scholarly journals Clinical Course of Cancer Patients with COVID-19: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Naomi Alpert ◽  
Joseph L Rapp ◽  
Bridget Marcellino ◽  
Wil Lieberman-Cribbin ◽  
Raja Flores ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Venous Thromboembolism ◽  
Cancer Patients ◽  
Kidney Injury ◽  
Adverse Outcomes ◽  
Cancer Treatments ◽  
Patients With Cancer ◽  
Significant Difference

Abstract Background Complications in cancer patients with COVID-19 have not been examined. This analysis aimed to compare characteristics of COVID-19 patients with and without cancer, and assess whether cancer is associated with COVID-19 morbidity or mortality. Methods COVID-19 positive patients with an inpatient or emergency encounter at the Mount Sinai Health System between March 1, 2020 and May 27, 2020 were included, and compared across cancer status on demographics and clinical characteristics. Multivariable logistic regressions were used to model the associations of cancer with sepsis, venous thromboembolism, acute kidney injury, intensive care unit admission, and all-cause mortality. Results There were 5,556 COVID-19 positive patients included; 421 (7.6%) with cancer (325 solid, 96 non-solid). Those with cancer were statistically significantly older, more likely to be non-Hispanic Black and to be admitted to the hospital during their encounter, and had more comorbidities than non-cancer COVID-19 patients. Cancer patients were statistically significantly more likely to develop sepsis (adjusted odds ratio [ORadj]=1.31, 95% confidence interval [CI]=1.06-1.61) and venous thromboembolism (ORadj=1.77, 95% CI = 1.01-3.09); there was no statistically significant difference in acute kidney injury (ORadj=1.10, 95% CI = 0.87-1.39), intensive care unit admissions (ORadj=1.04, 95% CI = 0.80-1.34), or mortality (ORadj=1.02, 95% CI = 0.81-1.29). Conclusions COVID-19 patients with cancer may have a higher risk for adverse outcomes. Although there was no statistically significant difference in mortality, COVID-19 patients with cancer have significantly higher risk of thromboembolism and sepsis. Further research is warranted into the potential effects of cancer treatments on inflammatory and immune responses to COVID-19, and on the efficacy of anticoagulant therapy in these patients.

scholarly journals Incidence and etiology of acute kidney injury in children admitted to PICU using pRIFLE criteria

2018 ◽  
Vol 5 (3) ◽  
pp. 917
Author(s):  
Javid Maqbool ◽  
Aajaz Ahmad Mir ◽  
Nisar Ahmad Bhat ◽  
Waseem Qadir Moona
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Adverse Outcomes ◽  
Critically Ill Children ◽  
Consensus Definition ◽  
Schwartz Formula

Background: Acute kidney injury is a common problem highly associated with hospitalization. Acute Kidney Injury (AKI) is associated with severe morbidity and mortality especially in children. Lack of consensus definition has been major limitation in improving outcomes. This study tries to address the need of limited data on pediatric AKI. Detection of the incidence, etiological profile and outcome of AKI is important for the initiation of preventive and therapeutic strategies, identifying patients early to avoid renal replacement therapy.Methods: This prospective observational study was conducted in the pediatric intensive care unit (PICU) of tertiary hospital (GMC Srinagar) between January 2015 to December 2016.This is the only prospective study conducted in this hospital, all other studies conducted here and other higher centers were retrospective. Serum creatinine level was estimated on all patients on admission and alternate days till discharge from Pediatric Intensive Care Unit (PICU). Urine output was recorded. Estimated Creatinine- Clearance (eCrCL) was calculated using Schwartz formula. AKI diagnosis and staging was based on pRIFLE (pediatric RIFLE) criteria. eCrCl criteria was used to diagnose and stage AKI. Maximal stage that the patient progressed during the stay in PICU was assigned the stage for that case.Results: Of total 500 cases, 480 cases met inclusion criteria. Of them, the incidence of AKI was 154 (32.1%). Stage ‘Risk (R)’, ‘Injury (I)’ and ‘Failure (F)’ constituted 93(60.38%), 46 (29.8%) and15 (9.74%) respectively. Maximum AKI occurred in <1 year (30.5%). Infections were commonest etiology. Amongst infections sepsis (30.5%) was most common, followed by acute gastroenteritis (20.7%) and pneumonia (16.9%). Hypotension, nephrotoxic drugs, sepsis, need for mechanical ventilation were significant (p<0.001) risk factors for AKI. Pre-renal causes constituted 68% and intrinsic renal 32%.Conclusions: The incidence of AKI is high among critically ill children. AKI continues to be associated with adverse outcomes. pRIFLE staging system provides early identification and stratification of AKI. Infections are leading etiology of AKI in children. 

scholarly journals Urinary angiotensinogen predicts adverse outcomes among acute kidney injury patients in the intensive care unit

Critical Care ◽  
2013 ◽  
Vol 17 (2) ◽  
pp. R69 ◽  
Author(s):  
Joseph L Alge ◽  
Nithin Karakala ◽  
Benjamin A Neely ◽  
Michael G Janech ◽  
Juan Carlos Q Velez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Kidney Injury ◽  
Adverse Outcomes ◽  
Urinary Angiotensinogen

scholarly journals The Relationship of Mean Perfusion Pressure (MPP) With Acute Kidney Injury (AKI) on Patients in Intensive Care Unit (ICU) at Haji Adam Malik General Hospital Medan

2020 ◽  
Vol 5 (8) ◽  
pp. 1260-1263
Author(s):  
Sri Rahmadhona ◽  
Asmin Lubis ◽  
Dadik Wahyu Wijaya ◽  
Akhyar Hamonangan Nasution
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Perfusion Pressure ◽  
Kidney Injury ◽  
Observation Time ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
Short And Long Term ◽  
Relationship Of

Acute Kidney Injury (AKI) is a common complication in patients with critical illness or multiple comorbid conditions who are hospitalized, especially at the Intensive Care Unit (ICU). AKI is associated with increased in short and long term mortality and morbidity. The connection between MAP and CVP on alteration of AKI causes researcher interested to investigate the correlation between Mean Perfusion Pressure (MPP) as a difference between MAP and CVP on the progression of AKI.  Methods: Forty-two patients treated in the ICU who met inclusion criteria (ages 18-65 years and signed informed consent) and exclusion criteria (chronic kidney disease, refused to have Central Venous Catheters (CVC) installed, and heart disease). After CVC installation, we perform hemodynamic examination, MAP and CVP measurements, and serum creatinine examination after installation, 6 hours, 12 hours, and 48 hours after installation.  Results: Significant differences were obtained during 12- hour observation between MPP values in the AKI group with lower values than the non-AKI group (p=0.009) and also obtained a significant difference during 48- hours observation between MPP values in the AKI group with a lower value than the non-AKI group (p=0.001). MAP values showed a significant difference at 12-hour observation time with creatinine serum in the MAP group<65mmHg higher than the MAP 65mmHg group (p=0.035). MPP values showed significant differences 12-hours observation with creatinine serum in the MPP group<55mmHg was higher than the MPP group 55mmHg (p=0.044). In addition, there was a correlation between creatinine serum increase with MPP decrease (r=-0.476; p=0.001).  Conclusion: Lower MPP tend to increase AKI occurence contrary higher MPP decrease AKI occurence at the observation. The mean MPP of AKI group was 90.6 ( 24.2) mmHg at T0, 78.2 ( 22.6) mmHg at T1, 67.2 ( 20.9) mmHg at T3, and 57, 0 ( 20,2) mmHg at T4 observation.

scholarly journals POS-004 HYPOALBUMINEMIA AND ACUTE KIDNEY INJURY IN PATIENTS ADMITTED TO INTENSIVE CARE UNIT

2021 ◽  
Vol 6 (4) ◽  
pp. S2
Author(s):  
A. BACA ◽  
M. Carmoma Antonio ◽  
M. Wasung ◽  
P. Visoso ◽  
M. Sebastian Alberto
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Kidney Injury

scholarly journals Dosing of daptomycin in intensive care unit patients with acute kidney injury undergoing extended dialysis--a pharmacokinetic study

2009 ◽  
Vol 25 (5) ◽  
pp. 1537-1541 ◽  
Author(s):  
J. T. Kielstein ◽  
C. Eugbers ◽  
S. M. Bode-Boeger ◽  
J. Martens-Lobenhoffer ◽  
H. Haller ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Pharmacokinetic Study ◽  
Kidney Injury

scholarly journals Intensive care unit physician-delivered point of care renal tract ultrasound in acute kidney injury is feasible

2018 ◽  
Vol 19 (4) ◽  
pp. 313-318 ◽  
Author(s):  
Prashant Parulekar ◽  
Ed Neil-Gallacher ◽  
Alex Harrison
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Point Of Care ◽  
Kidney Injury ◽  
Diagnostic Quality ◽  
The Core ◽  
Low Incidence

Acute kidney injury is common in critically ill patients, with ultrasound recommended to exclude renal tract obstruction. Intensive care unit clinicians are skilled in acquiring and interpreting ultrasound examinations. Intensive Care Medicine Trainees wish to learn renal tract ultrasound. We sought to demonstrate that intensive care unit clinicians can competently perform renal tract ultrasound on critically ill patients. Thirty patients with acute kidney injury were scanned by two intensive care unit physicians using a standard intensive care unit ultrasound machine. The archived images were reviewed by a Radiologist for adequacy and diagnostic quality. In 28 of 30 patients both kidneys were identified. Adequate archived images of both kidneys each in two planes were possible in 23 of 30 patients. The commonest reason for failure was dressings and drains from abdominal surgery. Only one patient had hydronephrosis. Our results suggest that intensive care unit clinicians can provide focussed renal tract ultrasound. The low incidence of hydronephrosis has implications for delivering the Core Ultrasound in Intensive Care competencies.

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