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Journal of Intensive Care Medicine

Somnath Bose, Alistair E W Johnson, Ari Moskowitz, Leo Anthony Celi, Jesse D Raffa
No abstract text is available yet for this article.
December 11, 2018: Journal of Intensive Care Medicine
Christopher Jou, Rian Shah, Andrew Figueroa, Jignesh K Patel
INTRODUCTION: Post-cardiac arrest syndrome (PCAS) is characterized by systemic ischemia/reperfusion injury, anoxic brain injury, and post-arrest myocardial dysfunction superimposed on a precipitating pathology. The role of inflammatory cytokines in cardiac arrest remains unclear. AIMS: We aimed to describe, with an emphasis on clinical applications, what is known about the role of inflammatory cytokines in cardiac arrest. DATA SOURCES: A PubMed literature review was performed for relevant articles...
December 10, 2018: Journal of Intensive Care Medicine
Uchenna R Ofoma, Shravan Kethireddy
No abstract text is available yet for this article.
December 4, 2018: Journal of Intensive Care Medicine
George L Anesi, Nicole B Gabler, Nikki L Allorto, Carel Cairns, Gary E Weissman, Rachel Kohn, Scott D Halpern, Robert D Wise
OBJECTIVE: To measure the association of intensive care unit (ICU) capacity strain with processes of care and outcomes of critical illness in a resource-limited setting. METHODS: We performed a retrospective cohort study of 5332 patients referred to the ICUs at 2 public hospitals in South Africa using the country's first published multicenter electronic critical care database. We assessed the association between multiple ICU capacity strain metrics (ICU occupancy, turnover, census acuity, and referral burden) at different exposure time points (ICU referral, admission, and/or discharge) with clinical and process of care outcomes...
December 4, 2018: Journal of Intensive Care Medicine
Nidhi Ravishankar, Rolla Nuoman, Krishna Amuluru, Mohammad El-Ghanem, Venkatraman Thulasi, Neha S Dangayach, Kiwon Lee, Fawaz Al-Mufti
Standard management strategies for lowering intracranial pressure (ICP) in traumatic brain injury has been well-studied, but the use of lesser known interventions for ICP in subarachnoid hemorrhage (SAH) remains elusive. Searches were performed in PubMed and EBSCO Host to identify best available evidence for evaluation and management of medically refractory ICP in SAH. The role of standard management strategies such as head elevation, hyperventilation, mannitol and hypertonic saline as well as lesser known management such as sodium bicarbonate, indomethacin, tromethamine, decompressive craniectomy, decompressive laparotomy, hypothermia, and barbiturate coma are reviewed...
December 4, 2018: Journal of Intensive Care Medicine
Xiao Lu, ChunShuang Wu, YuZhi Gao, Mao Zhang
BACKGROUND: High-flow nasal cannula (HFNC) oxygen therapy has been shown to reduce the need for mechanical ventilation and decrease the duration of hospital and intensive care unit (ICU) stays for patients with a severely compromised respiratory system. This study aims to observe the evolution of lung aeration via lung ultrasound score (LUS) in a chest-injured population who had been treated with HFNC oxygen therapy, and to assess the benefit of the HFNC oxygen therapy in trauma patients...
December 4, 2018: Journal of Intensive Care Medicine
Kartikeya Rajdev, Nina Loghmanieh, Maria A Farberov, Seleshi Demissie, Theodore Maniatis
It is important for health-care providers to be comfortable in providing end-of-life (EOL) care to critically ill patients and realizing when continuing aggressive measures would be futile. Therefore, there is a need to understand health-care providers' self-perceived skills and barriers to providing optimum EOL care. A total of 660 health-care providers from medicine and surgery departments were asked via e-mail to complete an anonymous survey assessing their self-reported EOL care competencies, of which 238 responses were received...
December 3, 2018: Journal of Intensive Care Medicine
Deborah M Siegal, Neal Manning, Nicholas L Jackson Chornenki, Christopher M Hillis, Nancy M Heddle
BACKGROUND: Intensive care unit (ICU) patients are at high risk of anemia, which is associated with adverse clinical outcomes and death. Blood sampling for diagnostic testing is a potentially modifiable contributor to anemia. METHODS: We conducted a systematic review by searching MEDLINE and EMBASE from inception to October 5, 2017, for studies reporting the volume of blood taken for laboratory testing using blood sampling conservation devices compared to standard care or another intervention in adult ICU patients...
November 27, 2018: Journal of Intensive Care Medicine
Vincent Issac Lau, Fran Priestap, Joyce N H Lam, John Basmaji, Ian M Ball
PURPOSE: To describe factors (demographics and clinical characteristics) that predict patients who are at an increased risk of adverse events or unplanned return visits to a health-care facility following discharge direct to home (DDH) from intensive care units (ICUs). METHODS: Prospective cohort study of all adult patients who survived their stay in our medical-surgical-trauma ICU between February 2016 and 2017 and were discharged directly home. Patients were followed for 8 weeks postdischarge...
November 26, 2018: Journal of Intensive Care Medicine
Charlisa D Gibson, Mai O Colvin, Michael J Park, Qingying Lai, Juan Lin, Abdissa Negassa, Chirag D Shah, Matthew D Langston
INTRODUCTION: Deep vein thrombosis (DVT) is a recognized but preventable cause of morbidity and mortality in the medical intensive care unit (MICU). We examined the prevalence and risk factors for DVT in MICU patients who underwent diagnostic venous duplex ultrasonography (DUS) and the potential effect on clinical outcomes. METHODS: This is a retrospective study examining prevalence of DVT in 678 consecutive patients admitted to a tertiary care level academic MICU from July 2014 to 2015...
November 19, 2018: Journal of Intensive Care Medicine
Krishna Thandra, Zuhair Salah, Sanjay Chawla
Cancer continues to be a leading cause of death despite a broader understanding of its biology and the development of novel therapies. Nonetheless, with an increasing survival of this population, intensivists must be aware of the associated emergencies, both old and new. Oncologic emergencies can be seen as an initial presentation of the disease or precipitated by its treatment. In this review, we present key oncologic emergencies that may be encountered in daily practice, complications associated with innovative therapies, and treatment-related adverse events...
November 9, 2018: Journal of Intensive Care Medicine
Virginie Lemiale, Sandrine Valade, Laure Calvet, Eric Mariotte
Hemophagocytic syndrome remains a rare but life-threatening complication and is associated with intensive care unit (ICU) admission. The pathophysiology is based on a defect of cytotoxicity in T cells that results in a state of hyperinflammation in the presence of a trigger. As a consequence, patients may develop multiorgan failure. The diagnosis of hemophagocytic syndrome (HS) remains difficult and relies on persistant high-grade fevers in the absence of infection and on constellation of laboratory parameters...
November 1, 2018: Journal of Intensive Care Medicine
Ying Liu, Wei Zhao, Wenxiu Chen, Xiao Shen, Run Fu, Yi Zhao, Han Liu
OBJECTIVE: To explore the therapeutic effects of early enteral nutrition (EEN) on patients with sepsis on mechanical ventilation. METHODS: Patients with sepsis on mechanical ventilation in the medical intensive care unit (ICU) from January 2013 to March 2016 were treated with enteral nutrition. Patients treated within 48 hours of initiation of mechanical ventilation were assigned to the EEN group, and the rest were assigned to the delayed enteral nutrition (DEN) group...
November 1, 2018: Journal of Intensive Care Medicine
Nathaniel Bendahan, Oliver Neal, Amanda Ross-White, John Muscedere, J Gordon Boyd
BACKGROUND: A common neurological complication of critical illness is delirium, defined as an acute change in level of consciousness, with impaired attention and disorganized thinking. Patients with delirium have increased risk of long-term cognitive dysfunction and mortality. The cause is unknown, which limits our ability to design therapeutic interventions. In patients undergoing surgery, low regional cerebral oxygenation (rSO2), as measured by near-infrared spectroscopy (NIRS), is associated with postoperative neurological dysfunction (eg delirium and long-term cognitive impairment)...
October 30, 2018: Journal of Intensive Care Medicine
Qiang Tai, Huimin Yi, Xuxia Wei, Wenfeng Xie, Ou Zeng, Donghua Zheng, Jiaqi Sun, Ganping Wang, Siqi Wang, Genglong Liu
BACKGROUND: Tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) are recent promising markers for identification of cardiac surgery-associated acute kidney injury (CSA-AKI). The aim of this study was systematically and quantitatively to evaluate the accuracy of urinary TIMP-2 and IGFBP7 for the diagnosis of CSA-AKI. METHODS: Three databases including PubMed, ISI web of knowledge, and Embase were systematically searched from inception to March 2018...
October 30, 2018: Journal of Intensive Care Medicine
Lucas W Smedley, Dana B Foster, Colleen A Barthol, Reed Hall, G Christina Gutierrez
PURPOSE: To compare clinical response of intermittent bolus versus continuous infusion neostigmine for acute colonic pseudo-obstruction (ACPO). Acute colonic pseudo-obstruction occurs due to reduced colonic parasympathetic activity. Neostigmine is an acetylcholinesterase inhibitor that increases frequency of smooth muscle contraction by increasing acetylcholine at autonomic nervous system synapses. Although these administration modalities have been studied separately, they have never been compared...
October 29, 2018: Journal of Intensive Care Medicine
João Pedro Baptista, Paulo Jorge Martins, Margarida Marques, Jorge Manuel Pimentel
BACKGROUND: Critically ill patients show a high, albeit variable, prevalence of augmented renal clearance (ARC). This condition has relevant consequences on the elimination of hydrophilic drugs. Knowledge of risk factors for ARC helps in the early identification of ARC. The aims of this study were evaluation of (1) risk factors for ARC and (2) the prevalence of ARC in critically ill patients over a period of 1 year. METHODS: A retrospective cohort study was performed for all consecutive patients admitted to our intensive care unit (ICU)...
October 29, 2018: Journal of Intensive Care Medicine
Marjan Islam, David Nesheim, Samuel Acquah, Pierre Kory, Ismini Kourouni, Navitha Ramesh, Madeline Ehrlich, Gargi Bajpayee, David Steiger, Jason Filopei
RATIONALE: Right heart thrombi (RiHT) is characterized by the presence of thrombus within the right atrium or right ventricle (RV). Current literature suggests pulmonary embolism (PE) with RiHT carries a high mortality. Guidelines lack recommendations in managing RiHT. We created a pooled analysis on RiHT and report on our institutional experience in managing RiHT. We aimed to evaluate whether patient characteristics and differing treatment modalities predict mortality. METHODS: We created a pooled analysis of case reports and series of patients with RiHT and PE between January 1956 and 2017...
October 29, 2018: Journal of Intensive Care Medicine
Aaron S Weinberg, William Chang, Grace Ih, Alan Waxman, Victor F Tapson
OBJECTIVE: Computed tomography angiography is limited in the intensive care unit (ICU) due to renal insufficiency, hemodynamic instability, and difficulty transporting unstable patients. A portable ventilation/perfusion (V/Q) scan can be used. However, it is commonly believed that an abnormal chest radiograph can result in a nondiagnostic scan. In this retrospective study, we demonstrate that portable V/Q scans can be helpful in ruling in or out clinically significant pulmonary embolism (PE) despite an abnormal chest x-ray in the ICU...
October 22, 2018: Journal of Intensive Care Medicine
Carrie M Goodson, Lisa Aronson Friedman, Earl Mantheiy, Kevin Heckle, Annette Lavezza, Amy Toonstra, Ann M Parker, Jason Seltzer, Michael Velaetis, Mary Glover, Caroline Outten, Kit Schwartz, Antionette Jones, Sarah Coggins, Erik H Hoyer, Kitty S Chan, Dale M Needham
PURPOSE: Early mobilization in the intensive care unit (ICU) can improve patient outcomes but has perceived barriers to implementation. As part of an ongoing structured quality improvement project to increase mobilization of medical ICU patients by nurses and clinical technicians, we adapted the existing, validated Patient Mobilization Attitudes & Beliefs Survey (PMABS) for the ICU setting and evaluated its performance characteristics and results. MATERIALS AND METHODS: The 26-item PMABS adapted for the ICU (PMABS-ICU) was administered as an online survey to 163 nurses, clinical technicians, respiratory therapists, attending and fellow physicians, nurse practitioners, and physician assistants in one medical ICU...
October 18, 2018: Journal of Intensive Care Medicine
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