Journal of critical care
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Journal of critical care · Aug 2018
Urinary potassium excretion and its association with acute kidney injury in the intensive care unit.
Using urinary indices as a quick bedside test to assist management of oliguria and acute kidney injury (AKI) has long been sought. This study assessed whether urinary potassium excretion is related to simultaneously calculated creatinine clearance (CrCl) and can predict AKI in the critically ill. ⋯ Urinary potassium excretion correlates with CrCl and predicts AKI in the critically ill without recent furosemide exposure. Given 2-h urinary potassium excretion can be measured easily, its potential as a marker of renal function deserves further study.
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Journal of critical care · Aug 2018
Fellowship training in extracorporeal life support: Characterization and educational needs assessment.
Adult Extracorporeal Life Support (ECLS) use is rapidly increasing. The structure of fellowship ECLS education is unknown. We sought to define current ECLS education and identify curricular needs. ⋯ CCPDs identified ECLS as a critical care skill, but believe that a minority of fellows are prepared for independent practice. Simulation, formal didactics and clinical volume are key needs. These data will guide the development of ECLS curriculum.
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Journal of critical care · Aug 2018
Routine chest X-ray is unnecessary after ultrasound-guided central venous line placement in the operating room.
Central venous catheters (CVC) can be useful for perioperative monitoring and insertion has low complication rates. However, routine post insertion chest X-rays have become standard of care and contribute to health care costs with limited impact on patient management. ⋯ Routine CXR consumes valuable time and resources (≅$155,000 annually) and rarely affects management. Selection should be guided by clinical factors.
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Journal of critical care · Aug 2018
Chikungunya: Report from the task force on tropical diseases by the World Federation of Societies of intensive and critical care medicine.
Chikungunya is an arbovirus that is transmitted by the Aedes mosquito causing a febrile illness with periodic outbreaks in large parts of the world. In the last decade it has become a public health concern in a host of countries and has affected international tourists. In the vast majority of cases Chikungunya presents as an acute febrile illness, associated with rash, headache, myalgia and debilitating arthralgia or even polyarthritis. ⋯ Over the years the epidemic potential of the virus has become apparent with spread related to an increase in global travel and the successful adaptation of the Aedes mosquito to the urban and sylvan environments in numerous countries. These epidemics have affected millions of people across the globe. Treatment is usually symptomatic and supportive.