An Official ATS/ERS/ESICM/SCCM/SRLF Statement: Prevention and Management of Acute Renal Failure in the ICU Patient

Brochard, Laurent; Abroug, Fékri; Brenner, Matthew; Broccard, Alain F.; Danner, Robert L.; Ferrer, Miquel; Laghi, Franco; Magder, Sheldon; Papazian, Laurent; Pelosi, Paolo; Polderman, Kees H.

doi:10.1164/rccm.200711-1664st

Cited by 265 publications

(180 citation statements)

References 329 publications

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“…Recent study recommends a higher trough vancomycin concentration of between 15-20 mg/L especially in the treatment of complicated infections (e.g. ventilatory associated pneumonia) and for a pathogen with an MIC of 1 mg/L in order to attain target vancomycin exposure 10,23 . Higher trough vancomycin concentrations may also increase the potential for nephrotoxicity but the extent of this risk is yet to be determined.…”

Section: Discussionmentioning

confidence: 99%

Vancomycin pharmacokinetics during high-volume continuous venovenous hemofiltration in critically ill septic patients

Petejová¹,

Martínek²,

Zahálková³

et al. 2014

BIOMED PAP

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Aims.To assess the influence of continuous venovenous hemofiltration (CVVH) at a filtration rate of 45 mL/kg/h on vancomycin pharmacokinetics in critically ill septic patients with acute kidney injury (AKI). Methods. Seventeen adult septic patients with acute kidney injury treated with CVVH and vancomycin were included. All patients received first dose of 1.0 g intravenously followed by 1.0 g/12 h if not adjusted. In sixteen patients vancomycin was introduced on the day of the start of CRRT therapy. Blood samples and ultrafiltrates were obtained before and 0.5, 1, 6 and 12 h after vancomycin administration. Results. On the first day, the median total vancomycin clearance (Cl tot ) was 0.89 mL/min/kg (range 0.31 -2.16). CRRT clearance accounted for around 50-60% of the total clearance of vancomycin found in a population with normal renal function (0.97 mL/min/kg). Vancomycin serum concentrations after the first dose were below the required target of 10 mg/L as early as 6 h in 10 patients, AUC 0-24 /MIC ≥ 400 ratio was achieved in 10 patients on the first day. Conclusions. CVVH at a filtration rate of 45 mL/kg/h leads to high and rapid extracorporeal removal of vancomycin in critically ill patients. Due to the rapid change in patient clinical status it was impossible to predict a fixed dosage regimen. We recommend blood sampling as early as 6 h after first vancomycin dose with maintenance dose based on vancomycin serum level monitoring.

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Section: Discussionmentioning

confidence: 99%

Vancomycin pharmacokinetics during high-volume continuous venovenous hemofiltration in critically ill septic patients

Petejová¹,

Martínek²,

Zahálková³

et al. 2014

BIOMED PAP

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“…Of note, intra-abdominal pressure (IAP) has recently been included in the consensus statement as the possible missing link explaining deterioration of renal function in critically ill patients [38,39] . IAP is an independent risk factor for AKI development and may also explain the cardiorenal syndrome [40][41][42][43] .…”

Section: Acute Respiratory Distress Syndromementioning

confidence: 99%

Acute kidney injury classification: AKIN and RIFLE criteria in critical patients

Lin

Chen

2012

WJCCM

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Acute kidney injury (AKI) is a common and serious complication in critically ill patients. The mortality rate remains high despite improved renal replacement techniques. A possible cause of the high mortality rate is that intensive care unit patients tend to be older and more debilitated than before. Pathophysiological factors associated with AKI are also implicated in the failure of other organs, indicating that AKI is often part of a multiple organ failure syndrome. Until recently, there was a lack of consensus as to the best definition, characterization, and evaluation of acute renal failure. This lack of a standard definition has been a major impediment to progress in clinical and basic research. The introduction of the risk, injury, failure, loss, and end-stage kidney disease criteria and the modified version proposed by the Acute Kidney Injury Network have increased the conceptual understanding of AKI syndrome, and these criteria have been successfully tested in clinical studies. This article reviews current findings concerning the application of these criteria for assessing epidemiology and predicting outcome in specific homogeneous critically ill patient groups.

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“…Majority of infected patients were septic in this study, Hashemian [40]. Many other factors are associated with an increased risk of AKI but their influence will be highly dependent on the specific nature of the population, Brochard et al [41].…”

Section: Discussion and Concluding Remarksmentioning

confidence: 95%

Bayesian Analysis of Joint Modeling of Longitudinal and Time to Event Data Using Some Skew-Elliptical Distributions

Khoundabi¹,

Kazemnejad²,

Mansourian³

et al. 2017

BBIJ

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Joint modeling of longitudinal and time to event data have been widely used for analyzing medical data, where longitudinal measurements is gathered with a time to event or survival data. In most of these studies, distributional assumption for modeling longitudinal response is normal, which leads to vulnerable inference in the presence of outliers in longitudinal measurements and violation of this assumption. Violation of the normality assumption can also make the statistical inference vague. Powerful distributions for robust analyzing and relaxing normality assumption, are skew-elliptical distributions, which include univariate and multivariate versions of the student's t, the Laplace and normal distributions. In this paper, a linear mixed effects model with skew-elliptical distribution for both random effects and residuals and a Cox's model for time to event data are used for joint modeling. This strategy allows for the skewness and the heavy tails of random effect distributions and thus makes inferences robust to the violation. For estimation, a Bayesian parametric approach using Markov chain Monte Carlo is adopted. The method is illustrated in a real Intensive Care Unit (ICU) data set and the best model is selected using some Bayesian criteria for model selection.

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An Official ATS/ERS/ESICM/SCCM/SRLF Statement: Prevention and Management of Acute Renal Failure in the ICU Patient

Cited by 265 publications

References 329 publications

Vancomycin pharmacokinetics during high-volume continuous venovenous hemofiltration in critically ill septic patients

Vancomycin pharmacokinetics during high-volume continuous venovenous hemofiltration in critically ill septic patients

Acute kidney injury classification: AKIN and RIFLE criteria in critical patients

Bayesian Analysis of Joint Modeling of Longitudinal and Time to Event Data Using Some Skew-Elliptical Distributions

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