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Journal of Critical Care

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https://www.readbyqxmd.com/read/28735156/adaptive-periodic-paralysis-allows-weaning-deep-sedation-overcoming-the-drowning-syndrome-in-ecmo-patients-bridged-for-lung-transplantation-a-case-series
#1
Irina Timofte, Michael Terrin, Erik Barr, June Kim, Joseph Rinaldi, Nicholas Ladikos, Jay Menaker, Ali Tabatabai, Zachary Kon, Bartley Griffith, Richard Pierson, Si Pham, Aldo Iacono, Daniel Herr
PURPOSE: Sedation in extracorporeal membrane oxygenation (ECMO) is challenging. Patients require deep sedation because of extremely high respiratory rates and increased work of breathing ("Drowning Syndrome") resulting in altered intra-thoracic pressure and reduced pump flow associated with hemodynamic compromise and decreased oxygenation. However, deep sedation impedes essential active rehabilitation with physical therapy. METHODS: We reviewed data on 3 ECMO patients for whom we used a novel approach to replace continuous drips with periodic sedation/paralysis...
July 17, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28735155/impact-of-restrictive-fluid-protocol-on-hypoxemia-after-aneurysmal-subarachnoid-hemorrhage
#2
Claire-Marie Drevet, Nicolas Opprecht, Abdelouaïd Nadji, Sebastien Mirek, Serge Aho, Frederic Ricolfi, Claude Girard, Bélaïd Bouhemad
PURPOSE: In patients with aneurysmal subarachnoid hemorrhage (aSAH), acute cardiac dysfunction and triple-H-therapy, can lead to hypoxemia. Our aim was to assess impact of a protocoled fluid restrictive approach on hypoxemia in these patients. METHODS: We included prospectively ICU patients with aSAH admitted within 24h after the bleed. The study was divided into 2 phases. The first phase, from January to December 2012, was designated as control group (group C)...
July 17, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28735154/accuracy-of-c-reactive-protein-as-a-bacterial-infection-marker-in-critically-immunosuppressed-patients-a-systematic-review-and-meta-analysis
#3
REVIEW
Vanessa Martins de Oliveira, Rafael Barberena Moraes, Airton Tetelbom Stein, Eliana Márcia Wendland
BACKGROUND: There is a need for a better understanding of the role of C-reactive protein (CRP) as a valid marker for the detection of bacterial infections in critically immunosuppressed patients. A high negative predictive value of CRP is also needed to rule out sepsis and bacterial infections in immunocompetent patients. However, few studies have evaluated the performance of CRP in immunocompromised hosts. The aim of the present study was to evaluate the performance of CRP as a marker of infection in critically immunosuppressed patients...
July 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28732314/the-effect-of-low-dose-furosemide-in-critically-ill-patients-with-early-acute-kidney-injury-a-pilot-randomized-blinded-controlled-trial-the-spark-study
#4
Sean M Bagshaw, R T Noel Gibney, Peter Kruger, Imran Hassan, Finlay A McAlister, Rinaldo Bellomo
PURPOSE: Furosemide is commonly prescribed in acute kidney injury (AKI). Prior studies have found conflicting findings on whether furosemide modifies the course and outcome of AKI. METHODS: Pilot multi-center randomized blinded placebo-controlled trial in adult patients with AKI admitted to three intensive care units. Participants were randomly allocated to furosemide bolus and infusion or 0.9% saline placebo. Primary endpoint was worsening AKI, defined by the RIFLE criteria...
July 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28719839/the-prognostic-value-of-brain-natriuretic-peptide-bnp-in-non-cardiac-patients-with-sepsis-ultra-long-follow-up
#5
Johad Khoury, Majd Arow, Adi Elias, Badira F Makhoul, Gidon Berger, Marielle Kaplan, Tanya Mashiach, Reem Ismael-Badarneh, Doron Aronson, Zaher S Azzam
OBJECTIVES: Sepsis is a multifactorial syndrome with increasing incidence of morbidity and mortality. Identification of outcome predictors is therefore essential. Recently, elevated brain natriuretic peptide (BNP) levels have been observed in patients with septic shock. Little information is available concerning BNP levels in patients with critical illness, especially with sepsis. Therefore, this study aims to evaluate the role of BNP as a biomarker for long-term mortality in patients with sepsis...
July 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28732315/total-and-ionized-magnesium-testing-in-the-surgical-intensive-care-unit-opportunities-for-improved-laboratory-and-pharmacy-utilization
#6
Daniel Dante Yeh, Nalin Chokengarmwong, Yuchiao Chang, Liyang Yu, Colleen Arsenault, Joseph Rudolf, Elizabeth Lee-Lewandrowski, Kent Lewandrowski
PURPOSE: Ionized fraction (iMg) is the physiologically active form of magnesium (Mg); total Mg may not accurately reflect iMg status. Erroneously "low" Mg levels may result in unnecessary repetitive testing. MATERIALS AND METHODS: From 11/2015 to 01/2016, patients ordered for Mg from a pilot ICU also had iMg tested. Weighted kappa statistic was used to assess agreement between Mg categories (low, normal, high). Predictors of unnecessary repeated Mg testing and repletion using data were explored through logistic regression models using GEE techniques to account for repeated measurements in both bivariate and multivariable analyses...
July 11, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28711861/healthcare-infrastructure-capacity-to-respond-to-severe-acute-respiratory-infection-sari-and-sepsis-in-vietnam-a-low-middle-income-country
#7
Vu Quoc Dat, Nguyen Thanh Long, Kim Bao Giang, Pham Bich Diep, Ta Hoang Giang, Janet V Diaz
PURPOSE: This study investigated the availability of relevant structural and human resources needed for the clinical management of patients with severe acute respiratory infections and sepsis in critical care units in Vietnam. MATERIAL AND METHODS: A questionnaire survey was conducted by purposive sampling of 128 hospitals (36% of total hospitals in surveyed provinces), including 25 provincial and 103 district level hospitals, from 20 provinces in Vietnam. Data on availability of hospital characteristics, structural resources and health care workers was then analyzed...
July 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28711860/management-of-septic-myocardial-dysfunction-in-intensive-care-unit-a-survey-of-french-speaking-intensivists
#8
LETTER
Alexandre Bedet, Keyvan Razazi, Guillaume Carteaux, Nicolas de Prost, Armand Mekontso Dessap
No abstract text is available yet for this article.
July 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28734541/response-to-mortality-length-of-stay-bloodstream-and-respiratory-viral-infections-in-a-pediatric-intensivecare-unit-comment-on-data-sparsity
#9
Kam Lun Hon, Maggie Haitian Wang
No abstract text is available yet for this article.
July 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28712651/the-association-between-red-cell-distribution-width-and-poor-outcomes-in-hospitalized-patients-with-influenza-methodological-issues
#10
LETTER
Erfan Ayubi, Saeid Safiri
No abstract text is available yet for this article.
July 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28712650/response-to-a-letter-to-the-editor
#11
LETTER
Lukana Preechasuk, Nattakarn Suwansaksri, Nantawan Ipichart, Sathit Vannasaeng, Chairat Permpikul, Apiradee Sriwijitkamol
No abstract text is available yet for this article.
July 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28711862/is-acute-kidney-injury-really-a-detrimental-factor-of-myocardial-injury-after-noncardiac-surgery-in-critical-patients
#12
LETTER
Ya-Yang Liu, Fu-Shan Xue, Hui-Xian Li, Gui-Zhen Yang
No abstract text is available yet for this article.
July 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28710987/the-long-term-quality-of-life-in-patients-with-persistent-inflammation-immunosuppression-and-catabolism-syndrome-after-severe-acute-pancreatitis-a-retrospective-cohort-study
#13
Na Yang, Baiqiang Li, Bo Ye, Lu Ke, Faxi Chen, Guotao Lu, Fangfang Jiang, Zhihui Tong, Jieshou Li, Weiqin Li
PURPOSE: To explore clinical characteristics and long-term quality of life (QOL) in severe acute pancreatitis (SAP) patients with persistent inflammation-immunosuppression and catabolism syndrome (PICS). MATERIALS AND METHODS: SAP patients admitted to ICU were eligible for the retrospective cohort study if they needed prolonged intensive care (>14days). Post-ICU QOL was assessed by a questionnaire, including 36-item Short Form Health Survey (SF-36) and record of re-work in a long-term follow-up...
July 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28723586/a-code-icu-expedited-review-of-critically-ill-patients-is-associated-with-reduced-emergency-department-length-of-stay-and-duration-of-mechanical-ventilation
#14
Matthew L Durie, Jai N Darvall, Daniel A Hadley, Mark A Tacey
PURPOSE: To examine the effect of a system of expedited review of critically ill patients in the Emergency Department (ED) on ED length of stay (LOS) and Intensive Care Unit (ICU) outcomes. MATERIALS AND METHODS: Retrospective cohort study at a tertiary hospital comparing two 12-month periods before and after implementation of a 'Code ICU' system of expedited review of critically ill patients in the ED. All adult ED to ICU admissions were included. Separate analyses were performed for patients intubated prior to ICU admission...
July 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28710988/intestinal-fatty-acid-binding-protein-level-as-a-predictor-of-28-day-mortality-and-bowel-ischemia-in-patients-with-septic-shock-a-preliminary-study
#15
Motohiro Sekino, Hiroyuki Funaoka, Shuntaro Sato, Kyoko Okada, Haruka Inoue, Rintaro Yano, Sojiro Matsumoto, Taiga Ichinomiya, Ushio Higashijima, Shuhei Matsumoto, Tetsuya Hara
PURPOSE: We sought to evaluate the levels of intestinal fatty acid-binding protein (I-FABP), a biomarker of enterocyte injury, as a predictor of 28-day mortality and bowel ischemia in septic shock patients. MATERIAL AND METHODS: In this preliminary prospective observational study, 57 adult septic shock patients under mechanical ventilation were enrolled. Serum I-FABP levels and prognostic biomarkers were recorded upon intensive care unit (ICU) admission. RESULTS: The overall 28-day mortality rate of participants was 23% (13/57)...
July 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28700964/clinical-and-laboratory-predictors-of-infectious-complications-in-patients-after-out-of-hospital-cardiac-arrest
#16
Josef Kroupa, Jiri Knot, Jaroslav Ulman, Frantisek Bednar, Alena Dohnalova, Zuzana Motovska
PURPOSE: Identification of clinical and laboratory predictors related to Infectious Complications (ICs) in patients after Out-of-Hospital Cardiac Arrest (OHCA). METHODS: Patients, aged >18, after an OHCA between 9/2013 and 11/2015, surviving >24h, were studied. RESULTS: Study group consisted of 42 patients (mean age 63.4years, 88.1% men). Forty percent of patients had IC; lower respiratory tract infections were most common (87.5% of cases)...
July 4, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28688238/increased-healthcare-facility-use-in-veterans-surviving-sepsis-hospitalization
#17
Kimberley M DeMerle, Brenda M Vincent, Theodore J Iwashyna, Hallie C Prescott
PURPOSE: We sought to measure inpatient healthcare utilization among U.S. Veteran Affairs beneficiaries surviving sepsis hospitalization, and to examine how post-sepsis utilization varies by select patient characteristics. MATERIALS AND METHODS: Retrospective cohort study of 26,561 Veterans who survived sepsis hospitalization in 2009. Using difference-in-differences analysis, we compared changes in healthcare utilization in one year before and one year after sepsis hospitalization by Veteran age, illness severity, and recent nursing facility use...
July 3, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28688239/successful-treatment-of-toxic-epidermal-necrolysis-using-plasmapheresis-a-prospective-observational-study
#18
Feng Han, Jingjing Zhang, Qi Guo, Yanjing Feng, Ya Gao, Litao Guo, Yanli Hou, Jingang An, Xiaopeng Wang, Bin Yan, Yan Zheng, Jingchun Song, Manxiang Li, Gang Wang
Toxic epidermal necrolysis (TEN) is a rare, severe, life-threatening skin disease and it requires urgent critical care, including admission to the intensive care unit (ICU). It is characterized by fatal sequelae and high mortality. Currently, insufficient evidence exists to support the use of any systemic adjuvant therapy, such as cyclophosphamide, intravenous immunoglobulin (IVIg), or corticosteroids. However, plasmapheresis has been increasingly valued by clinicians due to its significant efficacy and little adverse side effects...
July 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28675827/hyperglycemia-induced-hyponatremia-reevaluation-of-the-na-correction-factor
#19
Matthew B Wolf
This study addresses the clinically important relationship between the decreases in plasma Na(+) and the increases in plasma glucose concentrations seen in diabetes and other hyperglycemic syndromes. This plasma 'Na(+) correction factor', is generally accepted as 1.6mM Na(+) per 100mg% glucose (0.29mM/mM in SI units) assuming osmotic equilibrium, although much larger numbers have been measured in experiments on normal humans. To resolve this controversy, a mathematical model of whole-body fluid-electrolyte balance was used to perform the experiment wherein plasma glucose concentration was increased to diabetic levels and the plasma Na(+) concentration changes assessed, without the complications seen in human experiments...
June 29, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28672146/stroke-volume-guided-resuscitation-in-severe-sepsis-and-septic-shock-improves-outcomes
#20
Heath E Latham, Charles D Bengtson, Lewis Satterwhite, Mindy Stites, Dipti P Subramaniam, G John Chen, Steven Q Simpson
To determine whether stroke volume (SV) guided fluid resuscitation in patients with severe sepsis and septic shock alters Intensive Care Unit (ICU) fluid balance and secondary outcomes, this retrospective cohort study evaluated consecutive patients admitted to an ICU with the primary diagnosis of severe sepsis or septic shock. Cohorts were based on fluid resuscitation guided by changes in SV or by usual care (UC). The SV group comprised 100 patients, with 91 patients in the UC group. Net fluid balance for the ICU stay was lower in the SV group (1...
June 28, 2017: Journal of Critical Care
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