Background The optimal timing to start continuous renal replacement therapy （CRRT） for acute kidney injury （AKI） patients has not been accurately established. The recently proposed risk, injury, failure, loss, end...Background The optimal timing to start continuous renal replacement therapy （CRRT） for acute kidney injury （AKI） patients has not been accurately established. The recently proposed risk, injury, failure, loss, end-stage kidney disease （RIFLE） criteria for diagnosis and classification of AKI may provide a method for clinicians to decide the ＂optimal timing＂ for starting CRRT under uniform guidelines. The present study aimed： （1） to analyze the correlation between RIFLE stage at the start of CRRT and 90-day survival rate after CRRT start, （2） to further investigate the correlation of RIFLE stage with the malignant kidney outcome in the 90-day survivors, and （3） to determine the influence of the timing of CRRT defined by RIFLE classification on the 90-day survival and malignant kidney outcome in 90-day survivors.Methods A retrospective cohort analysis was performed on the data of 106 critically ill patients with AKI, treated with CRRT during a 6-year period in a university affiliated surgical intensive care unit （SICU）. Information such as sex, age, RIFLE stage, sepsis, sepsis-related organ failure assessment （SOFA） score, number of organ failures before CRRT, CRRT time during SICU, survival, and kidney outcome conditions at 90 days after CRRT start was collected. According to their baseline severity of AKI at the start of CRRT, the patients were assigned to three groups according to the increasing severity of RIFLE stages： RIFLE-R （risk of renal dysfunction, R）, RIFLE-I （injury to the kidney, I） and RIFLE-F （failure of kidney function, F） using RIFLE criteria. The malignant kidney outcome was classified as RIFLE-L （loss of kidney function L） or RIFLE-E （end-stage kidney disease, E） using RIFLE criteria. The correlation between RIFLE stage and 90-day survival rate was analyzed among these three RIFLE-categorized groups. Additionally, the association between RIFLE stage and the malignant kidney outcome （RIFLE-L＋RIFLF-E） in the 90-day survivors was anal展开更多
Spinal cord trauma is a prominent cause of mortality and morbidity. In developed countries a spinal cord injury(SCI) occurs every 16 min. SCI occurs due to tissue destruction, primarily by mechanical and secondarily i...Spinal cord trauma is a prominent cause of mortality and morbidity. In developed countries a spinal cord injury(SCI) occurs every 16 min. SCI occurs due to tissue destruction, primarily by mechanical and secondarily ischemic. Primary damage occurs at the time of the injury. It cannot be improved. Following the primary injury, secondary harm mechanisms gradually result in neuronal death. One of the prominent causesof secondary harm is energy deficit, emerging from ischemia, whose main cause in the early stage, is impaired perfusion. Due to the advanced techniques in spinal surgery, SCI is still challenging for surgeons. Spinal cord doesn't have a self-repair property. The main damage occurs at the time of the injury primarily by mechanical factors that cannot be improved. Secondarily mechanisms take part in the following sections. Spinal compression and neurological deficit are two major factors used to decide on surgery. According to advanced imaging techniques the classifications systems for spinal injury has been changed in time. Aim of the surgery is to decompress the spinal channel and to restore the spinal alinement and mobilize the patient as soon as possible. Use of neuroprotective agents as well as methods to achieve cell regeneration in addition to surgery would contribute to the solution.展开更多
文摘Background The optimal timing to start continuous renal replacement therapy （CRRT） for acute kidney injury （AKI） patients has not been accurately established. The recently proposed risk, injury, failure, loss, end-stage kidney disease （RIFLE） criteria for diagnosis and classification of AKI may provide a method for clinicians to decide the ＂optimal timing＂ for starting CRRT under uniform guidelines. The present study aimed： （1） to analyze the correlation between RIFLE stage at the start of CRRT and 90-day survival rate after CRRT start, （2） to further investigate the correlation of RIFLE stage with the malignant kidney outcome in the 90-day survivors, and （3） to determine the influence of the timing of CRRT defined by RIFLE classification on the 90-day survival and malignant kidney outcome in 90-day survivors.Methods A retrospective cohort analysis was performed on the data of 106 critically ill patients with AKI, treated with CRRT during a 6-year period in a university affiliated surgical intensive care unit （SICU）. Information such as sex, age, RIFLE stage, sepsis, sepsis-related organ failure assessment （SOFA） score, number of organ failures before CRRT, CRRT time during SICU, survival, and kidney outcome conditions at 90 days after CRRT start was collected. According to their baseline severity of AKI at the start of CRRT, the patients were assigned to three groups according to the increasing severity of RIFLE stages： RIFLE-R （risk of renal dysfunction, R）, RIFLE-I （injury to the kidney, I） and RIFLE-F （failure of kidney function, F） using RIFLE criteria. The malignant kidney outcome was classified as RIFLE-L （loss of kidney function L） or RIFLE-E （end-stage kidney disease, E） using RIFLE criteria. The correlation between RIFLE stage and 90-day survival rate was analyzed among these three RIFLE-categorized groups. Additionally, the association between RIFLE stage and the malignant kidney outcome （RIFLE-L＋RIFLF-E） in the 90-day survivors was anal
文摘Spinal cord trauma is a prominent cause of mortality and morbidity. In developed countries a spinal cord injury(SCI) occurs every 16 min. SCI occurs due to tissue destruction, primarily by mechanical and secondarily ischemic. Primary damage occurs at the time of the injury. It cannot be improved. Following the primary injury, secondary harm mechanisms gradually result in neuronal death. One of the prominent causesof secondary harm is energy deficit, emerging from ischemia, whose main cause in the early stage, is impaired perfusion. Due to the advanced techniques in spinal surgery, SCI is still challenging for surgeons. Spinal cord doesn't have a self-repair property. The main damage occurs at the time of the injury primarily by mechanical factors that cannot be improved. Secondarily mechanisms take part in the following sections. Spinal compression and neurological deficit are two major factors used to decide on surgery. According to advanced imaging techniques the classifications systems for spinal injury has been changed in time. Aim of the surgery is to decompress the spinal channel and to restore the spinal alinement and mobilize the patient as soon as possible. Use of neuroprotective agents as well as methods to achieve cell regeneration in addition to surgery would contribute to the solution.
