Continuous venovenous hemofiltration improves intensive care unit, but not hospital survival rate, in nonoliguric septic patients

2001 ◽  
Vol 16 (2) ◽  
pp. 69-73 ◽  
Author(s):  
Natan Weksler ◽  
Illia Chorni ◽  
Gabriel M. Gurman ◽  
Aviel R. Shapira ◽  
Lazaro Gotloib
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Survival Rate ◽  
Continuous Venovenous Hemofiltration ◽  
Hospital Survival

Renal Support Therapy

2018 ◽  
Author(s):  
Samuel M Galvagno Jr ◽  
Anthony E Tannous
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Surgical Intensive Care Unit ◽  
Continuous Venovenous Hemofiltration ◽  
Surgical Intensive Care ◽  
Core Skill ◽  
Renal Support Therapy

Knowledge regarding the practical aspects of managing continuous renal replacement therapy (CRRT) in the surgical intensive care unit is a prerequisite for achieving desired physiologic end points. Familiarity with the initiation, dosing, adjustment, and termination of CRRT is a core skill for surgical intensivists. Modalities, terminology, and components of CRRT are discussed in this review, with an emphasis on the practical aspects of dosing, adjustments, and termination. Filter selection and management of electrolyte and acid-base derangements are emphasized. Key words: continuous renal replacement therapy, continuous venovenous hemofiltration, continuous venovenous hemofiltration dialysis, dialysis, intensive care unit

In vivo Elimination of Clonidine by Continuous Venovenous Hemofiltration in Critically Ill Patients

2020 ◽  
Vol 49 (5) ◽  
pp. 622-626
Author(s):  
Huub L.A. van den Oever ◽  
Marieke Zeeman ◽  
Polina Nassikovker ◽  
Carmen Bles ◽  
Fred A.L. van Steveninck ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Continuous Venovenous Hemofiltration ◽  
Kidney Dysfunction ◽  
Sieving Coefficient ◽  
The Mean ◽  
Ventilated Patients

Background: Clonidine is an α2-agonist that is commonly used for sedation in the intensive care unit. When patients are on continuous venovenous hemofiltration (CVVH) in the presence of kidney dysfunction, the sieving coefficient of clonidine is required to estimate how much drug is removed by CVVH. In the present study, we measured the sieving coefficient of clonidine in critically ill, ventilated patients receiving CVVH. Methods: A total of 20 samples of plasma and ultrafiltrate of 3 patients on CVVH, using a standard 1.5 m2 polyacrylonitrile AN69 membrane, during continuous clonidine infusion were collected. After correction for the effect of predilution, we calculated the sieving coefficient for clonidine. Results: The mean sieving coefficient of clonidine was 0.52 (SD 0.097). Conclusion: Using a polyacrylonitrile AN69 membrane in a CVVH machine, the in vivo sieving coefficient of clonidine was 0.52.

Multicenter outcome study of cancer patients admitted to the intensive care unit: a probability of mortality model.

1998 ◽  
Vol 16 (2) ◽  
pp. 761-770 ◽  
Author(s):  
J S Groeger ◽  
S Lemeshow ◽  
K Price ◽  
D M Nierman ◽  
P White ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Logistic Regression ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Cancer Patients ◽  
The United States ◽  
Categorical Variables ◽  
Allogeneic Bone ◽  
Icu Admission ◽  
Hospital Survival

PURPOSE To develop prospectively and validate a model for probability of hospital survival at admission to the intensive care unit (ICU) of patients with malignancy. PATIENTS AND METHODS This was an inception cohort study in the setting of four ICUs of academic medical centers in the United States. Defined continuous and categorical variables were collected on consecutive patients with cancer admitted to the ICU. A preliminary model was developed from 1,483 patients and then validated on an additional 230 patients. Multiple logistic regression modeling was used to develop the models and subsequently evaluated by goodness-of-fit and receiver operating characteristic (ROC) analysis. The main outcome measure was hospital survival after ICU admission. RESULTS The observed hospital mortality rate was 42%. Continuous variables used in the ICU admission model are PaO2/FiO2 ratio, platelet count, respiratory rate, systolic blood pressure, and days of hospitalization pre-ICU. Categorical entries include presence of intracranial mass effect, allogeneic bone marrow transplantation, recurrent or progressive cancer, albumin less than 2.5 g/dL, bilirubin > or = 2 mg/dL, Glasgow Coma Score less than 6, prothrombin time greater than 15 seconds, blood urea nitrogen (BUN) greater than 50 mg/dL, intubation, performance status before hospitalization, and cardiopulmonary resuscitation (CPR). The P values for the fit of the preliminary and validation models are .939 and .314, respectively, and the areas under the ROC curves are .812 and .802. CONCLUSION We report a disease-specific multivariable logistic regression model to estimate the probability of hospital mortality in a cohort of critically ill cancer patients admitted to the ICU. The model consists of 16 unambiguous and readily available variables. This model should move the discussion regarding appropriate use of ICU resources forward. Additional validation in a community hospital setting is warranted.

Pharmacokinetics of Imipenem/Cilastatin Burn Intensive Care Unit Patients Undergoing High-Dose Continuous Venovenous Hemofiltration

2016 ◽  
Vol 36 (12) ◽  
pp. 1229-1237 ◽  
Author(s):  
Bradley A. Boucher ◽  
Joanna Q. Hudson ◽  
David M. Hill ◽  
Joseph M. Swanson ◽  
G. Christopher Wood ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Dose ◽  
Continuous Venovenous Hemofiltration

scholarly journals Pharmacokinetics of Levofloxacin and Ciprofloxacin during Continuous Renal Replacement Therapy in Critically Ill Patients

2001 ◽  
Vol 45 (10) ◽  
pp. 2949-2954 ◽  
Author(s):  
Rebecca S. Malone ◽  
Douglas N. Fish ◽  
Edward Abraham ◽  
Isaac Teitelbaum
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Effective Drug ◽  
Continuous Venovenous Hemofiltration ◽  
Drug Concentrations

ABSTRACT The pharmacokinetics of intravenously administered levofloxacin and ciprofloxacin were studied in intensive care unit patients during continuous venovenous hemofiltration (CVVH; four patients received levofloxacin, and five received ciprofloxacin) or hemodiafiltration (CVVHDF; six patients received levofloxacin, and five received ciprofloxacin). Levofloxacin clearance was substantially increased during both CVVH and CVVHDF, while ciprofloxacin clearance was affected less. The results of this study suggest that doses of levofloxacin of 250 mg/day and ciprofloxacin of 400 mg/day are sufficient to maintain effective drug concentrations in the plasma of patients undergoing CVVH or CVVHDF.

Development and Implementation of an ICU Quality Improvement Checklist

2007 ◽  
Vol 18 (2) ◽  
pp. 183-189
Author(s):  
Steven Q. Simpson ◽  
Douglas A. Peterson ◽  
Amy R. O’Brien-Ladner
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Survival Rate ◽  
Length Of Stay ◽  
Critically Ill ◽  
Evidence Based ◽  
Optimal Care ◽  
Life Threatening ◽  
Medical Intensive Care

Hospitals, especially their intensive care units, are not particularly safe for patients. Life-threatening mistakes and omissions in care can and do occur. To deter omissions and mistakes wherever possible, our medical intensive care team developed a checklist of care issues that must be addressed daily for every patient in our intensive care unit. The checklist augments our daily, multidisciplinary quality rounds and informs all personnel when important items have been missed. It is too soon to tell whether the checklist has had an impact on our survival rate or length of stay, but we have documented clear imrovement in our attention to these core intensive care issues. In addition, our team’s collegiality and team bonding are enhanced by using an evidence-based tool to achieve our care goals. We share our checklist, so that others can use and/or adapt it in their pursuit of optimal care for their critically ill patiens.

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