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Related Concept Videos

Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

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Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
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Acute Kidney Injury III: Clinical Manifestations01:29

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Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
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Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic01:26

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Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
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Pneumonia III: Complications and Assessment01:30

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Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
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Organ dysfunction as a new standard for defining sepsis.

Seitaro Fujishima1

  • 1Center for General Medicine Education, Keio University School of Medicine, Tokyo, Japan.

Inflammation and Regeneration
|December 21, 2017
PubMed
Summary

Sepsis, a major cause of death, has evolved diagnostic criteria from SIRS to Sepsis-3, focusing on organ dysfunction. This shift impacts clinical practice and basic research on sepsis pathophysiology.

Keywords:
Acute kidney injuryAcute respiratory distress syndromeDisseminated intravascular coagulationSepsis-3Sequential organ failure assessment score

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Area of Science:

  • Critical Care Medicine
  • Pathophysiology
  • Medical Diagnostics

Background:

  • Sepsis remains a leading cause of mortality, with increasing prevalence in aging populations.
  • Diagnostic criteria for sepsis have evolved from septicemia to Systemic Inflammatory Response Syndrome (SIRS) and subsequently to Sepsis-3.
  • The Sepsis-3 definition, introduced in 2016, utilizes organ dysfunction measured by the Sequential Organ Failure Assessment (SOFA) score.

Purpose of the Study:

  • To review the pathophysiology of sepsis and associated organ dysfunction.
  • To discuss the implications of the Sepsis-3 definition on clinical practice and research.
  • To identify potential future research directions in sepsis.

Main Methods:

  • Literature review of sepsis definitions and pathophysiology.
  • Analysis of the transition from SIRS criteria to the Sepsis-3 criteria.
  • Discussion of the impact of Sepsis-3 on patient populations and research focus.

Main Results:

  • The Sepsis-3 definition identifies a different patient population compared to previous criteria.
  • The shift to organ dysfunction as a diagnostic basis necessitates a re-evaluation of sepsis research.
  • Understanding sepsis pathophysiology is crucial for developing targeted therapies.

Conclusions:

  • The Sepsis-3 definition represents a significant change in sepsis diagnosis, impacting both clinical management and research paradigms.
  • Future research should focus on the mechanisms of organ dysfunction in sepsis under the Sepsis-3 framework.
  • Further investigation into sepsis pathophysiology is essential for improving patient outcomes.