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Critical Care Medicine

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https://www.readbyqxmd.com/read/29782357/reversible-microvascular-hyporeactivity-to-acetylcholine-during-diabetic-ketoacidosis
#1
Jérémie Joffre, Simon Bourcier, Geoffroy Hariri, Arnaud-Felix Miailhe, Naike Bigé, Guillaume Dumas, Vincent Dubée, Pierre-Yves Boelle, Idriss Abdallah, Jean-Luc Baudel, Bertrand Guidet, Eric Maury, Hafid Ait-Oufella
OBJECTIVES: Metabolic acidosis is commonly observed in critically ill patients. Experimental studies suggested that acidosis by itself could impair vascular function, but this has been poorly investigated in human. DESIGN: Prospective observational study. SETTING: Medical ICU in a tertiary teaching hospital. PATIENTS: To assess the relationship between metabolic acidosis severity and microvascular reactivity, we included adult diabetic patients admitted in ICU for ketoacidosis...
May 18, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29782356/acute-neurologic-complications-during-extracorporeal-membrane-oxygenation-a-systematic-review
#2
Raoul Sutter, Kai Tisljar, Stephan Marsch
OBJECTIVES: We determine the frequency, risk factors, and mortality of neurologic complications in adults on extracorporeal membrane oxygenation and propose an algorithm for preventive strategies. DATA SOURCES: PubMed, Embase, and Cochrane databases. STUDY SELECTION: Screening was performed using predefined search terms to identify cohort studies reporting neurologic complications in adults during extracorporeal membrane oxygenation from 1990 to 2017...
May 18, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29782355/inhibition-of-vascular-endothelial-cell-leak-following-escherichia-coli-attachment-in-an-experimental-model-of-sepsis
#3
Tony M McHale, Carolina D Garciarena, Robert P Fagan, Stephen G J Smith, Ignacio Martin-Loches, Gerard F Curley, Fidelma Fitzpatrick, Steve W Kerrigan
OBJECTIVES: The vascular endothelium is a major target of sepsis-induced events, and endothelial activation accounts for much of the pathology of sepsis. Urinary tract infections and pneumonia caused by Escherichia coli are among of the most common infections causing sepsis in both community and hospital settings. Currently, there are no approved drugs on the market to treat the underlying pathophysiology of sepsis. The aim of this study is to elucidate the molecular mechanism by which E...
May 18, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29782354/criteria-to-identify-a-potential-deceased-organ-donor-a-systematic-review
#4
Janet E Squires, Mary Coughlin, Kristin Dorrance, Stefanie Linklater, Michaël Chassé, Jeremy M Grimshaw, Sam D Shemie, Sonny Dhanani, Gregory A Knoll
OBJECTIVES: To systematically review the global published literature defining a potential deceased organ donor and identifying clinical triggers for deceased organ donation identification and referral. DATA SOURCES: Medline and Embase databases from January 2006 to September 2017. STUDY SELECTION: All published studies containing a definition of a potential deceased organ donor and/or clinical triggers for referring a potential deceased organ donor were eligible for inclusion...
May 18, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29771701/dynamic-contrast-enhanced-ultrasound-identifies-microcirculatory-alterations-in-sepsis-induced-acute-kidney-injury
#5
Alexandre Lima, Tom van Rooij, Bulent Ergin, Michele Sorelli, Yasin Ince, Patricia A C Specht, Egbert G Mik, Leonardo Bocchi, Klazina Kooiman, Nico de Jong, Can Ince
OBJECTIVES: We developed quantitative methods to analyze microbubble kinetics based on renal contrast-enhanced ultrasound imaging combined with measurements of sublingual microcirculation on a fixed area to quantify early microvascular alterations in sepsis-induced acute kidney injury. DESIGN: Prospective controlled animal experiment study. SETTING: Hospital-affiliated animal research institution. SUBJECTS: Fifteen female pigs...
May 15, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29771700/the-effect-of-iv-amino-acid-supplementation-on-mortality-in-icu-patients-may-be-dependent-on-kidney-function-post-hoc-subgroup-analyses-of-a-multicenter-randomized-trial
#6
Ran Zhu, Matilde J Allingstrup, Anders Perner, Gordon S Doig
OBJECTIVES: We investigated whether preexisting kidney function determines if ICU patients may benefit from increased (2.0 g/kg/d) protein intake. DESIGN: Post hoc, hypothesis-generating, subgroup analysis of a multicenter, phase 2, randomized clinical trial. All analyses were conducted by intention to treat and maintained group allocation. Ninety-day mortality was the primary outcome. SETTING: ICUs of 16 hospitals throughout Australia and New Zealand...
May 15, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29746358/delayed-cerebral-injury-in-adults-with-bacterial-meningitis-a-novel-complication-of-adjunctive-steroids
#7
Cinthia Gallegos, Farrell Tobowlosky, Masayuki Nigo, Rodrigo Hasbun
OBJECTIVES: To report the prevalence of delayed cerebral injury in adults with bacterial meningitis and explore its association with adjunctive steroids. DESIGN: Retrospective analysis of adults with bacterial meningitis between 2005 and 2016. SETTING: Ten hospitals in the Greater Houston area. PATIENTS: Consecutive subjects with culture proven community-acquired bacterial meningitis. INTERVENTION: Subjects were categorized as receiving or not adjunctive steroids within 4 hours...
May 9, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742585/cardiac-arrest-in-patients-managed-for-convulsive-status-epilepticus-characteristics-predictors-and-outcome
#8
Stephane Legriel, Edouard Bresson, Nicolas Deye, David Grimaldi, Bertrand Sauneuf, Olivier Lesieur, Jean-Baptiste Lascarrou, Laurent Argaud, Jonathan Chelly, Pascal Beuret, David Schnell, Anne-Laure Chateauneuf, Mathilde Holleville, François Perier, Virginie Lemiale, Cedric Bruel, Pierrick Cronier, Nicolas Pichon, Nicolas Mongardon, Nicolas de-Prost, Florence Dumas, Alain Cariou
OBJECTIVES: Cardiac arrest is a catastrophic event that may arise during the management of convulsive status epilepticus. We aimed to report the clinical characteristics, outcomes, and early predictors of convulsive status epilepticus-related cardiac arrest. DESIGN: Retrospective multicenter study. SETTING: Seventeen university or university affiliated participating ICUs in France and Belgium. PATIENTS: Consecutive patients admitted to the participating ICUs for management of successfully resuscitated out-of-hospital cardiac arrest complicating the initial management of convulsive status epilepticus between 2000 and 2015...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742584/predictive-validity-of-sepsis-3-definitions-and-sepsis-outcomes-in-critically-ill-patients-a-cohort-study-in-49-icus-in-argentina
#9
Elisa Estenssoro, Vanina S Kanoore Edul, Cecilia I Loudet, Javier Osatnik, Fernando G Ríos, Daniela N Vázquez, Mario O Pozo, Bernardo Lattanzio, Fernando Pálizas, Francisco Klein, Damián Piezny, Paolo N Rubatto Birri, Graciela Tuhay, Anatilde Díaz, Analía Santamaría, Graciela Zakalik, Arnaldo Dubin
OBJECTIVES: The new Sepsis-3 definitions have been scarcely assessed in low- and middle-income countries; besides, regional information of sepsis outcomes is sparse. Our objective was to evaluate Sepsis-3 definition performance in Argentina. DESIGN: Cohort study of 3-month duration beginning on July 1, 2016. SETTINGS: Forty-nine ICUs. PATIENTS: Consecutive patients admitted to the ICU with suspected infection that triggered blood cultures and antibiotic administration...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742583/adjunct-ketamine-use-in-the-management-of-severe-ethanol-withdrawal
#10
Anthony F Pizon, Michael J Lynch, Neal J Benedict, Joseph H Yanta, Adam Frisch, Nathan B Menke, Greg S Swartzentruber, Andrew M King, Michael G Abesamis, Sandra L Kane-Gill
OBJECTIVES: Ketamine offers a plausible mechanism with favorable kinetics in treatment of severe ethanol withdrawal. The purpose of this study is to determine if a treatment guideline using an adjunctive ketamine infusion improves outcomes in patients suffering from severe ethanol withdrawal. DESIGN: Retrospective observational cohort study. SETTING: Academic tertiary care hospital. PATIENTS: Patients admitted to the ICU and diagnosed with delirium tremens by Diagnostic and Statistical Manual of Mental Disorders V criteria...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742582/changes-in-microrna-expression-level-of-circulating-platelets-contribute-to-platelet-defect-after-cardiopulmonary-bypass
#11
Nobuhiro Mukai, Yoshinobu Nakayama, Sachiyo Ishi, Satoru Ogawa, Sachiko Maeda, Natuki Anada, Satoshi Murakami, Toshiki Mizobe, Teiji Sawa, Yasufumi Nakajima
OBJECTIVES: Platelet defect mechanisms after cardiopulmonary bypass remain unclear. Our hypothesis microRNA expressions in circulating platelets significantly change between pre and post cardiopulmonary bypass, and consequent messenger RNA and protein expression level alterations cause postcardiopulmonary bypass platelet defect. DESIGN: Single-center prospective observational study. SETTING: Operating room of Kyoto Prefectural University of Medicine...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742581/niacin-and-selenium-attenuate-brain-injury-after-cardiac-arrest-in-rats-by-up-regulating-dj-1-akt-signaling
#12
Woon Yong Kwon, Gil Joon Suh, Kyung Su Kim, Yoon Sun Jung, Sung Hee Kim, A Rum Lee, Kyoung Min You, Min Ji Park
OBJECTIVES: To determine neuroprotective effects and mechanism of the combination therapy of niacin and selenium in cardiac arrest rats. DESIGN: Prospective laboratory study. SETTING: University laboratory. SUBJECTS: Rat cortex neurons and male Sprague-Dawley rats (n = 68). INTERVENTIONS: In rat cortex neurons underwent 90 minutes of oxygen-glucose deprivation and 22.5 hours of reoxygenation, effects of the combination therapy of niacin (0...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742591/duration-of-respiratory-failure-after-trauma-is-not-associated-with-increased-long-term-mortality
#13
Mackenzie R Cook, Kathleen O'Connell, Qian Qiu, Andrew J Riggle, Thomas H Shoultz, Rebecca G Maine, Saman Arbabi, Grant E O'Keefe, Joseph Cuschieri, Ronald V Maier, Bryce R H Robinson
OBJECTIVES: Although 1-year survival in medically critically ill patients with prolonged mechanical ventilation is less than 50%, the relationship between respiratory failure after trauma and 1-year mortality is unknown. We hypothesize that respiratory failure duration in trauma patients is associated with decreased 1-year survival. DESIGN: Retrospective cohort of trauma patients. SETTING: Single center, level 1 trauma center. PATIENTS: Trauma patients admitted from 2011 to 2014; respiratory failure is defined as mechanical ventilation greater than or equal to 48 hours, excluded head Abbreviated Injury Score greater than or equal to 4...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742590/a-multicenter-observational-study-of-family-participation-in-icu-rounds
#14
Selena S Au, Amanda L Roze des Ordons, Jeanna Parsons Leigh, Andrea Soo, Simon Guienguere, Sean M Bagshaw, Henry T Stelfox
OBJECTIVES: Guidelines recommend offering family members of critically ill patients the option to attend interdisciplinary team rounds as a way to improve communication and satisfaction. Uncertainty remains around the benefits and risks. DESIGN: We conducted an observational study to describe family participation in ICU rounds and its association with rounding processes. SETTING: Rounds conducted under the leadership of 33 attending physicians in seven hospitals across three Canadian cities...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742589/clinical-factors-associated-with-icu-specific-care-following-supratentoral-brain-tumor-resection-and-validation-of-a-risk-prediction-score
#15
Lynze R Franko, Todd Hollon, Joseph Linzey, Christopher Roark, Venkatakrishna Rajajee, Kyle Sheehan, Magnus Teig, Shawn Hervey-Jumper, Jason Heth, Daniel Orringer, Craig A Williamson
OBJECTIVES: The postoperative management of patients who undergo brain tumor resection frequently occurs in an ICU. However, the routine admission of all patients to an ICU following surgery is controversial. This study seeks to identify the frequency with which patients undergoing elective supratentorial tumor resection require care, aside from frequent neurologic checks, that is specific to an ICU and to determine the frequency of new complications during ICU admission. Additionally, clinical predictors of ICU-specific care are identified, and a scoring system to discriminate patients most likely to require ICU-specific treatment is validated...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742588/derivation-and-validation-of-a-biomarker-based-clinical-algorithm-to-rule-out-sepsis-from-noninfectious-systemic-inflammatory-response-syndrome-at-emergency-department-admission-a-multicenter-prospective-study
#16
Filippo Mearelli, Nicola Fiotti, Carlo Giansante, Chiara Casarsa, Daniele Orso, Marco De Helmersen, Nicola Altamura, Maurizio Ruscio, Luigi Mario Castello, Efrem Colonetti, Rossella Marino, Giulia Barbati, Andrea Bregnocchi, Claudio Ronco, Enrico Lupia, Giuseppe Montrucchio, Maria Lorenza Muiesan, Salvatore Di Somma, Gian Carlo Avanzi, Gianni Biolo
OBJECTIVES: To derive and validate a predictive algorithm integrating a nomogram-based prediction of the pretest probability of infection with a panel of serum biomarkers, which could robustly differentiate sepsis/septic shock from noninfectious systemic inflammatory response syndrome. DESIGN: Multicenter prospective study. SETTING: At emergency department admission in five University hospitals. PATIENTS: Nine-hundred forty-seven adults in inception cohort and 185 adults in validation cohort...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742587/exploratory-application-of-neuropharmacometabolomics-in-severe-childhood-traumatic-brain-injury
#17
Fanuel T Hagos, Philip E Empey, Pengcheng Wang, Xiaochao Ma, Samuel M Poloyac, Hülya Bayır, Patrick M Kochanek, Michael J Bell, Robert S B Clark
OBJECTIVES: To employ metabolomics-based pathway and network analyses to evaluate the cerebrospinal fluid metabolome after severe traumatic brain injury in children and the capacity of combination therapy with probenecid and N-acetylcysteine to impact glutathione-related and other pathways and networks, relative to placebo treatment. DESIGN: Analysis of cerebrospinal fluid obtained from children enrolled in an Institutional Review Board-approved, randomized, placebo-controlled trial of a combination of probenecid and N-acetylcysteine after severe traumatic brain injury (Trial Registration NCT01322009)...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742586/long-term-survival-of-young-patients-surviving-icu-admission-with-severe-sepsis
#18
Heba Abu-Kaf, Yuval Mizrakli, Victor Novack, Jacob Dreiher
OBJECTIVES: Sepsis remains a disease with a high mortality rate. The study goal was to assess long-term survival of severe sepsis in young patients. DESIGN: Retrospective cohort study. SETTING: Patients admitted with sepsis to ICUs in seven tertiary hospitals between 2003 and 2011. PATIENTS: A total of 409 patients less than 45 years who survived to hospital discharge were age and sex matched with 818 patients with infectious disease without sepsis selected from internal medicine or surgical department admissions...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29727369/blue-light-enhances-bacterial-clearance-and-reduces-organ-injury-during-sepsis
#19
Anthony J Lewis, Xianghong Zhang, John E Griepentrog, Du Yuan, Richard D Collage, Paul K Waltz, Derek C Angus, Brian S Zuckerbraun, Matthew R Rosengart
OBJECTIVES: The physiology of nearly all mammalian organisms are entrained by light and exhibit circadian rhythm. The data derived from animal studies show that light influences immunity, and these neurophysiologic pathways are maximally entrained by the blue spectrum. Here, we hypothesize that bright blue light reduces acute kidney injury by comparison with either bright red or standard, white fluorescent light in mice subjected to sepsis. To further translational relevance, we performed a pilot clinical trial of blue light therapy in human subjects with appendicitis...
May 4, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29727368/platelet-transfusion-practices-in-critically-ill-children
#20
Marianne E Nellis, Oliver Karam, Elizabeth Mauer, Melissa M Cushing, Peter J Davis, Marie E Steiner, Marisa Tucci, Simon J Stanworth, Philip C Spinella
OBJECTIVES: Little is known about platelet transfusions in pediatric critical illness. We sought to describe the epidemiology, indications, and outcomes of platelet transfusions among critically ill children. DESIGN: Prospective cohort study. SETTING: Multicenter (82 PICUs), international (16 countries) from September 2016 to April 2017. PATIENTS: Children ages 3 days to 16 years prescribed a platelet transfusion in the ICU during screening days...
May 4, 2018: Critical Care Medicine
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