Introduction A 21-year-old woman presented to the emergency department with fatigue,abdominal pain and diarrhea.Her physical activity in school was strictly normal.She had no family medical history and no personal his...Introduction A 21-year-old woman presented to the emergency department with fatigue,abdominal pain and diarrhea.Her physical activity in school was strictly normal.She had no family medical history and no personal history but reported frequent episodes of nausea and vomiting lasting 2 to 7 days during the past two years,as well as a weight loss of 9 kg due to reactive anorexia(Body Mass Index 17.5),without triggering factors or self-medication.These gastrointestinal symptoms led to the detection of isolated elevated transaminases(aspartate aminotransferase[AST]190 U/L and alanine aminotransferase[ALT]170 U/L);however,the patient did not pursue the proposed etiological investigation.She has been using cannabis once a day for several years,with an increase in consumption over the past year,but no co-intoxication.She reported no other recent change in her habits.展开更多
Background:This study aimed to investigate renal replacement therapy (RRT) practices in a representative nationwide sample of French intensive care units (ICUs).Methods:From July 1 to October 5 2021, 67 French ICUs pr...Background:This study aimed to investigate renal replacement therapy (RRT) practices in a representative nationwide sample of French intensive care units (ICUs).Methods:From July 1 to October 5 2021, 67 French ICUs provided data regarding their ICU and RRT implementation. We used an online questionnaire to record general data about each participating ICU, including the type of hospital, number of beds, staff ratios, and RRT implementation. Each center then prospectively recorded RRT parameters from 5 consecutive acute kidney injury (AKI) patients, namely the indication, type of dialysis catheter used, type of catheter lock used, type of RRT (continuous or intermittent), the RRT parameters initially prescribed (dose, blood flow, and duration), and the anticoagulant agent used for the circuit.Results:A total of 303 patients from 67 ICUs were analyzed. Main indications for RRT were oligo-anuria (57.4%), metabolic acidosis (52.1%), and increased plasma urea levels (47.9%). The commonest insertion site was the right internal jugular (45.2%). In 71.0% of cases, the dialysis catheter was inserted by a resident. Ultrasound guidance was used in 97.0% and isovolumic connection in 90.1%. Citrate, unfractionated heparin, and saline were used as catheter locks in 46.9%, 24.1%, and 21.1% of cases, respectively.Conclusions:Practices in French ICUs are largely compliant with current national guidelines and international literature. The findings should be interpreted in light of the limitations inherent to this type of study.展开更多
文摘Introduction A 21-year-old woman presented to the emergency department with fatigue,abdominal pain and diarrhea.Her physical activity in school was strictly normal.She had no family medical history and no personal history but reported frequent episodes of nausea and vomiting lasting 2 to 7 days during the past two years,as well as a weight loss of 9 kg due to reactive anorexia(Body Mass Index 17.5),without triggering factors or self-medication.These gastrointestinal symptoms led to the detection of isolated elevated transaminases(aspartate aminotransferase[AST]190 U/L and alanine aminotransferase[ALT]170 U/L);however,the patient did not pursue the proposed etiological investigation.She has been using cannabis once a day for several years,with an increase in consumption over the past year,but no co-intoxication.She reported no other recent change in her habits.
文摘Background:This study aimed to investigate renal replacement therapy (RRT) practices in a representative nationwide sample of French intensive care units (ICUs).Methods:From July 1 to October 5 2021, 67 French ICUs provided data regarding their ICU and RRT implementation. We used an online questionnaire to record general data about each participating ICU, including the type of hospital, number of beds, staff ratios, and RRT implementation. Each center then prospectively recorded RRT parameters from 5 consecutive acute kidney injury (AKI) patients, namely the indication, type of dialysis catheter used, type of catheter lock used, type of RRT (continuous or intermittent), the RRT parameters initially prescribed (dose, blood flow, and duration), and the anticoagulant agent used for the circuit.Results:A total of 303 patients from 67 ICUs were analyzed. Main indications for RRT were oligo-anuria (57.4%), metabolic acidosis (52.1%), and increased plasma urea levels (47.9%). The commonest insertion site was the right internal jugular (45.2%). In 71.0% of cases, the dialysis catheter was inserted by a resident. Ultrasound guidance was used in 97.0% and isovolumic connection in 90.1%. Citrate, unfractionated heparin, and saline were used as catheter locks in 46.9%, 24.1%, and 21.1% of cases, respectively.Conclusions:Practices in French ICUs are largely compliant with current national guidelines and international literature. The findings should be interpreted in light of the limitations inherent to this type of study.
