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Critical Care Medicine

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https://www.readbyqxmd.com/read/29135521/the-effect-of-icu-out-of-hours-admission-on-mortality-a-systematic-review-and-meta-analysis
#1
Megan Galloway, Aoife Hegarty, Sarah McGill, Nishkantha Arulkumaran, Stephen J Brett, David Harrison
OBJECTIVES: Organizational factors are associated with outcome of critically ill patients and may vary by time of day and day of week. We aimed to identify the association between out-of-hours admission to critical care and mortality. DATA SOURCES: MEDLINE (via Ovid) and EMBASE (via Ovid). STUDY SELECTION: We performed a systematic search of the literature for studies on out-of-hours adult general ICU admission on patient mortality. DATA EXTRACTION: Meta-analyses were performed and Forest plots drawn using RevMan software...
November 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29135522/determinants-of-long-term-neurological-recovery-patterns-relative-to-hospital-discharge-among-cardiac-arrest-survivors
#2
Sachin Agarwal, Alex Presciutti, William Roth, Elizabeth Matthews, Ashley Rodriguez, David J Roh, Soojin Park, Jan Claassen, Ronald M Lazar
OBJECTIVE: To explore factors associated with neurological recovery at 1 year relative to hospital discharge after cardiac arrest. DESIGN: Observational, retrospective review of a prospectively collected cohort. SETTING: Medical or surgical ICUs in a single tertiary care center. PATIENTS: Older than 18 years, resuscitated following either in-hospital or out-of-hospital cardiac arrest and considered for targeted temperature management between 2007 and 2013...
November 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29135501/temperature-variability-in-a-modern-targeted-temperature-management-trial
#3
Ahmad Abu-Arafeh, Aryelly Rodriguez, Ross L Paterson, Peter J D Andrews
OBJECTIVES: The Eurotherm3235 trial showed that therapeutic hypothermia was deleterious in patients with raised intracranial pressure following traumatic brain injury. We sought to ascertain if increased temperature variability within the first 48 hours, or for 7 days post randomization, were modifiable risk factors associated with poorer outcome. DESIGN: Eurotherm3235 was a multicenter randomized controlled trial. Patients were randomized to receive either therapeutic hypothermia in addition to standard care or the later only...
November 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29135500/association-of-driving-pressure-with-mortality-among-ventilated-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#4
Hiroko Aoyama, Tommaso Pettenuzzo, Kazuyoshi Aoyama, Ruxandra Pinto, Marina Englesakis, Eddy Fan
OBJECTIVES: A recent post hoc analysis suggested that driving pressure may be more important than traditional ventilatory variables in determining outcome in mechanically ventilated patients with acute respiratory distress syndrome. We conducted a systematic review and meta-analysis to summarize the risk of mortality for higher versus lower driving pressure. DATA SOURCES: MEDLINE, EMBASE, PubMed, CINAHL, and Cochrane CENTRAL from inception to February 10, 2017. STUDY SELECTION: Studies including mechanically ventilated adult patients with acute respiratory distress syndrome, reporting driving pressure and mortality...
November 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29116999/treatment-outcome-of-combined-continuous-venovenous-hemofiltration-and-hemoperfusion-in-acute-paraquat-poisoning-a-prospective-controlled-trial
#5
Changbin Li, Dayong Hu, Wen Xue, Xinhua Li, Zhen Wang, Zisheng Ai, Yaxiang Song, Xinying Liu, Jiafeng Cheng, Shuling Fan, Limin Zhao, Liya Wang, Chandra Mohan, Ai Peng
OBJECTIVES: To investigate whether combined continuous venovenous hemofiltration and hemoperfusion among paraquat-poisoned patients would improve survival. DESIGN: Prospective, controlled interventional study over 4 years. SETTING: Single, tertiary, academic medical center. PATIENTS: We recruited patients admitted to Shanghai Tenth People's Hospital within 48 hours after paraquat ingestion. Exclusions were under 14 years old, ingestion of paraquat with other toxicants, pregnant, a history of chronic pulmonary disease, psychosis, hyperthyroidism, or diabetes with impaired liver or renal function...
November 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29116998/mesenchymal-stem-cells-from-bone-marrow-adipose-tissue-and-lung-tissue-differentially-mitigate-lung-and-distal-organ-damage-in-experimental-acute-respiratory-distress-syndrome
#6
Johnatas D Silva, Miquéias Lopes-Pacheco, Ana H R Paz, Fernanda F Cruz, Elga B Melo, Milena V de Oliveira, Débora G Xisto, Vera L Capelozzi, Marcelo M Morales, Paolo Pelosi, Elizabeth Cirne-Lima, Patricia R M Rocco
OBJECTIVES: Mesenchymal stem cells-based therapies have shown promising effects in experimental acute respiratory distress syndrome. Different mesenchymal stem cells sources may result in diverse effects in respiratory diseases; however, there is no information regarding the best source of mesenchymal stem cells to treat pulmonary acute respiratory distress syndrome. We tested the hypothesis that mesenchymal stem cells derived from bone marrow, adipose tissue, and lung tissue would lead to different beneficial effects on lung and distal organ damage in experimental pulmonary acute respiratory distress syndrome...
November 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29116997/hospital-differences-drive-antibiotic-delays-for-black-patients-compared-with-white-patients-with-suspected-septic-shock
#7
Stephanie Parks Taylor, Colleen H Karvetski, Megan A Templin, Brice T Taylor
OBJECTIVE: Evaluate racial disparities in sepsis processes of care. DESIGN: Observational cohort study. SETTING: Nine hospitals in the Southeastern United States between 2014 and 2016. PATIENTS: Two thousand two hundred twenty-one white and 707 black patients treated in the emergency department through "code sepsis" pathway for suspected septic shock. MEASUREMENTS AND MAIN RESULTS: Black patients were less likely to receive timely antibiotics than were white patients using multiple definitions (1 hr from code sepsis activation [odds ratio, 0...
November 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29116996/leptospirosis-in-icu-a-retrospective-study-of-134-consecutive-admissions
#8
Benjamin Delmas, Julien Jabot, Paul Chanareille, Cyril Ferdynus, Jérôme Allyn, Nicolas Allou, Loïc Raffray, Bernard-Alex Gaüzere, Olivier Martinet, David Vandroux
OBJECTIVES: Leptospirosis causes reversible multiple organ failure, and its mortality remains high. The aim of this study was to determine the mortality rate of leptospirosis in an ICU offering all types of organ support available nowadays and to compare it with mortality in bacterial sepsis. DESIGN: Retrospective, descriptive, and single-center cohort study. SETTINGS: The largest ICU of Reunion Island (Indian Ocean) in a teaching hospital...
November 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29116995/prolonged-infusion-piperacillin-tazobactam-decreases-mortality-and-improves-outcomes-in-severely-ill-patients-results-of-a-systematic-review-and-meta-analysis
#9
Nathaniel J Rhodes, Jiajun Liu, J Nicholas O'Donnell, Joel M Dulhunty, Mohd H Abdul-Aziz, Patsy Y Berko, Barbara Nadler, Jeffery Lipman, Jason A Roberts
OBJECTIVE: Piperacillin-tazobactam is a commonly used antibiotic in critically ill patients; however, controversy exists as to whether mortality in serious infections can be decreased through administration by prolonged infusion compared with intermittent infusion. The purpose of this systematic review and meta-analysis was to describe the impact of prolonged infusion piperacillin-tazobactam schemes on clinical endpoints in severely ill patients. DESIGN: We conducted a systematic literature review and meta-analysis searching MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library from inception to April 1, 2017, for studies...
November 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29112081/predictors-prevalence-and-outcomes-of-early-crystalloid-responsiveness-among-initially-hypotensive-patients-with-sepsis-and-septic-shock
#10
Daniel E Leisman, Martin E Doerfler, Sandra M Schneider, Kevin D Masick, Jason A D'Amore, John K D'Angelo
OBJECTIVES: The prevalence of responsiveness to initial fluid challenge among hypotensive sepsis patients is unclear. To avoid fluid overload, and unnecessary treatment, it is important to differentiate these phenotypes. We aimed to 1) determine the proportion of hypotensive sepsis patients sustaining favorable hemodynamic response after initial fluid challenge, 2) determine demographic and clinical risk factors that predicted refractory hypotension, and 3) assess the association between timeliness of fluid resuscitation and refractoriness...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29112080/%C3%AE-lactam-therapeutic-drug-management-in-the-picu
#11
Jeffrey J Cies, Wayne S Moore, Adela Enache, Arun Chopra
OBJECTIVES: To determine whether contemporary β-lactam anti-infective dosing recommendations in critically ill children achieve concentrations associated with maximal anti-infective activity. The secondary objective was to describe the microbiological and clinical outcomes associated with β-lactam therapeutic drug management. DESIGN: Electronic Medical Record Review. SETTING: A 189-bed, freestanding children's tertiary care teaching hospital in Philadelphia, PA...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29112079/acute-physiologic-stress-and-subsequent-anxiety-among-family-members-of-icu-patients
#12
Sarah J Beesley, Ramona O Hopkins, Julianne Holt-Lunstad, Emily L Wilson, Jorie Butler, Kathryn G Kuttler, James Orme, Samuel M Brown, Eliotte L Hirshberg
OBJECTIVES: The ICU is a complex and stressful environment and is associated with significant psychologic morbidity for patients and their families. We sought to determine whether salivary cortisol, a physiologic measure of acute stress, was associated with subsequent psychologic distress among family members of ICU patients. DESIGN: This is a prospective, observational study of family members of adult ICU patients. SETTING: Adult medical and surgical ICU in a tertiary care center...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29112078/survival-outcomes-following-the-use-of-extracorporeal-membrane-oxygenation-as-a-rescue-technology-in-critically-ill-patients-results-from-pennsylvania-2007-2015
#13
Marco D Huesch, Andrew Foy, Christoph Brehm
OBJECTIVE: To examine real-world outcomes of survival, length of stay, and discharge destination, among all adult extracorporeal membrane oxygenation admissions in one state over nearly a decade. DESIGN: Retrospective analysis of administrative discharge data. SETTING: State-wide administrative discharge data from Pennsylvania between 2007 and 2015. PATIENTS: All 2,948 consecutive patients billed under a Diagnosis-Related Grouper 3 grouper and in whom a procedural code for extracorporeal membrane oxygenation was present, admitted between the beginning of 2007 and the end of 2015 to hospitals regulated by the state of Pennsylvania...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29112077/technologic-distractions-part-2-a-summary-of-approaches-to-manage-clinical-alarms-with-intent-to-reduce-alarm-fatigue
#14
Bradford D Winters, Maria M Cvach, Christopher P Bonafide, Xiao Hu, Avinash Konkani, Michael F O'Connor, Jeffrey M Rothschild, Nicholas M Selby, Michele M Pelter, Barbara McLean, Sandra L Kane-Gill
OBJECTIVE: Alarm fatigue is a widely recognized safety and quality problem where exposure to high rates of clinical alarms results in desensitization leading to dismissal of or slowed response to alarms. Nonactionable alarms are thought to be especially problematic. Despite these concerns, the number of clinical alarm signals has been increasing as an everincreasing number of medical technologies are added to the clinical care environment. DATA SOURCES: PubMed, SCOPUS, Embase, and CINAHL...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29099420/predictors-of-intubation-in-patients-with-acute-hypoxemic-respiratory-failure-treated-with-a-noninvasive-oxygenation-strategy
#15
Jean-Pierre Frat, Stéphanie Ragot, Rémi Coudroy, Jean-Michel Constantin, Christophe Girault, Gwénael Prat, Thierry Boulain, Alexandre Demoule, Jean-Damien Ricard, Keyvan Razazi, Jean-Baptiste Lascarrou, Jérôme Devaquet, Jean-Paul Mira, Laurent Argaud, Jean-Charles Chakarian, Muriel Fartoukh, Saad Nseir, Alain Mercat, Laurent Brochard, René Robert, Arnaud W Thille
OBJECTIVES: In patients with acute hypoxemic respiratory failure, noninvasive ventilation and high-flow nasal cannula oxygen are alternative strategies to conventional oxygen therapy. Endotracheal intubation is frequently needed in these patients with a risk of delay, and early predictors of failure may help clinicians to decide early. We aimed to identify factors associated with intubation in patients with acute hypoxemic respiratory failure treated with different noninvasive oxygenation techniques...
November 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29099419/acute-systemic-complications-of-convulsive-status-epilepticus-a-systematic-review
#16
Raoul Sutter, Tolga Dittrich, Saskia Semmlack, Stephan Rüegg, Stephan Marsch, Peter W Kaplan
OBJECTIVES: Status epilepticus is a neurologic emergency with high morbidity and mortality requiring neurointensive care and treatment of systemic complications. This systematic review compiles the current literature on acute systemic complications of generalized convulsive status epilepticus in adults and their immediate clinical impact along with recommendations for optimal neurointensive care. DATA SOURCES: We searched PubMed, Medline, Embase, and the Cochrane library for articles published between 1960 and 2016 and reporting on systemic complications of convulsive status epilepticus...
November 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29095205/guidelines-for-the-diagnosis-and-management-of-critical-illness-related-corticosteroid-insufficiency-circi-in-critically-ill-patients-part-ii-society-of-critical-care-medicine-sccm-and-european-society-of-intensive-care-medicine-esicm-2017
#17
https://www.readbyqxmd.com/read/29095204/improvement-of-blood-brain-barrier-integrity-in-traumatic-brain-injury-and-hemorrhagic-shock-following-treatment-with-valproic-acid-and-fresh-frozen-plasma
#18
Vahagn C Nikolian, Simone E Dekker, Ted Bambakidis, Gerald A Higgins, Isabel S Dennahy, Patrick E Georgoff, Aaron M Williams, Anuska V Andjelkovic, Hasan B Alam
OBJECTIVE: Combined traumatic brain injury and hemorrhagic shock are highly lethal. Following injuries, the integrity of the blood-brain barrier can be impaired, contributing to secondary brain insults. The status of the blood-brain barrier represents a potential factor impacting long-term neurologic outcomes in combined injuries. Treatment strategies involving plasma-based resuscitation and valproic acid therapy have shown efficacy in this setting. We hypothesize that a component of this beneficial effect is related to blood-brain barrier preservation...
October 31, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29095203/acute-respiratory-distress-syndrome-cases-volume-and-icu-mortality-in-medical-patients
#19
Martin Dres, Peter C Austin, Tài Pham, Philippe Aegerter, Bertrand Guidet, Alexandre Demoule, Antoine Vieillard-Baron, Laurent Brochard, Guillaume Géri
OBJECTIVES: To determine whether ICUs caring for higher volumes of acute respiratory distress syndrome patients would be associated with lower ICU mortality. DESIGN: A 9-year multicenter retrospective cohort study of prospectively collected data. SETTING: French medical ICUs. PATIENTS: From 2004 to 2012, acute respiratory distress syndrome cases were identified from a coding system through a regional database (Collège des Utilisateurs de Données en Réanimation)...
October 31, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29095202/simultaneous-inhibition-of-tumor-necrosis-factor-receptor-1-and-matrix-metalloproteinase-8-completely-protects-against-acute-inflammation-and-sepsis
#20
Sophie Steeland, Sara Van Ryckeghem, Jolien Vandewalle, Marlies Ballegeer, Elien Van Wonterghem, Melanie Eggermont, Johan Decruyenaere, Liesbet De Bus, Claude Libert, Roosmarijn E Vandenbroucke
OBJECTIVES: Sepsis causes very high mortality and morbidity rates and remains one of the biggest medical challenges. This study investigates whether plasma levels of both matrix metalloproteinase 8 and tumor necrosis factor receptor 1 are associated with sepsis severity and also investigates the therapeutic applicability of simultaneous inhibition of the two molecules in sepsis. DESIGN: Observational human pilot study-prospective controlled animal study. SETTING: University hospital and research laboratory...
October 31, 2017: Critical Care Medicine
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