Interest of Urinary [TIMP-2] × [IGFBP-7] for Predicting the Occurrence of Acute Kidney Injury After Cardiac Surgery: A Gray Zone Approach.

Background: This study assessed the ability of 3-hour postoperative urinary tissue inhibitor of metalloproteinases-2 × insulin-like growth factor binding protein-7 ([TIMP-2] × [IGFBP-7]) to predict postoperative acute kidney injury (AKI) in patients undergoing cardiopulmonary bypass during cardiac surgery.

Methods: Patients undergoing cardiac surgery with cardiopulmonary bypass were eligible for this study. Patients with initial chronic renal insufficiency requiring renal replacement therapy, patients <18 years of age, and parturients were not included.

An increase in aortic blood flow after an infusion of 100 ml colloid over 1 minute can predict fluid responsiveness: the mini-fluid challenge study.

Background: Predicting fluid responsiveness remains a difficult question in hemodynamically unstable patients. The author's objective was to test whether noninvasive assessment by transthoracic echocardiography of subaortic velocity time index (VTI) variation after a low volume of fluid infusion (100 ml hydroxyethyl starch) can predict fluid responsiveness.

Methods: Thirty-nine critically ill ventilated and sedated patients with acute circulatory failure were prospectively studied.

Disagreement between pulse contour analysis and transpulmonary thermodilution for cardiac output monitoring after routine therapeutic interventions in ICU patients with acute circulatory failure.

Background And Objective: The present prospective study was aimed at assessing the reliability of the pulse contour method for measuring cardiac output (CO) after different routinely used therapeutic interventions that can influence vascular compliance and systemic vascular resistances in ICU patients (fluid challenges, changes in norepinephrine or dobutamine infusion rates and changes in ventilatory settings).

Methods: In ICU patients requiring CO monitoring, transpulmonary thermodilution CO (COTD) and pulse contour CO (COPC) were measured with a PiCCO device after therapeutic manoeuvre-free periods (≤ and >1 h) and after therapeutic interventions without recalibration.

Results: Three hundred fifty-two sets of CO measurement pairs in 63 ICU patients were performed.

Reversal of bupivacaine-induced cardiac electrophysiologic changes by two lipid emulsions in anesthetized and mechanically ventilated piglets.

Background: Accidental IV administration of bupivacaine can compromise cardiovascular function by inducing lethal arrhythmias whose hemodynamic consequences may be alleviated by lipid emulsions. However, little is known about the electrophysiologic effects of lipid emulsions. In this study, we assessed whether 2 different lipid emulsions can reverse cardiac electrophysiologic impairment induced by the IV administration of bupivacaine in anesthetized and mechanically ventilated piglets.

The influence of the airway driving pressure on pulsed pressure variation as a predictor of fluid responsiveness.

Objective: Assessing pulse pressure variation (PPV) to predict fluid responsiveness in mechanically ventilated patients with tidal volume (VT) and the impact of VT and airway driving pressure (P(plat) - PEEP) on the ability of PPV for predicting fluid responsiveness.

Design: Prospective interventional study.

Setting: ICU of a university hospital.