Critical care : the official journal of the Critical Care Forum
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Renal replacement therapy can be applied either in an intermittent fashion or in a continuous fashion in severe acute kidney injury. To date, no modality has been shown to consistently improve patient survival. ⋯ This association between nonrecovery and intermittent renal replacement therapy may be explained by a higher rate of hypotensive episodes and the lower capacity for fluid removal during the first 72 hours of therapy. Altogether, this study adds to the growing body of evidence to suggest improved likelihood of recovery of kidney function in critically ill survivors of AKI with continuous modalities for renal replacement therapy.
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Letter Case Reports
Extracorporeal membrane oxygenation therapy for pulmonary decompression illness.
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Comment
Measuring biomarkers of acute kidney injury during renal replacement therapy: wisdom or folly?
Early data are now appearing relating to the measurement of biomarkers of acute kidney injury during renal replacement therapy. These data go some way in describing the clearance of these molecules during renal support. Understanding the potential clearance, or otherwise, of these proteins may lead to directing our therapies in the future particularly with regard to cessation of renal support. We describe a recent study which has provided data that may aid in addressing this issue.
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Delirium is associated with impaired outcome, but it is unclear whether this relationship is limited to in-hospital outcomes and whether this relationship is independent of the severity of underlying conditions. The aim of this study was to investigate the association between delirium in the intensive care unit (ICU) and long-term mortality, self-reported health-related quality of life (HRQoL), and self-reported problems with cognitive functioning in survivors of critical illness, taking severity of illness at baseline and throughout ICU stay into account. ⋯ In this group of survivors of critical illness, delirium during ICU stay was not associated with long-term mortality or HRQoL after adjusting for confounding, including severity of illness throughout ICU stay. In contrast, delirium appears to be an independent risk factor for long-term self-reported problems with cognitive functioning.