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Journal of Intensive Care Medicine

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https://www.readbyqxmd.com/read/27913775/role-of-b-type-natriuretic-peptide-in-predicting-in-hospital-outcomes-in-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-with-preserved-left-ventricular-function-a-5-year-retrospective-analysis
#1
Saraschandra Vallabhajosyula, Toufik Mahfood Haddad, Pranathi R Sundaragiri, Anas A Ahmed, Muhammad Sarfraz Nawaz, Hamza A A Rayes, Harish C Devineni, Arun Kanmanthareddy, Dustin A McCann, Christopher S Wichman, Ariel M Modrykamien, Lee E Morrow
BACKGROUND: The role of B-type natriuretic peptide (BNP) is less understood in the risk stratification of patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), especially in patients with normal left ventricular ejection fraction (LVEF). METHODS: This retrospective study from 2008 to 2012 evaluated all adult patients with AECOPD having BNP levels and available echocardiographic data demonstrating LVEF ≥40%. The patients were divided into groups 1, 2, and 3 with BNP ≤ 100, 101 to 500, and ≥501 pg/mL, respectively...
December 2, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27903788/treatment-of-adenoviral-acute-respiratory-distress-syndrome-using-cidofovir-with-extracorporeal-membrane-oxygenation-case-series-and-literature-review
#2
Minhyeok Lee, Seulgi Kim, Oh Jung Kwon, Ji Hye Kim, Inbeom Jeong, Ji Woong Son, Moon Jun Na, Yoo Sang Yoon, Hyun Woong Park, Sun Jung Kwon
Adenovirus infections are associated with respiratory (especially upper respiratory) infection and gastrointestinal disease and occur primarily in infants and children. Although rare in adults, severe lower respiratory adenovirus infections including pneumonia are reported in specific populations, such as military recruits and immunocompromised patients. Antiviral treatment is challenging due to limited clinical experience and lack of well-controlled randomized trials. Several previously reported cases of adenoviral pneumonia showed promising efficacy of cidofovir...
November 30, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27899470/i-trach-validating-a-tool-for-predicting-prolonged-mechanical-ventilation
#3
Paul A Clark, Ryan C Inocencio, Christopher J Lettieri
PURPOSE: We previously developed a bedside model (I-TRACH), which used commonly obtained data at the time of intubation to predict the duration of mechanical ventilation (MV). We now sought to validate this in a prospective trial. METHODS: A prospective, observational study of 225 consecutive adult medical intensive care unit patients requiring MV. Utilizing the original 6 variables used in the I-TRACH model (Intubation in the ICU, Tachycardia [heart rate > 110], Renal dysfunction [blood urea nitrogen > 25], Acidemia [pH < 7...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27899469/emergency-surgical-airways-following-activation-of-a-difficult-airway-management-team-in-hospitalized-critically-ill-patients-a-case-series
#4
REVIEW
Joseph M Darby, Gregory Halenda, Courtney Chou, Joseph J Quinlan, Louis H Alarcon, Richard L Simmons
INTRODUCTION: An emergency surgical airway (ESA) is widely recommended for securing the airway in critically ill patients who cannot be intubated or ventilated. Little is known of the frequency, clinical circumstances, management methods, and outcomes of hospitalized critically ill patients in whom ESA is performed outside the emergency department or operating room environments. METHODS: We retrospectively reviewed all adult patients undergoing ESA in our intensive care units (ICUs) and other hospital units from 2008 to 2012 following activation of our difficult airway management team (DAMT)...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27881698/effects-of-electrolyte-replacement-protocol-implementation-in-a-medical-intensive-care-unit
#5
Daniel J Pearson, Anit Sharma, Joshua A Lospinoso, Michael J Morris, Edward T McCann
PURPOSE: To evaluate the effects of electrolyte replacement protocol (ERP) implementation in the medical intensive care unit (MICU) setting. We hypothesized that a protocol would reduce the time of replacement dose administration and increase provider satisfaction with the process of electrolyte replacement. METHODS: This was a retrospective review of electronic medical record data before and after implementation of a standardized ERP in an 18-bed military tertiary care MICU...
November 22, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27879296/elevated-modified-shock-index-within-24-hours-of-icu-admission-is-an-early-indicator-of-mortality-in-the-critically-ill
#6
Nathan J Smischney, Mohamed O Seisa, Katherine J Heise, Darrell R Schroeder, Timothy J Weister, Daniel A Diedrich
PURPOSE: To assess whether exposure to modified shock index (MSI) in the first 24 hours of intensive care unit (ICU) admission is associated with increased in-hospital mortality. METHODS: Adult critically ill patients were included in a case-control design with 1:2 matching. Cases (death) and controls (alive) were abstracted by a reviewer blinded to exposure status (MSI). Cases were matched to controls on 3 factors-age, end-stage renal disease, and ICU admission diagnosis...
November 21, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27872410/risk-of-mortality-of-catheter-related-bloodstream-infections-caused-by-acinetobacter-species-is-early-removal-of-the-catheters-associated-with-a-better-survival-outcome
#7
Yi Lee, Yi-Tzu Lee, Yung-Chih Wang, Chung-Ting Chen, Jun-Ren Sun, Chang-Pan Liu, Yuan-Meng Liu, Shu-Chen Kuo, Chun-Hsiang Chiu, Ya-Sung Yang, Jung-Chung Lin, Te-Li Chen
PURPOSE: Bloodstream infections (BSIs) caused by Acinetobacter species have been extensively reported, however, which majorly focused on respiratory tract infections. The risk of mortality and the effect of early catheter removal on survival in catheter-related BSIs (CRBSIs) caused by Acinetobacter spp. remain unclear. This study aims to investigate that. METHODS: This is a retrospective multicentric study conducted in Taiwan from 2012 to 2014. Patients with at least 1 positive blood culture and catheter culture for the same Acinetobacter spp...
November 20, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27872409/complexity-analysis-of-decision-making-in-the-critically-ill
#8
Barbara J Daly, Sara L Douglas, Elizabeth O'Toole, James Rowbottom, Alan Hoffer, Amy R Lipson, Christopher Burant
RATIONALE: Despite multiple trials of interventions to improve end-of-life care of the critically ill, there is a persistent lack of understanding of factors associated with barriers to decision-making at the end of life. OBJECTIVE: To apply the principles of complexity science in examining the extent to which transitions to end-of-life care can be predicted by physician, family, or patient characteristics; outcome expectations; and the evaluation of treatment effectiveness...
November 20, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27872408/active-expiration-and-the-measurement-of-central-venous-pressure
#9
Sheldon Magder, Karim Serri, Sara Verscheure, Renée Chauvin, Peter Goldberg
PURPOSE: To obtain a point prevalence estimate of alterations in central venous pressure (CVP) produced by active expiration in a consecutive series of intensive care patients. METHODS: We evaluated CVP tracings taken by the nurses at their morning shift change in a consecutive series of 60 cardiac surgery and 59 noncardiac surgery patients. We also assessed change in values due to the change in transducer level. Three physicians and a nurse instructor independently reviewed the tracings and determined whether there was evidence of forced expiration and whether it was type A, defined by decreasing CVP during expiration, or type B, defined by increasing CVP during expiration...
November 20, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27852959/percutaneous-dilatational-tracheostomy-in-ankylosing-spondylitis-bechterew-disease-is-feasible-and-not-associated-with-higher-complication-rates
#10
Uwe Hamsen, Oliver Kamp, Chris Kaczmarek, Mirko Aach, Christian Waydhas, Thomas A Schildhauer, Oliver Jansen
BACKGROUND: Ankylosing spondylitis (AS) is a common disease with an incidence of approximately 0.5% in Europe, causing severe limitations of axial spine mobility and cervical kyphosis. Deformities of the cervical spine and the temporomandibular joints could increase the risk of complications while performing an intubation or tracheostomy. The percutaneous dilatational tracheostomy (PDT) is a standard procedure in intensive care medicine. However, the combination of cervical kyphosis and osteoporosis makes patient positioning challenging...
November 15, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27837045/pharmacologic-stress-gastropathy-prophylaxis-may-not-be-necessary-in-at-risk-surgical-trauma-icu-patients-tolerating-enteral-nutrition
#11
Nicole M Palm, Brian McKinzie, Pamela L Ferguson, Emily Chapman, Margaret Dorlon, Evert A Eriksson, Brent Jewett, Stuart M Leon, Alicia R Privette, Samir M Fakhry
OBJECTIVE: Stress gastropathy is a rare complication of the intensive care unit stay with high morbidity and mortality. There are data that support the concept that patients tolerating enteral nutrition have sufficient gut blood flow to obviate the need for prophylaxis; however, no robust studies exist. This study assesses the incidence of clinically significant gastrointestinal bleeding in surgical trauma intensive care unit (STICU) patients at risk of stress gastropathy secondary to mechanical ventilation receiving enteral nutrition without pharmacologic prophylaxis...
November 10, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27821581/association-between-the-use-of-long-acting-insulin-and-hypoglycemia-in-nondiabetic-patients-in-the-surgical-intensive-care-unit
#12
Jordan Masse, Christopher Alan Giuliano, Sara Brown, Renee Alexander Paxton
PURPOSE: The purpose of this study was to examine the association between long-acting insulin and hypoglycemia in nondiabetic surgical intensive care patients. METHODS: This single-center, retrospective cohort study evaluated glycemic control in nondiabetic critically ill surgical patients receiving long-acting insulin plus sliding scale versus those receiving sliding scale alone. Patients were matched based on sliding scale order and type of surgery. The primary outcome was the proportion of patients who experienced hypoglycemia (glucose values <70 mg/dL)...
November 7, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27798316/facial-drooping-aphasia-and-an-incidental-lung-mass-in-a-nonsmoker
#13
Justin K Lui, Lacey J McIntosh, Jorge Escobar Valle, Thomas Stockl, Stephen Summers
BACKGROUND: Atrial fibrillation and atrial flutter are atrial tachycardias associated with embolic strokes. To date, there have only been a few reports highlighting the incidence of these atrial tachycardias due to mechanical compression of myocardial structures and the pulmonary vasculature in certain mediastinal masses and cysts. CASE: We present a case of a 75-year-old gentleman who is a nonsmoker with a history of hypertension who presents with an acute embolic stroke due to atrial flutter likely from mechanical compression from an underlying squamous cell carcinoma of the lung...
October 26, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27798315/detection-of-ventilator-autotriggering-by-an-esophageal-catheter-used-to-monitor-the-neural-input-and-diaphragm-excitation
#14
Harbaksh Sangha, Troy Whitacre
Patient-ventilator synchrony has been the focus of attention in the field of mechanical ventilation for quite some time now. Toward that end, the modern ventilators are equipped with very sensitive pneumatic triggering mechanisms, which allow for minimal wasting of patient effort. The increasingly sensitive pneumatic triggers have the potential to cause autotriggering, where stimuli other than neural signals (eg, cardiac oscillations) can trigger the mechanical breath. Although autotriggering has been well documented in brain-dead patients, its existence is difficult to prove in patients who have the ability to trigger breath through neural diaphragmatic activity...
October 25, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27798314/cerebral-blood-flow-autoregulation-in-sepsis-for-the-intensivist-why-its-monitoring-may-be-the-future-of-individualized-care
#15
Carrie M Goodson, Kathryn Rosenblatt, Lucia Rivera-Lara, Paul Nyquist, Charles W Hogue
Cerebral blood flow (CBF) autoregulation maintains consistent blood flow across a range of blood pressures (BPs). Sepsis is a common cause of systemic hypotension and cerebral dysfunction. Guidelines for BP management in sepsis are based on historical concepts of CBF autoregulation that have now evolved with the availability of more precise technology for its measurement. In this article, we provide a narrative review of methods of monitoring CBF autoregulation, the cerebral effects of sepsis, and the current knowledge of CBF autoregulation in sepsis...
October 25, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27756870/early-goal-directed-therapy-in-severe-sepsis-and-septic-shock-a-meta-analysis-and-trial-sequential-analysis-of-randomized-controlled-trials
#16
Yao Lu, Han Zhang, Fang Teng, Wen-Jun Xia, Gui-Xiang Sun, Ai-Qing Wen
INTRODUCTION: The Surviving Sepsis Campaign guidelines recommend early goal-directed therapy (EGDT) for the resuscitation of patients with sepsis; however, the recent evidences quickly evolve and convey conflicting results. We performed a meta-analysis to evaluate the effect of EGDT on mortality in adults with severe sepsis and septic shock. METHODS: We searched electronic databases to identify randomized controlled trials that compared EGDT with usual care or lactate-guided therapy in adults with severe sepsis and septic shock...
October 18, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27733643/the-impact-of-mean-arterial-pressure-on-functional-outcome-post-trauma-related-acute-spinal-cord-injury-a-scoping-systematic-review-of-the-human-literature
#17
Behzad Sabit, Frederick Adam Zeiler, Neil Berrington
PURPOSE: To perform a scoping systematic review on the literature surrounding mean arterial pressure (MAP) and functional outcomes post traumatic acute spinal cord injury (ASCI). METHODS: We performed a systematic review of the literature via searching MEDLINE, BIOSIS, EMBASE, Global Health, SCOPUS, and Cochrane Library from inception to January 2015. We also performed a handsearch of various published meeting proceedings. Through a 2-step review process, employing 2 independent reviewers, we selected articles for the final review based on predefined inclusion/exclusion criteria...
October 12, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27758849/sensory-input-and-motor-responses-after-brain-death-diagnosis-a-word-of-caution
#18
Mohamed Y Rady, Joseph L Verheijde
No abstract text is available yet for this article.
October 6, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27708007/the-physiology-of-early-goal-directed-therapy-for-sepsis
#19
Lindsay Lief, John Arbo, David A Berlin
In 2001, Rivers and colleagues published a randomized controlled trial of early goal-directed therapy (EGDT) for the treatment of sepsis. More than a decade later, it remains a landmark achievement. The study proved the benefits of early aggressive treatment of sepsis. However, many questions remain about specific aspects of the complex EGDT algorithm. Recently, 3 large trials attempted to replicate these results. None of the studies demonstrated a benefit of an EGDT protocol for sepsis. This review explores the physiologic basis of goal-directed therapy, including the hemodynamic targets and the therapeutic interventions...
October 5, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27686326/association-of-microcirculation-macrocirculation-and-severity-of-illness-in-septic-shock-a-prospective-observational-study-to-identify-microcirculatory-targets-potentially-suitable-for-guidance-of-hemodynamic-therapy
#20
Timo Sturm, Julia Leiblein, Verena Schneider-Lindner, Thomas Kirschning, Manfred Thiel
PURPOSE: Clinically unapparent microcirculatory impairment is common and has a negative impact on septic shock, but specific therapy is not established so far. This prospective observational study aimed at identifying candidate parameters for microcirculatory-guided hemodynamic therapy. CLINICALTRIALSGOV: NCT01530932. MATERIALS AND METHODS: Microcirculatory flow and postcapillary venous oxygen saturation were detected during vaso-occlusive testing (VOT) on days 1 (T0), 2 (T24), and 4 (T72) in 20 patients with septic shock at a surgical intensive care unit using a laser Doppler spectrophotometry system (O2C)...
September 29, 2016: Journal of Intensive Care Medicine
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