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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The pathophysiological mechanism of the serious and frequently occurring disorder delirium is poorly understood. Inflammation and sepsis are known risk factors for ICU delirium and therefore these patients are highly susceptible to delirium. ⋯ Also, new biomarkers associated with brain dysfunction and cognitive impairment are still recognized and need to be studied to determine their relation with delirium. In this commentary we address some limitations concerning an interesting new study that warrants directions for future studies.