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Critical Care Medicine

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https://www.readbyqxmd.com/read/28181941/sodium-bicarbonate-versus-sodium-chloride-for-preventing-contrast-associated-acute-kidney-injury-in-critically-ill-patients-a-randomized-controlled-trial
#1
Xavier Valette, Isabelle Desmeulles, Benoit Savary, Romain Masson, Amélie Seguin, Bertrand Sauneuf, Jennifer Brunet, Pierre Verrier, Véronique Pottier, Marie Orabona, Désiré Samba, Gérald Viquesnel, Mathilde Lermuzeaux, Pascal Hazera, Jean-Jacques Dutheil, Jean-Luc Hanouz, Jean-Jacques Parienti, Damien du Cheyron
OBJECTIVES: To test whether hydration with bicarbonate rather than isotonic sodium chloride reduces the risk of contrast-associated acute kidney injury in critically ill patients. DESIGN: Prospective, double-blind, multicenter, randomized controlled study. SETTING: Three French ICUs. PATIENTS: Critically ill patients with stable renal function (n = 307) who received intravascular contrast media. INTERVENTIONS: Hydration with 0...
February 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28169946/differences-in-utilization-of-life-support-and-end-of-life-care-for-medical-icu-patients-with-versus-without-cancer
#2
Geoffrey Koff, Urvashi Vaid, Edward Len, Albert Crawford, David A Oxman
OBJECTIVES: To explore differences in the utilization of life support and end-of-life care between patients dying in the medical ICU with cancer compared with those without cancer. DESIGN: Retrospective review of 403 deaths or hospice transfers in the medical ICU from January 1, 2012, to June 30, 2013. SETTING: Urban tertiary care university hospital. PATIENTS: Consecutive medical ICU deaths or hospice transfers over an 18-month period...
February 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28169945/causes-and-consequences-of-treatment-variation-in-moderate-and-severe-traumatic-brain-injury-a-multicenter-study
#3
Maryse C Cnossen, Suzanne Polinder, Teuntje M Andriessen, Joukje van der Naalt, Iain Haitsma, Janneke Horn, Gaby Franschman, Pieter E Vos, Ewout W Steyerberg, Hester Lingsma
OBJECTIVES: Although guidelines have been developed to standardize care in traumatic brain injury, between-center variation in treatment approach has been frequently reported. We examined variation in treatment for traumatic brain injury by assessing factors influencing treatment and the association between treatment and patient outcome. DESIGN: Secondary analysis of prospectively collected data. SETTING: Five level I trauma centers in the Netherlands (2008-2009)...
February 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28169944/increased-time-to-initial-antimicrobial-administration-is-associated-with-progression-to-septic-shock-in-severe-sepsis-patients
#4
Bristol B Whiles, Amanda S Deis, Steven Q Simpson
OBJECTIVES: To determine if time to initial antimicrobial is associated with progression of severe sepsis to septic shock. DESIGN: Retrospective cohort. SETTING: Six hundred fifty-six bed urban academic medical center. PATIENTS: Emergency department patients greater than or equal to 18 years old with severe sepsis and/or septic shock and antimicrobial administration within 24 hours. Patients with shock on presentation were excluded...
February 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28169943/bedside-glucose-monitoring-is-it-safe-a-new-regulatory-compliant-risk-assessment-evaluation-protocol-in-critically-ill-patient-care-settings
#5
Jeffrey Anton DuBois, Robbert Jan Slingerland, Marion Fokkert, Alain Roman, Nam Khoa Tran, William Clarke, David Alan Sartori, Tina Louise Palmieri, Andrei Malic, Martha Elizabeth Lyon, Andrew William Lyon
OBJECTIVES: New data have emerged from ambulatory and acute care settings about adverse patient events, including death, attributable to erroneous blood glucose meter measurements and leading to questions over their use in critically ill patients. The U.S. Food and Drug Administration published new, more stringent guidelines for glucose meter manufacturers to evaluate the performance of blood glucose meters in critically ill patient settings. The primary objective of this international, multicenter, multidisciplinary clinical study was to develop and apply a rigorous clinical accuracy assessment algorithm, using four distinct statistical tools, to evaluate the clinical accuracy of a blood glucose monitoring system in critically ill patients...
February 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28169942/rbc-transfusion-improves-cerebral-oxygen-delivery-in-subarachnoid-hemorrhage
#6
Rajat Dhar, Allyson R Zazulia, Colin P Derdeyn, Michael N Diringer
OBJECTIVES: Impaired oxygen delivery due to reduced cerebral blood flow is the hallmark of delayed cerebral ischemia following subarachnoid hemorrhage. Since anemia reduces arterial oxygen content, it further threatens oxygen delivery increasing the risk of cerebral infarction. Thus, subarachnoid hemorrhage may constitute an important exception to current restrictive transfusion practices, wherein raising hemoglobin could reduce the risk of ischemia in a critically hypoperfused organ...
February 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28157141/icu-acquisition-rate-risk-factors-and-clinical-significance-of-digestive-tract-colonization-with-extended-spectrum-beta-lactamase-producing-enterobacteriaceae-a-systematic-review-and-meta-analysis
#7
Marios Detsis, Styliani Karanika, Eleftherios Mylonakis
OBJECTIVE: To evaluate the acquisition rate, identify risk factors, and estimate the risk for subsequent infection, associated with the colonization of the digestive tract with extended-spectrum beta-lactamase-producing Enterobacteriaceae during ICU-hospitalization. DATA SOURCES: PubMed, EMBASE, and reference lists of all eligible articles. STUDY SELECTION: Included studies provided data on ICU-acquired colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae in previously noncolonized and noninfected patients and used the double disk synergy test for extended-spectrum beta-lactamase-producing Enterobacteriaceae phenotypic confirmation...
February 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28157140/a-quasi-experimental-before-after-trial-examining-the-impact-of-an-emergency-department-mechanical-ventilator-protocol-on-clinical-outcomes-and-lung-protective-ventilation-in-acute-respiratory-distress-syndrome
#8
Brian M Fuller, Ian T Ferguson, Nicholas M Mohr, Anne M Drewry, Christopher Palmer, Brian T Wessman, Enyo Ablordeppey, Jacob Keeperman, Robert J Stephens, Cristopher C Briscoe, Angelina A Kolomiets, Richard S Hotchkiss, Marin H Kollef
OBJECTIVES: To evaluate the impact of an emergency department mechanical ventilation protocol on clinical outcomes and adherence to lung-protective ventilation in patients with acute respiratory distress syndrome. DESIGN: Quasi-experimental, before-after trial. SETTING: Emergency department and ICUs of an academic center. PATIENTS: Mechanically ventilated emergency department patients experiencing acute respiratory distress syndrome while in the emergency department or after admission to the ICU...
February 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28151758/case-volume-outcomes-associations-among-patients-with-severe-sepsis-who-underwent-interhospital-transfer
#9
Uchenna R Ofoma, John Dahdah, Shravan Kethireddy, Daniel Maeng, Allan J Walkey
OBJECTIVES: Case volume-outcome associations bolster arguments to regionalize severe sepsis care, an approach that may necessitate interhospital patient transfers. Although transferred patients may most closely reflect care processes involved with regionalization, associations between sepsis case volume and outcomes among transferred patients are unclear. We investigated case volume-outcome associations among patients with severe sepsis transferred from another hospital. DESIGN: Serial cross-sectional study using the Nationwide Inpatient Sample...
February 1, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28145907/evaluation-of-reperfusion-pulmonary-edema-by-extravascular-lung-water-measurements-after-pulmonary-endarterectomy
#10
François Stéphan, Aurélien Mazeraud, Florent Laverdure, Julien Camous, Elie Fadel
OBJECTIVES: Reperfusion pulmonary edema is a specific complication of pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Extravascular lung water measurement may be valuable for diagnosing reperfusion pulmonary edema. The primary objective of this study was to describe and assess the clinical significance of extravascular lung water variations after pulmonary endarterectomy. DESIGN: Prospective observational study. SETTING: Nineteen-bed cardiothoracic ICU...
January 31, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28141683/fever-in-the-emergency-department-predicts-survival-of-patients-with-severe-sepsis-and-septic-shock-admitted-to-the-icu
#11
Jonas Sundén-Cullberg, Rebecca Rylance, Jesper Svefors, Anna Norrby-Teglund, Jonas Björk, Malin Inghammar
OBJECTIVES: To study the prognostic value of fever in the emergency department in septic patients subsequently admitted to the ICU. DESIGN: Observational cohort study from the Swedish national quality register for sepsis. SETTING: Thirty ICU's in Sweden. PATIENTS: Two thousand two hundred twenty-five adults who were admitted to an ICU within 24 hours of hospital arrival with a diagnosis of severe sepsis or septic shock were included...
January 30, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28107207/dynamic-mechanical-interactions-between-neighboring-airspaces-determine-cyclic-opening-and-closure-in-injured-lung
#12
Ludovic Broche, Gaetano Perchiazzi, Liisa Porra, Angela Tannoia, Mariangela Pellegrini, Savino Derosa, Alessandra Sindaco, João Batista Borges, Loïc Degrugilliers, Anders Larsson, Göran Hedenstierna, Anthony S Wexler, Alberto Bravin, Sylvia Verbanck, Bradford J Smith, Jason H T Bates, Sam Bayat
OBJECTIVES: Positive pressure ventilation exposes the lung to mechanical stresses that can exacerbate injury. The exact mechanism of this pathologic process remains elusive. The goal of this study was to describe recruitment/derecruitment at acinar length scales over short-time frames and test the hypothesis that mechanical interdependence between neighboring lung units determines the spatial and temporal distributions of recruitment/derecruitment, using a computational model. DESIGN: Experimental animal study...
January 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28079607/mapping-regional-differences-of-local-pressure-volume-curves-with-electrical-impedance-tomography
#13
Alessandro Beda, Alysson R Carvalho, Nadja C Carvalho, Sören Hammermüller, Marcelo B P Amato, Thomas Muders, Claudia Gittel, Katharina Noreikat, Hermann Wrigge, Andreas W Reske
OBJECTIVES: Lung-protective mechanical ventilation aims to prevent alveolar collapse and overdistension, but reliable bedside methods to quantify them are lacking. We propose a quantitative descriptor of the shape of local pressure-volume curves derived from electrical impedance tomography, for computing maps that highlight the presence and location of regions of presumed tidal recruitment (i.e., elastance decrease during inflation, pressure-volume curve with upward curvature) or overdistension (i...
January 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28079605/delirium-in-critically-ill-children-an-international-point-prevalence-study
#14
Chani Traube, Gabrielle Silver, Ron W Reeder, Hannah Doyle, Emily Hegel, Heather A Wolfe, Christopher Schneller, Melissa G Chung, Leslie A Dervan, Jane L DiGennaro, Sandra D W Buttram, Sapna R Kudchadkar, Kate Madden, Mary E Hartman, Mary L deAlmeida, Karen Walson, Erwin Ista, Manuel A Baarslag, Rosanne Salonia, John Beca, Debbie Long, Yu Kawai, Ira M Cheifetz, Javier Gelvez, Edward J Truemper, Rebecca L Smith, Megan E Peters, A M Iqbal O'Meara, Sarah Murphy, Abdulmohsen Bokhary, Bruce M Greenwald, Michael J Bell
OBJECTIVES: To determine prevalence of delirium in critically ill children and explore associated risk factors. DESIGN: Multi-institutional point prevalence study. SETTING: Twenty-five pediatric critical care units in the United States, the Netherlands, New Zealand, Australia, and Saudi Arabia. PATIENTS: All children admitted to the pediatric critical care units on designated study days (n = 994). INTERVENTION: Children were screened for delirium using the Cornell Assessment of Pediatric Delirium by the bedside nurse...
January 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28067711/early-goal-directed-therapy-for-sepsis-a-novel-solution-for-discordant-survival-outcomes-in-clinical-trials
#15
Andre C Kalil, Daniel W Johnson, Steven J Lisco, Junfeng Sun
OBJECTIVES: Early goal-directed therapy has shown discordant survival outcomes in sepsis studies. We aim to find the reasons for this discordance. DESIGN: Random-effects and Bayesian hierarchical analyses. SETTING: Studies that evaluated early goal-directed therapy. SUBJECTS: Patients with severe sepsis and/or septic shock. INTERVENTIONS: Early goal-directed therapy. MEASUREMENTS AND MAIN RESULTS: A total of 19,998 patients were included in the main analysis: 31 observational (n = 15,656) and six randomized (n = 4,342) studies...
January 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27941370/meta-analysis-of-therapeutic-hypothermia-for-traumatic-brain-injury-in-adult-and-pediatric-patients
#16
Ellie M Crompton, Irina Lubomirova, Ioana Cotlarciuc, Thang S Han, Sapna D Sharma, Pankaj Sharma
OBJECTIVE: Therapeutic hypothermia has been used to attenuate the effects of traumatic brain injuries. However, the required degree of hypothermia, length of its use, and its timing are uncertain. We undertook a comprehensive meta-analysis to quantify benefits of hypothermia therapy for traumatic brain injuries in adults and children by analyzing mortality rates, neurologic outcomes, and adverse effects. DATA SOURCES: Electronic databases PubMed, Google Scholar, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials...
December 9, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27941501/isoflurane-sedation-on-the-icu-in-cardiac-arrest-patients-treated-with-targeted-temperature-management-an-observational-propensity-matched-study
#17
Alexander Krannich, Christoph Leithner, Martin Engels, Jens Nee, Victor Petzinka, Tim Schröder, Achim Jörres, Jan Kruse, Christian Storm
OBJECTIVE: Targeted temperature management after cardiac arrest requires deep sedation to prevent shivering and discomfort. Compared to IV sedation, volatile sedation has a shorter half-life and thus may allow more rapid extubation and neurologic assessment. DESIGN: Observational analysis of clinical data. SETTING: University hospital, medical ICU. PATIENTS: Four hundred thirty-two cardiac arrest survivors underwent targeted temperature management; of those, 110 were treated with volatile sedation using an anesthetic conserving device and isoflurane, and 322 received standard IV sedation...
December 8, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27922877/diagnostic-accuracy-of-central-venous-catheter-confirmation-by-bedside-ultrasound-versus-chest-radiography-in-critically-ill-patients-a-systematic-review-and-meta-analysis
#18
Enyo A Ablordeppey, Anne M Drewry, Alexander B Beyer, Daniel L Theodoro, Susan A Fowler, Brian M Fuller, Christopher R Carpenter
OBJECTIVE: We performed a systematic review and meta-analysis to examine the accuracy of bedside ultrasound for confirmation of central venous catheter position and exclusion of pneumothorax compared with chest radiography. DATA SOURCES: PubMed, Embase, Cochrane Central Register of Controlled Trials, reference lists, conference proceedings and ClinicalTrials.gov. STUDY SELECTION: Articles and abstracts describing the diagnostic accuracy of bedside ultrasound compared with chest radiography for confirmation of central venous catheters in sufficient detail to reconstruct 2 × 2 contingency tables were reviewed...
December 5, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/28212249/one-delirium-tool-revisited-a-reply
#19
Jan N M Schieveld, Jurjen J van Zwieten
No abstract text is available yet for this article.
March 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28212248/use-of-echocardiography-in-critical-illness-dead-or-alive-does-it-matter
#20
Rasmus Aagaard, Asger Granfledt, Morten Thingemann Bødtker, Bo Løfgren
No abstract text is available yet for this article.
March 2017: Critical Care Medicine
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