Journal of critical care
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Journal of critical care · Oct 2013
Editorial Comment LetterI-TRACH, you-TRACH, we all-TRACH for….?
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Journal of critical care · Oct 2013
Randomized Controlled Trial Comparative StudyPhoxilium vs Hemosol-B0 for continuous renal replacement therapy in acute kidney injury.
This study aimed to compare the biochemical effects of Phoxilium (containing phosphate at 1.2 mmol/L; Gambro Lundia AB, Lund, Sweden) and Hemosol-B0 (Gambro Lundia AB) as dialysate and/or replacement fluid during continuous renal replacement therapy (CRRT). ⋯ Phoxilium effectively prevented hypophosphatemia during CRRT but was associated with relative metabolic acidosis and hypocalcemia compared with Hemosol-B0 use.
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Journal of critical care · Oct 2013
ReviewAssessment and management of cerebral edema and intracranial hypertension in acute liver failure.
Acute liver failure is uncommon but not a rare complication of liver injury. It can happen after ingestion of acetaminophen and exposure to toxins and hepatitis viruses. The defining clinical symptoms are coagulopathy and encephalopathy occurring within days or weeks of the primary insult in patients without preexisting liver injury. ⋯ Intracranial pressure monitoring, transcranial Doppler, and jugular venous oximetry provide valuable information for monitoring ICP and guiding therapeutic measures in patients with encephalopathy grade III or IV. Osmotic therapy using hypertonic saline and mannitol, therapeutic hypothermia, and propofol sedation are shown to improve ICPs and stabilize the patient for liver transplantation. In this article, diagnosis and management of hepatic encephalopathy and cerebral edema in patients with acute liver failure are reviewed.
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Journal of critical care · Oct 2013
Multicenter StudyPrevalence of acute kidney injury in intensive care units: The "COrte de prevalencia de disFunción RenAl y DEpuración en críticos" point-prevalence multicenter study.
This study aimed to measure the point prevalence of kidney dysfunction (KD) in the intensive care setting. ⋯ Each day of study, more that half of the patients admitted to the ICU showed some derangement in kidney function. More than 25% of patients not fulfilling the KD criteria by serum creatinine or acute kidney injury network showed, in fact, a severe KD, and this finding was associated with higher mortality. More than 50% of the patients admitted to the ICU were subjected to at least 1 renal insult.