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July 3, 2008
December 18, 2008
(relative risk of survival, 0.87; 95% confidence interval, 0.65 to 1.15; P =
0.36)
June 5, 2008
October 1, 2009
July 10,, 2008
January 1,, 2009
Chest 2010;137;544-551
seven RCT studies that included 11,425 patients.
JAMA, March 3, 2010—Vol 303, No. 9
JAMA. 2010;303(8):739-746
JAMA. 2009;302(18):1977-1984
The COIITSS Study InvestigatorsJAMA. 2010;303(4):341-348
Crit Care Med 2009 Vol. 37, No. 6
Crit Care Med 2009 Vol. 37, No. 9
Crit Care Med 2010 Vol. 38, No. 4
Avoid
Crit Care Med 2009 Vol. 37, No. 6
Crit Care Med 2009 Vol. 37, No. 2
Total cohort number 66,184
Crit Care Med 2010 Vol. 38, No. 3
Crit Care Med 2009 Vol. 37, No. 5
Crit Care Med 2010 Vol. 38, No. 2
155/255 survival 61%
Crit Care Med 2009 Vol. 37, No. 3
Crit Care Med 2009 Vol. 37, No. 9
Overall, 22% (n 71,486) of patients developed acute kidney injury
(Stage I: 17.5%; Stage II: 2.4%; Stage III: 2%)
Odds of death associated with AKI in ICU
Crit Care Med 2010 Vol. 38, No. 2
The need for early serial IAP monitoring when IAH/ACS risk factors are present
Improving abdominal wall compliance through sedation, analgesia, and pharmacologic paralysis
Evacuating intraluminal contents through nasogastric or rectal decompression
Evacuating abdominal fluid collections via percutaneous drainage
Correcting positive fluid balance through the use of hypertonic fluids, colloids, and careful diuresis
Supporting organ function vasopressors and judicious goal-directed fluid resuscitation to maintain an abdominal perfusion pressure (calculated as mean arterial pressure IAP) 60 mm Hg
Early surgical intervention when IAP exceeds 25 mm Hg
Crit Care Med 2009 Vol. 37, No. 2
Score Variables Points
Predisposition COPD or Immunosuppression
1
Age > 70 ys 1
Insult Bacteremia 1
Multilobar opacities on radiograph
1
Response Shock 1
Severe hypoxemia 1
Organ dysfunction Acute renal failure 1
Respiratory distress syndrome
1
Critical Care Medicine: February 2009 - Volume 37 - Issue 2 - pp 456-462
Range 0-8 points
Critical Care Medicine: February 2009 - Volume 37 - Issue 2 - pp 456-462
HOMEHOSPITAL
ICU?CARE
Crit Care Med 2009 Vol. 37, No. 8
Crit Care Med 2009 Vol. 37, No. 9
Crit Care Med 2009 Vol. 37, No. 5
24%
Crit Care Med 2009 Vol. 37, No. 1
Crit Care Med 2010 Vol. 38, No. 2
Crit Care Med 2009 Vol. 37, No. 4
Crit Care Med 2009 Vol. 37, No. 5
Crit Care Med 2009 Vol. 37, No. 5
Total parenteral nutrition X1 Surgery X1 Multifocal Candida colonization X1 Severe sepsis X 2.