Abstract:
BACKGROUND:Despite improvements in intermittent hemodialysis management, intradialytic hemodynamic instability (IHI) remains a common issue that could account for increased mortality and delayed renal recovery. However, predictive factors of IHI remain poorly explored. The objective of this study was to evaluate the relationship between baseline macrohemodynamic, tissue hypoperfusion parameters and IHI occurrence. METHODS:Prospective observational study conducted in a 18-bed medical ICU of a tertiary teaching hospital. Cardiovascular SOFA score, index capillary refill time (CRT) and lactate level were measured just before (T0) consecutive intermittent hemodialysis sessions performed for AKI. The occurrence of IHI requiring a therapeutic intervention was recorded. RESULTS:Two hundred eleven sessions, corresponding to 72 (34%) first sessions and 139 (66%) later sessions, were included. As IHI mostly occurred during first sessions (43% vs 12%, P < 0.0001), following analyses were performed on the 72 first sessions. At T0, cardiovascular SOFA score ≥1 (87% vs 51%, P = 0.0021) was more frequent before IHI sessions, as well as index CRT ≥ 3 s (55% vs 15%, P = 0.0004), and hyperlactatemia > 2 mmol/L (68% vs 29%, P = 0.0018). Moreover, the occurrence of IHI increased with the number of macrohemodynamic and tissue perfusion impaired parameters, named SOCRATE score (cardiovascular SOFA, index CRT and lactATE): 10% (95% CI [3%, 30%]), 33% (95% CI [15%, 58%]), 55% (95% CI [35%, 73%]) and 80% (95% CI [55%, 93%]) for 0, 1, 2 and 3 parameters, respectively (AUC = 0.79 [0.69-0.89], P < 0.0001). These results were confirmed by analyzing the 139 later sessions included in the study. CONCLUSIONS:The SOCRATE score based on 3 easy-to-use bedside parameters correlates with the risk of IHI. By improving risk stratification of IHI, this score could help clinicians to manage intermittent hemodialysis initiation in critically ill AKI patients.
journal_name
Ann Intensive Carejournal_title
Annals of intensive careauthors
Bigé N,Lavillegrand JR,Dang J,Attias P,Deryckere S,Joffre J,Dubée V,Preda G,Dumas G,Hariri G,Pichereau C,Baudel JL,Guidet B,Maury E,Boelle PY,Ait-Oufella Hdoi
10.1186/s13613-020-00663-xsubject
Has Abstractpub_date
2020-04-22 00:00:00pages
47issue
1issn
2110-5820pii
10.1186/s13613-020-00663-xjournal_volume
10pub_type
杂志文章abstract:BACKGROUND AND AIMS:Data on outcome of critically ill children with cirrhosis are scarce. We aimed to evaluate the prognostic accuracy of sequential organs scoring systems in children with cirrhosis admitted to Paediatric Intensive Care Units (PICU). METHODS:We performed a multicentre retrospective analysis of childre...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00753-w
更新日期:2020-10-14 00:00:00
abstract:BACKGROUND:Changeovers of norepinephrine infusion pumps (CNIPs) frequently lead to haemodynamic instability. The aim of this study was to identify risk factors for haemodynamic instability associated with CNIP, independent of the method used to perform the relay. METHODS:We performed a prospective study, in a universi...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0139-3
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abstract:BACKGROUND:Critical illness has detrimental effects on the diaphragm, but the impact of critical illness on other major muscles of the respiratory pump has been largely neglected. This study aimed to determine the impact of critical illness on the most important muscles of the respiratory muscle pump, especially on the...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00731-2
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journal_title:Annals of intensive care
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doi:10.1186/s13613-018-0382-x
更新日期:2018-03-13 00:00:00
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journal_title:Annals of intensive care
pub_type: 信件
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-S1-S4
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abstract:BACKGROUND:Aneurysmal subarachnoid hemorrhage (SAH) is a serious condition associated with high mortality rates and long-term disability. We investigated the impact of fluid balance on neurologic outcome after adjustment for possible confounders related to intensive care therapy and extra-cerebral organ failure during ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-016-0128-6
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00699-z
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journal_title:Annals of intensive care
pub_type: 杂志文章
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-3-2
更新日期:2013-01-15 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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journal_title:Annals of intensive care
pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0477-4
更新日期:2019-01-03 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0366-x
更新日期:2018-02-21 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-2-S1-S1
更新日期:2012-07-05 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2015-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2017-12-19 00:00:00
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pub_type: 杂志文章
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更新日期:2012-12-31 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2017-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2017-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章,评审
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更新日期:2019-06-10 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2019-10-11 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2019-05-07 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2021-01-27 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0267-4
更新日期:2017-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Noninvasive ventilation (NIV) is the first-line treatment of adult patients with exacerbations of cystic fibrosis (CF). High-flow nasal oxygen therapy (HFNT) might benefit patients with hypoxemia and can reduce physiological dead space. We hypothesized that HFNT and NIV would similarly reduce work of breathi...
journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2018-09-05 00:00:00