scholarly journals From Multiple Organ Support Therapy to Extracorporeal Organ Support in Critically Ill Patients

2019 ◽  
Vol 48 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Claudio Ronco ◽  
Zaccaria Ricci ◽  
Faeq Husain-Syed
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Journal Club ◽  
Multiple Organ ◽  
Artificial Organs ◽  
Organ Support ◽  
Future Research ◽  
Advantages And Disadvantages ◽  
Early Implementation ◽  
Open Debate

Critically ill patients developing severe forms multiple organ dysfunction syndrome (MODS) may not be adequately supported by pharmacologic management. In these complex cases, a single form of extracorporeal organ support (ECOS) may be required, but multiple organ support therapy (MOST) is currently seen as a feasible approach. Severe renal dysfunction is a typical syndrome requiring renal replacement therapy (RRT) in the context of MODS. After more than a decade of RRT application in various intensive care settings, ECOS are not anymore seen as extraordinary or particularly aggressive techniques in MODS patients. Nowadays, a significant increase in the use of extracorporeal membrane oxygenation and extracorporeal carbon dioxide removal is occurring. When renal and cardio-pulmonary ECOS are used together, a multidisciplinary approach is necessary to minimize negative interactions and unwanted adverse effects. In this editorial, we focus on the organ crosstalk between the native and artificial organs, including the advantages and disadvantages of organ support on multiorgan function. Much of current experience on MOST has been gained upon RRT connected to other organ support therapies. Overall, available literature has not definitely established the ideal timing of these interventions, and whether early implementation impacts organ recovery and optimizes resource utilization is still a matter of open debate: it is possible that future research will be devoted to identify patient groups that may benefit from short- and long-term multiple organ support. Video Journal Club “Cappuccino with Claudio Ronco” at  https://www.karger.com/Journal/ArticleNews/490694?sponsor=52

scholarly journals Transport of Critically Ill Patients – A Review of Early Interventions, Protocols, and Recommendations

2021 ◽  
Vol 11 (4) ◽  
pp. 133-143
Author(s):  
Sibghatullah M Khan ◽  
Marcus D. Lance ◽  
Mariam Ali Karrar Elobied
Keyword(s):  
Adverse Events ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multiple Organ ◽  
Organ Support ◽  
Early Interventions ◽  
Health Care Environment ◽  
Staff Members ◽  
Quality Of Patient Care

The transportation of critically ill patients into or outside the hospital (ICU) has been associated with several adverse events [1, 2]. Mostly, patients admitted to the Intensive Care Unit (ICU) are considered to be critically ill. ICU can provide the best possible care to the patients, including monitoring, multiple organ support, frequent clinical round, and dedicated staff members for each patient. However, specific situations occur when the patient has to be transported out of the ICU to the best of the patient's interest. The benefits attached to the purpose of the transportation outweigh the risks. This literature review aims to summarize timely interventions, minimum standards for transportation, transport protocols, and recommendations to reduce critically ill patients to the potential risk in the ICU. We aim to improve the quality of patient care, risk evaluation, minimizing preventable hazards, standardization of the protocols, homogeneity of the modalities involved in the patient’s transport, and ultimately improving the patient’s health care environment. Findings shows that, a total of 1.7% of adverse events during transportation were identified. In this study, 3383 charts of completed transports were observed [6]. The incidence of adverse effects is quite variable, i.e., from 1.7% to 75.7%, and in other studies, it is sometimes recorded as high as 80% [4]. Key words: Transport, Critically Ill Patients, Early Interventions, Protocols, Recommendations.

scholarly journals Report of the first AKI Round Table meeting: an initiative of the ESICM AKI Section

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
M. Ostermann ◽  
A. Schneider ◽  
T. Rimmele ◽  
I. Bobek ◽  
M. van Dam ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Critical Care ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Future Research ◽  
Knowledge Gaps ◽  
Blood Pressure Targets

Abstract Purpose Critical Care Nephrology is an emerging sub-specialty of Critical Care. Despite increasing awareness about the serious impact of acute kidney injury (AKI) and renal replacement therapy (RRT), important knowledge gaps persist. This report represents a summary of a 1-day meeting of the AKI section of the European Society of Intensive Care Medicine (ESICM) identifying priorities for future AKI research. Methods International Members of the AKI section of the ESICM were selected and allocated to one of three subgroups: “AKI diagnosis and evaluation”, “Medical management of AKI” and “Renal Replacement Therapy for AKI.” Using a modified Delphi methodology, each group identified knowledge gaps and developed potential proposals for future collaborative research. Results The following key research projects were developed: Systematic reviews: (a) epidemiology of AKI with stratification by patient cohorts and diagnostic criteria; (b) role of higher blood pressure targets in patients with hypertension admitted to the Intensive Care Unit, and (c) specific clearance characteristics of different modalities of continuous renal replacement therapy (CRRT). Observational studies: (a) epidemiology of critically ill patients according to AKI duration, and (b) current clinical practice of CRRT. Intervention studies:( a) Comparison of different blood pressure targets in critically ill patients with hypertension, and (b) comparison of clearance of solutes with various molecular weights between different CRRT modalities. Conclusion Consensus was reached on a future research agenda for the AKI section of the ESICM.

Metabolic encephalopathy in critically ill patients suffering from septic or nonseptic multiple organ failure

2000 ◽  
Vol 28 (5) ◽  
pp. 1310-1315 ◽  
Author(s):  
Christian Zauner ◽  
Alexandra Gendo ◽  
Ludwig Kramer ◽  
Alexander Kranz ◽  
Georg Grimm ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multiple Organ ◽  
Metabolic Encephalopathy

Association of frailty with short-term outcomes, organ support and resource use in critically ill patients

2018 ◽  
Vol 44 (9) ◽  
pp. 1512-1520 ◽  
Author(s):  
Fernando G. Zampieri ◽  
◽  
Theodore J. Iwashyna ◽  
Elizabeth M. Viglianti ◽  
Leandro U. Taniguchi ◽  
...  
Keyword(s):  
Critically Ill ◽  
Resource Use ◽  
Critically Ill Patients ◽  
Organ Support ◽  
Short Term

SOLUBLE FAS LEVELS CORRELATE WITH MULTIPLE ORGAN DYSFUNCTION SEVERITY, SURVIVAL AND NITRATE LEVELS, BUT NOT WITH CELLULAR APOPTOTIC MARKERS IN CRITICALLY ILL PATIENTS

Shock ◽  
2000 ◽  
Vol 14 (2) ◽  
pp. 107-112 ◽  
Author(s):  
Elizabeth D. E. Papathanassoglou ◽  
Jan A. Moynihan ◽  
Dianne L. Vermillion ◽  
Michael P. McDermott ◽  
Michael H. Ackerman
Keyword(s):  
Critically Ill ◽  
Organ Dysfunction ◽  
Critically Ill Patients ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Soluble Fas ◽  
Apoptotic Markers

ASSESSMENT OF CEREBRAL FUNCTION IN CRITICALLY ILL PATIENTS WITH MULTIPLE ORGAN FAILURE DUE TO SEPTIC AND NON-SEPTIC CONDITIONS

1999 ◽  
Vol 27 (Supplement) ◽  
pp. 125A
Author(s):  
Christian Zauner ◽  
Alexandra Gendo ◽  
Ludwig Kramer ◽  
Alexander Kranz ◽  
Christian Madl
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multiple Organ ◽  
Cerebral Function

scholarly journals Redox Changes Induced by General Anesthesia in Critically Ill Patients with Multiple Traumas

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Marius Papurica ◽  
Alexandru Florin Rogobete ◽  
Dorel Sandesc ◽  
Raluca Dumache ◽  
Radu Nartita ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
General Anesthesia ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Trauma Team ◽  
Multiple Organ ◽  
Cellular Mechanisms ◽  
Surgical Interventions ◽  
Polytrauma Patient ◽  
Multiple Traumas

The critically ill polytrauma patient is a constant challenge for the trauma team due to the complexity of the complications presented. Intense inflammatory response and infections, as well as multiple organ dysfunctions, significantly increase the rate of morbidity and mortality in these patients. Moreover, due to the physiological and biochemical imbalances present in this type of patients, the bioproduction of free radicals is significantly accelerated, thus installing the oxidative stress. In the therapeutic management of such patients, multiple surgical interventions are required and therefore they are being subjected to repeated general anesthesia. In this paper, we want to present the pathophysiological implications of oxidative stress in critically ill patients with multiple traumas and the implications of general anesthesia on the redox mechanisms of the cell. We also want to summarize the antioxidant treatments able to reduce the intensity of oxidative stress by modulating the biochemical activity of some cellular mechanisms.

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