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Background: Exploring a biomarker with enhanced sensitivity and specificity for tissue perfusion may facilitate the timely identification of circulatory collapse, and enable more precise resuscitation efforts. Objective: The objective of this study was to ascertain the correlation between whole blood lactate versus plasma renin concentration being a biomarker of tissue perfusion and predictor of mortality among hypotensive critically ill patients. Methods: This prospective, observational cohort study enrolled 84 hypotensive critically ill patients. Plasma renin concentration and blood lactate were measured at enrollment, 24, 48, and 72 hours. The primary outcome is the correlation between the recorded renin, lactate concentrations and mortality rate during hospitalization. Results: The mean plasma renin concentration at enrollment was 61.95 pg/ml in survivors, and 104.45 pg/ml in non-survivors (p = <0.001). The non-survivors exhibited a significant boost in plasma renin concentration after 48 and 72 hours, opposed to the survivors (112 vs 40.89, and 106.64 vs 28.85 pg/ml) respectively. There was a significant positive correlation between plasma renin, blood lactate concentrations and patient mortality (r = 0.389 & 0.601) respectively. Conclusion: Plasma renin and whole blood lactate had positive correlation to mortality, yet plasma renin revealed superior diagnostic accuracy over blood lactate for mortality prediction in hypotensive critically-ill patients. Trial registration: The protocol of this study can be obtained on ClinicalTrials.gov with the id NCT05810415. [ABSTRACT FROM AUTHOR]

Objective: Different anaesthetists for sedation or monitored anaesthesia care have been used for colonoscopy. The target of this research was the ability to perform colonoscopy under a painless degree of sedation and the prevalence of undesired proceedings., Methods: A total of 60 patients were randomly divided into two groups: Group D received dexmedetomidine and Group PF received propofol-fentanyl. Patients in both groups received the same infusion ratio. The minimum infusion amount of dexmetatomidine is (0.1 to 0.4 μg kg -1 h -1 ) in Group D, whereas fentanyl is administered at a rate of 0.01 to 0.05 μg kg -1 min -1 in the PF group during the approximately 45-min colonoscopy., Results: Group D exhibited significantly lower modified Observer's Assessment of Alertness/Sedation (OAA/S) scores at intraoperative time points T1-T12. Group D also exhibited significantly lower visual analog scale scores for pain at intraoperative time points T4 and T7. The mean arterial pressure was significantly lower in Group D at intraoperative times T6-T8 and T11-T12, as well as upon admission to the post-anaesthesia care unit (PACU) and 30 min after admission to the PACU. The results of the ANOVA tests revealed a significantly lower heart rate in Group D. The respiratory rate exhibited a notable decrease during time intervals T8 and T10 in the PF group., Conclusion: The administration of dexmetatomidine and propofol-fentanyl during colonoscopy was found to be safe. In addition, dexmetatomidine may present significant benefits in this context because of its lower occurrence of adverse respiratory events., Competing Interests: Declaration of Interests: The authors have no conflict of interest to declare., (©Copyright 2024 by the Turkish Anesthesiology and Reanimation Association / Turkish Journal of Anaesthesiology & Reanimation is published by Galenos Publishing House.)