Abstract:
:Acute kidney injury (AKI) is commonly and increasingly encountered in patients with critical illness. In the past, epidemiologic studies have consistently found that oliguria further increases the risk of death from AKI. Compared with patients outside the intensive care unit (ICU), critically ill patients are more likely to have volume overload as a result of impaired solute and water excretion. Recently, broad changes have occurred in ICU practice, such as early goal-directed therapy in sepsis, which may further compound volume overload in the ICU patient with oliguric AKI. Evidence has also emerged to suggest that a positive fluid accumulation in ICU patients can unfavorably affect outcome. Thus, the ICU patient with oliguric AKI presents a dilemma with limited therapeutic options. These would include optimization of systemic hemodynamics, added fluid therapy, administration of loop diuretics, or finally, the initiation of renal replacement therapy. Interestingly, recent survey data and observational studies indicate that a majority of intensivists use loop diuretics, specifically furosemide, at some point during the course of illness in patients with AKI. Paradoxically, loop diuretics have been found in several clinical studies of patients with AKI to be potentially detrimental or, at the least, lack effectiveness for improving clinical outcomes. This contradiction between clinical practice and available evidence would suggest there is equipoise and need for higher-quality evidence to better characterize the role of loop diuretics in ICU patients with AKI.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Bagshaw SM,Bellomo R,Kellum JAdoi
10.1097/CCM.0b013e318168c92fsubject
Has Abstractpub_date
2008-04-01 00:00:00pages
S172-8issue
4 Suppleissn
0090-3493issn
1530-0293pii
00003246-200804001-00006journal_volume
36pub_type
杂志文章,评审abstract::Given the limitations of high-dose diuretics and vasodilators and the increasing literature showing that inotropes, regardless of the dose used, have a detrimental effect on mortality, a variety of new agents are under investigation for the treatment of pulmonary and systemic congestion and restoration of cardiac outp...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000296810.74724.8D
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVES:To quantitate duplex Doppler measurements of splanchnic perfusion to determine if these measurements are reproducible in euvolemic humans and if such measurements are sensitive to mild degrees of systemic hypovolemia. DESIGN:Prospective, nonrandomized, controlled trial. SETTING:Clinical research center. P...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00003246-199503000-00013
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to quantify the effect of hypertonic saline solution on contused and noncontused brain tissue in patients with traumatic brain injury. We hypothesize that hypertonic saline would increase the volume of brain contusion while decreasing the volume of noncontused hemispheric areas. DES...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000243797.42346.64
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:Several studies report calcium mishandling, sarcomere disarray, and caspase activation during heart failure. Although active caspases have been shown to cleave myofibrillar proteins, little is known regarding their effects on calcium handling proteins. Therefore, we aimed to explore how endotoxin-induced casp...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181eedafb
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:To investigate the impact of circulating histones on cardiac injury and dysfunction in a murine model and patients with sepsis. DESIGN:Prospective, observational clinical study with in vivo and ex vivo translational laboratory investigations. SETTING:General ICU and university research laboratory. SUBJECTS...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001162
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Overdoses of calcium channel blocker agents result in hyperglycemia, primarily due to the blockade of pancreatic L-type calcium channels and insulin resistance on the cellular level. The clinical significance of the hyperglycemia in this setting has not previously been described. METHODS:This study is a ret...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000278916.04569.23
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVES:To determine the reliability of volitional and nonvolitional limb muscle strength assessment in critically ill patients and to provide guidelines for the implementation of limb muscle strength assessment this population. DATA SOURCES:The following computerized bibliographic databases were searched with MeSH...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/CCM.0000000000000030
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:Vascular dysfunction plays a central role in sepsis, and it is characterized by hypotension and hyporesponsiveness to vasoconstrictors. Nitric oxide is regarded as a central element of sepsis vascular dysfunction. The high amounts of nitric oxide produced during sepsis are mainly derived from the inducible is...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0000000000000301
更新日期:2014-06-01 00:00:00
abstract::Sequential assessment of renal function in 50 critically ill postoperative patients was done by simultaneous determinants of osmolar, free water, creatinine and sodium clearances, and fractional excretion of sodium. The traumatic and nontraumatic critically ill surgical patients had a characteristic pattern of creatin...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198002000-00004
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:The benefit of continuous on-site presence by a staff academic critical care specialist in the intensive care unit of a teaching hospital is not known. We compared the quality of care and patient/family and provider satisfaction before and after changing the staffing model from on-demand to continuous 24-hr c...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1097/01.CCM.0000297887.84347.85
更新日期:2008-01-01 00:00:00
abstract::This review focuses on the effects of restoring hormonal levels and/or influence on muscle protein metabolism in the stressed state. We have highlighted our clinical experience in the administration of anabolic and anticatabolic agents in stressed clinical populations, primarily adult and pediatric burn injury, as wel...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000278529.44899.57
更新日期:2007-09-01 00:00:00
abstract::In a prospective randomized trial in patients with a history of preoperative pulmonary hypertension who were undergoing surgery for valvular replacement or annuloplasty, the effects of ketanserin (KET) (12 patients) and sodium nitroprusside (SNP) (14 patients) on the systemic and pulmonary circulation and pulmonary sh...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-198907000-00003
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVES:To compare the incidence of withdrawal or withholding of life support (WD/WHLS), and to identify similarities and differences in the process of the withdrawal of life support (WDLS) between teaching and community hospitals' intensive care units (ICUs). DESIGN:Prospective cohort study, with some data obtaine...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199802000-00018
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVES:Lung-protective ventilation for acute respiratory distress syndrome aims for providing sufficient oxygenation and carbon dioxide clearance, while limiting the harmful effects of mechanical ventilation. "Flow-controlled ventilation", providing a constant expiratory flow, has been suggested as a new lung-prote...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004209
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:Transfusion of red blood cells has been linked to disappointing clinical outcomes in the critically ill, but specific mechanisms of organ dysfunction after transfusion remain poorly understood. We tested the hypothesis that red blood cell storage impairs the ability of red blood cells to release adenosine-5'-...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318225754f
更新日期:2011-11-01 00:00:00
abstract::Simple insertion of a nasogastric (NG) tube was successful in only 52 of 100 anesthetized intubated patients. After the larynx was manually pulled forward, the NG tube was successfully inserted in 33 patients. In the remaining 15 patients, the NG tube was inserted only with the aid of a finger or a laryngoscope used w...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198503000-00013
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVE:To examine the frequency of obtaining Institutional Review Board (IRB) approval and informed consent in critical care research. DATA SOURCES AND DATA EXTRACTION:One-year retrospective review of original critical care research in humans published in seven journals, including American Journal of Respiratory an...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199809000-00035
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVES:High physical activity levels are associated with wide-ranging health benefits, disease prevention, and longevity. In the present study, we examined the impact of regular physical exercise on the severity of organ injury and survival probability, as well as characteristics of the systemic immune and metaboli...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31828a2ae3
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:Previous workers have demonstrated that controlled mechanical ventilation results in diaphragm inactivity and elicits a rapid development of diaphragm weakness as a result of both contractile dysfunction and fiber atrophy. Limited data exist regarding the impact of pressure support ventilation, a commonly us...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31823c8cc9
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To assess clinician perceptions of a machine learning-based early warning system to predict severe sepsis and septic shock (Early Warning System 2.0). DESIGN:Prospective observational study. SETTING:Tertiary teaching hospital in Philadelphia, PA. PATIENTS:Non-ICU admissions November-December 2016. INTERVE...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003803
更新日期:2019-11-01 00:00:00
abstract::This study was undertaken to investigate ventilatory requirements during high frequency ventilation (HFV). Six anesthetized dogs were ventilated with bird M-2 or Emerson 2-V ventilators at respiratory rates (RRs) ranging from 13-1300 breath/min. PaCO2 was maintained within normal range at all rates by tidal volume (VT...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198303000-00005
更新日期:1983-03-01 00:00:00
abstract::Human hemoglobin (Hb) solution is being developed for use as an oxygen-delivering resuscitation fluid. Substantial improvements in the general purity and quality of experimental Hb solutions have been achieved by recent research efforts. Hb solutions now appear to be free of the undesirable biological effects that wer...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-198204000-00002
更新日期:1982-04-01 00:00:00
abstract:OBJECTIVES:To evaluate the internal consistency, validity, responsiveness, and minimal important difference of the Functional Status Score for the ICU, a physical function measure designed for the ICU. DESIGN:Clinimetric analysis. SETTINGS:Five international datasets from the United States, Australia, and Brazil. PA...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000001949
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the prognostic value of sublingual PCO2 (P(SL)CO2), lactate concentration, and mixed venous oxygen saturation (S(MV)O2) in hemodynamically unstable intensive care patients and, additionally, to compare the temporal changes of these variables in response to treatment....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000054862.74829.EA
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVES:To determine whether pulse oximetry is accurate and if it correlates with arterial blood gas saturation in pediatric patients with sickle cell anemia. DESIGN:Prospective, comparative study using a convenience sample of patients with sickle cell anemia who had simultaneous arterial blood gas sampling and pul...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200109000-00025
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVES:To evaluate the frequency of unsuspected posterior vessel wall penetration of the internal jugular vein during ultrasound-guided needle cannulation. DESIGN:Prospective, single-blinded observational study. SETTING:Urban level I emergency department with an annual census of 80,000. PATIENTS:Residents who ha...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181a067d4
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that therapeutic hypercapnia enhances the proinflammatory responses to endotoxemia in the lung and spleen of rats. DESIGN:Prospective randomized study. SETTINGS:Hospital research institute. SUBJECTS:Forty-eight adult male rats. INTERVENTIONS:Rats were randomly assigned for a 24-hr p...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31820ee1f2
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:The use of corticosteroids in patients with sepsis or septic shock has been controversial for many decades. Clinical studies have reported beneficial, as well as negative results. We conducted a meta-analysis to assess the clinical evidence and to evaluate treatment effects in specific subgroups of patients. ...
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析
doi:10.1097/00003246-199507000-00021
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVES:Peripherally inserted central catheters are increasingly used in ICU as an alternative to centrally inserted central catheters for IV infusion. However, their reliability for hemodynamic measurements with transpulmonary thermodilution is currently unknown. We investigated the agreement between transpulmonary...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003917
更新日期:2019-10-01 00:00:00
abstract::To evaluate the effect of meconium on pulmonary surface tension properties, the mechanics of 30 excised, separated canine pulmonary lobes were studied. Meconia were blended in normal saline to produce solutions of 10% and 20%. Solutions were filtered to remove large particles and instilled endobronchially into the can...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198504000-00005
更新日期:1985-04-01 00:00:00