Use of Doppler ultrasound renal resistive index and neutrophil gelatinase-associated lipocalin in prediction of acute kidney injury in patients with septic shock

Poster PresentationThis journal suppl. contain meeting abstracts of the 31st International Symposium on Intensive Care and Emergency MedicineINTRODUCTION: Acute kidney injury (AKI) is common in septic shock and there is no good marker to predict it. Neutrophil gelatinase-associated lipocalin (NGAL) is a novel renal biomarker showing promising results in prediction of AKI in patients across diff erent clinical settings. Another potential marker is the resistive index (RI) of renal interlobar artery (calculated as (peak systolic velocity – end diastolic velocity) / peak systolic velocity), which has been shown to be useful in identifying those who will develop AKI in patients with septic shock. The aim of this study is to evaluate the usefulness of RI and NGAL in the early detection of AKI. METHODS: A prospective, observational study in a 20-bed medical/surgical ICU of a university teaching hospital. All patients with septic shock were recruited, excluding those with chronic renal failure (serum creatinine >120 μmol/l). Within the fi rst 24 hours after the introduction of vasopressor, urine and serum were collected for NGAL measurement and RI was determined by two independent operators. The occurrence of AKI was measured at day 3, according to RIFLE criteria. RI and NGAL were compared between patients with (RIFLE-F) and without (RIFLE-0/R/I) AKI. RESULTS: During the period from August to November 2010, 20 patients (age 58 ± 16) with septic shock were recruited. Eleven patients were classifi ed as having AKI. No signifi cant diff erence in baseline characteristics such as APACHE II score and baseline creatinine was shown at enrollment. RI, serum-NGAL and urine-NGAL were all higher in patients with AKI (RI: 0.749 ± 0.0697 (mean ± SD) vs. 0.585 ± 0.0983, P <0.001; serum-NGAL: 2,182 ± 838 ng/ml (mean ± SD) vs. 1,075 ± 1,006, P = 0.015; urine-NGAL: 2,009 ± 3,370 vs. 993 ± 1,789 (median ± IQR), P = 0.025). Area under the ROC curve for RI and serum-NGAL was 0.909 (±0.088, P = 0.002) and 0.808 (±0.113, P = 0.02), respectively. For RI, using 0.65 as the cut-off , sensitivity and specifi city was 1 and 0.89, respectively. For serum-NGAL, using a cut-off of 1,200 ng/ml, it had a sensitivity of 1 and specifi city of 0.67. Inter-observer diff erence of RI was low (0.0015 ± 0.0074 (mean ± SD)). CONCLUSIONS: Doppler ultrasound renal RI is non-invasive, rapidly available and easily reproducible, and is at least as good as NGAL as a predictor of AKI in patients with septic shock.link_to_OA_fulltextThe 31st International Symposium on Intensive Care and Emergency Medicine, Brussels, Belgium. 22-25 March 2011. In Critical Care, 2011, v. 15 suppl 1, p. 539, abstract no. P10

Harvesting convalescent plasma for hyperimmune intravenous globulin production: a multicentre randomised double-blind controlled trial for treatment of patients with serious S-OIV H1N1 infection

Poster Presentations: Emerging / Infectious Diseases: abstract no. P107-Ab0089Symposium Theme: Translating Health Research into Policy and Practice for Health of the Populationpublished_or_final_versio

Harvesting convalescent plasma for hyperimmune intravenous globulin production: a multicentre randomised double-blind controlled trial for treatment of patients with serious S-OIV H1N1 infection

Poster Presentations: Emerging / Infectious Diseases: abstract no. P107-Ab0089Symposium Theme: Translating Health Research into Policy and Practice for Health of the Populationpublished_or_final_versio

Hyperimmune intravenous immunoglobulin treatment: a multicentre double-blind randomised controlled trial for patients with severe A(H1N1)pdm09 Infection

Oral Presentation - Best Abstract in Clinical MedicineThis journal suppl. entitled: 19th Medical Research Conference; Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong KongBACKGROUND: Experience from influenza pandemics suggested that convalescent plasma treatment given within 4 to 5 days of symptom onset might be beneficial. However, robust treatment data are lacking ...postprin

Knowledge Management and Organisational Culture

This international Handbook provides a comprehensive overview of key topics, debates and issues within the now well-established field of Knowledge Management (KM)

Evolution of the Reactor Antineutrino Flux and Spectrum at Daya Bay

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Measurement of electron antineutrino oscillation based on 1230 days of operation of the Daya Bay experiment

published_or_final_versio

Improved Search for a Light Sterile Neutrino with the Full Configuration of the Daya Bay Experiment

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Improved measurement of the reactor antineutrino flux and spectrum at Daya Bay

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The Leiognathus splendens complex (Perciformes: Leiognathidae) with the description of a new species, Leiognathus kupanensis Kimura and Peristiwady

Taxonomic analysis of a group of morphologically similar ponyfishes (Perciformes: Leiognathidae) establishes the Leiognathus splendens complex comprising four valid species: L. jonesi James, 1971, widely distributed in the Indo-West Pacific, from Mauritius to Papua New Guinea, north to Hainan I. (China), and south to Brisbane, Australia; L. kupanensis sp. nov., currently known only from Kupang, Timor, Indonesia; L. rapsoni Munro, 1964, currently known only from India, Indonesia, and Papua New Guinea, and L. splendens Cuvier, 1829, widely distributed in the eastern Indian and western Pacific oceans, from India to Papua New Guinea, and from southern Japan to northern Australia. The L. splendens complex can be defined by the following combination of characters: body depth 42–60% of standard length; mouth protruding downward; slender, minute teeth uniserially on jaws; lower margin of orbit above the horizontal through the gape when mouth closed; breast almost completely scaled; lateral line complete, and a dark blotch on top of spinous dorsal fin. Diagnostic characters of the members are as follows: L. jonesi —anterior dorsolateral body surface with a semicircular naked area on nape, and a paler dark blotch on spinous dorsal fin; L. kupanensis —anterior dorsolateral body surface widely naked; L. rapsoni —cheek scaled; L. splendens —anterior dorsolateral body surface completely scaled and a jet black blotch on spinous dorsal fin.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41595/1/10228_2005_Article_283.pd