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Venous congestion: are we adding insult to kidney injury in sepsis?
In critical illness, septic shock is a contributing factor in nearly half of all cases of acute kidney injury (AKI). Traditional approaches to prevention of organ dysfunction in early sepsis have focused on prevention of hypoperfusion by optimisation of systemic haemodynamics, primarily by fluid res...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055982/ https://www.ncbi.nlm.nih.gov/pubmed/24467922 http://dx.doi.org/10.1186/cc13709 |
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author | Rajendram, Rajkumar Prowle, John R |
author_facet | Rajendram, Rajkumar Prowle, John R |
author_sort | Rajendram, Rajkumar |
collection | PubMed |
description | In critical illness, septic shock is a contributing factor in nearly half of all cases of acute kidney injury (AKI). Traditional approaches to prevention of organ dysfunction in early sepsis have focused on prevention of hypoperfusion by optimisation of systemic haemodynamics, primarily by fluid resuscitation. Fluid administration to a target central venous pressure (CVP) of 8 to 12 mmHg (12 to 15 mmHg in mechanically ventilated patients) is currently recommended for the early resuscitation of septic shock. However, in the previous issue of Critical Care, Legrand and colleagues report that higher CVP in the first 24 hours of ICU admission with septic shock was associated with increased risk for development or persistence of AKI over the next 5 days. This study highlights a potential association between venous congestion and the development of septic AKI, suggesting that CVP-targeted fluid resuscitation in septic shock might not be beneficial for renal function. |
format | Online Article Text |
id | pubmed-4055982 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-40559822015-01-27 Venous congestion: are we adding insult to kidney injury in sepsis? Rajendram, Rajkumar Prowle, John R Crit Care Commentary In critical illness, septic shock is a contributing factor in nearly half of all cases of acute kidney injury (AKI). Traditional approaches to prevention of organ dysfunction in early sepsis have focused on prevention of hypoperfusion by optimisation of systemic haemodynamics, primarily by fluid resuscitation. Fluid administration to a target central venous pressure (CVP) of 8 to 12 mmHg (12 to 15 mmHg in mechanically ventilated patients) is currently recommended for the early resuscitation of septic shock. However, in the previous issue of Critical Care, Legrand and colleagues report that higher CVP in the first 24 hours of ICU admission with septic shock was associated with increased risk for development or persistence of AKI over the next 5 days. This study highlights a potential association between venous congestion and the development of septic AKI, suggesting that CVP-targeted fluid resuscitation in septic shock might not be beneficial for renal function. BioMed Central 2014 2014-01-27 /pmc/articles/PMC4055982/ /pubmed/24467922 http://dx.doi.org/10.1186/cc13709 Text en Copyright © 2014 BioMed Central Ltd. |
spellingShingle | Commentary Rajendram, Rajkumar Prowle, John R Venous congestion: are we adding insult to kidney injury in sepsis? |
title | Venous congestion: are we adding insult to kidney injury in sepsis? |
title_full | Venous congestion: are we adding insult to kidney injury in sepsis? |
title_fullStr | Venous congestion: are we adding insult to kidney injury in sepsis? |
title_full_unstemmed | Venous congestion: are we adding insult to kidney injury in sepsis? |
title_short | Venous congestion: are we adding insult to kidney injury in sepsis? |
title_sort | venous congestion: are we adding insult to kidney injury in sepsis? |
topic | Commentary |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055982/ https://www.ncbi.nlm.nih.gov/pubmed/24467922 http://dx.doi.org/10.1186/cc13709 |
work_keys_str_mv | AT rajendramrajkumar venouscongestionareweaddinginsulttokidneyinjuryinsepsis AT prowlejohnr venouscongestionareweaddinginsulttokidneyinjuryinsepsis |