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Critical Care Medicine

Shannon M Fernando, Peter M Reardon, Daniel I McIsaac, Debra Eagles, Kyle Murphy, Peter Tanuseputro, Daren K Heyland, Kwadwo Kyeremanteng
OBJECTIVES: Rapid response teams are groups of healthcare providers that have been implemented by many hospitals to respond to acutely deteriorating patients admitted to the hospital wards. Hospitalized older patients are at particular risk of deterioration. We sought to examine outcomes of older patients requiring rapid response team activation. DESIGN: Analysis of a prospectively collected registry. SETTING: Two hospitals within a single tertiary care level hospital system between 2012 and 2016...
September 18, 2018: Critical Care Medicine
Jin Yang, Yan Xiao, Eugenie Y Quan, Zhangle Hu, Qinyue Guo, Changqing Miao, Jennifer L Bradley, Mary A Peberdy, Joseph P Ornato, Martin J Mangino, Wanchun Tang
OBJECTIVES: Polyethylene glycol-20k is a hybrid cell impermeant that reduces ischemia injury and improves microcirculatory flow during and following low flow states through nonenergy-dependent water transfer in the microcirculation. We investigated the effects of polyethylene glycol-20k on postresuscitation microcirculation, myocardial and cerebral function, and duration of survival in a rat model of cardiopulmonary resuscitation. DESIGN: Ventricular fibrillation was induced in 20 male Sprague Dawley rats and untreated for 6 minutes...
September 18, 2018: Critical Care Medicine
Karla D Krewulak, Henry T Stelfox, Jeanna Parsons Leigh, E Wesley Ely, Kirsten M Fiest
OBJECTIVES: Use systematic review and meta-analytic methodology to estimate the pooled incidence, prevalence, and proportion of delirium cases for each delirium subtype (hypoactive, hyperactive, and mixed) in an adult ICU population. DATA SOURCES: We conducted a search of the MEDLINE, EMBASE, CINAHL, SCOPUS, Web of Science, and PsycINFO databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards from database inception until October 22, 2017, with no restrictions...
September 17, 2018: Critical Care Medicine
Robert Cartotto, Sandra L Taylor, James H Holmes, Michael Peck, Amalia Cochran, Booker T King, Daval Bhavsar, Edward E Tredget, David Mozingo, David Greenhalgh, Brad H Pollock, Tina L Palmieri
OBJECTIVES: Major trials examining storage age of blood transfused to critically ill patients administered relatively few blood transfusions. We sought to determine if the storage age of blood affects outcomes when very large amounts of blood are transfused. DESIGN: A secondary analysis of the multicenter randomized Transfusion Requirement in Burn Care Evaluation study which compared restrictive and liberal transfusion strategies. SETTING: Eighteen tertiary-care burn centers...
September 17, 2018: Critical Care Medicine
Amra Sakusic, Ognjen Gajic, Tarun D Singh, John C O'Horo, Gregory Jenkins, Gregory A Wilson, Ronald Petersen, John D Fryer, Rahul Kashyap, Alejandro A Rabinstein
OBJECTIVES: Persistent cognitive impairment after critical illness is an important healthcare problem forecasted to worsen in the near future. However, the epidemiology is insufficiently explored. We aimed to determine potentially modifiable risk factors during ICU hospitalization that play a significant role in developing persistent cognitive impairment. DESIGN: An observational case-control study. SETTINGS: Mayo Clinic ICUs between July 1, 2004, and November 20, 2015...
September 14, 2018: Critical Care Medicine
Punkaj Gupta, Jeffrey M Gossett, Mallikarjuna Rettiganti
OBJECTIVES: To use two national databases to quantify the pace and magnitude of improvement in hospital performance (as measured by mortality) across hospitals caring for critically ill children in the United States. DESIGN: We used empirical Bayes shrinkage estimators to obtain shrinkage estimators of observed/expected mortality ratios for each hospital assuming a Gamma Poisson posterior distribution. Revised mortality rates for each hospital were obtained from the shrunken incidence ratios...
September 14, 2018: Critical Care Medicine
Ayòtúndé B Fadayomi, Reine Ibala, Federico Bilotta, Michael B Westover, Oluwaseun Akeju
OBJECTIVES: Basic science and clinical studies suggest that sleep disturbance may be a modifiable risk factor for postoperative delirium. We aimed to assess the association between preoperative sleep disturbance and postoperative delirium. DATA SOURCES: We searched PubMed, Embase, CINAHL, Web of Science, and Cochrane from inception until May 31, 2017. STUDY SELECTION: We performed a systematic search of the literature for all studies that reported on sleep disruption and postoperative delirium excluding cross-sectional studies, case reports, and studies not reported in English language...
September 14, 2018: Critical Care Medicine
Han Ting Wang, Andrea D Hill, Tara Gomes, Duminda N Wijeysundera, Ruxandra Pinto, Damon C Scales, Robert Fowler, Hannah Wunsch
OBJECTIVES: Critical illness is often associated with painful procedures and prolonged opioid infusions, raising the concern that chronic opioid users may be exposed to escalating doses that are continued after hospital discharge. We sought to assess patterns of opioid use after intensive care among elderly patients identified as chronic opioid users prior to hospitalization. DESIGN: Population-based cohort study. SETTING: All adult ICUs in the province of Ontario, Canada...
September 14, 2018: Critical Care Medicine
Hong Pu, Gordon S Doig, Philippa T Heighes, Matilde J Allingstrup
OBJECTIVES: To identify, appraise, and synthesize current evidence to determine whether early enteral nutrition alters patient outcomes from major burn injury. DATA SOURCES: Medline, Embase, and the China National Knowledge Infrastructure were searched. The close out date was May 1, 2018. STUDY SELECTION: Early enteral nutrition was defined as a standard formula commenced within 24 hours of injury or admission to ICU or burn unit. Comparators included any form of nutrition support "except" early enteral nutrition...
September 14, 2018: Critical Care Medicine
Dhruv Parekh, Rachel C A Dancer, Aaron Scott, Vijay K D'Souza, Phillip A Howells, Rahul Y Mahida, Jonathan C Y Tang, Mark S Cooper, William D Fraser, LamChin Tan, Fang Gao, Adrian R Martineau, Olga Tucker, Gavin D Perkins, David R Thickett
OBJECTIVES: Observational studies suggest an association between vitamin D deficiency and adverse outcomes of critical illness and identify it as a potential risk factor for the development of lung injury. To determine whether preoperative administration of oral high-dose cholecalciferol ameliorates early acute lung injury postoperatively in adults undergoing elective esophagectomy. DESIGN: A double-blind, randomized, placebo-controlled trial. SETTING: Three large U...
September 14, 2018: Critical Care Medicine
Makoto Aoki, Toshikazu Abe, Daizoh Saitoh, Shuichi Hagiwara, Kiyohiro Oshima
OBJECTIVES: To evaluate the possible association of vasopressor use with mortality in traumatic hemorrhagic shock patients. DESIGN: Retrospective cohort study. SETTING: Traumatic hemorrhagic shock patients at 260 emergency hospitals in Japan between 2004 and 2015. PATIENTS: Three-thousand five-hundred fifty-one traumatic hemorrhagic shock patients who had systolic hypotension (< 90 mm Hg) on arrival at the emergency department and a blood transfusion received within the first 24 hours...
September 7, 2018: Critical Care Medicine
Samuel A Tisherman, Deborah M Stein
OBJECTIVES: To describe the current state of the art regarding management of the critically ill trauma patient with an emphasis on initial management in the ICU. DATA SOURCES AND STUDY SELECTION: A PubMed literature review was performed for relevant articles in English related to the management of adult humans with severe trauma. Specific topics included airway management, hemorrhagic shock, resuscitation, and specific injuries to the chest, abdomen, brain, and spinal cord...
September 7, 2018: Critical Care Medicine
Saptharishi Lalgudi Ganesan, Craig P Stewart, Eshetu G Atenafu, Rohit Sharma, Anne-Marie Guerguerian, James S Hutchison, Cecil D Hahn
OBJECTIVES: To compare the performance of critical care providers with that of electroencephalography experts in identifying seizures using quantitative electroencephalography display tools. DESIGN: Diagnostic accuracy comparison among healthcare provider groups. SETTING: Multispecialty quaternary children's hospital in Canada. SUBJECTS: ICU fellows, ICU nurses, neurophysiologists, and electroencephalography technologists...
September 4, 2018: Critical Care Medicine
Stine Estrup, Cilia K W Kjer, Frederik Vilhelmsen, Lone M Poulsen, Ismail Gøgenur, Ole Mathiesen
OBJECTIVES: Studies have shown impaired cognitive function after ICU discharge. We aimed to describe long-term cognitive function in Danish ICU patients. DESIGN: Prospective cohort study. SETTING: Single-center ICU at Zealand University Hospital, Køge, Denmark. PATIENTS: Adult patients admitted for over 24 hours. INTERVENTION: Three and 12 months after discharge, the patients were visited at home and tested with the Repeatable Battery for the Assessment of Neuropsychological Status...
September 4, 2018: Critical Care Medicine
Mayur B Patel, Josef Bednarik, Patricia Lee, Yahya Shehabi, Jorge I Salluh, Arjen J Slooter, Kate E Klein, Yoanna Skrobik, Alessandro Morandi, Peter E Spronk, Andrew M Naidech, Brenda T Pun, Fernando A Bozza, Annachiara Marra, Sayona John, Pratik P Pandharipande, E Wesley Ely
OBJECTIVES: The Society of Critical Care Medicine recommends routine delirium monitoring, based on data in critically ill patients without primary neurologic injury. We sought to answer whether there are valid and reliable tools to monitor delirium in neurocritically ill patients and whether delirium is associated with relevant clinical outcomes (e.g., survival, length of stay, functional independence, cognition) in this population. DATA SOURCES: We systematically reviewed Cumulative Index to Nursing and Allied Health Literature, Web of Science, and PubMed...
August 23, 2018: Critical Care Medicine
Igor Barjaktarevic, William E Toppen, Scott Hu, Elizabeth Aquije Montoya, Stephanie Ong, Russell Buhr, Ian J David, Tisha Wang, Talayeh Rezayat, Steven Y Chang, David Elashoff, Daniela Markovic, David Berlin, Maxime Cannesson
OBJECTIVES: Adequate assessment of fluid responsiveness in shock necessitates correct interpretation of hemodynamic changes induced by preload challenge. This study evaluates the accuracy of point-of-care Doppler ultrasound assessment of the change in carotid corrected flow time induced by a passive leg raise maneuver as a predictor of fluid responsiveness. Noninvasive cardiac output monitoring (NICOM, Cheetah Medical, Newton Center, MA) system based on a bioreactance method was used...
August 21, 2018: Critical Care Medicine
Yaseen M Arabi, Stephen A McClave
No abstract text is available yet for this article.
August 21, 2018: Critical Care Medicine
Robert Goulden, Tony Whitehouse, Nick Murphy, Tom Hayton, Zahid Khan, Catherine Snelson, Julian Bion, Tonny Veenith
OBJECTIVES: In various medical and surgical conditions, research has found that centers with higher patient volumes have better outcomes. This relationship has not previously been explored for status epilepticus. This study sought to examine whether centers that see higher volumes of patients with status epilepticus have lower in-hospital mortality than low-volume centers. DESIGN: Cohort study, using 2010-2015 data from the nationwide Case Mix Programme database of the U...
August 21, 2018: Critical Care Medicine
Oliver C Redfern, Gary B Smith, David R Prytherch, Paul Meredith, Matthew Inada-Kim, Paul E Schmidt
OBJECTIVES: The Sepsis-3 task force recommended the quick Sequential (Sepsis-Related) Organ Failure Assessment score for identifying patients with suspected infection who are at greater risk of poor outcomes, but many hospitals already use the National Early Warning Score to identify high-risk patients, irrespective of diagnosis. We sought to compare the performance of quick Sequential (Sepsis-Related) Organ Failure Assessment and National Early Warning Score in hospitalized, non-ICU patients with and without an infection...
August 20, 2018: Critical Care Medicine
Daniel R Kievlan, Li A Zhang, Chung-Chou H Chang, Derek C Angus, Christopher W Seymour
OBJECTIVES: Among patients with suspected infection, a single measurement of the quick Sepsis-related Organ Failure Assessment has good predictive validity for sepsis, yet the increase in validity from repeated measurements is unknown. We sought to determine the incremental predictive validity for sepsis of repeated quick Sepsis-related Organ Failure Assessment measurements over 48 hours compared with the initial measurement. DESIGN: Retrospective cohort study. SETTING: Twelve hospitals in southwestern Pennsylvania in 2012...
August 20, 2018: Critical Care Medicine
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