Candidemia is associated with high mortality rate especially in critically ill (ICU) patients with septic shock and echinocandins such as anidulafungin are recommended as first-line treatment. Available pharmacokinetic studies of anidulafungin in healthy volunteers and in patients with renal or hepatic impairment showed that no dose adjustment is needed even in patients receiving standard inter...

disease characterized by neurological symptoms due to cerebral edema after hemodialysis (HD). However, a direct measurement of intracranial pressure (ICP) rarely objectifi ed this edema [1]. We report the case of a patient whose DDS was diagnosed by an increase of ICP. A 51-year-old man was admitted for severe traumatic brain injury. At admission, an extradural hematoma was evacuated. After sur...

In the continuing dispute about the superiority of either intermittent or continuous renal replacement therapy for the critically ill, hybrid methods such as sustained low-efficiency dialysis (SLED) combining the advantages of both modalities--that is, excellent hemodynamic stability and low costs--receive growing attention. The study by Schwenger and colleagues is the first randomized trial in...

OBJECTIVES To explore the pharmacokinetics (PK) and pharmacodynamics (PD) of micafungin in patients undergoing continuous venovenous haemofiltration (CVVH). PATIENTS AND METHODS Ten patients receiving CVVH treated with 100 mg/day micafungin were included (April-December 2012). CVVH was performed using polyethersulphone or polysulphone haemofilters. Dialysis membranes were not changed on sampl...

BACKGROUND Systemic heparinization is associated with a high rate of bleeding when used to maintain patency of the extracorporeal circuit during continuous renal replacement therapy (CRRT) in critically ill patients. Regional anticoagulation can be achieved with citrate, but previously described techniques are cumbersome and associated with metabolic complications. METHODS We designed a simpl...

BACKGROUND Exertional heatstroke is a life-threatening condition with high mortality because of the rapid progress of multiple organ dysfunction syndrome even if aggressive treatments are initiated rapidly. Mild to moderate hepatic injury is common in exertional heatstroke, while fulminant liver failure is rare. Extrapyramidal symptoms and pulmonary aspergillosis secondary to liver failure indu...

BACKGROUND AND METHODS Conventional extracorporeal CO2 removal systems require blood flow rates of 1 to 2.5 L/min in the extracorporeal circuit. We hypothesized that standard hemofiltration equipment can be combined with a high-performance extracorporeal lung to achieve high rates of CO2 removal at lower blood flow rates. To test this hypothesis, we performed experiments on nine sheep to examin...

It has been brought to the attention of the Editor and the Publication Committee for the Shock Society that a previously published article in Shock contains inconsistencies that may alter data interpretation. The article of concern is: Boldt J, Wollbruck M, Menges T, Diridis K, Hempelmann G. Changes in regulators of circulation in patients undergoing continuous pump-driven veno-venous hemofiltr...

BACKGROUND There is ongoing controversy concerning optimum anticoagulation and buffering in continuous venovenous haemofiltration (CVVH). Regional anticoagulation with trisodium citrate also acting as a buffer in the replacement fluid has several advantages and disadvantages over prefilter citrate administration alone. We analysed a large cohort of patients with acute kidney injury (AKI) treate...