Concentration of meropenem in patients with sepsis and acute kidney injury before and after initiation of continuous renal replacement therapy: a prospective observational trial.

Background: The effect of renal replacement therapy on drug concentrations in patients with sepsis has not been fully elucidated because the pharmacokinetic properties of many antimicrobials are influenced by both pathophysiological and treatment-related factors. The aim of this study was to determine meropenem concentrations in patients with sepsis before and after the initiation of continuous venovenous hemodialysis with regional citrate anticoagulation (RCA-CVVHD).

Methods: The study included 15 critically ill patients undergoing RCA-CVVHD due to sepsis-induced acute kidney injury.

Continuous renal replacement therapy during extracorporeal membrane oxygenation in patients treated in medical intensive care unit: technical considerations.

Extracorporeal membrane oxygenation (ECMO) is used as a salvage therapy in refractory acute respiratory distress syndrome (ARDS). Although technological progress in the ECMO systems improved the survival rate, prognosis is still significantly worsened by acute kidney injury (AKI), particularly if renal replacement therapy (RRT) is required. There are no exact guidelines recommending which techniques of ECMO and continuous RRT (CRRT) should be used for management of AKI coexisting with respiratory or circulatory failure, and how to combine them.

Supportive therapy for a patient with toxic epidermal necrolysis undergoing plasmapheresis.

A patient with severe toxic epidermal necrolysis underwent 2 cycles of therapeutic plasma exchange and received specialized wound care for widespread skin damage of more than 80% of his body surface area. Extensive involvement of mucous membranes, including the conjunctivas and the oropharyngeal cavity, and damage of his genitourinary organs required meticulous wound care. Daily care of injuries of tissues affected only in the most severe cases of toxic epidermal necrolysis was provided by an experienced intensive care unit nursing team.

Complications in patients treated with plasmapheresis in the intensive care unit.

Introduction: Plasmapheresis is one of the methods of extracorporeal blood purification involving the removal of inflammatory mediators and antibodies. The procedure is used in a variety of conditions, including autoimmune diseases. The aim of the present study was to analyse the incidence of plasmapheresis-related complications in patients treated in the intensive care unit (ICU).

[Plasmapheresis--possible complications and their prevention].

Plasmapheresis it is a therapeutic method based on extracorporeal plasma exchange. First attempts at treatment with plasmapheresis date back to the beginning of the 20th century. However, it was first brought to clinical practice only in the 1950s as a way of treating Waldenstrom macroglobulinemia and in last decades a dynamic improvement in this method has been observed.

Beneficial therapeutic effect of plasmapheresis after unsuccessful treatment with corticosteroids in two patients with severe toxic epidermal necrolysis.

Toxic epidermal necrolysis (TEN) is a rare, life-threatening disease with a high mortality rate. It is linked to drug toxicity and characterized by epidermal necrolysis with mucositis and conjunctivitis. Treatment is not established due to the unknown pathogenesis and lack of randomized clinical trials.

Acute respiratory failure in patients with Guillain-Barré syndrome and myasthenic crisis treated with plasmapheresis in the intensive care unit.

We present the cases of two patients with Guillain-Barré syndrome and one with myasthenic crisis who developed acute respiratory failure and needed mechanical ventilation in the intensive care unit. All the patients were treated with plasmapheresis, resulting in weaning from mechanical ventilation, and eventually complete functional recovery. Early treatment with plasma exchange shortens the treatment duration, whereas early intubation can prevent life-threatening complications.