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Journal of Intensive Care Medicine

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https://www.readbyqxmd.com/read/28299952/n-acetylcysteine-s-role-in-sepsis-and-potential-benefit-in-patients-with-microcirculatory-derangements
#1
Jason Chertoff
OBJECTIVE: To review the data surrounding the utility of N-acetylcysteine (NAC) in sepsis and identify areas needed for additional research. DATA SOURCES: A review of articles describing the mechanisms of action and clinical use of NAC in sepsis. SUMMARY OF REVIEW: Despite many advances in critical care medicine, still as many as 50% of patients with septic shock die. Treatments thus far have focused on resuscitation and restoration of macrocirculatory targets in the early phases of sepsis, with less focus on microcirculatory dysfunction...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28292221/investigation-of-the-usability-of-computerized-critical-care-information-systems-in-germany
#2
Falk von Dincklage, Klaudiusz Suchodolski, Gregor Lichtner, Wolfgang Friesdorf, Beatrice Podtschaske, Maximilian Ragaller
INTRODUCTION: The term "usability" describes how effectively, efficiently, and with what level of user satisfaction an information system can be used to accomplish specific goals. Computerized critical care information systems (CCISs) with high usability increase quality of care and staff satisfaction, while reducing medication errors. Conversely, systems lacking usability can interrupt clinical workflow, facilitate errors, and increase charting time. The aim of this study was to investigate and compare usability across CCIS currently used in Germany...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28292220/impact-of-low-dose-hydrocortisone-on-the-incidence-of-atrial-fibrillation-in-patients-with-septic-shock
#3
Yoann Launey, Sigismond Lasocki, Karim Asehnoune, Baptiste Gaudriot, Claire Chassier, Raphael Cinotti, Pascale Le Maguet, Leila Laksiri, Olivier Mimoz, Audrey Tawa, Nicolas Nesseler, Yannick Malledant, Bastien Perrot, Philippe Seguin
PURPOSE: Atrial fibrillation (AF) is common in the intensive care unit (ICU), notably in patients with septic shock for whom inflammation is an already identified risk factor. The aim of this study was to evaluate the effect of low-dose hydrocortisone on AF occurrence in patients with septic shock. METHODS: We performed a prospective nonrandomized observational study in 5 academic ICUs in France. From November 2012 to June 2014, all patients ≥16 years having septic shock were included, except those who had a history of AF, had a pacemaker, and/or experienced AF during hospitalization before the onset of shock or in whom the onset of shock occurred prior to admission to the ICU...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28288543/renal-function-weaning-and-survival-in-patients-with-ventilator-dependent-respiratory-failure
#4
Debapriya Datta, Raymond J Foley, Rong Wu, James Grady, Paul Scalise
BACKGROUND: Acute kidney injury in acute critical illness has been associated with poor weaning and survival outcomes. The relation between renal dysfunction as defined by creatinine clearance (CrCl) and weaning from prolonged mechanical ventilation (PMV) is not known. The objective of this study was to determine the relation of measured CrCl to weaning and survival in patients on PMV. METHODS: We retrospectively studied 167 patients on PMV admitted to a long-term acute care facility for weaning over a 3-year period...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28285546/left-heart-decompression-in-acute-complicated-myocardial-infarction-during-extracorporeal-membrane-oxygenation
#5
Seok In Lee, So Young Lee, Chang Hyu Choi, Kook Yang Park, Chul-Hyun Park
Acute myocardial infarction (AMI) can progress to cardiogenic shock and mechanical complications. When extracorporeal membrane oxygenation (ECMO) is applied to a patient with AMI with cardiogenic shock and mechanical complications, left ventricular (LV) decompression is an important recovery factor because LV dilation increases myocardial wall stress and oxygen consumption. The authors present the case of a 72-year-old man with AMI and LV dilation who developed cardiogenic shock and papillary muscle rupture and who was treated successfully by ECMO with a left atrial venting...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28173733/practice-of-intubation-of-the-critically-ill-at-mayo-clinic
#6
Nathan J Smischney, Mohamed O Seisa, Katherine J Heise, Kyle D Busack, Theodore O Loftsgard, Darrell R Schroeder, Daniel A Diedrich
OBJECTIVE: To describe the practice of intubation of the critically ill at a single academic institution, Mayo Clinic's campus in Rochester, Minnesota, and to report the incidence of immediate postintubation complications. PATIENTS AND METHODS: Critically ill adult (≥18 years) patients admitted to a medical-surgical intensive care unit from January 1, 2013, to December 31, 2014, who required endotracheal intubation included. RESULTS: The final cohort included 420 patients...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28142307/misdirected-sympathy
#7
Jason A Ferreira, Brittany D Bissell
The spectrum of sepsis and septic shock remains a highly prevalent disease state, carrying a high risk of morbidity and mortality. The sympathetic nervous system (SNS) plays an important role in this initial cascade, enabling the host to respond to invading pathogens; however, prolonged activation can become pathological. The potential for unregulated sympathetic tone to become of detriment in patients with sepsis has fueled interest in the role and impact of sympatholysis, the selective inhibition of sympathetic tone...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28142306/noninvasive-ventilation-in-patients-with-hematologic-malignancy
#8
Jiajia Liu, Conor Bell, Vagia Campbell, Julian DeBacker, Erik Tamberg, Christie Lee, Sangeeta Mehta
INTRODUCTION: Noninvasive ventilation (NIV) is commonly used as first-line therapy for immunocompromised patients with acute respiratory failure. However, it may not be appropriate for all patients, as failure of NIV and delayed endotracheal intubation (ETI) may increase mortality. We report our center's experience and outcomes for patients with active hematologic malignancy (HM) treated with NIV. METHODS: We conducted a retrospective study of consecutive patients with HM who were admitted to the intensive care unit (ICU) of Mount Sinai Hospital for acute respiratory failure between January 1, 2010, and May 31, 2015, and were initially treated with NIV...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28122469/dexmedetomidine-for-refractory-intracranial-hypertension
#9
Kendra J Schomer, Christian M Sebat, Jason Y Adams, Jeremiah J Duby, Kiarash Shahlaie, Erin L Louie
Dexmedetomidine (DEX) is a selective α2 adrenergic agonist that is commonly used for sedation in the intensive care unit (ICU). The role of DEX for adjunctive treatment of refractory intracranial hypertension is poorly defined. The primary objective of this study was to determine the effect of DEX on the need for rescue therapy (ie, hyperosmolar boluses, extraventricular drain [EVD] drainages) for refractory intracranial hypertension. Secondary objectives included the number of intracranial pressure (ICP) excursions, bradycardic, hypotensive, and compromised cerebral perfusion pressure episodes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28118769/probabilistic-return-on-investment-analysis-of-single-family-versus-open-bay-rooms-in-neonatal-intensive-care-units-synthesis-and-evaluation-of-early-evidence-on-nosocomial-infections-length-of-stay-and-direct-cost-of-care
#10
Hessam Sadatsafavi, Bahar Niknejad, Mardelle Shepley, Mohsen Sadatsafavi
BACKGROUND: There is increasing evidence that the physical environment of neonatal intensive care units (NICUs), including single-family rooms (SFRs) versus open-bay rooms (OPBYs), has tangible effects on vulnerable patients. The objective of this study was to illustrate the financial implications of SFR versus OPBY units by synthesizing and evaluating the evidence regarding the benefits and costs of each unit from a hospital perspective. METHODS: We assumed a hypothetical NICU with 40 beds in OPBY rooms, to be replaced with a new NICU with 32 SFRs and 8 OPBYs...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28110613/adrenomedullin-is-associated-with-surgical-trauma-and-impaired-renal-function-in-vascular-surgery-patients
#11
Hans-Jörg Gillmann, Antje Meinders, Jan Larmann, Bianca Sahlmann, Claudia Schrimpf, Thomas Aper, Ralf Lichtinghagen, Omke E Teebken, Gregor Theilmeier
BACKGROUND: Patients undergoing vascular surgery are prone to perioperative organ injury because of both higher prevalence of cardiovascular risk factors and the extent of surgery. Early detection of organ failure is essential to facilitate appropriate medical care. Midregional pro-adrenomedullin (MR-proADM) has been investigated in acute medical care settings to guide clinical decision-making regarding patient pathways and to identify patients prone to imminent cardiovascular or inflammatory complications...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28110612/efficacy-of-high-flow-nasal-cannula-therapy-in-intensive-care-units
#12
Timothy N Liesching, Yuxiu Lei
PURPOSE: We conducted a meta-analysis to compare the physiological and clinical outcomes of high-flow nasal cannula (HFNC) with standard oxygen (O2) or conventional noninvasive ventilation (NIV) in intensive care units (ICUs). PROCEDURES: We selected the full-text prospective studies comparing HFNC with standard O2 or NIV in ICU. The continuous variables were analyzed with sample size-adjusted pooled t test. The categorical variables were extracted and combined for recalculating odds ratio...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28100110/mortality-in-patients-with-septic-shock-by-multidrug-resistant-bacteria
#13
Stefano Busani, Giulia Serafini, Elena Mantovani, Claudia Venturelli, Maddalena Giannella, Pierluigi Viale, Cristina Mussini, Andrea Cossarizza, Massimo Girardis
BACKGROUND: Patients with septic shock by multidrug resistant (MDR) microorganism maybe considered a specific population of critical patients at very high risk of death in whom the effects of standard sepsis treatment has never been assessed. The objective of this retrospective analysis was to evaluate the risk factors for 30-day mortality and the impact of sepsis management in patients with septic shock caused by MDR bacteria. METHODS: Patients with septic shock by MDR bacteria admitted to the mixed intensive care unit (ICU) of Modena University Hospital during a 6-year period were studied...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28073314/safety-of-the-peripheral-administration-of-vasopressor-agents
#14
Tyler Lewis, Cristian Merchan, Diana Altshuler, John Papadopoulos
Vasopressors are an integral component of the management of septic shock and are traditionally given via a central venous catheter (CVC) due to the risk of tissue injury and necrosis if extravasated. However, the need for a CVC for the management of septic shock has been questioned, and the risk of extravasation and incidence of severe injury when vasopressors are given via a peripheral venous line (PVL) remains poorly defined. We performed a retrospective chart review of 202 patients who received vasopressors through a PVL...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28049389/external-validation-of-two-classification-and-regression-tree-models-to-predict-the-outcome-of-inpatient-cardiopulmonary-resuscitation
#15
Ryan W R Guilbault, Marcus Andreas Ohlsson, Anna M Afonso, Mark H Ebell
OBJECTIVE: To prospectively validate a previously developed classification and regression tree (CART) model that predicts the likelihood of a good outcome among patients undergoing inpatient cardiopulmonary resuscitation. DESIGN: Prospective validation of a clinical decision rule. SETTING: Skåne University Hospital in Malmo, Sweden. PATIENTS: All adult patients (N = 287) experiencing in-hospital cardiopulmonary arrest and undergoing cardiopulmonary resuscitation between 2007 and 2010...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28040989/n-terminal-pro-brain-natriuretic-peptide-concentrations-after-hypertensive-intracerebral-hemorrhage
#16
Fei Li, Qian-Xue Chen, Shou-Gui Xiang, Shi-Zhun Yuan, Xi-Zhen Xu
INTRODUCTION: The role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with hypertensive intracerebral hemorrhage (HICH) is poorly understood. This study aimed to investigate the secretion pattern of NT-proBNP in patients with HICH and to assess its relationship with hematoma size, hyponatremia, and intracranial pressure (ICP). METHODS: This prospective study enrolled 147 isolated patients with HICH. Blood samples were obtained from each patient, and values of serum NT-proBNP, hematoma size, blood sodium, and ICP were collected for each patient...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28125947/letter-to-the-editor-regarding-do-serially-recorded-prognostic-scores-predict-outcome-better-than-one-time-recorded-score-on-admission-a-prospective-study-in-adult-intensive-care-patients
#17
https://www.readbyqxmd.com/read/28125946/do-serially-recorded-prognostic-scores-predict-outcome-better-than-one-time-recorded-score-on-admission-a-prospective-study-in-adult-intensive-care-patients
#18
Sangeeta Manerikar, Seetharaman Hariharan
No abstract text is available yet for this article.
March 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27903788/treatment-of-adenoviral-acute-respiratory-distress-syndrome-using-cidofovir-with-extracorporeal-membrane-oxygenation
#19
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...
March 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27798316/facial-drooping-aphasia-and-an-incidental-lung-mass-in-a-nonsmoker
#20
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...
March 2017: Journal of Intensive Care Medicine
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