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Critical Care: the Official Journal of the Critical Care Forum

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https://www.readbyqxmd.com/read/28526086/comparison-of-fluid-balance-and-hemodynamic-and-metabolic-effects-of-sodium-lactate-versus-sodium-bicarbonate-versus-0-9-nacl-in-porcine-endotoxic-shock-a-randomized-open-label-controlled-study
#1
Thibault Duburcq, Arthur Durand, Anne-Frédérique Dessein, Joseph Vamecq, Jean-Claude Vienne, Dries Dobbelaere, Karine Mention, Claire Douillard, Patrice Maboudou, Valery Gmyr, François Pattou, Mercé Jourdain, Fabienne Tamion, Julien Poissy, Daniel Mathieu, Raphaël Favory
BACKGROUND: Sodium lactate has been shown to improve hemodynamics and avoid fluid overload. The objective of this study was to confirm a beneficial effect on fluid balance with sodium lactate infusion and to specify whether the advantage of lactate is related to a negative chloride balance, its particular metabolism, or simply its energy load. METHODS: This was an interventional, randomized, open-label, controlled experimental study. Fifteen female "large white" pigs (2 months old) were challenged with intravenous infusion of Escherichia coli endotoxin...
May 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28511660/simvastatin-for-patients-with-acute-respiratory-distress-syndrome-long-term-outcomes-and-cost-effectiveness-from-a-randomised-controlled-trial
#2
A Agus, C Hulme, R M Verghis, C McDowell, C Jackson, C M O'Kane, J G Laffey, D F McAuley
BACKGROUND: Simvastatin therapy for patients with acute respiratory distress syndrome (ARDS) has been shown to be safe and associated with minimal adverse effects, but it does not improve clinical outcomes. The aim of this research was to report on mortality and cost-effectiveness of simvastatin in patients with ARDS at 12 months. METHODS: This was a cost-utility analysis alongside a multicentre, double-blind, randomised controlled trial carried out in the UK and Ireland...
May 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28511655/video-vs-direct-laryngoscopy-in-the-icu-are-we-asking-the-right-question
#3
LETTER
Michael Chaim Sklar, Stephen Lapinsky
No abstract text is available yet for this article.
May 16, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28506243/cost-analysis-of-the-very-elderly-admitted-to-intensive-care-units
#4
Nicolas Chin-Yee, Gianni D'Egidio, Kednapa Thavorn, Daren Heyland, Kwadwo Kyeremanteng
BACKGROUND: Very elderly patients are often admitted to intensive care units (ICUs) despite poor outcomes and frequent preference to avoid unnecessary prolongation of life. We sought to determine the cost of ICU admission for the very elderly and the factors influencing this cost. METHODS: This prospective, observational cohort study included patients ≥80 years old admitted to 22 Canadian ICUs from 2009 to 2013. A subset of consenting individuals comprised a longitudinal cohort followed over 12 months...
May 16, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28506303/erratum-to-contribution-of-candida-biomarkers-and-dna-detection-for-the-diagnosis-of-invasive-candidiasis-in-icu-patients-with-severe-abdominal-conditions
#5
Cristóbal León, Sergio Ruiz-Santana, Pedro Saavedra, Carmen Castro, Ana Loza, Ismail Zakariya, Alejandro Úbeda, Manuel Parra, Desirée Macías, José Ignacio Tomás, Antonio Rezusta, Alejandro Rodríguez, Frederic Gómez, Estrella Martín-Mazuelos
No abstract text is available yet for this article.
May 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28506290/pre-admission-functional-status-impacts-the-performance-of-the-apache-iv-model-of-mortality-prediction-in-critically-ill-patients
#6
James S Krinsley, Thomas Wasser, Gina Kang, Sean M Bagshaw
BACKGROUND: Functional status (FS) before intensive care unit (ICU) admission is associated with short-term and long-term outcomes among critically ill patients. However, measures of FS are generally not integrated into ICU-specific mortality prediction models. METHODS: This retrospective cohort study used prospectively collected data from 9638 consecutive patients admitted to a single ICU between 1 October 2005 and 30 September 2015. For each ICU admission, FS was prospectively determined and classified into three discrete categories based on performance of basic daily living activities (FS1 - fully independent; FS2 - partly dependent; FS3 - completely dependent)...
May 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28506286/high-protein-intake-without-concerns
#7
Olav Rooyackers, Martin Sundström Rehal, Felix Liebau, Åke Norberg, Jan Wernerman
The high fashion in nutrition for the critically ill is to recommend a high protein intake. Several opinion leaders are surfing on this wave, expanding the suggested protein allowance upwards. At the same time, there is no new evidence supporting this change in recommendations. Observational data show that in clinical practice protein intake is most often far below current ESPEN recommendations of 1.2-1.5 g/kg/day. Therefore, it may be in the best interests of our patients just to adhere to that guideline, and not to stretch them upwards for protein intake? Here we give arguments to stay conservative...
May 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28506244/early-eeg-for-outcome-prediction-of-postanoxic-coma-prospective-cohort-study-with-cost-minimization-analysis
#8
Lotte Sondag, Barry J Ruijter, Marleen C Tjepkema-Cloostermans, Albertus Beishuizen, Frank H Bosch, Janine A van Til, Michel J A M van Putten, Jeannette Hofmeijer
BACKGROUND: We recently showed that electroencephalography (EEG) patterns within the first 24 hours robustly contribute to multimodal prediction of poor or good neurological outcome of comatose patients after cardiac arrest. Here, we confirm these results and present a cost-minimization analysis. Early prognosis contributes to communication between doctors and family, and may prevent inappropriate treatment. METHODS: A prospective cohort study including 430 subsequent comatose patients after cardiac arrest was conducted at intensive care units of two teaching hospitals...
May 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28499395/time-course-of-blood-lactate-levels-inflammation-and-mitochondrial-function-in-experimental-sepsis
#9
Thiago Domingos Corrêa, Adriano José Pereira, Sebastian Brandt, Madhusudanarao Vuda, Siamak Djafarzadeh, Jukka Takala, Stephan Mathias Jakob
BACKGROUND: A decrease in blood lactate levels (Lac) >10% during the first hours of resuscitation in sepsis is associated with better outcomes, but the mechanisms are unclear. Our objective was to investigate the relationship between the time course of Lac, inflammatory response, and mitochondrial respiration during experimental sepsis. METHODS: Original data from two previously published studies were reanalyzed. In cohort 1, pigs were randomized to be resuscitated for 48 h starting at 6, 12, and 24 h, respectively, after fecal peritonitis induction (n = 8 each)...
May 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28494815/association-between-fluid-intake-and-mortality-in-critically-ill-patients-with-negative-fluid-balance-a-retrospective-cohort-study
#10
Yanfei Shen, Xinmei Huang, Weimin Zhang
BACKGROUND: Compared to positive fluid balance (FB), negative FB is associated with improved clinical outcomes in critically ill patients. However, as to whether achieving more negative FB can further improve outcomes has not been investigated. This study aimed to investigate whether more negative FB and restricted fluid intake were associated with improved outcomes in critically ill patients. METHOD: Data were extracted from the Multi-parameter Intelligent Monitoring in Intensive Care III Database...
May 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28476137/understanding-the-null-hypothesis-h0-in-non-inferiority-trials
#11
LETTER
Jihad Mallat
No abstract text is available yet for this article.
May 6, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28472994/a-brief-comment-on-vaccinations-for-opportunistic-microorganisms
#12
LETTER
Ferhat Arslan, Haluk Vahaboğlu
No abstract text is available yet for this article.
May 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28468676/blood-pressure-deficits-in-acute-kidney-injury-not-all-about-the-mean-arterial-pressure
#13
Lui G Forni, Michael Joannidis
Acute kidney injury (AKI) is associated with increased morbidity and mortality. Although there are many causes of AKI, it is known that patients undergoing high-risk surgery are known to be at significant risk. Although much effort has centred on the minimum arterial pressure needed to maintain renal perfusion, this tends to be based on relatively crude measures such as the mean arterial pressure (MAP), which is widely used as an index for the optimal blood pressure. The rationale behind maintaining MAP is to provide adequate organ perfusion, although this is difficult to assess other than by applying crude end-points...
May 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28468661/erratum-to-cardiac-ischemia-in-patients-with-septic-shock-randomized-to-vasopressin-or-norepinephrine
#14
Sangeeta Mehta, John Granton, Anthony C Gordon, Deborah J Cook, Stephen Lapinsky, Gary Newton, Kris Bandayrel, Anjuli Little, Chuin Siau, Dieter Ayers, Joel Singer, Terry C K Lee, Keith R Walley, Michelle Storms, D James Cooper, Cheryl L Holmes, Paul Hebert, Jeffrey Presneill, James A Russell
No abstract text is available yet for this article.
May 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28468638/bacteriophage-lysins-as-antibacterials
#15
LETTER
Umender Sharma, Vivek D Paul
No abstract text is available yet for this article.
May 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28468633/myocardial-and-haemodynamic-responses-to-two-fluid-regimens-in-african-children-with-severe-malnutrition-and-hypovolaemic-shock-afrim-study
#16
Nchafatso Obonyo, Bernadette Brent, Peter Olupot-Olupot, Michael Boele van Hensbroek, Irene Kuipers, Sidney Wong, Kenji Shiino, Jonathan Chan, John Fraser, Job B M van Woensel, Kathryn Maitland
BACKGROUND: Fluid therapy in severely malnourished children is hypothesized to be deleterious owing to compromised cardiac function. We evaluated World Health Organization (WHO) fluid resuscitation guidelines for hypovolaemic shock using myocardial and haemodynamic function and safety endpoints. METHODS: A prospective observational study of two sequential fluid management strategies was conducted at two East African hospitals. Eligible participants were severely malnourished children, aged 6-60 months, with hypovolaemic shock secondary to gastroenteritis...
May 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28424077/plasma-metabolomics-for-the-diagnosis-and-prognosis-of-h1n1-influenza-pneumonia
#17
Mohammad M Banoei, Hans J Vogel, Aalim M Weljie, Anand Kumar, Sachin Yende, Derek C Angus, Brent W Winston
BACKGROUND: Metabolomics is a tool that has been used for the diagnosis and prognosis of specific diseases. The purpose of this study was to examine if metabolomics could be used as a potential diagnostic and prognostic tool for H1N1 pneumonia. Our hypothesis was that metabolomics can potentially be used early for the diagnosis and prognosis of H1N1 influenza pneumonia. METHODS: (1)H nuclear magnetic resonance spectroscopy and gas chromatography-mass spectrometry were used to profile the metabolome in 42 patients with H1N1 pneumonia, 31 ventilated control subjects in the intensive care unit (ICU), and 30 culture-positive plasma samples from patients with bacterial community-acquired pneumonia drawn within the first 24 h of hospital admission for diagnosis and prognosis of disease...
April 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28407743/new-drugs-new-toxicities-severe-side-effects-of-modern-targeted-and-immunotherapy-of-cancer-and-their-management
#18
REVIEW
Frank Kroschinsky, Friedrich Stölzel, Simone von Bonin, Gernot Beutel, Matthias Kochanek, Michael Kiehl, Peter Schellongowski
Pharmacological and cellular treatment of cancer is changing dramatically with benefits for patient outcome and comfort, but also with new toxicity profiles. The majority of adverse events can be classified as mild or moderate, but severe and life-threatening complications requiring ICU admission also occur. This review will focus on pathophysiology, symptoms, and management of these events based on the available literature.While standard antineoplastic therapy is associated with immunosuppression and infections, some of the recent approaches induce overwhelming inflammation and autoimmunity...
April 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28410590/early-predictors-of-poor-outcome-after-out-of-hospital-cardiac-arrest
#19
Louise Martinell, Niklas Nielsen, Johan Herlitz, Thomas Karlsson, Janneke Horn, Matt P Wise, Johan Undén, Christian Rylander
BACKGROUND: Early identification of predictors for a poor long-term outcome in patients who survive the initial phase of out-of-hospital cardiac arrest (OHCA) may facilitate future clinical research, the process of care and information provided to relatives. The aim of this study was to determine the association between variables available from the patient's history and status at intensive care admission with outcome in unconscious survivors of OHCA. METHODS: Using the cohort of the Target Temperature Management trial, we performed a post hoc analysis of 933 unconscious patients with OHCA of presumed cardiac cause who had a complete 6-month follow-up...
April 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28403909/clinical-pathophysiology-of-hypoxic-ischemic-brain-injury-after-cardiac-arrest-a-two-hit-model
#20
REVIEW
Mypinder S Sekhon, Philip N Ainslie, Donald E Griesdale
Hypoxic ischemic brain injury (HIBI) after cardiac arrest (CA) is a leading cause of mortality and long-term neurologic disability in survivors. The pathophysiology of HIBI encompasses a heterogeneous cascade that culminates in secondary brain injury and neuronal cell death. This begins with primary injury to the brain caused by the immediate cessation of cerebral blood flow following CA. Thereafter, the secondary injury of HIBI takes place in the hours and days following the initial CA and reperfusion. Among factors that may be implicated in this secondary injury include reperfusion injury, microcirculatory dysfunction, impaired cerebral autoregulation, hypoxemia, hyperoxia, hyperthermia, fluctuations in arterial carbon dioxide, and concomitant anemia...
April 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
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