Management of Patients with Renal Failure Complicated by Cerebral Oedema

Davenport, Andrew; Finn, Richard S.; Goldsmith, H J

doi:10.1159/000169594

Cited by 31 publications

(8 citation statements)

References 15 publications

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“…This reflects the fact that post‐OLT patients are frequently haemodynamically unstable. Continuous therapy is the preferred therapy for patients with fulminant hepatic failure as it can minimize the volume changes and osmotic shifts that occur during dialysis, thereby reducing the risk of cerebral oedema and intra‐cranial hypertension (27–29).…”

Section: Discussionmentioning

confidence: 99%

Acute Renal Disease, as Defined by the RIFLE Criteria, Post-Liver Transplantation

O'Riordan¹,

Wong²,

McQuillan³

et al. 2007

American Journal of Transplantation

174

135

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Acute renal failure (ARF) can complicate up to 60% of orthotopic liver transplants (OLT). The RIFLE criteria were developed to provide a consensus definition for acute renal disease in critically ill patients. Using the RI-FLE criteria, we aimed to determine the incidence and risk factors for ARF and acute renal injury (ARI), and to evaluate the link with the outcomes, patient survival and length of hospital stay. Three hundred patients, who received 359 OLTs, were retrospectively analyzed. ARI and ARF occurred post 11.1 and 25.7% of OLTs, respectively. By multivariate analysis, ARI was associated with pre-OLT hypertension and alcoholic liver disease and ARF with higher pre-OLT creatinine, inotrope and aminoglycoside use. ARF, but not ARI, had an impact on 30-day and 1-year patient survival and longer length of hospital stay. ARI and ARF, as defined by the RIFLE criteria, are common complications of OLT, with distinct risk factors and ARF has serious clinical consequences. The development of a consensus definition is a welcome advance, however these criteria do need to be validated in large studies in a wide variety of patient populations.

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Section: Discussionmentioning

confidence: 99%

Acute Renal Disease, as Defined by the RIFLE Criteria, Post-Liver Transplantation

O'Riordan¹,

Wong²,

McQuillan³

et al. 2007

American Journal of Transplantation

174

135

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“…15 In addition, for patients who are at risk of or who have increased intracranial pressure including neurosurgical patients, patients with encephalitis or acute liver failure, studies have demonstrated the benefits of prevention of the surge in intracranial pressure. [16][17][18] The future trend of the use of RRT modality in ICUs may change as a number of results of recent published studies favoring CRRT on the clinical outcomes. In 2014, Wald et al 19 reported the findings of their retrospective cohort study conducted between July 1996 and December 2009.…”

Section: Discussionmentioning

confidence: 99%

Trends in the use of renal replacement therapy modality in intensive care unit: a 7 year study

Cheungpasitporn

Ahmed

2015

Renal Failure

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Background: The use of renal replacement therapy (RRT) modality in the intensive care unit (ICU) depends primarily on provider preference and hospital resource. This study aims to describe the prevalence of RRT use and the trends in RRT modality use in the ICU over the past 7 years. Methods: All ICU admissions, including medical, cardiac, and surgical ICUs from 1 January 2007 to 31 December 2013, were included in this study. RRT use was defined as the use of intermittent hemodialysis (IHD) or continuous renal replacement therapy (CRRT) within a given ICU day. The RRT use was reported as the proportion of ICU days on each RRT modality divided by the total ICU days with RRT usage. Results: Over the course of this study (72,005 ICU admissions), 272,271 ICU days were generated. RRTs were used in 4110 ICU admissions (5.7%) and on 21,159 ICU days (7.8%). RRT use was 10,402 (49%) for IHD, and 10,954 (52%) for CRRT. The trend of IHD and CRRT use did not change from year 2007 to 2013. On ICU days with RRT, the choice of RRT modality was associated with the number of vasopressor use (p50.001). CRRT was more preferred on the ICU days with the increasing number of vasopressor use. Conclusions: RRTs were used in about 6% of ICU admission. The use of IHD and CRRT was similar and did not change over 7 years. The choice of RRT modality mainly depended on the number of vasopressors used on ICU days with RRT.

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“…More commonly, disturbances in renal function result directly from liver failure or its hemodynamic consequences. Early initiation of continuous renal replacement therapy15, 16 affords tight control of intravascular volume, thereby minimizing the potential for pulmonary and cerebral edema. Intensive renal replacement therapy with daily hemodialysis was of benefit for critically ill patients in comparison with the standard of care 17.…”

Section: Acute Liver Failure As a Paradigm For Sepsis With Respect Tomentioning

confidence: 99%

Reply:

Barbier

Trottier

2007

Hepatology

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Management of Patients with Renal Failure Complicated by Cerebral Oedema

Cited by 31 publications

References 15 publications

Acute Renal Disease, as Defined by the RIFLE Criteria, Post-Liver Transplantation

Acute Renal Disease, as Defined by the RIFLE Criteria, Post-Liver Transplantation

Trends in the use of renal replacement therapy modality in intensive care unit: a 7 year study

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