The Epidemiology of Acute Respiratory Distress Syndrome Before and After Coronavirus Disease 2019
Acute respiratory distress syndrome (ARDS) is a heterogeneous syndrome of high morbidity and mortality with global impact. Current epidemiologic estimates are imprecise given differences in patient populations, risk factors, resources, and practice styles around the world. Despite improvement in supportive care which has improved mortality, effective targeted therapies remain elusive. The Coronavirus Disease 2019 pandemic has resulted in a large number of ARDS cases that, despite less heterogeneity than multietiologic ARDS populations, still exhibit wide variation in physiology and outcomes. Intensive care unit rates of de...
Source: Critical Care Clinics - September 19, 2021 Category: Intensive Care Authors: Kathryn W. Hendrickson, Ithan D. Peltan, Samuel M. Brown Source Type: research

Environmental Factors
The acute respiratory distress syndrome (ARDS) remains a major cause of morbidity and mortality in the intensive care unit. Improving outcomes depends on not only evidence-based care once ARDS has already developed but also preventing ARDS incidence. Several environmental exposures have now been shown to increase the risk of ARDS and related adverse outcomes. How environmental factors impact the risk of developing ARDS is a growing and important field of research that should inform the care of individual patients as well as public health policy. (Source: Critical Care Clinics)
Source: Critical Care Clinics - September 19, 2021 Category: Intensive Care Authors: Katherine D. Wick, Michael A. Matthay Source Type: research

Genetics of Acute Respiratory Distress Syndrome
This article discusses the latest advances in ARDS genomics, provides historical perspective, and highlights some of the ways that the coronavirus disease 2019 (COVID-19) pandemic is accelerating genomic ARDS research. (Source: Critical Care Clinics)
Source: Critical Care Clinics - September 19, 2021 Category: Intensive Care Authors: Heather M. Giannini, Nuala J. Meyer Source Type: research

Pharmacologic Treatments for Acute Respiratory Distress Syndrome
Acute respiratory distress syndrome is a heterogenous syndrome with many etiologies for which there are no definitive pharmacologic treatments, despite decades of research. We explore some adjunctive pharmacologic therapies, including neuromuscular blockade, corticosteroids, and inhaled pulmonary vasodilators. Additionally, we explore some investigative therapies, including Vitamin C, beta-agonists, statins, mesenchymal stromal cells, and granulocyte –macrophage colony stimulating factor. We do discuss the potential role of steroids in acute respiratory distress syndrome with severe acute respiratory syndrome coronav...
Source: Critical Care Clinics - September 19, 2021 Category: Intensive Care Authors: Nida Qadir, Steven Y. Chang Source Type: research

Toward Optimal Acute Respiratory Distress Syndrome Outcomes
Acute respiratory distress syndrome is a common condition among critically ill patients, but remains under-recognized and undertreated. Under-recognition may result from confusion over the clinical inclusion criteria, as well as a misunderstanding of the complex relationship between the clinical syndrome, the variable histopathologic patterns, and the myriad clinical disorders that cause acute respiratory distress syndrome. The identification of the clinical syndrome and determination of the causal diagnosis are both required to optimize patient outcomes. Here we review the definition, discuss pitfalls in recognizing acute...
Source: Critical Care Clinics - September 19, 2021 Category: Intensive Care Authors: Maya E. Kotas, B. Taylor Thompson Source Type: research

Fluid Therapy and Acute Respiratory Distress Syndrome
The optimal fluid management for acute respiratory distress syndrome (ARDS) remains unknown. Liberal fluid management may improve cardiac function and end-organ perfusion, but may lead to increased pulmonary edema and inhibit gas exchange. Trials suggest that conservative fluid management leads to better clinical outcomes, although prospective randomized, controlled trials have not demonstrated mortality benefit. Recent discoveries suggest there is large heterogeneity in ARDS, and varying phenotypes of ARDS respond differently to fluid treatments. Future advances in management will require real-time assignment of ARDS phen...
Source: Critical Care Clinics - September 19, 2021 Category: Intensive Care Authors: Jisoo Lee, Keith Corl, Mitchell M. Levy Source Type: research

Preface
We are pleased to introduce this issue of Critical Care Clinics, focused on acute respiratory distress syndrome (ARDS). Although planned before the COVID-19 pandemic, this issue is particularly timely given the world events of the past 18  months. The articles in this issue address several key topics in the field of ARDS with both a clinical and a research focus, as well as define some of the important questions that need to be answered for our understanding of the pathogenesis and treatment of ARDS to advance. (Source: Critical Care Clinics)
Source: Critical Care Clinics - September 19, 2021 Category: Intensive Care Authors: Michael A. Matthay, Kathleen D. Liu Source Type: research

Acute Respiratory Distress Syndrome
CRITICAL CARE CLINICS (Source: Critical Care Clinics)
Source: Critical Care Clinics - September 19, 2021 Category: Intensive Care Authors: Michael A. Matthay, Kathleen D. Liu Source Type: research

Copyright
ELSEVIER (Source: Critical Care Clinics)
Source: Critical Care Clinics - September 19, 2021 Category: Intensive Care Source Type: research

Contributors
GREGORY S. MARTIN, MD, MSC (Source: Critical Care Clinics)
Source: Critical Care Clinics - September 19, 2021 Category: Intensive Care Source Type: research

Contents
Michael A. Matthay and Kathleen D. Liu (Source: Critical Care Clinics)
Source: Critical Care Clinics - September 19, 2021 Category: Intensive Care Source Type: research

Forthcoming Issues
Diagnostic Excellence in the ICU: Thinking Critically and Masterfully (Source: Critical Care Clinics)
Source: Critical Care Clinics - September 19, 2021 Category: Intensive Care Source Type: research

Pharmacokinetic and Pharmacodynamic Principles for Toxicology
Pharmacokinetic and pharmacodynamic interactions between drugs and the body play a vital role in the therapeutic effects of drugs as well as their toxicity. Toxic effects may evolve from high doses of drugs or from alterations in the absorption, distribution, metabolism, and excretion of those drugs. The effective dose of a drug is influenced by the initial dose, route of administration, drug formulation, and bioavailability. This effective dose, in conjunction with the frequency of dosing, duration of exposure, and pharmacodynamic variability, directly affects the toxicity experienced in the body. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Annette D. Lista, Michael Sirimaturos Source Type: research

Drugs of Abuse
Sympathomimetic drugs comprise a broad category of substances including both illicit and prescribed drugs that have deleterious effects when ingested or abused. The clinical syndromes that result from overstimulation of the sympathetic nervous system by reuptake inhibition of biogenic amines, such as norepinephrine and dopamine, carry significant morbidity. Recognition and awareness of the appropriate supportive measures are required to mitigate life-threatening complications of multiple organ systems. The sympathomimetic toxidrome is recognized by a constellation of symptoms including agitation, hyperthermia, tachycardia,...
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Hallie Brown, Katherine A. Pollard Source Type: research

Drugs of Abuse —Opioids, Sedatives, Hypnotics
Over the last 2  decades, prescription and nonprescription substance use has significantly increased. In this article, 3 particular drug classes—opioids, sedatives, and hypnotics—are discussed. For each class, a brief history of the agent, a description of relevant pharmacology, the clinical presentation of ov erdose, the management of specific drug overdoses, and a summary of salient points are presented. The intent is to provide a clinically relevant and comprehensive approach to understanding these potential substance exposures in order to provide a framework for management of opioid, sedative, and hyp ...
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Keith Azevedo, Molly Johnson, Michael Wassermann, Jessica Evans-Wall Source Type: research

Toxicity of Immunotherapeutic Agents
This article reviews the most common toxicities from immunotherapy and of fers a therapy-specific and system-based approach for affected patients. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Cristina Gutierrez, Colleen McEvoy, Daniel Reynolds, Joseph L. Nates Source Type: research

Acetaminophen Poisoning
Acetaminophen is a common medication taken in deliberate self-poisoning and unintentional overdose. It is the commonest cause of severe acute liver injury in Western countries. The optimal management of most acetaminophen poisonings is usually straightforward. Patients who present early should be offered activated charcoal and those at risk of acute liver injury should receive acetylcysteine. This approach ensures survival in most. The acetaminophen nomogram is used to assess the need for treatment in acute immediate-release overdoses with a known time of ingestion. However, scenarios that require different management path...
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Angela L. Chiew, Nicholas A. Buckley Source Type: research

Cardiovascular Drug Toxicity
This article summarizes the mechanisms of toxicity; clinical presentations; and the current evidence available for the treatment of cardiovascular drug toxicity due to calcium channel blockers, beta-blockers, cardiac glycosides, and sodium channel blockers. In addition, management approaches are proposed. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Maude St-Onge Source Type: research

Toxicology of Medications for Diabetes Mellitus
Medications used to treat diabetes mellitus are heterogeneous, with widely differing safety profiles in therapeutic use and in overdose. Insulin overdose may produce severe and prolonged hypoglycemia. Sulfonylurea poisoning should be treated with octreotide, sparing intravenous dextrose where possible. Acute metformin overdose may lead to life-threatening acidosis with elevated lactate concentrations, which may require hemodialysis. Glucagon-like peptide 1 agonists and dipeptidyl peptidase 4 inhibitors are benign in overdose in diabetic patients but may produce profound hypoglycemia in nondiabetic patients. Euglycemic diab...
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Kevin Baumgartner, Jason Devgun Source Type: research

Iatrogenic Toxicities in the Intensive Care Unit
This article reviews several types of iatrogenic toxicities associated with medications that are commonly used in critically ill patients. The mechanism of the iatrogenic toxicities, clinical presentation, and diagnosis, as well as management are discussed. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Lama H. Nazer, Anne Rain T. Brown, Wedad Awad Source Type: research

Toxic Alcohols
This article reviews the background, metabolism, clinical effects, and treatment of toxic alcohols, specifically ethylene glycol, methanol, diethylene glycol, propylene glycol, and isopropyl alcohol. This article also reviews the importance of an anion gap metabolic acidosis in relation to toxic alcohols and explores both the utility and the limitations of the osmole gap in patient management. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Jennifer A. Ross, Heather A. Borek, Christopher P. Holstege Source Type: research

Carbon Monoxide Poisoning
Carbon monoxide is a colorless, odorless, highly toxic gas primarily produced through the incomplete combustion of organic material. Carbon monoxide binds to hemoglobin and other heme molecules, causing tissue hypoxia and oxidative stress. Symptoms of carbon monoxide poisoning can vary from a mild headache to critical illness, which can make diagnosis difficult. When there is concern for possible carbon monoxide poisoning, the diagnosis can be made via blood co-oximetry. The primary treatment for patients with carbon monoxide poisoning is supplemental oxygen, usually delivered via a nonrebreather mask. Hyperbaric oxygen ca...
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: James A. Chenoweth, Timothy E. Albertson, Matthew R. Greer Source Type: research

Management of Organophosphorus Poisoning
Organophosphorus (OP) compounds remain a leading cause of self-poisoning and mortality, especially in South East Asia, China, and Africa. Organophosphorus causes an acute cholinergic syndrome by inhibiting acetylcholinesterase. Atropine remains the mainstay of treatment, but recently some promising therapies are in the pipeline. Oximes are used widely in the management of organophosphorus poisoning, however clinical efficacy remains to be established. Magnesium sulfate, calcium channel blockers (nimodipine), plasma alkalinizing agents, β-2 agonists, nicotinic receptor antagonists, clonidine, and lipid emulsions are pr...
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Sakib Aman, Shrebash Paul, Fazle Rabbi Chowdhury Source Type: research

Antithrombotic and Antiplatelet Drug Toxicity
Anticoagulant and antiplatelet drugs target a specific portion of the coagulation cascade or the platelet activation and aggregation pathway. The primary toxicity associated with these agents is hemorrhage. Understanding the pharmacology of these drugs allows the treating clinician to choose the correct antidotal therapy. Reversal agents exist for some of these drugs; however, not all have proven patient-centered outcomes. The anticoagulants covered in this review are vitamin K antagonists, heparins, fondaparinux, hirudin derivatives, argatroban, oral factor Xa antagonists, and dabigatran. The antiplatelet agents reviewed ...
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: David B. Liss, Michael E. Mullins Source Type: research

Toxicology of Psychoactive Substances
This article provides a summary of the toxicologic features of commonly used and abused PADs: antidepressants, antipsychotics, mood stabilizers, hallucinogens, NPSs, caffeine, nicotine, and cannabis. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Lara Prisco, Aarti Sarwal, Mario Ganau, Francesca Rubulotta Source Type: research

Inhalants
Toxic inhalants include various xenobiotics. Irritants cause upper and lower respiratory tract injuries. Highly water-soluble agents injure the upper respiratory tract, while low water-soluble inhalants injure the lower track. Asphyxiants are divided into simple asphyxiants and chemical asphyxiants. Simple asphyxiants displace oxygen, causing hypoxia, while chemical asphyxiants also impair the body ’s ability to use oxygen. Cyanide is a classic chemical asphyxiant. Treatment includes hydroxocobalamin. Electronic cigarette or vaping use-associated lung injury (EVALI) is a relatively new illness. Patients present with ...
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Evan S. Schwarz Source Type: research

Toxicology
CRITICAL CARE CLINICS (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Janice L. Zimmerman Source Type: research

Copyright
ELSEVIER (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Source Type: research

Contributors
JOHN A. KELLUM, MD, MCCM (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Source Type: research

Contents
Janice L. Zimmerman (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Source Type: research

Forthcoming Issues
Acute Respiratory Distress Syndrome (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Source Type: research

Pathophysiology of Acute Respiratory Distress Syndrome and COVID-19 Lung Injury
The pathophysiology of acute respiratory distress syndrome (ARDS) is marked by inflammation-mediated disruptions in alveolar-capillary permeability, edema formation, reduced alveolar clearance and collapse/derecruitment, reduced compliance, increased pulmonary vascular resistance, and resulting gas exchange abnormalities due to shunting and ventilation-perfusion mismatch. Mechanical ventilation, especially in the setting of regional disease heterogeneity, can propagate ventilator-associated injury patterns including barotrauma/volutrauma and atelectrauma. Lung injury due to the novel coronavirus SARS-CoV-2 resembles other ...
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Kai Erik Swenson, Erik Richard Swenson Source Type: research

Pathophysiology of ARDS and COVID-19 Lung Injury
Acute respiratory distress syndrome (ARDS) is a rapidly developing non-cardiogenic pulmonary edema caused by pulmonary and systemic infections or sterile tissue injuries that evoke a severe lung-damaging host inflammatory response. The lung loses its normal gas exchange efficiency with disruption of the tight permeability characteristics of the alveolar capillary barrier. Interstitial and subsequent alveolar edema lead to alveolar collapse/de-recruitment, reduced lung compliance and greater pulmonary vascular resistance, often with marked regional heterogeneity in severity. Regional heightened stress applied to surrounding...
Source: Critical Care Clinics - May 28, 2021 Category: Intensive Care Authors: Kai E. Swenson, Erik R. Swenson Source Type: research

Acute Respiratory Distress Syndrome
This review describes the management of mechanical ventilation in patients with acute respiratory distress syndrome, including in those with coronavirus disease 2019. Low tidal volume ventilation with a moderate to high positive end-expiratory pressure remains the foundation of an evidence-based approach. We consider strategies for setting positive end-expiratory pressure levels, the use of recruitment maneuvers, and the potential role of driving pressure. Rescue therapies including prone positioning and extracorporeal membrane oxygenation are also discussed. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 26, 2021 Category: Intensive Care Authors: Melissa H. Coleman, J. Matthew Aldrich Source Type: research

Long-Term Outcomes in Acute Respiratory Distress Syndrome
Survivors of acute respiratory distress syndrome (ARDS) experience challenges that persist well beyond the time of hospital discharge. Impairment in physical function, cognitive function, and mental health are common and may last for years. The current coronavirus disease 2019 pandemic is drastically increasing the incidence of ARDS worldwide, and long-term impairments will remain lasting effects of the pandemic. Evaluation of the ARDS survivor should be comprehensive, and common domains of impairment that have emerged from long-term outcomes research over the past 2  decades should be systematically evaluated. (Sourc...
Source: Critical Care Clinics - May 26, 2021 Category: Intensive Care Authors: Jessica A. Palakshappa, Jennifer T.W. Krall, Lanazha T. Belfield, D. Clark Files Source Type: research

Acute Kidney Injury and Acute Respiratory Distress Syndrome
The most consistent signal for mortality in acute respiratory distress syndrome (ARDS) is multi-organ failure, specifically when it involves the kidneys. Acute kidney injury (AKI) complicates approximately a third of all ARDS cases, and the combination of the two drastically worsens prognosis. Recent advances in ARDS supportive care have led to improved outcomes, however, much less is known on how to prevent and support patients with AKI and ARDS together. Understanding the dynamic relationship between the kidneys and lungs is crucial for the practicing intensivist in order to prevent injury. In this review, we summarize k...
Source: Critical Care Clinics - May 26, 2021 Category: Intensive Care Authors: Bryan D. Park, Sarah G. Faubel Source Type: research

Acute Respiratory Distress Syndrome: Ventilator Management and Rescue Therapies
This review describes the management of mechanical ventilation in patients with acute respiratory distress syndrome, including in those with COVID-19. Low tidal volume ventilation with moderate to high positive end expiratory pressure (PEEP) remains the foundation of an evidence-based approach. We consider strategies for setting PEEP levels, the use of recruitment maneuvers, and the potential role of driving pressure. Rescue therapies including prone positioning and extracorporeal membrane oxygenation are also discussed. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 26, 2021 Category: Intensive Care Authors: Melissa H. Coleman, J. Matthew Aldrich Source Type: research

Long-Term Outcomes in Acute Respiratory Distress Syndrome: Epidemiology, Mechanisms, and Patient Evaluation
Survivors of ARDS experience challenges that persist well beyond the time of hospital discharge. Impairment in physical function, cognitive function and mental health are common and may last for years. The current COVID-19 pandemic is drastically increasing the incidence of ARDS worldwide, and long-term impairments will remain lasting effects of the pandemic. The evaluation of the ARDS survivor should be comprehensive and systematically evaluate common domains of impairment that have emerged from long-term outcomes research over the past two decades. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 26, 2021 Category: Intensive Care Authors: Jessica A. Palakshappa, Jennifer T.W. Krall, Lanazha T. Belfield, D. Clark Files Source Type: research

COVID-19 –Associated Acute Respiratory Distress Syndrome
Reports examining lung histopathology in coronavirus disease 2019 (COVID-19) infection provide an essential body of information for clinicians and investigators. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) –induced lung injury is complex, involving the airways, alveoli, and pulmonary vessels. Although no anatomic marker is specific, the signature histologic lesion is diffuse alveolar damage (DAD). The biological and molecular mechanisms that drive this pattern of injury are unknown, and the relation ship of SARS-CoV-2-induced DAD to physiologic alterations and clinical outcomes in COVID-19–asso...
Source: Critical Care Clinics - May 25, 2021 Category: Intensive Care Authors: Elizabeth A. Middleton, Guy A. Zimmerman Source Type: research

Pathophysiology of the Acute Respiratory Distress Syndrome
Acute respiratory distress syndrome (ARDS) is a heterogeneous clinical syndrome that manifests secondary to numerous etiologic insults, and consequently it is associated with a multitude of pathophysiological abnormalities. Despite more than 50  years of experimental studies, translation of these benchside discoveries into effective biological therapies has been elusive. In this review, some of the key advances made in our knowledge of the pathophysiology of ARDS, based on histopathology, imaging, protein, and transcriptomic biomarkers, a re presented. Finally, the role of such human studies in understanding the patho...
Source: Critical Care Clinics - May 25, 2021 Category: Intensive Care Authors: Pratik Sinha, Lieuwe D. Bos Source Type: research

COVID-19-Associated Acute Respiratory Distress Syndrome: Lessons from Tissues and Cells
Reports examining lung histopathology in COVID-19 infection provide an essential body of information for clinicians and investigators. SARS-CoV-2-induced lung injury is complex, involving the airways, alveoli, and pulmonary vessels. Although no anatomic marker is specific the signature histologic lesion is diffuse alveolar damage (DAD). The biologic and molecular mechanisms that drive this pattern of injury are unknown, and the relationship of SARS-CoV-2-induced DAD to physiologic alterations and clinical outcomes in COVID-19-associated acute respiratory distress syndrome is undefined. Additional histologic patterns that m...
Source: Critical Care Clinics - May 25, 2021 Category: Intensive Care Authors: Elizabeth A. Middleton, Guy A. Zimmerman Source Type: research

Pathophysiology of The Acute Respiratory Distress Syndrome: Insights from Clinical Studies
Acute respiratory distress syndrome (ARDS) is a heterogeneous clinical syndrome that manifests secondary to numerous aetiological insults and consequently it is associated with a multitude of pathophysiological abnormalities. Despite over 50 years of experimental studies, translation of these benchside discoveries into effective biological therapies has been elusive. Recent advances in high throughput biological sampling, imaging and advances in data analytics has allowed studying ARDS in human subjects based on pragmatic studies. In this review, we present some of the key advances made in our knowledge of the pathophysiol...
Source: Critical Care Clinics - May 25, 2021 Category: Intensive Care Authors: Pratik Sinha, Lieuwe D. Bos Source Type: research

Poisons and Patients
Critical care providers frequently care for patients who are poisoned under a variety of circumstances and develop a wide range of clinical syndromes. Poisonings may be intentional (eg, suicide, homicide) or unintentional (eg, recreational abuse, medication error). They may involve over-the-counter medications, prescribed outpatient drugs, inpatient drug regimens, illicit substances, or environmental exposures. In the United States, deaths from overdoses reached 70,630 in 2019.1 Exposures with more serious outcomes (moderate, major, or death) increased 4.61% per year since 2000. (Source: Critical Care Clinics)
Source: Critical Care Clinics - May 5, 2021 Category: Intensive Care Authors: Janice L. Zimmerman Tags: Preface Source Type: research

Defining Acute Kidney Injury
Acute kidney injury (AKI) is a syndrome of impaired kidney function associated with reduced survival and increased morbidity. International consensus criteria were developed based on changes in serum creatinine and urine output. Based on these definitions, epidemiologic studies have shown strong associations with clinical outcomes including death and dialysis. However, numerous limitations exist for creatinine and urine volume as markers of AKI and novel biomarkers have been developed to detect cellular stress or damage. Persistent AKI and acute kidney disease are relatively new concepts that explore the idea of AKI as a c...
Source: Critical Care Clinics - March 20, 2021 Category: Intensive Care Authors: Siddharth Verma, John A. Kellum Source Type: research

Neonatal Acute Kidney Injury
The study of neonatal acute kidney injury (AKI) has transitioned from small, single-center studies to the development of a large, multicenter cohort. The scope of research has expanded from assessment of incidence and mortality to analysis of more specific risk factors, novel urinary biomarkers, interplay between AKI and other organ systems, impact of fluid overload, and quality improvement efforts. The intensification has occurred through collaboration between the neonatology and nephrology communities. This review discusses 2 case scenarios to illustrate the clinical presentation of neonatal AKI, important risk factors, ...
Source: Critical Care Clinics - March 20, 2021 Category: Intensive Care Authors: Keegan J. Kavanaugh, Jennifer G. Jetton, Alison L. Kent Source Type: research

Biomarkers in Acute Kidney Injury
Biomarkers have become a pillar of precision medicine in acute kidney injury (AKI). Traditional markers for diagnosis of AKI are insensitive and insufficient to provide comprehensive information for prognostication. Several emerging biomarkers have shown promising results in large-scale clinical studies. These novel markers likely will be beneficial for personalized AKI prevention and treatment. (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 20, 2021 Category: Intensive Care Authors: Win Kulvichit, John A. Kellum, Nattachai Srisawat Source Type: research

Acute Kidney Injury
CRITICAL CARE CLINICS (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 20, 2021 Category: Intensive Care Authors: Dana Y. Fuhrman, John A. Kellum Source Type: research

Copyright
ELSEVIER (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 20, 2021 Category: Intensive Care Source Type: research

Contributors
JOHN A. KELLUM, MD, MCCM (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 20, 2021 Category: Intensive Care Source Type: research

Contents
Dana Y. Fuhrman and John A. Kellum (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 20, 2021 Category: Intensive Care Source Type: research