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The 10 studies comprised 1956 participants (989 ‘early’ group; 967 ‘late’ group) with 918 total deaths; the analysis demonstrated no significant differences between the ‘early’ and ‘late’ renal replacement therapy groups (RR = 0.98 (95% CI = 0.84, 1.15)) for mortality. No significant differences between groups were evident for period-wise mortality; dialysis dependence; recovery of renal function; length of intensive care unit or hospital stay; or number of renal replacement therapies, mechanical ventilation and vasopressor-free days.

Current evidence does not support the use of early renal replacement therapy for patients with acute kidney injury. Data from ongoing and future randomised controlled trials are required to strengthen the evidence base in the area.

Current evidence does not support the use of early renal replacement therapy for patients with acute kidney injury. Data from ongoing and future randomised controlled trials are required to strengthen the evidence base in the area.

Social media is increasingly used in the dissemination of medical research. Traditional measures of the impact of a paper do not account for this. Altmetrics are a measure of the dissemination of a publication via social media websites. The purpose of this study is to ascertain if the altmetric attention score of an article is a reliable measure of the impact it has in the field of critical care medicine. To this end, we investigated if a correlation exists between future citation count and altmetric attention score.

The top nine journals by impact factor in the field of critical care medicine were identified for 2014 and 2015. The 100 most cited articles from these journals were recorded to form the Scientific Impact Group, i.e. those with the greatest impact on the scientific community. The altmetric attention score was recorded for each article. The top 100 articles by altmetric attention score were also identified to form the Media Impact Group, i.e. those that generated the most online attention. Thever, papers that generate a lot of online attention are less likely to have a high citation count. CP 43 ic50 Therefore, altmetric attention score is not a reliable predictor of future citation count in critical care medicine.

Intensive care staff have high levels of stress. We conducted a service improvement initiative to assess workplace stress levels among staff in one adult general intensive care unit and deliver a stress management intervention.

A psychological intervention of four stress management sessions, and fortnightly staff support drop-in groups, was developed and delivered within a year. Pre- and post-intervention, workplace stress in the unit was assessed using a Health and Safety Executive tool.

Pre-intervention assessment of 76 (47.2%) staff indicated that improvement was needed in all domains of workplace stress. 125 staff (77.6%) participated in the intervention and gave positive ratings for content, relevance, practicality and personal value (median 4 (1-5); interquartile range 3.8-4.6). Post-intervention assessment of 71 staff (41.3%) demonstrated improvements in all workplace stress domains.

A reduction in workplace stress was observed following a service improvement intervention in one intensive care unit although no causality can be assumed. Similar interventions should be evaluated using robust study designs.

A reduction in workplace stress was observed following a service improvement intervention in one intensive care unit although no causality can be assumed. Similar interventions should be evaluated using robust study designs.

Combined antiretroviral therapy has led to significant decreases in morbidity and mortality in acquired immunodeficiency syndrome patients. Survival among these patients admitted to intensive care units has also improved in the last years. However, the prognostic predictors of human immunodeficiency vírus patients in intensive care units have not been adequately studied. The main objective of this study was to evaluate if non-adherence to antiretroviral therapy is a predictor of hospital mortality.

A unicentric, retrospective, cohort study composed of patients admitted to a 59-bed mixed intensive care unit including all patients with human immunodeficiency vírus infection. Patients were excluded if exclusive palliative care was established before completing 48 h of intensive care unit admission. Clinical and treatment data were obtained, including demographic records, underlying diseases, Simplified Acute Physiology III score at the time of intensive care unit admission, CD4 lymphocyte count, antiretrovirulation. Highly active antiretroviral therapy non-adherence may be associated with other comorbidities that may be associated with a worst prognosis in this scenario.

To assess the feasibility, tolerance and effectiveness of enteral nutrition in critically ill patients receiving invasive mechanical ventilation in the prone position for severe Acute Respiratory Distress Syndrome (ARDS).

Prospective observational study conducted in a multidisciplinary critical care unit of a tertiary care hospital from January 2013 until July 2015. All patients with ARDS who received invasive mechanical ventilation in prone position during the study period were included. Patients’ demographics, severity of illness (Acute Physiology and Chronic Health Evaluation (APACHE II) score), baseline markers of nutritional status (subjective global assessment (SGA) and body mass index), details of nutrition delivery during prone and supine hours and outcomes (Length of stay and discharge status) were recorded.

Fifty-one patients met inclusion criteria out of whom four patients were excluded from analysis since they did not receive any enteral nutrition due to severe hemodynamic instability. The meiving invasive mechanical ventilation in the prone position, enteral nutrition with nasogastric/orogastric feeding is feasible and well tolerated. Nutritional delivery of calories and proteins in prone position is comparable to that in supine position.

In critically ill patients receiving invasive mechanical ventilation in the prone position, enteral nutrition with nasogastric/orogastric feeding is feasible and well tolerated. Nutritional delivery of calories and proteins in prone position is comparable to that in supine position.