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Medical Category: Endocrine, Metabolic, Fluid, and Electrolytes

STARRT-AKI Trial: Timing of Renal Replacement Therapy Initiation in Acute Kidney Injury

Background Information: It is well documented throughout the literature that critically ill patients admitted to the intensive care unit (ICU) with acute kidney injury have a higher morbidity and mortality.1–4 Acute kidney injury may be complicated by acidosis, hyperkalemia and ...

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Endocrine, Metabolic, Fluid, and ElectrolytesRenal and Genitourinary

Fluid Administration in End-Stage Renal Disease for Severe Sepsis and Septic Shock by Shyam Murali, MD

Background: In end-stage renal disease (ESRD) patients on hemodialysis (HD), infection is the second most common cause of mortality after cardiovascular disease (Sarnik 2000). Because of the systemic inflammation and increased capillary permeability, septic patients are at significant risk for fluid ...

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Endocrine, Metabolic, Fluid, and ElectrolytesInfectious DiseaseResuscitation

REBEL Core Cast 31.0 – Hyperthyroidism

Take Home Points Hyperthyroidism can present along a spectrum from the minimally symptomatic to severely decompensated and presentation can vary with age If there are a lot of interconnecting systems complaints consider obtaibning a TSH, t3 and t4  Once you’ve ...

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Endocrine, Metabolic, Fluid, and Electrolytes

REBEL Core Cast 26.0 – Lactated Ringers

Take Home Points When compared to 0.9% saline, lactated ringers is a more balanced solution and more closely resembles our serum. SALT ED and SMART trials show normal saline may increase the occurrence of major adverse kidney events in comparison ...

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Endocrine, Metabolic, Fluid, and ElectrolytesResuscitation

SMART Trial Part 2: Secondary Analysis of Balanced Crystalloids vs Saline in Sepsis

Background: Saline (0.9% sodium chloride) has historically been one of the most common intravenous fluids administered in critically ill adults.  However, the supraphysiologic chloride concentration can cause hyperchloremia, metabolic acidosis, renal vasoconstriction and alter immune function.  There is nothing normal ...

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Endocrine, Metabolic, Fluid, and Electrolytes

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