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Management of the Potential Organ Donor in the ICU: Society of Critical Care Medicine/American College of Chest Physicians/Association of Organ Procurement Organizations Consensus Statement
This document was developed through the collaborative efforts of the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations. Under the auspices of these societies, a multidisciplinary, multi-institutional task force was convened, incorporating expertise in critical care medicine, organ donor management, and transplantation. Members of the task force were divided into 13 subcommittees, each focused on one of the following general or organ-specific areas: death determination using neurologic criteria, donation after circulatory death determination, ...
Source: Critical Care Medicine - May 16, 2015 Category: Emergency Medicine Tags: Special Article Source Type: research

Validation of the KDIGO acute kidney injury criteria in a pediatric critical care population
Conclusions Using the KDIGO criteria to define AKI, we observed a high prevalence of AKI among critically ill children. Worsening stages of AKI were associated with increased ICU LOS, and AKI was independently associated with prolonged mechanical ventilation and increased mortality. The KDIGO criteria describe clinically relevant AKI in a broad pediatric critical care population.
Source: Intensive Care Medicine - September 26, 2014 Category: Intensive Care Source Type: research

SCCMPod-463 CCM: Clazakizumab for COVID-19: Friend or Foe?
Clazakizumab is a monoclonal antibody against human interleukin-6 that may benefit patients hospitalized with severe or critical COVID-19 accompanied by hyperinflammation. Although not yet FDA approved, clinical trials of clazakizumab for treatment of COVID-19 are under way worldwide. Samantha Gambles Farr, MSN, NP-C, CCRN, RNFA, is joined by Bonnie E. Lonze, MD, PhD, to discuss the article, A Randomized Double-Blinded Placebo Controlled Trial of Clazakizumab for the Treatment of COVID-19 Pneumonia With Hyperinflammation, published in the September 2022 issue of Critical Care Medicine. Dr. Lonze is a faculty transplant sur...
Source: SCCM PodCast - iCritical Care - October 6, 2022 Category: Intensive Care Authors: The Society of Critical Care Medicine (SCCM) Tags: Medicine Source Type: podcasts

SCCM Pod-463 CCM: Clazakizumab for COVID-19: Friend or Foe?
Clazakizumab is a monoclonal antibody against human interleukin-6 that may benefit patients hospitalized with severe or critical COVID-19 accompanied by hyperinflammation. Although not yet FDA approved, clinical trials of clazakizumab for treatment of COVID-19 are under way worldwide. Samantha Gambles Farr, MSN, NP-C, CCRN, RNFA, is joined by Bonnie E. Lonze, MD, PhD, to discuss the article, A Randomized Double-Blinded Placebo Controlled Trial of Clazakizumab for the Treatment of COVID-19 Pneumonia With Hyperinflammation, published in the September 2022 issue of Critical Care Medicine. Dr. Lonze is a faculty transplant sur...
Source: SCCM PodCast - iCritical Care - December 21, 2022 Category: Intensive Care Authors: The Society of Critical Care Medicine (SCCM) Tags: Medicine Source Type: podcasts

Acute Kidney Injury in Pediatric Acute Decompensated Heart Failure
Objective: Acute kidney injury in adult patients with acute decompensated heart failure is associated with increased mortality. There is limited literature in pediatric patients with acute decompensated heart failure and acute kidney injury. We aim to study acute kidney injury in the pediatric acute decompensated heart failure population and its association with specific outcomes. Design: Retrospective, case-control study. Setting: Cardiac ICU in a children’s tertiary care hospital. Patients: Index admissions of patients younger than 21 years with acute decompensated heart failure between January 2008 and December 2012. ...
Source: Pediatric Critical Care Medicine - July 1, 2015 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Risk Factors for Mortality in Critically Ill Children Requiring Renal Replacement Therapy*
Conclusions: Earlier renal replacement therapy initiation with respect to the development of severe acute kidney injury was associated with lower mortality in this cohort of critically ill children. Additionally, invasive mechanical ventilation at the time of renal replacement therapy initiation and a higher degree of fluid accumulation after initiating renal replacement therapy were associated with increased mortality.
Source: Pediatric Critical Care Medicine - November 1, 2019 Category: Pediatrics Tags: Renal Critical Care Source Type: research

SCCM Pod-365 Medications and RRT: We Know How to Dose, Right?
Dr. Fraser, MD, speaks with Bruce A. Mueller, PharmD, FCCP, FASN, about his talk presented at the 47th Critical Care Congress in San Antonio, Texas, entitled Artificial Kidney Meets Mechanical Lung: Comanaging the Patient with Renal and Respiratory Failure.
Source: SCCM PodCast - iCritical Care - July 12, 2018 Category: Intensive Care Authors: The Society of Critical Care Medicine (SCCM) Tags: Medicine Source Type: podcasts

Critical Care Compendium update
LITFL’s Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care. Currently there are almost 1,500 entries with more in the works… Some pages are more developed than others, and all the pages are being constantly revised and improved. Links to new references and online resources are added daily, with an emphasis on those that are free and open access (FOAM!). These pages originated from the FCICM exam study notes created by Dr Jeremy Fernando in 2011, and have been updated, modified and added to since. As such will be particularly us...
Source: Life in the Fast Lane - November 17, 2013 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: Critical Care Compendium Education eLearning Emergency Medicine Featured CCC LITFL collection Source Type: blogs

Cardiac Surgery–Associated Kidney Injury in Children and Renal Oximetry
Conclusions: Findings demonstrate that preoperative oxygen supply/demand balance is an important predictor of cardiac surgery–associated acute kidney injury, suggesting lower preoperative (and intraoperative) renal blood flow may be protective. There is not yet a definite link between remote ischemic preconditioning and prevention of cardiac surgery–associated acute kidney injury; however, renal protective effects of sublethal ischemia should continue to be explored.
Source: Pediatric Critical Care Medicine - September 1, 2018 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Association Between Continuous Kidney Replacement Therapy Clearance and Outcome in Pediatric Patients With Hyperammonemia Not Due to Inborn Error of Metabolism
CONCLUSIONS: In our single-center retrospective study, we failed to find an association between clearance on CKRT and improved survival nor decreased cerebral edema on head imaging. In fact, we failed to find an association between ammonia level and mortality, after controlling for illness severity.
Source: Pediatric Critical Care Medicine - July 1, 2022 Category: Pediatrics Tags: Online Brief Reports Source Type: research

Reversal of severe lactic acidosis with thiamine in a renal allograft recipient
K Nanda Kumar, Veena R Shah, Beena K Parikh, Sumedha SondeIndian Journal of Critical Care Medicine 2015 19(7):425-428A 48-year-old female patient with end-stage renal failure developed unexplained severe lactic acidosis (LA) associated with hyperglycemia during robotic-assisted laparoscopic renal transplantation. Initial treatment with sodium bicarbonate and insulin infusion were ineffective in treating acidemia. Postoperatively, intravenous administration of thiamine resulted in rapid improvement of LA and blood sugar levels. Uremia and chronic hemodialysis might be the causes behind the quantitative/qualitative deficienc...
Source: Indian Journal of Critical Care Medicine - July 8, 2015 Category: Intensive Care Authors: K Nanda KumarVeena R ShahBeena K ParikhSumedha Sonde Source Type: research

The need for extracorporeal membrane oxygenation in adults undergoing congenital heart surgery: Impact and trends of utilization
Conclusion: ECMO is only needed in a small proportion of postoperative ACHD patients. The use of ECMO significantly increases cost, length of stay and mortality in these patients. Improved identification of postoperative ACHD patients who are more likely to survive ECMO may facilitate improved survival and decreased resource utilization.
Source: Indian Journal of Critical Care Medicine - September 14, 2017 Category: Intensive Care Authors: Salvatore Aiello Rohit S Loomba Connor Kriz Matthew Buelow Saurabh Aggarwal Rohit R Arora Source Type: research

Posterior reversible encephalopathy syndrome-an under recognized manifestation of Chronic Kidney Disease
We report successful renal transplantation (RTx) in a CKD patient with PRES. Constraints in operating an effective maintenance dialysis program leave RTx as the only viable option for ESRD patients in our country to prevent complications like PRES associated with uremia and uncontrolled hypertension
Source: Indian Journal of Critical Care Medicine - October 24, 2013 Category: Intensive Care Authors: Vivek B KuteHargovind L TrivediPankaj R ShahManoj R GumberHimanshu V PatelAruna V Vanikar Source Type: research

Urinary neutrophil gelatinase associated lipocalin as an early marker of acute kidney injury in the recipient after liver transplantation
Conclusion Urinary NGAL/creatinine ratio may be used as a test for the early prediction of adverse outcome of LDLT recipient patients at ICU admission.
Source: The Egyptian Journal of Critical Care Medicine - December 23, 2016 Category: Intensive Care Source Type: research