal_title:Journal of critical care
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更新日期:2018-12-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.06.011
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Intensive care unit (ICU) physicians should provide relatives of critically ill patients with appropriate and clear information, regarding prognosis, treatment options and expectations. OBJECTIVES:To assess whether a structured communication tool improves satisfaction with care and engenders realistic expec...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.01.011
更新日期:2019-06-01 00:00:00
abstract:PURPOSE:Decisions to withdraw life-sustaining therapy (WDLS) are relatively common in intensive care units across Canada. As part of preliminary work to develop guidelines for WDLS, we performed a narrative review of the literature to identify published studies of WDLS. MATERIALS AND METHODS:A search of MEDLINE and EM...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2016.04.006
更新日期:2016-10-01 00:00:00
abstract:PURPOSE:To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research. MATERIALS AND METHODS:We engaged a panel of multidisciplinary stakeholders in a modified Delphi process. Items generated from a literature review and panelist suggestions ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.08.008
更新日期:2017-12-01 00:00:00
abstract:PURPOSE:To assess the atrial systolic function and the contribution of atrial contraction to left ventricular (LV) filling in septic shock patients as compared with healthy volunteers. METHODS:Twenty-seven septic patients evaluated during first 48 h of ICU admission and compared with 27 healthy volunteers. Left atrial...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.09.006
更新日期:2019-12-01 00:00:00
abstract:PURPOSE:The mortality rate of severe acute pancreatitis (AP) is 20-30% even after admission to intensive care unit (ICU). Thus we aimed to develop a laboratory-based nomogram to identify AP patients at high risk for mortality. MATERIALS AND METHODS:The primary and validation cohorts were extracted from the Medical Inf...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.10.030
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:To validate a brief index of patient and family experiences of respect in the intensive care unit. MATERIAL AND METHODS:A survey including the 10-item ICU-RESPECT scale was administered to patients and family members in one ICU at a large west coast academic medical center. Confirmatory psychometric analyses w...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.03.026
更新日期:2018-08-01 00:00:00
abstract:PURPOSE:To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2019. MATERIALS AND METHODS:The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 36 journals monthly for impactful articles and reviewed 113 articles during 2019 according to Grading of Re...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
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更新日期:2020-12-27 00:00:00
abstract:PURPOSE:To examine the impact of the COVID-19 pandemic on the presentation and care provided to patients with acute ischemic stroke (AIS) at the emergency department (ED). METHOD:A retrospective-archive study was conducted between January-April 2020, compared with the parallel months in 2017-2019, in a comprehensive s...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2020.12.011
更新日期:2020-12-26 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.01.004
更新日期:2016-06-01 00:00:00
abstract:PURPOSE:Studies have shown that lung-ultrasound may be superior to chest x-ray (CXR) in diagnosing ventilator-associated pneumonia (VAP). This study investigated whether the use of lung-ultrasound monitoring could detect VAP earlier and improve patient outcome. METHODS:This was a single-center diagnostic randomized co...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2020.03.012
更新日期:2020-08-01 00:00:00
abstract:PURPOSE:Pulmonary embolism (PE) is a frequently occurring complication in critically ill patients. Simultaneous occurrence of PE and life-threatening bleeding, may render medical anticoagulation impossible. For these patients, inferior vena cava filters (IVCF) present a valuable therapeutic alternative. The Angel® cath...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.10.009
更新日期:2018-04-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jcrc.2019.06.027
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To describe the associations between right ventricular (RV) function and outcomes of patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). METHODS:This is a retrospective study, conducted 2006-2015 at an academic hospital in USA. We included patients with AKI requirin...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2020.11.022
更新日期:2020-11-30 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.jcrc.2020.09.034
更新日期:2021-02-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.04.029
更新日期:2017-10-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.10.031
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:The optimal mode of ventilation in acute respiratory distress syndrome (ARDS) remains uncertain. Airway pressure release ventilation (APRV) is a recognized treatment for mechanically-ventilated patients with severe hypoxaemia. However, contemporary data on its role as a rescue modality in ARDS is lacking. Th...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.03.002
更新日期:2016-08-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.09.011
更新日期:2013-06-01 00:00:00
abstract::Patients with COVID-19 ARDS have distinct physiological and immunological phenotypes compared to patients with non-COVID ARDS. Patients with COVID-19 ARDS (n = 32) had a significant improvement in PaO2: FiO2 ratio (p = 0.046) following low-dose steroid treatment, unlike patients with non-COVID ARDS (n = 16) (p = 0.529...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2020.11.012
更新日期:2020-11-21 00:00:00
abstract:PURPOSE:Utilization of renal replacement therapy (RRT) in cirrhotic patients has been controversial and is typically dependent on the status of transplantation. A better understanding of the central role for arterial vasodilatation in the pathogenesis of hepatorenal syndrome (HRS) has led to routine use of vasoconstric...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.05.006
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:Automated weaning modes are available in some mechanical ventilators, but no studies compared them hitherto. We compared the performance of 3 automated modes under standard and challenging situations. METHODS:We used a lung simulator to compare 3 automated modes, adaptive support ventilation (ASV), mandatory r...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2011.12.021
更新日期:2012-12-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2018.09.033
更新日期:2018-12-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2008.03.036
更新日期:2009-06-01 00:00:00