Sodium Bicarbonate Versus Sodium Chloride for Preventing Contrast-Associated Acute Kidney Injury in Critically Ill Patients: A Randomized Controlled Trial.

Objectives: To test whether hydration with bicarbonate rather than isotonic sodium chloride reduces the risk of contrast-associated acute kidney injury in critically ill patients.

Design: Prospective, double-blind, multicenter, randomized controlled study.

Setting: Three French ICUs.

Intravascular Complications of Central Venous Catheterization by Insertion Site.

Background: Three anatomical sites are commonly used to insert central venous catheters, but insertion at each site has the potential for major complications.

Methods: In this multicenter trial, we randomly assigned nontunneled central venous catheterization in patients in the adult intensive care unit (ICU) to the subclavian, jugular, or femoral vein (in a 1:1:1 ratio if all three insertion sites were suitable [three-choice scheme] and in a 1:1 ratio if two sites were suitable [two-choice scheme]). The primary outcome measure was a composite of catheter-related bloodstream infection and symptomatic deep-vein thrombosis.

Diagnostic accuracy of hemoconcentration for pulmonary edema as the cause of weaning failure.

Background: Our objective was to assess the diagnostic accuracy of hemoconcentration for cardiogenic pulmonary edema (PE) as the cause of weaning failure, using left ventricular filling pressure elevation assessed by transthoracic echocardiography as the reference standard.

Methods: This prospective observational study included 41 patients who failed their first spontaneous breathing trial of weaning from mechanical ventilation. They were divided into two groups, with and without PE by echocardiographic criteria.

Accuracy of plasma neutrophil gelatinase-associated lipocalin in the early diagnosis of contrast-induced acute kidney injury in critical illness.

Purpose: Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker for acute kidney injury (AKI). We evaluated the diagnostic and prognostic accuracies of plasma NGAL (pNGAL) for contrast-induced AKI (CI-AKI) in critically ill patients.

Methods: In a prospective observational study in two adult intensive care units in a university hospital, 100 consecutive critically ill patients with stable serum creatinine concentrations up to 48 h before contrast medium (CM) injection were enrolled.

Overview of adverse events related to invasive procedures in the intensive care unit.

Background: This study was conducted to determine the frequency, predictors, and clinical impact of adverse events (AEs) related to invasive procedures in the intensive care unit (ICU).

Methods: This was a prospective observational study of ICUs in a university hospital.

Results: A total of 893 patients requiring invasive procedures were admitted over a 1-year period.