Japanese restaurant, Aki, and Deli 181 at night, #Bruntsfield (with passing light trail)
https://www.flickr.com/photos/woolamaloo_gazette/54285311853/in/dateposted/

Boudica, finally did a poo.

And it was a very good poo.

Still not out of the woods yet, but it has released one of the strangling vines, wrapped around my heart.

Defining Major Adverse Kidney Events, scoping review:
annual increase in the number of articles employing MAKE as
an endpoint for assessing impact of #AKI
substantial heterogeneity in applied criteria (particularly on components of persistent renal dysfunction/dialysis dependence) & observation periods to evaluate MAKE across published articles
This potentially leads to inconsistent results + difficulties in comparing/integrating renal outcome data among studies.
https://rdcu.be/dJHBM

DRINGENDER AUFRUF des GKV #IPReG ThinkTank
#AKI #AußerklinischeIntensivpflege
#Selbstbestimmung

Immer wieder hören wir, die Deutsche interdisziplinäre Gesellschaft für außerklinische Beatmung (DIGAB) e.V., und der GKV-IPReG ThinkTank, eine Interessenvertretung der Menschen mit Intensivpflegebedarf, dass Menschen gegen ihren Willen dekanüliert oder geweant werden. Nicht selten kommen sie hierbei zu Schaden, und im schlimmsten Fall versterben sie. Dies erfüllt uns mit größter Sorge. 1/

Hepatorenal syndrome in the #ICU
diagnostic criteria for #AKI & hepatorenal syndrome
specifc management of HRS–AKI
role of biomarkers in AKI phenotyping
Free to read #FOAMcc on @ICM
https://rdcu.be/dGQHz

Renal replacement therapy in comatose patients with severe #AKI: possible harmful consequence of delaying initiation?? Post hoc secondary analysis analysis of AKIKI2 multicenter randomized controlled trial:
168 pts, 2 #RRT initiation strategies
more-delayed strategy (vs currently recommended) resulted in lower chance of awakening
in selected pts RRT may reduce duration of coma
Full results free to read on @ICM at
https://rdcu.be/dF3qU
Below visual abstract

Liberation from CRRT in critically ill children and young adults, analysis of the worldwide exploration of renal replacement outcomes collaborative in Kidney Disease Registry:
over 600 pts aged 0-25 years treated with #CRRT for #AKI or fluid balance disorders
inability to liberate from CRRT common
several factors associated with successful liberation, including higher VIS & higher PELOD-2 score at CRRT initiation, higher UO prior to CRRT and shorter CRRT duration
https://rdcu.be/dAs4w

Second 2024 issue of @ICM is now available!!
dyspnea in acutely ill adults ERS & ESICM statement
trajectory of very old critically ill patients
ventilator induced lung injury
pulmonary embolism in #ICU
mechanical circulatory support #MCS for cardiogenic shock
CO2 in acute brain injury
#AKI after major surgery
circadian medicine in ICU
angiotensin II
imaging in intensive care medicine
#ICMfromtheInside
& more…
https://bit.ly/ICMFeb2024

Concurrent renal replacement therapy & extracorporeal membrane oxygenation: what pediatric nephrologists need to know
#ECMO modalities & their usages
pathophysiology of inflammation during #ECLS
#AKI
fluid overload
anticoagulation strategies in ECMO
therapeutic plasma exchange
indications & modalities of #CRRT
technical aspects of implementing #RRT into the extracorporeal circuit
outcomes associated with RRT in #PedsICU
#FOAMcc #FOAMecmo
https://rdcu.be/dzuG4

Acute kidney disease among patients undergoing major (cardiac & non) surgery, secondary analysis of EPIS‑AKI international multi-center trial
9.5K patients without pre-existing CKD
1 in 10 patients developed AKD beyond 7 days after major surgery
most patients developed AKD without a prior episode of early postoperative-AKI; however
early postoperative #AKI major independent risk factor; its severity/duration strongly associated w increased rate of subsequent AKD
https://rdcu.be/dxhiP

Impact of hypotension during #ICU, SR/MA:
significant association between hypotension & increase in mortality
association between hypotension & #AKI
strength of associations intensifying for both outcomes as hypotension severity increased in studies comparing multiple levels of hypotension exposure
associations particularly consistent if MAP < 60 mmHg/SBP < 90 mmHg for mortality, & if MAP < 55 mmHg for AKI
Open access #FOAMcc on @ICM
https://bit.ly/47QoMbD

Recombinant human alkaline phosphatase in sepsis-associated #AKI in #ICU: REVIVAL phase-3 trial found:
no evidence that improved survival
it may reduce major adverse kidney events (mortality, new onset, RRT >25% reduction in estimated glomerular filtration rate, rehospitalization)
Free to read on @ICM
https://rdcu.be/dvT09

Coming with editorial on what should we conclude from this trial… Target of intervention & end points potential reasons for “failure”??
https://rdcu.be/dvTxk

#Earthquake (#地震) M3.5 strikes 29 km NE of #Aki (#Japan) 9 min ago. More info: https://m.emsc.eu/?id=1598569

December issue of @ICM is out!!
surgery associated #AKI
age & outcome on #ECMO
#ARDS
steroids in CA
palliative care
sustainability
& more... Manuscripts free to read #FOAMcc using links shared through our #SoMe accounts!!
https://bit.ly/ICMDec2023

Any #AKI occurred in 38% of OHCA patients

Targeting higher MAP after cardiac arrest does not appear to influence AKI development

Higher age, non‐shockable rhythm, and longer time to ROSC were associated with shorter time to AKI

https://pubmed.ncbi.nlm.nih.gov/37987871/ @of_aic

AKI after major surgery?? Identifying interventions to avoid postoperative AKI & reduce progression from acute to chronic kidney disease remain key challenges for future research. Meanwhile, it could be prudent to avoid restrictive/zero balance perioperative fluid regimens & to optimize intraoperative hemodynamics.
Editorial
https://rdcu.be/dp9R5

Refers to EPIS #AKI study on epidemiology of major surgery associated acute kidney injury, free to read #FOAMcc
https://rdcu.be/dp9QD

From #LIVES2023 in NEJM
https://www.nejm.org/doi/full/10.1056/NEJMoa2310307?query=featured_home

Inhaled #Amikacin in high risk patients reduces VAP, but would it cause more #AKI

Interestingly - risk of AKI is halved w/ amikacin!

- less pneumonia = less AKI?
- inhaled Amikacin is probably not nephrotoxic as well!

Renal biomarkers can be used to define/identify of subclinical acute kidney injury, frequent & severe condition with prognosis equivalent to #AKI, as defined by KDIGO criteria based on serum creatinine: ancillary analysis of FROG-ICU study
Results free to read on @ICM #FOAMcc
https://rdcu.be/dlsf9
Below visual abstract

Initiation of renal replacement therapy in #ICU? Optimal modality to deliver of #RRT to critically ill patients with severe acute kidney injury controversial: any potential link between RRT modality and kidney recovery?? In this retrospective analysis of STARRT #AKI trial CRRT vs IHD associated
with significant reduction of risk of death or RRT dependence at 90 days.
Free to read #FOAMcc on @ICM https://rdcu.be/dosj9