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Journal of Intensive Care Medicine

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https://www.readbyqxmd.com/read/28612677/an-unusual-complication-with-the-administration-of-a-volatile-anesthetic-agent-for-status-asthmaticus-in-the-pediatric-intensive-care-unit-case-report-and-review-of-the-literature
#1
Brittany Shutes, W Joshua Frazier, Joseph D Tobias
In severe cases of status asthmaticus, when conventional therapies fail, volatile anesthetic agents remain a therapeutic option. When delivered outside of the operating room setting, specialized delivery techniques are needed to ensure the safe and effective use of volatile anesthetic agents. We present a 16-year-old adolescent with status asthmaticus who required the therapeutic administration of the volatile anesthetic agent, sevoflurane, in the pediatric intensive care unit (PICU). Although initially effective in reducing bronchospasm, progressive hypercarbia developed due to defective functioning of the carbon dioxide absorber of the anesthesia machine...
July 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27402396/diagnostic-bedside-ultrasonography-for-acute-respiratory-failure-and-severe-hypoxemia-in-the-medical-intensive-care-unit-basics-and-comprehensive-approaches
#2
Justin K Lui, Gisela I Banauch
Bedside goal-directed ultrasound is a powerful tool for rapid differential diagnosis and monitoring of cardiopulmonary disease in the critically ill patient population. The bedside intensivist is in a unique position to integrate ultrasound findings with the overall clinical situation. Medically critically ill patients who require urgent bedside diagnostic assessment fall into 2 categories: (1) acute respiratory failure and (2) hemodynamic derangements. The first portion of this review outlines the diagnostic role of bedside ultrasound in the medically critically ill patient population for the diagnosis and treatment of acute respiratory failure, acute respiratory distress, and severe hypoxemia...
July 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/26647407/ketamine-for-analgosedation-in-the-intensive-care-unit-a-systematic-review
#3
Asad E Patanwala, Jennifer R Martin, Brian L Erstad
OBJECTIVE: To evaluate the evidence for the use of intravenous ketamine for analgosedation in the intensive care unit. METHODS: MEDLINE and EMBASE were queried from inception until July 2015. Search terms used included ketamine, intensive care, and critical care. The search retrieved 584 articles to be screened for inclusion. The intent was to include randomized controlled studies using sustained intravenous infusions (>24 hours) of ketamine in the critically ill patients...
July 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
#4
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...
June 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27356945/bivalirudin-for-alternative-anticoagulation-in-extracorporeal-membrane-oxygenation-a-systematic-review
#5
Filippo Sanfilippo, Sven Asmussen, Dirk M Maybauer, Cristina Santonocito, John F Fraser, Gabor Erdoes, Marc O Maybauer
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) offers therapeutic options in refractory respiratory and/or cardiac failure. Systemic anticoagulation with heparin is routinely administered. However, in patients with heparin-induced thrombocytopenia or heparin resistance, the direct thrombin inhibitor bivalirudin is a valid option and has been increasingly used for ECMO anticoagulation. We aimed at evaluating its safety and its optimal dosing for ECMO. METHODS: Systematic web-based literature search of PubMed and EMBASE performed via National Health Service Library Evidence and manually, updated until January 30, 2016...
June 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27179058/in-hospital-management-and-follow-up-treatment-of-venous-thromboembolism-focus-on-new-and-emerging-treatments
#6
Joshua D Lenchus, Michelle Biehl, Jorge Cabrera, Alice Gallo de Moraes, Cameron Dezfulian
Venous thromboembolism (VTE), encompassing pulmonary embolism (PE) and deep venous thrombosis (DVT), is a major cause of morbidity and mortality of particular relevance for intensivists and hospitalists. Acute VTE is usually managed with parenteral unfractionated heparin or low-molecular-weight heparin, followed by an oral vitamin K antagonist. Data are lacking for optimal treatment of less common occurrences, such as upper extremity DVT, and for approaches such as thrombolysis for PE associated with early signs of hemodynamic compromise or inferior vena cava filters when anticoagulation is contraindicated...
June 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/26951579/value-of-serum-cholinesterase-activity-in-the-diagnosis-of-septic-shock-due-to-bacterial-infections
#7
Mabrouk Bahloul, Najeh Baccouch, Kamilia Chtara, Mouna Turki, Olfa Turki, Chokri Ben Hamida, Hedi Chelly, Fatma Ayedi, Anis Chaari, Mounir Bouaziz
BACKGROUND: We aimed to investigate whether serum cholinesterase (SChE) activity can be helpful for the diagnosis of septic shock and to evaluate its usefulness in comparison with procalcitonin (PCT) and C-reactive protein (CRP). METHODS: A prospective single-blinded study conducted in an intensive care unit of university hospital. Patients were classified as having cardiogenic shock, septic shock, or hemorrhagic shock. We also included a control group without neither hemodynamic instability nor sepsis...
June 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/26880005/influence-of-obesity-diagnosis-with-organ-dysfunction-mortality-and-resource-use-among-children-hospitalized-with-infection-in-the-united-states
#8
Nidhi Maley, Achamyeleh Gebremariam, Folafoluwa Odetola, Kanakadurga Singer
BACKGROUND: Sepsis induces inflammation in response to infection and is a major cause of mortality and hospitalization in children. Obesity induces chronic inflammation leading to many clinical manifestations. Our understanding of the impact of obesity on diseases, such as infection and sepsis, is limited. The objective of this study was to evaluate the association of obesity with organ dysfunction, mortality, duration, and charges during among US children hospitalized with infection...
June 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/26438417/acute-respiratory-distress-syndrome-mortality-in-a-single-center-according-to-different-definitions
#9
Roberto Santa Cruz, Lic Veronica Alvarez, Roberto Heredia, Fernando Villarejo
BACKGROUND: Mortality in acute lung injury (ALI) remains high, with outcome data arising mostly from multicenter studies. We undertook this investigation to determine hospital mortality in patients with ALI in a single center. METHODS: We studied patients admitted between 2005 and 2012 with ALI and acute respiratory distress syndrome (ARDS) according to the American European Consensus Conference (AECC) criteria and recorded clinical variables. Thereafter, patients were classified as subgroups according to the AECC and Berlin definition in order to compare the clinical characteristics and outcomes...
June 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/26358469/the-prognostic-value-of-soluble-intercellular-adhesion-molecule-1-plasma-level-in-children-with-acute-lung-injury
#10
Mohammed A Al-Biltagi, Ahmed Ahmed Abd ElBasset Abo-Elezz, Khaled Talaat Abu-Ela, Ghada Abudelmomen Suliman, Tamer Gomaa Hassan Sultan
OBJECTIVE: The objective of this study was to evaluate the prognostic significance of soluble intercellular adhesion molecule 1 (sICAM-1) measurement in plasma for the prediction of outcome of acute lung injury (ALI) in children that may allow early recognition of critical cases. METHODS: The study was performed as a prospective, controlled cohort study involving 40 children with ALI and 30 healthy children. The plasma level of sICAM-1 was measured at days 1 and 3 of development of ALI for the patient group and measured only once for the control group...
June 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28421895/metastatic-pulmonary-angiosarcoma-presenting-with-bilateral-secondary-spontaneous-pneumothoraces
#11
Daniel Jimenez, James Antaki, Nader Kamangar
BACKGROUND: Spontaneous pneumothorax (SP) is uncommon and can present as a primary disease process or as a result of underlying lung pathology. Several parenchymal lung diseases, such as malignancy, are known to cause SP. One such malignancy, angiosarcoma, has a high propensity to metastasize to the lung and present as cavitary and cystic lesions. CASE: We present a case of a 76-year-old male diagnosed with angiosarcoma of the scalp that was found to have extensive cystic pulmonary metastatic lesions...
May 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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/27530513/analysis-of-unplanned-intensive-care-unit-admissions-in-postoperative-pediatric-patients
#16
Elizabeth K Landry, Rodney A Gabriel, Sascha Beutler, Richard P Dutton, Richard D Urman
BACKGROUND: Currently, there are only a few retrospective, single-institution studies that have addressed the prevalence and risk factors associated with unplanned admissions to the pediatric intensive care unit (ICU) after surgery. Based on the limited amount of studies, it appears that airway and respiratory complications put a child at increased risk for unplanned ICU admission. A more extensive and diverse analysis of unplanned postoperative admissions to the ICU is needed to address risk factors that have yet to be revealed by the current literature...
March 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/26912409/the-flipped-classroom-model-for-teaching-in-the-intensive-care-unit
#17
Christopher R Tainter, Nelson L Wong, Gaston A Cudemus-Deseda, Edward A Bittner
INTRODUCTION: The intensive care unit (ICU) is a dynamic and complex learning environment. The wide range in trainee's experience, specialty training, fluctuations in patient acuity and volume, limitations in trainee duty hours, and additional responsibilities of the faculty contribute to the challenge in providing a consistent experience with traditional educational strategies. The "flipped classroom" is an educational model with the potential to improve the learning environment. In this paradigm, students gain exposure to new material outside class and then use class time to assimilate the knowledge through problem-solving exercises or discussion...
March 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/26905540/controlled-donation-after-circulatory-determination-of-death
#18
Anne L Dalle Ave, David M Shaw
Controlled donation after circulatory determination of death (cDCDD) concerns donation after withdrawal of life-sustaining therapy (W-LST). We examine the ethical issues raised by W-LST in the cDCDD context in the light of a review of cDCDD protocols and the ethical literature. Our analysis confirms that W-LST procedures vary considerably among cDCDD centers and that despite existing recommendations, the conflict of interest in the W-LST decision and process might be difficult to avoid, the process of W-LST might interfere with usual end-of-life care, and there is a risk of hastening death...
March 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/26768425/hidden-obligatory-fluid-intake-in-critical-care-patients
#19
Muhammad Umair Bashir, Anan Tawil, Vishnu R Mani, Umer Farooq, Michael A DeVita
INTRODUCTION: In addition to the fluid intake in the form of intravenous maintenance or boluses in intensive care unit (ICU) patients, there are sources of fluids that may remain unrecognized but contribute significantly to the overall fluid balance. We hypothesized that fluids not ordered as boluses or maintenance infusions-"hidden obligatory fluids"-may contribute more than a liter to the fluid intake of a patient during any random 24 hours of critical care admission. METHODS: Patients admitted to the Harlem Hospital ICU for at least 24 hours were included in this study (N = 98)...
March 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/26732769/low-transmission-of-airway-pressures-to-the-abdomen-in-mechanically-ventilated-patients-with-or-without-acute-respiratory-failure-and-intra-abdominal-hypertension
#20
Bram G A D H Heijnen, Angelique M E Spoelstra-de Man, A B Johan Groeneveld
PURPOSE: Intra-abdominal pressure, measured at end expiration, may depend on ventilator settings and transmission of intrathoracic pressure. We determined the transmission of positive intrathoracic pressure during mechanical ventilation at inspiration and expiration into the abdominal compartment. METHODS AND RESULTS: We included 9 patients after uncomplicated cardiac surgery and 9 with acute respiratory failure. Intravesical pressures were measured thrice (reproducibility of 1...
March 2017: Journal of Intensive Care Medicine
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