Article
Critical Care Medicine
M. W. F. van den Hoogen, L. Seghers, O. C. Manintveld, S. Roest, J. A. Bekkers, C. M. den Hoed, R. C. Minnee, H. R. H. de Geus, R. J. van Thiel, D. A. Hesselink
Summary: Transplant recipients must receive a combination of medications to prevent complications and rejection, necessitating the collaboration of a multidisciplinary team post-surgery. Different types of transplant patients require specific interventions for potential complications.
JOURNAL OF CRITICAL CARE
(2021)
Review
Biochemistry & Molecular Biology
Marco Fiorentino, Francesca Bagagli, Annamaria Deleonardis, Alessandra Stasi, Rossana Franzin, Francesca Conserva, Barbara Infante, Giovanni Stallone, Paola Pontrelli, Loreto Gesualdo
Summary: Kidney transplantation is the preferred treatment for end-stage renal disease (ESRD). Kidney transplant recipients (KTRs) are at a higher risk of ICU admission, mainly in the late post-transplant period. Urosepsis and bloodstream infections are the main reasons for ICU admissions, and side effects of immunosuppressive treatment should also be accounted for. AKI incidence is common in KTRs during ICU stay, and in-hospital mortality can be high. The present review aims to explore the impact of AKI on outcomes in KTRs and provide insights into its diagnosis, management, and immunosuppression modulation.
Article
Urology & Nephrology
Hilda E. Fernandez, Bethany J. Foster
Summary: Pediatric kidney transplant recipients face challenges such as long-term graft function, the impact of CKD on neurodevelopment, and the changing immune environment. Graft failure rates are highest during adolescence and young adulthood, with factors like poor adherence to treatment and transitioning to adult care playing a role.
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
(2022)
Review
Anesthesiology
Matteo Di Nardo, Jussi Tikkanen, Shahid Husain, Lianne G. Singer, Marcelo Cypel, Niall D. Ferguson, Shaf Keshavjee, Lorenzo Del Sorbo
Summary: The number of lung transplantations is increasing worldwide, presenting challenges to healthcare teams. The outcome of lung transplantation recipients is influenced by various factors, and understanding these factors is crucial for effective postoperative management. Due to the lack of evidence-based guidelines, this review aims to provide updated information on the postoperative management of lung transplantation recipients in the intensive care unit. The six main areas covered include mechanical ventilation, fluid and hemodynamic management, immunosuppressive therapies, prevention and management of neurologic complications, antimicrobial therapy, and nutritional support and abdominal complications. Integrated care from a multidisciplinary team is essential for optimizing the postoperative management of lung transplant recipients in the ICU.
Review
Anesthesiology
N. Boyer, K. Horne, N. M. Selby, L. G. Forni
Summary: Kidney disease is common in intensive care units and can greatly impact prescribing and therapeutic management due to the kidneys' role in maintaining whole body homeostasis. This review explores the pathophysiology of acute kidney injury and chronic kidney disease in critically ill patients. It covers various aspects of renal dysfunction management, including kidney replacement therapy, acute kidney injury management, and the use of novel biomarkers for identifying and stratifying patients. Early involvement of nephrology specialists can improve outcomes and provide valuable guidance for patients with end stage kidney disease or already known to nephrology services. Ongoing research questions within this field are also discussed.
Article
Multidisciplinary Sciences
Shinhyeung Kwak, Jeong Yeon Kim, Heeyeon Cho
Summary: This retrospective study conducted at Samsung Medical Center in Seoul, South Korea, aimed to investigate the prevalence and risk factors of vancomycin-induced nephrotoxicity in non-ICU pediatric patients. The study found that a longer hospital stay, concomitant use of piperacillin-tazobactam, and a serum trough level of vancomycin above 24.35 mu g/mL were independently associated with VIN. The study suggests that measuring serum trough level of vancomycin can help clinicians prevent VIN in pediatric patients.
SCIENTIFIC REPORTS
(2021)
Article
Medicine, General & Internal
Raul Juarez-Vela, Eva Maria Andres-Esteban, Ivan Santolalla-Arnedo, Regina Ruiz de Vinaspre-Hernandez, Carmen Benito-Puncel, Ainhoa Serrano-Lazaro, Pilar Marcos-Neira, Alba Lopez-Fernandez, Clara Isabel Tejada-Garrido, Juan Luis Sanchez-Gonzalez, Manuel Quintana-Diaz, Jose Antonio Garcia-Erce
Summary: Severe traumatic injury is a major global health issue, leading to a significant number of deaths. Uncontrolled hemorrhage is the main avoidable cause of death among these patients. Managing trauma patients is a challenging task in emergency care, and timely diagnosis and intervention for bleeding, including blood transfusion, are crucial for patient outcomes.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Gastroenterology & Hepatology
Constantine J. J. Karvellas, Thierry Gustot, Javier Fernandez
Summary: Acute on chronic liver failure (ACLF) is the development of organ failure(s) in cirrhosis patients and has a high short-term mortality rate. Medical management of ACLF needs to consider the relationship between the underlying chronic liver disease/cirrhosis, precipitating insult, and involved organ systems. Intensive care management of ACLF focuses on promptly recognizing and treating triggering events and providing aggressive support for failing organs to ensure successful liver transplantation or recovery. The complexity of managing ACLF patients arises from their propensity to develop new organ failures and complications like infections or bleeding. A multidisciplinary team with expertise in critical care and transplant medicine is best suited for the management of critically ill ACLF patients. This review aims to identify common complications of ACLF and describe the appropriate management for critically ill patients awaiting liver transplantation, including organ support, prognostic assessment, and determining the likelihood of recovery.
LIVER INTERNATIONAL
(2023)
Review
Medicine, General & Internal
Danae Olaso, Miriam Manook, Dimitrios Moris, Stuart Knechtle, Jean Kwun
Summary: Patients with previous sensitization events against anti-HLA have higher rates of antibody-mediated rejection post organ transplantation, requiring stringent donor matching and focus on reducing preformed antibodies for treatment.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Pediatrics
Cal Robinson, Erin Hessey, Sophia Nunes, Marc Dorais, Rahul Chanchlani, Jacques Lacroix, Philippe Jouvet, Veronique Phan, Michael Zappitelli
Summary: This study found that nephrology follow-up after pediatric AKI was uncommon, but nearly all survivors received follow-up from non-nephrologist physicians within one year post discharge. This suggests that knowledge translation strategies for AKI follow-up should be targeted at non-nephrology healthcare providers.
PEDIATRIC RESEARCH
(2022)
Article
Infectious Diseases
Alex R. Schuurman, Robert F. J. Kullberg, Willem Joost Wiersinga
Summary: There has been significant progress in understanding the gut microbiome in health and disease over the past decade. The gut microbiome interacts with the immune system and plays a crucial role in defending the host against pathogens. However, disturbances in the gut microbiome due to disease or interventions like antibiotic treatment can have negative consequences. This review focuses on the potential role of probiotics in the ICU, summarizes evidence from randomized clinical trials, and discusses challenges and future prospects.
Article
Cardiac & Cardiovascular Systems
Karishma Priyadarshani Ramlakhan, Maaike van der Bie, Corstiaan A. den Uil, Eric A. Dubois, Jolien W. Roos-Hesselink
Summary: This study investigates non-elective ICU admissions in patients with adult congenital heart disease (ACHD). The results show that ACHD patients have lower short-term and total mortality compared with non-ACHD patients, but higher long-term mortality than expected.
Article
Medicine, Research & Experimental
Stephanie Ruiz, Fanny Vardon-Bounes, Marie Virtos, Thierry Seguin, Laure Crognier, Antoine Rouget, Bernard Georges, Jean-Marie Conil, Vincent Minville
Summary: This observational study aimed to evaluate the impact of arterial blood gases on renal arterial resistive index (RI) in the ICU setting. The results showed correlations between RI and PaCO2, age, diastolic arterial pressure, and SaO2. Multivariate analysis confirmed that age > 58 years and PaCO2 were significant factors influencing the RI. These findings suggest that thresholds for PaCO2, age, and diastolic arterial pressure should be considered in interpreting RI.
JOURNAL OF TRANSLATIONAL MEDICINE
(2023)
Review
Critical Care Medicine
Zaccaria Ricci, Stefano Romagnoli, Thiago Reis, Rinaldo Bellomo, Claudio Ronco
Summary: This narrative review provides an overview of the current knowledge regarding technical concepts, safety, and clinical results of hemoperfusion. It also focuses on the most recent literature on adsorption applied in critically ill patients, including randomized controlled trials, and future areas of investigation.
INTENSIVE CARE MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Thomas S. Metkus, John Lindsley, Linda Fair, Sarah Riley, Stephen Berry, Sarina Sahetya, Steven Hsu, Nisha A. Gilotra
Summary: Patients with heart failure in the intensive care unit represent high-risk and resource-intensive cases requiring high-quality care. Efforts to improve outcomes for these patients include reconsidering critical care paradigms, enhancing teamwork, and optimizing ICU resource use. Expanding high-quality initiatives for heart failure patients in critical care settings is essential for achieving optimal health-system performance.
JOURNAL OF CARDIAC FAILURE
(2021)