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Critical Care Medicine

Shafqat R Chaudhry, Agi Güresir, Birgit Stoffel-Wagner, Rolf Fimmers, Thomas M Kinfe, Dirk Dietrich, Alf Lamprecht, Hartmut Vatter, Erdem Güresir, Sajjad Muhammad
OBJECTIVES: To investigate the release of proinflammatory damage-associated molecular pattern molecule "high-mobility group box-1" in the serum of patients after aneurysmal subarachnoid hemorrhage and its association with cerebral vasospasm. DESIGN: Retrospective observational study. SETTING: University hospital. PATIENTS: Aneurysmal subarachnoid hemorrhage patients admitted within 24 hours of ictus. INTERVENTIONS: Standard subarachnoid hemorrhage treatment after clipping or coiling of aneurysm...
July 18, 2018: Critical Care Medicine
Pablo Mercado, Julien Maizel, Loay Kontar, Marek Nalos, Stephen Huang, Sam Orde, Anthony McLean, Michel Slama
OBJECTIVES: Open lung ventilation with a recruitment maneuver could be beneficial for acute respiratory distress syndrome patients. However, the increased airway pressures resulting from the recruitment maneuver may induce cardiac dysfunction, limiting the benefit of this maneuver. We analyzed the effect of a recruitment maneuver and decremental positive end-expiratory pressure titration on cardiac function. SETTINGS: Medical ICU Amiens, France. PATIENTS: Twenty patients with moderate to severe acute respiratory distress syndrome INTERVENTIONS:: Patients underwent a stepwise recruitment maneuver with respiratory evaluation and echocardiography assessment of cardiac function including longitudinal strain at baseline, peak positive end-expiratory pressure of recruitment maneuver (positive end-expiratory pressure 40 cm H2O), and at "optimal" positive end-expiratory pressure...
July 18, 2018: Critical Care Medicine
Anoopindar K Bhalla, Nadir Yehya, Wendy J Mack, Melissa L Wilson, Robinder G Khemani, Christopher J L Newth
OBJECTIVES: To investigate the association between inhaled nitric oxide treatment and ICU mortality and 28-day ventilator-free days in pediatric acute respiratory distress syndrome. DESIGN: Retrospective cohort study. A propensity score for inhaled nitric oxide treatment was developed and used in the analysis. SETTING: Two quaternary care PICUs. PATIENTS: Children with pediatric acute respiratory distress syndrome. INTERVENTIONS: None...
July 18, 2018: Critical Care Medicine
Jordan A Woolum, Erin L Abner, Andrew Kelly, Melissa L Thompson Bastin, Peter E Morris, Alexander H Flannery
OBJECTIVES: Mounting evidence has shown that critically ill patients are commonly thiamine deficient. We sought to test the hypothesis that critically ill patients with septic shock exposed to thiamine would demonstrate improved lactate clearance and more favorable clinical outcomes compared with those not receiving thiamine. DESIGN: Retrospective, single-center, matched cohort study. SETTING: Tertiary care academic medical center. PATIENTS: Adult patients admitted with an International Classification of Diseases, 9th Edition, or International Classification of Diseases, 10th Edition, diagnosis code of septic shock to either the medicine or surgery ICU...
July 18, 2018: Critical Care Medicine
Kelly M Hatfield, Raymund B Dantes, James Baggs, Mathew R P Sapiano, Anthony E Fiore, John A Jernigan, Lauren Epstein
OBJECTIVES: To assess the variability in short-term sepsis mortality by hospital among Centers for Medicare and Medicaid Services beneficiaries in the United States during 2013-2014. DESIGN: A retrospective cohort design. SETTING: Hospitalizations from 3,068 acute care hospitals that participated in the Centers for Medicare and Medicaid Services inpatient prospective payment system in 2013 and 2014. PATIENTS: Medicare fee-for-service beneficiaries greater than or equal to 65 years old who had an inpatient hospitalization coded with present at admission severe sepsis or septic shock...
July 17, 2018: Critical Care Medicine
Mariana Dutra, Mariana V Monteiro, Karina B Ribeiro, Guilherme P Schettino, Andre Carlos Kajdacsy-Balla Amaral
OBJECTIVES: Handovers are associated with medical errors, and our primary objective is to identify missed diagnosis and goals immediately after a shift handover. Our secondary objective is to assess clinicians' diagnostic accuracy in anticipating clinical events during the night shift. DESIGN: Single-center prospective observational cohort study. SETTING: Thirty-bed tertiary ICU in Sao Paulo, Brazil. PATIENTS: Three-hundred fifty-two patient encounters over 44 day-to-night handovers...
July 17, 2018: Critical Care Medicine
Garrett Keim, R Scott Watson, Neal J Thomas, Nadir Yehya
OBJECTIVES: Much of the research related to pediatric acute respiratory distress syndrome has focused on inhospital mortality and interventions affecting this outcome. Limited data exist on survivors' morbidity, hospital disposition, and 1-year survival. The aim of this study was to determine new morbidity rate, discharge disposition, and 1-year mortality for survivors of pediatric acute respiratory distress syndrome. DESIGN: Secondary analysis of prospective cohort study...
July 17, 2018: Critical Care Medicine
Michele C Balas, Gerald L Weinhouse, Linda Denehy, Gerald Chanques, Bram Rochwerg, Cheryl J Misak, Yoanna Skrobik, John W Devlin, Gilles L Fraser
No abstract text is available yet for this article.
July 17, 2018: Critical Care Medicine
Johannes Grand, Anna Sina P Meyer, Christian Hassager, Henrik Schmidt, Jacob E Møller, Jesper Kjaergaard
OBJECTIVES: No double-blinded clinical trials have investigated optimal mean arterial pressure targets in the ICU. The aim of this study was to develop and validate a method for blinded investigation of mean arterial pressure targets in patients monitored with arterial catheter in the ICU. DESIGN: Prospective observational study (substudy A) and prospective, randomized, controlled clinical study (substudy B). SETTING: ICU, Department of Cardiology, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark...
July 9, 2018: Critical Care Medicine
Benjamin Delwarde, Estelle Peronnet, Fabienne Venet, Elisabeth Cerrato, Boris Meunier, Julie Mouillaux, Alain Lepape, Alexandre Pachot, Thomas Rimmelé, Guillaume Monneret, Julien Textoris
OBJECTIVES: Septic shock is the primary cause of death in ICUs. A better comprehension of its pathophysiology, in particular, the immune alteration mechanisms, opened new therapeutic perspectives such as the recombinant interleukin-7. The use of biomarkers could improve the identification of eligible patients for this therapy. The soluble form of the interleukin-7 appears as a promising candidate in this regard since an association between its high plasmatic level and mortality in critically ill patients has been demonstrated...
July 6, 2018: Critical Care Medicine
John W Devlin, Yoanna Skrobik, Bram Rochwerg, Mark E Nunnally, Dale M Needham, Celine Gelinas, Pratik P Pandharipande, Arjen J C Slooter, Paula L Watson, Gerald L Weinhouse, Michelle E Kho, John Centofanti, Carrie Price, Lori Harmon, Cheryl J Misak, Pamela D Flood, Waleed Alhazzani
OBJECTIVES: To describe novel guideline development strategies created and implemented as part of the Society of Critical Care Medicine's 2018 clinical practice guidelines for pain, agitation (sedation), delirium, immobility (rehabilitation/mobility), and sleep (disruption) in critically ill adults. DESIGN: We involved critical illness survivors from start to finish, used and expanded upon Grading of Recommendations, Assessment, Development and Evaluation methodology for making recommendations, identified evidence gaps, and developed communication strategies to mitigate challenges...
July 6, 2018: Critical Care Medicine
Lotte Kok, Arjen J Slooter, Manon H Hillegers, Diederik van Dijk, Dieuwke S Veldhuijzen
OBJECTIVES: A systematic assessment of the role of benzodiazepine use during ICU stay as a risk factor for neuropsychiatric outcomes during and after ICU admission. DATA SOURCES: PubMed/Medline, EMBASE, The Cochrane Library, CINAHL, and PsychINFO. STUDY SELECTION: Databases were searched independently by two reviewers for studies in adult (former) ICU patients, reporting benzodiazepine use, and neuropsychiatric outcomes of delirium, posttraumatic stress disorder, depression, anxiety, and cognitive dysfunction...
July 5, 2018: Critical Care Medicine
Jonathan A Silversides, Emma Fitzgerald, Uma S Manickavasagam, Stephen E Lapinsky, Rosane Nisenbaum, Noel Hemmings, Christopher Nutt, T John Trinder, David G Pogson, Eddy Fan, Andrew J Ferguson, Daniel F McAuley, John C Marshall
OBJECTIVES: To characterize current practice in fluid administration and deresuscitation (removal of fluid using diuretics or renal replacement therapy), the relationship between fluid balance, deresuscitative measures, and outcomes and to identify risk factors for positive fluid balance in critical illness. DESIGN: Retrospective cohort study. SETTING: Ten ICUs in the United Kingdom and Canada. PATIENTS: Adults receiving invasive mechanical ventilation for a minimum of 24 hours...
July 5, 2018: Critical Care Medicine
Maximiliano A Hawkes, Ivan D Carabenciov, Eelco F M Wijdicks, Alejandro A Rabinstein
OBJECTIVE: To assess the long-term outcomes of patients hospitalized with severe West Nile neuroinvasive disease. DESIGN: Retrospective cohort. SETTING: Patients admitted to a referral center (Saint Mary's Hospital, Mayo Clinic). PARTICIPANTS: Twenty-six patients with West Nile neuroinvasive disease were identified by retrospective search of electronic database of Saint Mary's Hospital from January 1999 to November 2016...
July 5, 2018: Critical Care Medicine
Harriet Sommer, Jean-François Timsit, Maja von Cube, Martin Schumacher, Michael Darmon, Carole Schwebel, Stéphane Ruckly, Martin Wolkewitz
OBJECTIVES: We aim to examine the effect of early adequate treatment in comparison with inadequate or delayed treatment on being extubated or discharged alive over time, in patients with Pseudomonas aeruginosa-related ventilator-associated pneumonia. DESIGN: Retrospective analyses of a prospective observational multicenter cohort study. SETTING: ICU. PATIENTS: Patients of the French prospective database (OUTCOMEREA) were included if they acquired a ventilator-associated pneumonia due to P...
July 5, 2018: Critical Care Medicine
Candelaria de Haro, Josefina López-Aguilar, Rudys Magrans, Jaume Montanya, Sol Fernández-Gonzalo, Marc Turon, Gemma Gomà, Encarna Chacón, Guillermo M Albaiceta, Rafael Fernández, Carles Subirà, Umberto Lucangelo, Gastón Murias, Montserrat Rué, Robert M Kacmarek, Lluís Blanch
OBJECTIVES: Double cycling generates larger than expected tidal volumes that contribute to lung injury. We analyzed the incidence, mechanisms, and physiologic implications of double cycling during volume- and pressure-targeted mechanical ventilation in critically ill patients. DESIGN: Prospective, observational study. SETTING: Three general ICUs in Spain. PATIENTS: Sixty-seven continuously monitored adult patients undergoing volume control-continuous mandatory ventilation with constant flow, volume control-continuous mandatory ventilation with decelerated flow, or pressure control-continuous mandatory mechanical ventilation for longer than 24 hours...
July 5, 2018: Critical Care Medicine
Amra Sakusic, Moldovan Sabov, Amanda J McCambridge, Alejandro A Rabinstein, Tarun D Singh, Kumar Mukesh, Kianoush B Kashani, David Cook, Ognjen Gajic
OBJECTIVES: To evaluate the epidemiology of hyperammonemia unrelated to liver failure in the critical care setting. DESIGN: Retrospective case series. SETTING: Critically ill patients admitted to ICUs at Mayo Clinic, Rochester, MN (medical ICU, two mixed medical-surgical ICUs, coronary care unit, or the cardiosurgical ICU) between July 1, 2004, and October 31, 2015. PATIENTS: Adult critically ill patients with hyperammonemia not related to acute or chronic liver failure...
July 5, 2018: Critical Care Medicine
Teresa L May, Richard R Riker, Gilles L Fraser, Karen G Hirsch, Sachin Agarwal, Christine Duarte, Hans Friberg, Eldar Søreide, John McPherson, Robert Hand, David Kent, Niklas Nielsen, David B Seder
OBJECTIVES: Sedation and neuromuscular blockade protocols in patients undergoing targeted temperature management after cardiac arrest address patient discomfort and manage shivering. These protocols vary widely between centers and may affect outcomes. DESIGN: Consecutive patients admitted to 20 centers after resuscitation from cardiac arrest were prospectively entered into the International Cardiac Arrest Registry between 2006 and 2016. Additional data about each center's sedation and shivering management practice were obtained via survey...
July 2, 2018: Critical Care Medicine
Francisco Vasques-Nóvoa, Tiago L Laundos, Rui J Cerqueira, Catarina Quina-Rodrigues, Ricardo Soares-Dos-Reis, Fabiana Baganha, Sara Ribeiro, Luís Mendonça, Francisco Gonçalves, Carlos Reguenga, Wouter Verhesen, Fátima Carneiro, José Artur Paiva, Blanche Schroen, Paulo Castro-Chaves, Perpétua Pinto-do-Ó, Diana S Nascimento, Stephane Heymans, Adelino F Leite-Moreira, Roberto Roncon-Albuquerque
OBJECTIVES: Septic shock is a life-threatening clinical situation associated with acute myocardial and vascular dysfunction, whose pathophysiology is still poorly understood. Herein, we investigated microRNA-155-dependent mechanisms of myocardial and vascular dysfunction in septic shock. DESIGN: Prospective, randomized controlled experimental murine study and clinical cohort analysis. SETTING: University research laboratory and ICU at a tertiary-care center...
July 2, 2018: Critical Care Medicine
Jianfeng Wu, Bing Han, Vito Fanelli, Xiaoyan Wen, Yongbo Huang, Alice Luo, Mirna Ghazarian, Dingyan Wang, Julie Khang, Florence Morriello, Patricia C Liaw, John Marshall, Nanshan Zhong, Xiangdong Guan, Arthur S Slutsky, Yimin Li, Haibo Zhang
OBJECTIVES: To examine the effects and mechanisms of human neutrophil peptides in systemic infection and noninfectious inflammatory lung injury. DESIGN: Prospective experimental study. SETTING: University hospital-based research laboratory. SUBJECTS: In vitro human cells and in vivo mouse models. INTERVENTIONS: Wild-type (Friend virus B-type) and conditional leukocyte human neutrophil peptides transgenic mice were subjected to either sepsis induced by cecal ligation and puncture or acute lung injury by intratracheal instillation of hydrochloric acid followed by mechanical ventilation...
July 2, 2018: Critical Care Medicine
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