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The aim of our study is to evaluate the impact of early vs. late initiation of continuous renal replacement therapy (CRRT), defined by clinical information system (CIS) software using an early warning algorithm based on acute kidney injury network (AKIN) stages, on survival outcome of critically ill intensive care unit (ICU) patients with acute kidney injury (AKI). Of 1144 patients (mean [SD] age: 61.3 [17.9] years, 57.7% were males) hospitalized in ICU over a 2‐year‐period from January 2016 to December 2017, a total of 272 patients who had developed AKI requiring CRRT were included in this retrospective cross‐sectional study. Data on patient demographics (age, gender), reason for ICU hospitalization, AKIN stage, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, indications for CRRT, and time of CRRT initiation with respect to AKIN early warning algorithm were retrieved from hospital records and the CIS software database. Survivorship status was assessed based on total, in‐hospital and 90‐day post‐discharge mortality rates and analyzed with respect to CRRT onset before vs. after AKIN alarm. CRRT was initiated before the AKIN alarm in 41(15.0%) patients, and after the AKIN alarm in 231(85.0%) patients involving treatment within 0–24 h of alarm in 146 (63.2%) patients and within 24–120 h of alarm in 85 (36.8%) patients. Mortality occurred in 175 (64.3%) patients involving 25 (61.0%) out of 41 patients who received CRRT before AKIN alarm and 150 (64.9%) out of 231 patients who received CRRT after AKIN alarm. Mortality rate was significantly higher in those who received CRRT 24–120 h vs. 0–24 h after the AKIN alarm (82.4% vs. 54.8%, P < 0.001). Pre‐ and post‐CRRT SOFA scores were significantly lower in patients who received CRRT 0–24 h vs. 24–120 h after the AKIN alarm (P = 0.009 and P = 0.004, respectively), while pre‐CRRT APACHE II scores were significantly lower in patients who received CRRT before vs. after the AKIN alarm (P = 0.008). In conclusion, our findings indicate the potential role of using AKIN stage‐based early warning system in guiding time to start CRRT and improved survival in critically ill patients with AKI, provided that the CRRT was initiated within the early (first 24 h) of the alarming AKIN Stage II–III events. Future well‐designed clinical trials addressing early vs. late initiation of CRRT in critical care patients with AKI are needed to find and answer to the ongoing controversy and help clinicians in refining their indications for starting CRRT. [ABSTRACT FROM AUTHOR]

Copyright of Medical Journal of Bakirkoy is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medical Journal of Bakirkoy is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medical Journal of Bakirkoy is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medical Journal of Bakirkoy is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Single-session hypnosis has never been evaluated as a premedication technique in patients undergoing coronary artery bypass grafting (CABG). The aim of the present study was to evaluate the beneficial effects of clinical hypnotherapy on perioperative anxiety, pain perception, sedation, and necessity for ventilator assistance in patients undergoing CABG. Methods Double-blind, randomized, clinical trial was performed. Forty-four patients undergoing CABG surgery were randomized into two groups. The patients in group A received preprocedural hypnosis by an anesthesiologist. Patients in group B (control) had only information on the surgical intervention by the same anesthesiologist. State- Trait-Anxiety Index-I (STAI-I) and Beck Depression Inventory (BDI) were performed preoperatively in both groups. Visual analog scale (VAS) and Ramsay sedation scale (RSS) were evaluated on 0th, 1st, 2nd, 4th, 6th, 8th, 10th, 12th, and 24th hours, postoperatively. Postoperative anxiety level, analgesic drug consumption, and duration of ventilator assistance and intensive care unit (ICU) stay were also documented. Results When anxiety and depression levels were compared, significantly lower STA-I and BDI values were detected in group A after hypnotherapy (p = 0.001, p = 0.001, respectively). Significantly less total doses of remifentanil (34.4 ∓ 11.4 vs. 50.0 ∓ 13.6 mg) and morphine (4.9 ∓ 3.3 vs. 13.6 ∓ 2.7 mg) were administered in group A in the postoperative period. Ventilator assistance duration (6.8 ∓ 2.0 vs. 8.9 ∓ 2.7 hours) was also shorter in group A when compared with that in group B (p = 0.007). Conclusion Hypnosis session prior to surgery was an effective complementary method in decreasing presurgical anxiety, and it resulted in better pain control as well as reduced ventilator assistance following CABG surgery. [ABSTRACT FROM AUTHOR]

Copyright of Medical Journal of Bakirkoy is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)