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Journal of Critical Care

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https://www.readbyqxmd.com/read/30243203/robotic-technology-provides-objective-and-quantifiable-metrics-of-neurocognitive-functioning-in-survivors-of-critical-illness-a-feasibility-study
#1
Michael D Wood, David M Maslove, John Muscedere, Stephen H Scott, J Gordon Boyd
PURPOSE: To assess the feasibility of using an integrated multimodal data collection strategy to characterize the post-intensive care syndrome (PICS). MATERIALS AND METHODS: Adult patients admitted to the ICU requiring invasive mechanical ventilation for >24 h and/or requiring vasopressor support were eligible for enrollment. We assessed cognitive and sensorimotor function at 3- and 12-months after ICU discharge with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and with the KINARM robot...
September 12, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30243204/an-automated-computerized-critical-illness-severity-scoring-system-derived-from-apache-iii-modified-apache
#2
Spyridon Fortis, Amy M J O'Shea, Brice F Beck, Rajeshwari Nair, Michihiko Goto, Peter J Kaboli, Eli N Perencevich, Heather S Reisinger, Mary V Sarrazin
PURPOSE: To evaluate the performance of an automated computerized ICU severity scoring derived from the APACHE III. MATERIALS AND METHODS: Within a retrospective cohort of patients admitted to Veterans Health Administration ICUs between 2009 and 2015, we created an automated illness severity score(modified APACHE or mAPACHE), that we extracted from the electronic health records, using the same scoring as the APACHE III excluding the Glasgow Coma Scale, urine output, arterial blood gas components of APACHE III...
September 6, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30243202/a-multi-center-evaluation-of-a-disposable-catheter-to-aid-in-correct-positioning-of-the-endotracheal-tube-after-intubation-in-critically-ill-patients
#3
Avi Cohen, Laren Tan, Ramiz Fargo, James D Anholm, Chris Gasho, Kashif Yaqub, Sahil Chopra, Jennifer Hansen, Cynthia Huang, Dafne Moretta, Destry Washburn, H Bryant Nguyen
PURPOSE: To demonstrate that use of a minimally invasive catheter reduces endotracheal tube (ETT) malposition rate after intubation. MATERIALS AND METHODS: This study is a multi-center, prospective observational cohort of intubated patients in the medical intensive care unit. The catheter was inserted into the ETT immediately after intubation. The ETT was adjusted accordingly based on qualitative color markers on the catheter. A confirmatory chest radiograph was obtained to determine the ETT position...
September 6, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30243201/bedside-electromagnetic-guided-placement-of-nasoenteral-feeding-tubes-among-critically-ill-patients-a-single-centre-randomized-controlled-trial
#4
Xuejin Gao, Li Zhang, Jie Zhao, Feng Tian, Haifeng Sun, Peng Wang, Jiwei Wang, Zhiming Wang, Xinying Wang
PURPOSE: We aimed to compare the effectiveness of EM-guided and endoscopic nasoenteral feeding tube placement among critically ill patients. MATERIALS AND METHODS: We performed a single-center, randomized controlled trial among 161 adult patients admitted to intensive care units (ICUs) requiring nasoenteral feeding. Patients were randomly assigned to EM-guided or endoscopic nasoenteral feeding tube placement (1:1). The primary end point was the total success rate of correct jejunal placement...
September 6, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30243200/high-central-venous-pressure-is-associated-with-acute-kidney-injury-and-mortality-in-patients-underwent-cardiopulmonary-bypass-surgery
#5
Yanli Yang, Jun Ma, Liyun Zhao
No abstract text is available yet for this article.
September 4, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30240991/patient-ventilator-interaction-with-conventional-and-automated-management-of-pressure-support-during-difficult-weaning-from-mechanical-ventilation
#6
Domenico Luca Grieco, Maria Maddalena Bitondo, Hernan Aguirre-Bermeo, Stefano Italiano, Francesco Antonio Idone, Antonia Moccaldo, Maria Teresa Santantonio, Davide Eleuteri, Massimo Antonelli, Jordi Mancebo, Salvatore Maurizio Maggiore
PURPOSE: Optimizing pressure support ventilation (PSV) can improve patient-ventilator interaction. We conducted a two-center, randomized cross-over study to determine whether automated PSV lowers asynchrony rate during difficult weaning from mechanical ventilation. METHODS: Thirty patients failing the first weaning attempt were randomly ventilated for 2 three-hour consecutive periods with: 1)PSV managed by physicians (convPSV); 2)PSV managed by Smartcare® (autoPSV)...
August 31, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30218959/antibiotics-has-more-impact-on-mortality-than-other-early-goal-directed-therapy-components-in-patients-with-sepsis-an-instrumental-variable-analysis
#7
Jessica Londoño, César Niño, Andrea Archila, Marta Valencia, Diana Cárdenas, Mayla Perdomo, Giovanny Moncayo, César Vargas, Carlos E Vallejo, Carolina Hincapié, Johana Ascuntar, Alba León, Fabián Jaimes
PURPOSE: To estimate the effect of each of the EGDT components, as well as of the antibiotics, on length-of-stay and mortality. METHODS: Prospective cohort in three hospitals. Adult patients admitted by the Emergency Rooms (ER) with infection and any of systolic blood pressure < 90 mmHg or lactate >4 mmol/L. An instrumental analysis with hospital of admission as the instrumental variable was performed to estimate the effect of each intervention on hospital mortality and secondary outcomes...
August 30, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30212749/the-respiratory-effect-of-tracheal-gas-insufflation-tgi-on-tracheostomized-spontaneously-breathing-icu-patients
#8
K Grigoriadis, I Tsangaris, A Koutsoukou, P Kopterides, E Grammatopoulou, A Grigoriadou, A Armaganidis
No abstract text is available yet for this article.
August 30, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30195194/prognostic-value-of-plasma-brain-natriuretic-peptide-value-for-patientswith-sepsis-a-meta-analysis
#9
Yu-Long Bai, Bang-Li Hu, Han-Chun Wen, Yi-Ling Zhang, Ji-Jin Zhu
PURPOSE: The aim of this meta-analysis was to clarify the diagnostic role of plasma BNP and NT-proBNP in predicting mortality for septic patients. METHODS: A systematic review was conducted prior to January 2018. Summary sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) of the prognostic value of plasma BNP and NT-proBNP for septic patients. The area under the receiver operating curves (AUROC) were used to summarize overall test performance...
August 30, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30232056/abrupt-versus-gradual-cessation-of-steroids-in-patients-with-septic-shock
#10
Kristine A Sobolewski, Alison Brophy, Yekaterina Opsha, Abdul Zaid, Nirav Mistry
PURPOSE: To determine if a difference in hemodynamic stability would be identified in patients with abrupt withdrawal of steroids compared to patients who underwent a taper. MATERIAL AND METHODS: This retrospective cohort study identified patients who received vasopressors followed by IV hydrocortisone for treatment of septic shock from January 1, 2013 until January 1, 2015.The primary endpoint evaluated the percent of patients requiring vasopressor re-initiation during taper and 72 h following taper, or 72 h directly following abrupt withdrawal...
August 29, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30216936/the-italian-law-on-informed-consent-and-advance-directives-new-rules-of-conduct-for-the-autonomy-of-doctors-and-patients-in-end-of-life-care
#11
Rosagemma Ciliberti, Ilaria Gorini, Valentina Gazzaniga, Francesco De Stefano, Matteo Gulino
PURPOSE: Italy has long lacked a law regulating patients' informed consent and advance directives (ADs). All previous attempts to introduce a law on this matter failed to reach positive outcomes, and aroused heated ideological debate over the exact meaning of life and death. We report on the new law on informed consent and ADs approved by the Italian Parliament on 14th December 2017. MATERIALS AND METHODS: We analyse the new law and discuss the main ethical points connected with it, in the Italian context and in comparison with the international situation...
August 29, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30216934/patients-with-small-vessel-vasculitides-have-the-highest-mortality-among-systemic-autoimmune-diseases-patients-treated-in-intensive-care-unit-a-retrospective-study-with-5-year-follow-up
#12
Anna Włudarczyk, Kamil Polok, Jacek Górka, Andrzej Hałek, Grzegorz Biedroń, Paweł Krawczyk, Jacek Musiał, Wojciech Szczeklik
PURPOSE: Systemic autoimmune diseases are a heterogeneous group of disorders associated with dysfunction of multiple organs and unpredictable course. Complicated management and treatment become even more challenging when patients require critical care. This study aims to compare outcomes of small-vessel vasculitides (SVV) and other systemic autoimmune diseases (SAD) patients admitted to the intensive care unit (ICU). MATERIALS AND METHODS: Retrospective, observational study conducted in the ICU of Allergy and Immunology Department at the University Hospital in Krakow, Poland, between years 2001-2014, with 5-years follow-up and no lost to follow-up patients...
August 28, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30224150/effectiveness-and-cost-effectiveness-of-early-nutritional-support-via-the-parenteral-versus-the-enteral-route-for-critically-ill-adult-patients
#13
Z Sadique, D A Harrison, D E Bear, K M Rowan, R Grieve
No abstract text is available yet for this article.
August 26, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30218958/tolerability-and-effectiveness-of-4-factor-prothrombin-complex-concentrate-4f-pcc-for-warfarin-and-non-warfarin-reversals
#14
M Santibanez, C A Lesch, L Lin, K Berger
PURPOSE: Current guidelines favor 4F-PCC over plasma for warfarin reversal. Uncertainty remains on its thrombotic risk and hemostatic effectiveness when used for direct-acting oral anticoagulants (DOACs), transplants, massive transfusion protocols (MTP), and non-anticoagulated patients. This study sought to evaluate the tolerability and effectiveness of 4F-PCC in a real-world setting. MATERIALS AND METHODS: This was a retrospective study of adults who received 4F-PCC from March 2014 to December 2015...
August 26, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30193172/a-feasibility-study-to-assess-pre-admission-status-and-six-month-outcomes-of-major-trauma-patients-admitted-to-an-intensive-care-unit-using-the-who-das-2-0
#15
Rebekah Haylett, Owen Gustafson
PURPOSE: To report the feasibility of assessing pre-admission functional status of ICU trauma patients, with repeat assessment at six months post ICU discharge using a standardised measure. MATERIALS AND METHODS: A prospective longitudinal observational cohort design recruited consecutive adult major trauma admissions to a UK general ICU, between 1st November 2016 and 1st November 2017. The 12-item World Health Organisation Disability Schedule 2.0 was completed to assess pre-admission functional status as soon as possible after ICU admission...
August 26, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30193171/organ-donation-education-in-the-icu-setting-a-qualitative-and-quantitative-analysis-of-family-preferences
#16
Christopher P Michetti, Anna Newcomb, Vihitha Thota, Chang Liu
PURPOSE: Determine family-centered methods of providing organ donation education to families in ICU waiting rooms. MATERIALS AND METHODS: We performed a qualitative analysis of semi-structured interviews and quantitative analysis of paper surveys of family members of 118 ICU patients in the acute ICU setting. RESULTS: Twelve interviews and 152 surveys (66% response rate) were completed. Respondents' knowledge of organ donation processes was incomplete: only 32% answered all of four questions about donation correctly...
August 25, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30176528/heart-rate-variability-is-associated-with-outcome-in-spontaneous-intracerebral-hemorrhage
#17
Jozef Szabo, Peter Smielewski, Marek Czosnyka, Stanislava Jakubicek, Stefan Krebs, Pavel Siarnik, Marek Sykora
PURPOSE: Autonomic imbalance as measured by heart rate variability (HRV) has been associated with poor outcome after stroke. Observations on HRV changes in intracerebral hemorrhage (ICH) are scarce. Here, we aimed to investigate HRV in ICH as compared to a control group and to explore associations with stroke severity, hemorrhage volume and outcome after ICH. METHODS: We examined the autonomic modulation using frequency domain analysis of HRV during the acute phase of the ICH and in a healthy age- and hypertension-matched control group...
August 25, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30216935/clinical-characteristics-evolution-and-treatment-related-risk-factors-for-mortality-among-immunosuppressed-patients-with-influenza-a-h1n1-virus-admitted-to-the-intensive-care-unit
#18
José Garnacho-Montero, Cristina León-Moya, Antonio Gutiérrez-Pizarraya, Angel Arenzana-Seisdedos, Loreto Vidaur, José Eugenio Guerrero, Mónica Gordón, Ignacio Martín-Loeches, Alejandro Rodriguez
PURPOSE: Information about immunocompromised patients infected with influenza A (H1N1) virus and requiring admission to the ICU is lacking. Our objective was to know the clinical characteristics of these patients and to identify treatment-related variables associated with mortality. MATERIAL AND METHODS: A prospective multicenter observational cohort study was based on data from a Spanish registry (2009-2015) collected by 148 Spanish ICUs. All patients admitted to the ICU with the diagnosis of influenza A (H1N1) virus infection were included...
August 24, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30189356/histologically-proven-acute-tubular-necrosis-in-a-series-of-27-icu-patients
#19
René Robert, Denis Frasca, Bertrand Souweine, Jean-François Augusto, Carole Philipponnet, Florent Joly, Jean-Michel Goujon, Nicolas Lerolle
PURPOSE: Since renal biopsy is rarely performed for identifying acute tubular necrosis in ICU patients, there is little information on the real histopathological abnormalities observed in such situations. MATERIALS AND METHODS: The clinical data of 27 patients with a confirmed diagnostic of acute tubular necrosis issued from two recent series gathering 125 patients who had renal biopsy during their ICU stay were reviewed. They were divided into sepsis (n = 14) and non-sepsis (n = 13) groups...
August 24, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30179762/association-between-death-and-loss-of-stage-n2-sleep-features-among-critically-ill-patients-with-delirium
#20
Melissa P Knauert, Emily J Gilmore, Terrence E Murphy, Henry K Yaggi, Peter H Van Ness, Ling Han, Lawrence J Hirsch, Margaret A Pisani
PURPOSE: Critically ill patients experience significant sleep disruption. In this study of ICU patients with delirium, we evaluated associations between the loss of stage N2 features (K-complexes, sleep spindles), grade of encephalopathy based on electroencephalography (EEG), and intensive care unit (ICU) outcomes. We hypothesized that loss of stage N2 features is associated with more severe grades of encephalopathy and worse ICU outcomes including death. MATERIALS AND METHODS: This was an observational cohort study of 93 medical ICU patients without primary acute brain injury who underwent continuous EEG...
August 23, 2018: Journal of Critical Care
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