English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background  Patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) have an increased short-term and long-term risk of mortality. In most North American intensive care units (ICUs), these patients receive continuous renal replacement therapy (CRRT).    Objective  We aim to identify clinical and demographic factors associated with mortality within 24 h of initiating CRRT.    Design  This paper is a prospective cohort study.    Setting  The setting involves three ICUs (12-bed surgical ICU, 10-bed medical ICU, and a 7-bed combined ICU for both medical and surgical patients) of the Regina Qu’Appelle Health Region (RQHR) Saskatchewan, Canada.    Patients  The patients were 106 individuals with AKI who were admitted to the ICUs and received CRRT from April 2013 to September 2014.    Measurements  Date and time of admission, transfer to, and initiation of CRRT were documented. Demographic data, use of vasoactive medications, ventilator settings, pH, urine output, and chronic disease comorbidities were measured.    Methods  The methods involved a stepwise multiple variable logistic regression model using death within 24 h of starting CRRT as the dependent variable, with significant variables derived from univariate analysis as covariates.    Results  Of the 2634 patients admitted to the ICUs in the study period (April 2013 to September 2014), 83.6 % (2201/2634) had no AKI. Two hundred and sixty-nine or 10.2 % of the patients had stage 3 AKI. One hundred six of the 269 patients (40%) were started on CRRT. Of those on CRRT, 66/106 died in the ICU while on CRRT. Seventeen of the 66 patients (26%) died within 24 h of initiating therapy. In univariate logistic regression models, factors associated with early mortality included fraction of inspired oxygen (per 0.1 unit) (OR 1.39, 95 % CI 1.09–1.77); epinephrine dose >10 μg/min (OR 5.81, 95 % CI 1.86–18.16); vasopressin >0.02 μg/min (OR 3.99, 95 % CI 1.07–14.84); and norepinephrine dose >20 μg/min (OR 11.04, 95 % CI 2.38–51.24) which were associated with early mortality. When included in stepwise multivariate logistic regression analysis, only FiO 2  (per 0.1 unit) and the dose of norepinephrine of >20 μg/min were independently associated with early mortality.    Limitations  The small sample size was a limitation of this study.    Conclusion  Patients admitted to the ICU with AKI requiring CRRT have a high risk of early mortality. In these patients, vasopressor use and hypoxia were independently associated with adverse short-term survival.

Early Mortality on Continuous Renal Replacement Therapy (CRRT): The Prairie CRRT Study