Tag: renal

PermiT underfeeding?

High calorie intake on ICU has long been known to be a bad idea. Topping up early enteral feeding deficits with parenteral nutrition is now felt to be non-life-saving and possibly dangerous. Animal studies have suggested that it is the protein element of feeding that keeps the mitochondria happy, not calories per se. So, the PermiT study, a refocussed repeat of …

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Know your phases and master fluid management

The ADQI renal authority turns its attention to fluid strategy in ADQI III’s BJA article.           Choose the right fluid balance target for the stage of critical illness: Rescue – first few minutes; generous fluid boluses to treat shock. Obviously, not all patients require this phase. Optimization – few hours; assessment of …

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The earlier the better? Maybe, maybe not for renal replacement therapy.

In this recent re-look at patients from a previous seminal study, a ‘nested’ cohort from the RENAL study with RIFLE ‘I’ acute kidney injury (GFR<50%, creatinine rise to twice baseline, UOP <0.5ml/kg for 12hr).were selected. The APACHE III score for those supported late was significantly lower suggesting there may have been something different (a covariate, so not …

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