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Critical Care Medicine

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https://www.readbyqxmd.com/read/28806221/admission-to-intensive-care-for-palliative-care-or-potential-organ-donation-demographics-circumstances-outcomes-and-resource-use
#1
Andrew Melville, Gali Kolt, David Anderson, Joanna Mitropoulos, David Pilcher
OBJECTIVES: To describe the characteristics, circumstances, change over time, resource use, and outcomes of patients admitted to ICUs in Australia and New Zealand for the purposes of "palliative care of a dying patient" or "potential organ donation," and compare with actively managed ICU patients. DESIGN: A retrospective study of data from the Australian and New Zealand Intensive Care Society Adult Patient Database and a nested cohort analysis of a single center...
August 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28806220/association-of-gender-with-outcome-and-host-response-in-critically-ill-sepsis-patients
#2
Lonneke A van Vught, Brendon P Scicluna, Maryse A Wiewel, Arie J Hoogendijk, Peter M C Klein Klouwenberg, David S Y Ong, Olaf L Cremer, Janneke Horn, Marek Franitza, Mohammad R Toliat, Peter Nürnberg, Marc M J Bonten, Marcus J Schultz, Tom van der Poll
OBJECTIVE: To determine the association of gender with the presentation, outcome, and host response in critically ill patients with sepsis. DESIGN AND SETTING: A prospective observational cohort study in the ICU of two tertiary hospitals between January 2011 and January 2014. PATIENTS: All consecutive critically ill patients admitted with sepsis, involving 1,815 admissions (1,533 patients). INTERVENTIONS: The host response was evaluated on ICU admission by measuring 19 plasma biomarkers reflecting organ systems implicated in sepsis pathogenesis (1,205 admissions) and by applying genome-wide blood gene expression profiling (582 admissions)...
August 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28806219/selective-activation-of-basal-forebrain-cholinergic-neurons-attenuates-polymicrobial-sepsis-induced-inflammation-via-the-cholinergic-anti-inflammatory-pathway
#3
Qian Zhai, Dengming Lai, Ping Cui, Rui Zhou, Qixing Chen, Jinchao Hou, Yunting Su, Libiao Pan, Hui Ye, Jing-Wei Zhao, Xiangming Fang
OBJECTIVES: Basal forebrain cholinergic neurons are proposed as a major neuromodulatory system in inflammatory modulation. However, the function of basal forebrain cholinergic neurons in sepsis is unknown, and the neural pathways underlying cholinergic anti-inflammation remain unexplored. DESIGN: Animal research. SETTING: University research laboratory. SUBJECTS: Male wild-type C57BL/6 mice and ChAT-ChR2-EYFP (ChAT) transgenic mice...
August 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28806218/hypoxemic-patients-with-bilateral-infiltrates-treated-with-high-flow-nasal-cannula-present-a-similar-pattern-of-biomarkers-of-inflammation-and-injury-to-acute-respiratory-distress-syndrome-patients
#4
Marina García-de-Acilu, Judith Marin-Corral, Antonia Vázquez, Laura Ruano, Mònica Magret, Ricard Ferrer, Joan R Masclans, Oriol Roca
OBJECTIVE: To examine whether patients with acute hypoxemia and bilateral opacities treated with high-flow nasal cannula and acute respiratory distress syndrome patients who were directly mechanically ventilated are similar in terms of lung epithelial, endothelial, and inflammatory biomarkers. DESIGN: Prospective, multicenter study. SETTING: ICUs at three university tertiary hospitals. PATIENTS: Intubated and nonintubated patients admitted to the ICU with acute hypoxemia (PaO2/FIO2 ≤ 300) and bilateral opacities...
August 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28799949/quantifying-the-effects-of-prior-acetyl-salicylic-acid-on-sepsis-related-deaths-an-individual-patient-data-meta-analysis-using-propensity-matching
#5
James Trauer, Stephen Muhi, Emma S McBryde, Shmeylan A Al Harbi, Yaseen M Arabi, Andrew J Boyle, Rodrigo Cartin-Ceba, Wei Chen, Yung-Tai Chen, Marco Falcone, Ognjen Gajic, Jack Godsell, Michelle Ng Gong, Daryl Kor, Wolfgang Lösche, Daniel F McAuley, Hollis R O'Neal, Michael Osthoff, Gordon P Otto, Maik Sossdorf, Min-Juei Tsai, Juan C Valerio-Rojas, Tom van der Poll, Francesco Violi, Lorraine Ware, Andreas F Widmer, Maryse A Wiewel, Johannes Winning, Damon P Eisen
OBJECTIVE: The primary objective was to conduct a meta-analysis on published observational cohort data describing the association between acetyl-salicylic acid (aspirin) use prior to the onset of sepsis and mortality in hospitalized patients. STUDY SELECTION: Studies that reported mortality in patients on aspirin with sepsis with a comparison group of patients with sepsis not on prior aspirin therapy were included. DATA SOURCES: Fifteen studies described hospital-based cohorts (n = 17,065), whereas one was a large insurance-based database (n = 683,421)...
August 9, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28787296/long-term-survival-in-adult-patients-with-severe-acute-lung-failure-receiving-veno-venous-extracorporeal-membrane-oxygenation
#6
Tone Bull Enger, Alois Philipp, Matthias Lubnow, Marcus Fischer, Daniele Camboni, Dirk Lunz, Thomas Bein, Thomas Müller
OBJECTIVES: To assess long-term survival in adult patients with severe acute lung failure receiving veno-venous extracorporeal membrane oxygenation and explore risk factors for long-term mortality. DESIGN: Single-center prospective cohort study. SETTING: University Hospital Regensburg, Germany. PATIENTS: All primary cases supported with veno-venous extracorporeal membrane oxygenation from 2007 to 2016 (n = 553). INTERVENTIONS: None...
August 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28787295/critically-ill-patients-with-the-middle-east-respiratory-syndrome-a-multicenter-retrospective-cohort-study
#7
Yaseen M Arabi, Awad Al-Omari, Yasser Mandourah, Fahad Al-Hameed, Anees A Sindi, Basem Alraddadi, Sarah Shalhoub, Abdullah Almotairi, Kasim Al Khatib, Ahmed Abdulmomen, Ismael Qushmaq, Ahmed Mady, Othman Solaiman, Abdulsalam M Al-Aithan, Rajaa Al-Raddadi, Ahmed Ragab, Ghaleb A Al Mekhlafi, Abdulrahman Al Harthy, Ayman Kharaba, Mashael Al Ahmadi, Musharaf Sadat, Hanan Al Mutairi, Eman Al Qasim, Jesna Jose, Maliha Nasim, Abdulaziz Al-Dawood, Laura Merson, Robert Fowler, Frederick G Hayden, Hanan H Balkhy
OBJECTIVES: To describe patient characteristics, clinical manifestations, disease course including viral replication patterns, and outcomes of critically ill patients with severe acute respiratory infection from the Middle East respiratory syndrome and to compare these features with patients with severe acute respiratory infection due to other etiologies. DESIGN: Retrospective cohort study. SETTING: Patients admitted to ICUs in 14 Saudi Arabian hospitals...
August 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28787294/oxygen-thresholds-and-mortality-during-extracorporeal-life-support-in-adult-patients
#8
Laveena Munshi, Alex Kiss, Marcelo Cypel, Shaf Keshavjee, Niall D Ferguson, Eddy Fan
OBJECTIVES: Extracorporeal life support can lead to rapid reversal of hypoxemia and shock; however, it can also result in varying degrees of hyperoxia. Recent data have suggested an association between hyperoxia and mortality; however, this conclusion has not been consistent across the literature. We evaluated the association between oxygenation thresholds and mortality in three cohorts of extracorporeal life support patients. DESIGN: We performed a retrospective cohort study using the Extracorporeal Life Support Organization Registry...
August 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28787293/worldwide-survey-of-the-assessing-pain-both-spontaneous-awakening-and-breathing-trials-choice-of-drugs-delirium-monitoring-management-early-exercise-mobility-and-family-empowerment-abcdef-bundle
#9
Alessandro Morandi, Simone Piva, E Wesley Ely, Sheila Nainan Myatra, Jorge I F Salluh, Dawit Amare, Elie Azoulay, Giuseppe Bellelli, Akos Csomos, Eddy Fan, Nazzareno Fagoni, Timothy D Girard, Gabriel Heras La Calle, Shigeaki Inoue, Chae-Man Lim, Rafael Kaps, Katarzyna Kotfis, Younsuck Koh, David Misango, Pratik P Pandharipande, Chairat Permpikul, Cheng Cheng Tan, Dong-Xin Wang, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Jeffrey M Singh, Arjen Slooter, Martin Smith, Ryosuke Tsuruta, Nicola Latronico
OBJECTIVES: To assess the knowledge and use of the Assessment, prevention, and management of pain; spontaneous awakening and breathing trials; Choice of analgesia and sedation; Delirium assessment; Early mobility and exercise; and Family engagement and empowerment (ABCDEF) bundle to implement the Pain, Agitation, Delirium guidelines. DESIGN: Worldwide online survey. SETTING: Intensive care. INTERVENTION: A cross-sectional online survey using the Delphi method was administered to intensivists worldwide, to assess the knowledge and use of all aspects of the ABCDEF bundle...
August 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28787292/safety-hazards-during-intrahospital-transport-a-prospective-observational-study
#10
Lina M Bergman, Monica E Pettersson, Wendy P Chaboyer, Eric D Carlström, Mona L Ringdal
OBJECTIVE: To identify, classify, and describe safety hazards during the process of intrahospital transport of critically ill patients. DESIGN: A prospective observational study. Data from participant observations of the intrahospital transport process were collected over a period of 3 months. SETTING: The study was undertaken at two ICUs in one university hospital. PATIENTS: Critically ill patients transported within the hospital by critical care nurses, unlicensed nurses, and physicians...
August 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28777199/alterations-in-spanish-language-interpretation-during-pediatric-critical-care-family-meetings
#11
Carolyn S Sinow, Irene Corso, Javier Lorenzo, Kiley A Lawrence, David C Magnus, Alisa C Van Cleave
OBJECTIVES: To characterize alterations in Spanish language medical interpretation during pediatric critical care family meetings. DESIGN: Descriptive, observational study using verbatim transcripts of nine PICU family meetings conducted with in-person, hospital-employed interpreters. SETTING: A single, university-based, tertiary children's hospital. SUBJECTS: Medical staff, family members, ancillary staff, and interpreters...
August 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28777198/nosocomial-infections-during-extracorporeal-membrane-oxygenation-incidence-etiology-and-impacton-patients-outcome
#12
Giacomo Grasselli, Vittorio Scaravilli, Stefano Di Bella, Stefano Biffi, Michela Bombino, Nicolò Patroniti, Luca Bisi, Anna Maria Peri, Antonio Pesenti, Andrea Gori, Laura Alagna
OBJECTIVE: To study incidence, type, etiology, risk factors, and impact on outcome of nosocomial infections during extracorporeal membrane oxygenation. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Italian tertiary referral center medical-surgical ICU. PATIENTS: One hundred five consecutive patients who were treated with extracorporeal membrane oxygenation from January 2010 to November 2015...
August 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28777197/elabela-improves-cardio-renal-outcome-in-fatal-experimental-septic-shock
#13
David Coquerel, Frédéric Chagnon, Xavier Sainsily, Lauralyne Dumont, Alexandre Murza, Jérôme Côté, Robert Dumaine, Philippe Sarret, Éric Marsault, Dany Salvail, Mannix Auger-Messier, Olivier Lesur
OBJECTIVES: Apelin-13 was recently proposed as an alternative to the recommended β-adrenergic drugs for supporting endotoxin-induced myocardial dysfunction. Since Apelin-13 signals through its receptor (Apelin peptide jejunum) to exert singular inotropic/vasotropic actions and to optimize body fluid balance, this candidate pathway might benefit septic shock management. Whether the newly discovered ELABELA (ELA), a second endogenous ligand of the Apelin peptide jejunum receptor highly expressed in the kidney, further improves cardio-renal impairment remains unknown...
August 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28777196/adaptation-of-the-acute-organ-failure-score-for-use-in-a-medicare-population
#14
Katherine R Courtright, Scott D Halpern, Brian Bayes, Michael O Harhay, Eli Raneses, Patricia Kipnis, Gabriel J Escobar, Meeta Prasad Kerlin
OBJECTIVES: Without widely available physiologic data, a need exists for ICU risk adjustment methods that can be applied to administrative data. We sought to expand the generalizability of the Acute Organ Failure Score by adapting it to a commonly used administrative database. DESIGN: Retrospective cohort study. SETTING: One hundred fifty-one hospitals in Pennsylvania. PATIENTS: A total of 90,733 ICU admissions among 77,040 unique patients between January 1, 2009, and December 1, 2009, in the Medicare Provider Analysis and Review database...
August 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28777195/prevalence-and-prognostic-association-of-circulating-troponin-in-the-acute-respiratory-distress-syndrome
#15
Thomas S Metkus, Eliseo Guallar, Lori Sokoll, David Morrow, Gordon Tomaselli, Roy Brower, Steven Schulman, Frederick K Korley
OBJECTIVE: Circulating cardiac troponin has been associated with adverse prognosis in the acute respiratory distress syndrome in small and single-center studies; however, comprehensive studies of myocardial injury in acute respiratory distress syndrome using modern high-sensitivity troponin assays, which can detect troponin at much lower circulating concentrations, have not been performed. DESIGN: We performed a prospective cohort study. SETTING: We included patients enrolled in previously completed trials of acute respiratory distress syndrome...
August 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28759474/quick-sequential-organ-failure-assessment-and-systemic-inflammatory-response-syndrome-criteria-as-predictors-of-critical-care-intervention-among-patients-with-suspected-infection
#16
Ari Moskowitz, Parth V Patel, Anne V Grossestreuer, Maureen Chase, Nathan I Shapiro, Katherine Berg, Michael N Cocchi, Mathias J Holmberg, Michael W Donnino
OBJECTIVES: The Sepsis III clinical criteria for the diagnosis of sepsis rely on scores derived to predict inhospital mortality. In this study, we introduce the novel outcome of "received critical care intervention" and investigate the related predictive performance of both the quick Sequential Organ Failure Assessment and the Systemic Inflammatory Response Syndrome criteria. DESIGN: This was a single-center, retrospective analysis of electronic health records. SETTING: Tertiary care hospital in the United States...
July 28, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28749855/outcomes-of-patient-and-family-centered-care-interventions-in-the-icu-a-systematic-review-and-meta-analysis
#17
Michael J Goldfarb, Lior Bibas, Virginia Bartlett, Heather Jones, Naureen Khan
OBJECTIVE: To determine whether patient- and family-centered care interventions in the ICU improve outcomes. DATA SOURCES: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library databases from inception until December 1, 2016. STUDY SELECTION: We included articles involving patient- and family-centered care interventions and quantitative, patient- and family-important outcomes in adult ICUs. DATA EXTRACTION: We extracted the author, year of publication, study design, population, setting, primary domain investigated, intervention, and outcomes...
July 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28749854/risk-stratification-in-pediatric-acute-respiratory-distress-syndrome-a-multicenter-observational-study
#18
Judith Ju-Ming Wong, Huu Phuc Phan, Suwannee Phumeetham, Jacqueline Soo May Ong, Yek Kee Chor, Suyun Qian, Rujipat Samransamruajkit, Nattachai Anantasit, Chin Seng Gan, Feng Xu, Rehena Sultana, Tsee Foong Loh, Jan Hau Lee
OBJECTIVES: The Pediatric Acute Lung Injury Consensus Conference developed a pediatric specific definition for acute respiratory distress syndrome (PARDS). In this definition, severity of lung disease is stratified into mild, moderate, and severe groups. We aim to describe the epidemiology of patients with PARDS across Asia and evaluate whether the Pediatric Acute Lung Injury Consensus Conference risk stratification accurately predicts outcome in PARDS. DESIGN: A multicenter, retrospective, descriptive cohort study...
July 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28749853/the-icu-is-becoming-a-main-battlefield-for-severe-maternal-rescue-in-china-an-8-year-single-center-clinical-experience
#19
Liu Yuqi, Guoliang Tan, Shang Chengming, Sun Xuri
OBJECTIVES: To review the characteristics of and to identify the reasons for severe maternal admissions to the ICU. DESIGN: This was an analytical, observational, open, and retrospective study. SETTING: In our ICU. PATIENTS: A total of 487 severe maternal cases were reviewed during the 8-year study period of January 2009 to December 2016. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: A total of 487 severe maternal cases (12...
July 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28742550/can-concurrent-abnormalities-in-free-light-chains-and-immunoglobulin-concentrations-identify-a-target-population-for-immunoglobulin-trials-in-sepsis
#20
Manu Shankar-Hari, Mervyn Singer, Jo Spencer
OBJECTIVES: Light chains κ and λ are immunoglobulin constituents but also circulate independently in blood as free light chains. We investigated whether a concomitant abnormality in free light chain and immunoglobulin levels could identify a high risk of death sepsis subpopulation to inform future IV immunoglobulin trials. We tested whether light chain allelic inclusion occurs in circulating B cells. DESIGN: Prospective cohort study. SETTING: Adult general ICUs...
July 22, 2017: Critical Care Medicine
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