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Critical Care Medicine

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https://www.readbyqxmd.com/read/28430698/the-right-ventricle-is-dilated-during-resuscitation-from-cardiac-arrest-caused-by-hypovolemia-a-porcine-ultrasound-study
#1
Rasmus Aagaard, Asger Granfeldt, Morten T Bøtker, Troels Mygind-Klausen, Hans Kirkegaard, Bo Løfgren
OBJECTIVES: Dilation of the right ventricle during cardiac arrest and resuscitation may be inherent to cardiac arrest rather than being associated with certain causes of arrest such as pulmonary embolism. This study aimed to compare right ventricle diameter during resuscitation from cardiac arrest caused by hypovolemia, hyperkalemia, or primary arrhythmia (i.e., ventricular fibrillation). DESIGN: Thirty pigs were anesthetized and then randomized to cardiac arrest induced by three diffrent methods...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28430697/abusive-head-trauma-and-mortality-an-analysis-from-an-international-comparative-effectiveness-study-of-children-with-severe-traumatic-brain-injury
#2
Nikki Miller Ferguson, Ajit Sarnaik, Darryl Miles, Nadeem Shafi, Mark J Peters, Edward Truemper, Monica S Vavilala, Michael J Bell, Stephen R Wisniewski, James F Luther, Adam L Hartman, Patrick M Kochanek
OBJECTIVES: Small series have suggested that outcomes after abusive head trauma are less favorable than after other injury mechanisms. We sought to determine the impact of abusive head trauma on mortality and identify factors that differentiate children with abusive head trauma from those with traumatic brain injury from other mechanisms. DESIGN: First 200 subjects from the Approaches and Decisions in Acute Pediatric Traumatic Brain Injury Trial-a comparative effectiveness study using an observational, cohort study design...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28430696/sequential-analysis-of-a-panel-of-biomarkers-and-pathologic-findings-in-a-resuscitated-rat-model-of-sepsis-and-recovery
#3
Nishkantha Arulkumaran, Marije L Sixma, Elisa Jentho, Elias Ceravola, Paul S Bass, John A Kellum, Robert J Unwin, Fred W K Tam, Mervyn Singer
OBJECTIVES: To characterize the temporal pattern of a panel of blood and urinary biomarkers in an animal model of fecal peritonitis and recovery. DESIGN: Prospective observational animal study. SETTING: University research laboratory. SUBJECTS: Male Wistar rats. INTERVENTIONS: A fluid-resuscitated, long-term (3 d) rat model of sepsis (fecal peritonitis) and recovery was used to understand the temporal association of sepsis biomarkers in relation to systemic hemodynamics, inflammation, and renal function...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28430695/cerebral-recovery-index-reliable-help-for-prediction-of-neurologic-outcome-after-cardiac-arrest
#4
Marleen C Tjepkema-Cloostermans, Jeannette Hofmeijer, Albertus Beishuizen, Harold W Hom, Michiel J Blans, Frank H Bosch, Michel J A M van Putten
OBJECTIVE: Early electroencephalography measures contribute to outcome prediction of comatose patients after cardiac arrest. We present predictive values of a new cerebral recovery index, based on a combination of quantitative electroencephalography measures, extracted every hour, and combined by the use of a random forest classifier. DESIGN: Prospective observational cohort study. SETTING: Medical ICU of two large teaching hospitals in the Netherlands...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28426531/high-fat-feeding-protects-mice-from-ventilator-induced-lung-injury-via-neutrophil-independent-mechanisms
#5
Michael R Wilson, Joanne E Petrie, Michael W Shaw, Cong Hu, Charlotte M Oakley, Samantha J Woods, Brijesh V Patel, Kieran P O'Dea, Masao Takata
OBJECTIVE: Obesity has a complex impact on acute respiratory distress syndrome patients, being associated with increased likelihood of developing the syndrome but reduced likelihood of dying. We propose that such observations are potentially explained by a model in which obesity influences the iatrogenic injury that occurs subsequent to intensive care admission. This study therefore investigated whether fat feeding protected mice from ventilator-induced lung injury. DESIGN: In vivo study...
April 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28422779/the-utility-of-high-fidelity-simulation-for-training-critical-care-fellows-in-the-management-of-extracorporeal-membrane-oxygenation-emergencies-a-randomized-controlled-trial
#6
Bishoy M Zakhary, Lily M Kam, Brian S Kaufman, Kevin J Felner
OBJECTIVE: Although extracorporeal membrane oxygenation volume has increased, proficiency in the technology requires extensive training. We compared traditional water-drill-based extracorporeal membrane oxygenation training with simulation-based extracorporeal membrane oxygenation training with the hypothesis that simulation-based training is superior. DESIGN: Randomized controlled trial. SETTING: Academic medical center. SUBJECTS: Pulmonary/critical care fellows...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28422778/ultrasound-as-a-screening-tool-for-central-venous-catheter-positioning-and-exclusion-of-pneumothorax
#7
Rabia Amir, Ziyad O Knio, Feroze Mahmood, Achikam Oren-Grinberg, Akiva Leibowitz, Ruma Bose, Shahzad Shaefi, John D Mitchell, Muneeb Ahmed, Amit Bardia, Daniel Talmor, Robina Matyal
OBJECTIVES: Although real-time ultrasound guidance during central venous catheter insertion has become a standard of care, postinsertion chest radiograph remains the gold standard to confirm central venous catheter tip position and rule out associated lung complications like pneumothorax. We hypothesize that a combination of transthoracic echocardiography and lung ultrasound is noninferior to chest radiograph when used to accurately assess central venous catheter positioning and screen for pneumothorax...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28422777/population-based-epidemiology-of-sepsis-in-a-subdistrict-of-beijing
#8
Jianfang Zhou, Hongcheng Tian, Xueping Du, Xiuming Xi, Youzhong An, Meili Duan, Li Weng, Bin Du
OBJECTIVE: Information about the epidemiology of sepsis in community residents in China remains scarce and incomplete. The purpose of this study was to describe the occurrence rate and outcome of sepsis in Yuetan Subdistrict of Beijing and to estimate the occurrence rate of sepsis in China. DESIGN: Retrospective cohort study. SETTING: All public hospitals serving residents in Yuetan Subdistrict, Beijing. PATIENTS: All patients (n = 1,716) meeting criteria for sepsis based on American College of Chest Physicians/Society of Critical Care Medicine consensus definition...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28422776/lower-cranial-nerves-paralysis-following-prone-position-mechanical-ventilation
#9
Jose M Trejo-Gabriel-Galan, Maria Eugenia Perea-Rodriguez, Irene Aicua-Rapun, Esther Martinez-Barrio
OBJECTIVE: To communicate a complication of prone-position ventilation. DATA SOURCES: Case history. STUDY SELECTION: Case report. DATA EXTRACTION AND DATA SYNTHESIS: Clinical information from medical record. CONCLUSIONS: This is a very infrequent cause of dysphagia following prone-position ventilation.
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28422775/a-contemporary-assessment-of-acute-mechanical-ventilation-in-beijing-description-costs-and-outcomes
#10
Yanping Ye, Bo Zhu, Li Jiang, Qi Jiang, Meiping Wang, Lin Hua, Xiuming Xi
OBJECTIVE: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. DESIGN: A prospective observational cohort study. SETTING: Fourteen ICUs among 13 hospitals in Beijing, China. PATIENTS: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. INTERVENTION: None...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28410347/accuracy-of-zero-heat-flux-cutaneous-temperature-in-intensive-care-adults
#11
Claire Dahyot-Fizelier, Solène Lamarche, Thomas Kerforne, Thierry Bénard, Benoit Giraud, Rémy Bellier, Elsa Carise, Denis Frasca, Olivier Mimoz
OBJECTIVES: To compare accuracy of a continuous noninvasive cutaneous temperature using zero-heat-flux method to esophageal temperature and arterial temperature. DESIGN: Prospective study. SETTING: ICU and NeuroICU, University Hospital. PATIENTS: Fifty-two ICU patients over a 4-month period who required continuous temperature monitoring were included in the study, after informed consent. INTERVENTIONS: All patients had esophageal temperature probe and a noninvasive cutaneous device to monitor their core temperature continuously...
April 13, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28410346/improved-survival-in-a-long-term-rat-model-of-sepsis-is-associated-with-reduced-mitochondrial-calcium-uptake-despite-increased-energetic-demand
#12
Bernardo B Pinto, Alex Dyson, Michele Umbrello, Jane E Carré, Cristiane Ritter, Innes Clatworthy, Michael R Duchen, Mervyn Singer
OBJECTIVES: To investigate the relationship between prognosis, changes in mitochondrial calcium uptake, and bioenergetic status in the heart during sepsis. DESIGN: In vivo and ex vivo controlled experimental studies. SETTING: University research laboratory. SUBJECTS: Male adult Wistar rats. INTERVENTIONS: Sepsis was induced by intraperitoneal injection of fecal slurry. Sham-operated animals served as controls...
April 13, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28406814/pilot-feasibility-study-of-therapeutic-hypothermia-for-moderate-to-severe-acute-respiratory-distress-syndrome
#13
Donald F Slack, Douglas S Corwin, Nirav G Shah, Carl B Shanholtz, Avelino C Verceles, Giora Netzer, Kevin M Jones, Clayton H Brown, Michael L Terrin, Jeffrey D Hasday
OBJECTIVES: Prior studies suggest hypothermia may be beneficial in acute respiratory distress syndrome, but cooling causes shivering and increases metabolism. The objective of this study was to assess the feasibility of performing a randomized clinical trial of hypothermia in patients with acute respiratory distress syndrome receiving treatment with neuromuscular blockade because they cannot shiver. DESIGN: Retrospective study and pilot, prospective, open-label, feasibility study...
April 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28406813/effects-of-hypercapnia-and-hypercapnic-acidosis-on-hospital-mortality-in-mechanically-ventilated-patients
#14
Ravindranath Tiruvoipati, David Pilcher, Hergen Buscher, John Botha, Michael Bailey
OBJECTIVES: Lung-protective ventilation is used to prevent further lung injury in patients on invasive mechanical ventilation. However, lung-protective ventilation can cause hypercapnia and hypercapnic acidosis. There are no large clinical studies evaluating the effects of hypercapnia and hypercapnic acidosis in patients requiring mechanical ventilation. DESIGN: Multicenter, binational, retrospective study aimed to assess the impact of compensated hypercapnia and hypercapnic acidosis in patients receiving mechanical ventilation...
April 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28406812/electroencephalography-predicts-poor-and-good-outcomes-after-cardiac-arrest-a-two-center-study
#15
Andrea O Rossetti, Diego F Tovar Quiroga, Elsa Juan, Jan Novy, Roger D White, Nawfel Ben-Hamouda, Jeffrey W Britton, Mauro Oddo, Alejandro A Rabinstein
OBJECTIVE: The prognostic role of electroencephalography during and after targeted temperature management in postcardiac arrest patients, relatively to other predictors, is incompletely known. We assessed performances of electroencephalography during and after targeted temperature management toward good and poor outcomes, along with other recognized predictors. DESIGN: Cohort study (April 2009 to March 2016). SETTING: Two academic hospitals (Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Mayo Clinic, Rochester, MN)...
April 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28403121/pheochromocytoma-crisis-in-icu-a-french-multicenter-cohort-study-with-emphasis-on-rescue-extracorporeal-membrane-oxygenation
#16
Bertrand Sauneuf, Nicolas Chudeau, Benoit Champigneulle, Claire Bouffard, Marion Antona, Nicolas Pichon, David Marrache, Romain Sonneville, Antoine Marchalot, Camille Welsch, Antoine Kimmoun, Bruno Bouchet, Elmi Messai, Sylvie Ricome, David Grimaldi, Jonathan Chelly, Jean-Luc Hanouz, Alain Mercat, Nicolas Terzi
OBJECTIVES: To describe the characteristics, management, and outcome of patients admitted to ICUs for pheochromocytoma crisis. DESIGN: A 16-year multicenter retrospective study. SETTING: Fifteen university and nonuniversity ICUs in France. PATIENTS: Patients admitted in ICU for pheochromocytoma crisis. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: We included 34 patients with a median age of 46 years (40-54 yr); 65% were males...
April 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28403120/detection-of-pulmonary-embolism-during-cardiac-arrest-ultrasonographic-findings-should-be-interpreted-with-caution
#17
Rasmus Aagaard, Philip Caap, Nicolaj C Hansson, Morten T Bøtker, Asger Granfeldt, Bo Løfgren
OBJECTIVES: The aim of this study was to test the hypothesis that the right ventricle is more dilated during resuscitation from cardiac arrest caused by pulmonary embolism, compared with hypoxia and primary arrhythmia. DESIGN: Twenty-four pigs were anesthetized and cardiac arrest was induced using three different methods. Pigs were resuscitated after 7 minutes of untreated cardiac arrest. Ultrasonographic images were obtained and the right ventricular diameter was measured...
April 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28403119/combined-measurement-of-soluble-st2-and-amino-terminal-pro-b-type-natriuretic-peptide-provides-early-assessment-of-severity-in-cardiogenic-shock-complicating-acute-coronary-syndrome
#18
Heli Tolppanen, Mercedes Rivas-Lasarte, Johan Lassus, Malha Sadoune, Etienne Gayat, Kari Pulkki, Mattia Arrigo, Evguenia Krastinova, Alessandro Sionis, John Parissis, Jindrich Spinar, James Januzzi, Veli-Pekka Harjola, Alexandre Mebazaa
OBJECTIVES: Mortality in cardiogenic shock complicating acute coronary syndrome is high, and objective risk stratification is needed for rational use of advanced therapies such as mechanical circulatory support. Traditionally, clinical variables have been used to judge risk in cardiogenic shock. The aim of this study was to assess the added value of serial measurement of soluble ST2 and amino-terminal pro-B-type natriuretic peptide to clinical parameters for risk stratification in cardiogenic shock...
April 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28403118/validation-of-intensive-care-and-mechanical-ventilation-codes-in-medicare-data
#19
Hannah Wunsch, Andrew Kramer, Hayley B Gershengorn
OBJECTIVES: To assess the reliability of codes relevant to critically ill patients in administrative data. DESIGN: Retrospective cohort study linking data from Acute Physiology and Chronic Health Evaluation Outcomes, a clinical database of ICU patients with data from Medicare Provider Analysis and Review. We linked data based on matching for sex, date of birth, hospital, and date of admission to hospital. SETTING: Forty-six hospitals in the United States participating in Acute Physiology and Chronic Health Evaluation Outcomes...
April 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28398926/early-systolic-dysfunction-following-traumatic-brain-injury-a-cohort-study
#20
Vijay Krishnamoorthy, Ali Rowhani-Rahbar, Edward F Gibbons, Frederick P Rivara, Nancy R Temkin, Crystal Pontius, Kevin Luk, Morgan Graves, Danielle Lozier, Nophanan Chaikittisilpa, Taniga Kiatchai, Monica S Vavilala
OBJECTIVE: Prior studies have suggested that traumatic brain injury may affect cardiac function. Our study aims were to determine the frequency, longitudinal course, and admission risk factors for systolic dysfunction in patients with moderate-severe traumatic brain injury. DESIGN: Prospective cohort study. SETTING: Level 1 trauma center. MEASUREMENTS: Transthoracic echocardiogram within 1 day and over the first week after moderate-severe traumatic brain injury; transthoracic echocardiogram within 1 day after mild traumatic brain injury (comparison group)...
April 10, 2017: Critical Care Medicine
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