Background: Acute kidney injury is associated with increased morbidity and mortality. In the NONSEDA trial 700 mechanically ventilated patients were randomized to non-sedation or light sedation with a wake-up trial. The purpose of this post hoc sub-study is to present the effect of non-sedation on renal function, especially the need for renal replacement therapy (RRT)

Methods: The primary endpoint was mortality at 90 days. The secondary endpoints were thromboembolic events, coma or delirium free days, ventilator free days and acute kidney injury. Every day Risk, Injury, Failure, Loss of kidney function, Endstage kidney disease (RIFLE) and the need for CRRT were registered. In addition fluid balance, weight, mean arterial and systolic blood pressure and noradrenaline infusion were registered.

Results: The percentage of patients treated with continuous renal replacement therapy (CRRT) was 28% in the non-sedated compared to 40% in the sedated group (p=0.04). Need for CRRT at discharge was 5% in the non-sedated compared to 11% in the sedated group (p=0.02). The number of days in the RIFLE category renal failure was 1365 in the non-sedated compared to 1678 in the sedated group (p=0.01). In the sedated group, the mean blood pressure was 79.8 mmHg compared to 81.8 in the non-sedated group (p=0.05). Days with noradrenaline was 4.2 in the sedated compared to 3.7 in the non-sedated group (p=0.01). There was no difference in fluid balance.

Conclusion: The kidney function might be better preserved in the non-sedation group compared to light sedation with a wake-up trial. Clinicaltrials.gov (NCT01967680)2013-10-18.

Objectives : The primary objective of this case report is to review the clinical presentation, diagnostic methods, treatment, and outcomes associated with cavernous hemangioma of the urinary bladder. We aim to enhance awareness among healthcare professionals regarding this rare entity and improve management strategies for similar cases.

Introduction : Cavernous hemangioma of the urinary bladder is a rare vascular tumor that arises from the proliferation of blood vessels. While it can occur in various anatomical locations, its incidence in the bladder is particularly low, accounting for approximately 0.6% of urinary bladder tumors, with painless hematuria being the most common presenting symptom. The most frequent locations in the bladder are the base, posterior wall, and trigone. This condition presents diagnostic challenges due to its nonspecific symptoms, which often overlap with more common urological disorders. Cavernous hemangiomas are typically found in organs such as the liver, skin, or brain, where they are usually asymptomatic unless their size or location causes symptoms. Complete surgical excision is generally curative. Methods : A comprehensive literature review was conducted, focusing on case reports and studies published in peer-reviewed journals. The review iden

tified several cases of cavernous hemangioma, most commonly presenting with hematuria, urinary frequency, and pelvic pain. Imaging modalities such as ultrasound and CT scans revealed heterogeneous masses, often leading to differential diagnoses. Surgical excision emerged as the predominant treatment method.

Results : Most patients experienced favorable outcomes with no recurrence during follow-up.

Conclusion : Cavernous hemangioma of the urinary bladder, although rare, should be considered in the differential diagnosis of bladder masses, particularly in patients presenting with unexplained hematuria. Early diagnosis and appropriate surgical intervention lead to excellent long-term outcomes. Increased awareness and further research are essential to refine management protocols and improve patient care.