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Critical Care: the Official Journal of the Critical Care Forum

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https://www.readbyqxmd.com/read/30005596/plasma-myeloperoxidase-conjugated-dna-level-predicts-outcomes-and-organ-dysfunction-in-patients-with-septic-shock
#1
Yuki Maruchi, Masanobu Tsuda, Hisatake Mori, Nobuyoshi Takenaka, Takayoshi Gocho, Muhammad A Huq, Naoshi Takeyama
BACKGROUND: Recent studies have suggested that excessive formation of neutrophil extracellular traps (NETs) plays a critical role in the pathogenesis of sepsis. Although elevation of the plasma level of cell-free DNA (cf-DNA) has been reported in sepsis patients, there has been little direct measurement of circulating free NETs such as myeloperoxidase-conjugated DNA (MPO-DNA). The objectives of this study were to detect NETs in the bloodstream of patients with septic shock, and to assess the correlations of circulating NET levels with organ dysfunction, disease severity, and mortality...
July 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29980218/clinical-characteristics-and-prognosis-of-bacteraemia-during-postoperative-intra-abdominal-infections
#2
Adel Alqarni, Elie Kantor, Nathalie Grall, Sebastien Tanaka, Nathalie Zappella, Mathieu Godement, Lara Ribeiro-Parenti, Alexy Tran-Dinh, Philippe Montravers
BACKGROUND: Bloodstream infections of abdominal origin are usually associated with poor prognosis. We assessed the clinical and microbiological characteristics of critically ill patients admitted to the intensive care unit (ICU) for postoperative intra-abdominal infection (PIAI) and analysed the influence of bacteraemia on their outcome. METHODS: All consecutive PIAI patients admitted to the ICU between 1999 and 2014 were prospectively analysed. Bacteraemic patients (at least one positive blood culture in the 24 h preceding/following surgery) were compared with non-bacteraemic patients...
July 7, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29980222/early-application-of-continuous-high-volume-haemofiltration-can-reduce-sepsis-and-improve-the-prognosis-of-patients-with-severe-burns
#3
Bo You, Yu Long Zhang, Gao Xing Luo, Yong Ming Dang, Bei Jiang, Guang Tao Huang, Xin Zhu Liu, Zi Chen Yang, Yu Chen, Jing Chen, Zhi Qiang Yuan, Su Peng Yin, Yi Zhi Peng
BACKGROUND: In the early stage of severe burn, patients often exhibit a high level of inflammatory mediators in blood and are likely to develop sepsis. High-volume haemofiltration (HVHF) can eliminate these inflammatory mediators. We hypothesised that early application of HVHF may be beneficial in reducing sepsis and improving the prognosis of patients with severe burns. METHODS: Adults patients with burns ≥ 50% total burn surface area (TBSA) and in whom the sum of deep partial and full-thickness burn areas was ≥ 30% were enrolled in this randomised prospective study, and they were divided into control (41 cases) and HVHF (41 cases) groups...
July 6, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29980217/definitions-and-pathophysiology-of-vasoplegic-shock
#4
REVIEW
Simon Lambden, Ben C Creagh-Brown, Julie Hunt, Charlotte Summers, Lui G Forni
Vasoplegia is the syndrome of pathological low systemic vascular resistance, the dominant clinical feature of which is reduced blood pressure in the presence of a normal or raised cardiac output. The vasoplegic syndrome is encountered in many clinical scenarios, including septic shock, post-cardiac bypass and after surgery, burns and trauma, but despite this, uniform clinical definitions are lacking, which renders translational research in this area challenging. We discuss the role of vasoplegia in these contexts and the criteria that are used to describe it are discussed...
July 6, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29976238/emergency-department-disposition-decisions-and-associated-mortality-and-costs-in-icu-patients-with-suspected-infection
#5
Shannon M Fernando, Bram Rochwerg, Peter M Reardon, Kednapa Thavorn, Andrew J E Seely, Jeffrey J Perry, Douglas P Barnaby, Peter Tanuseputro, Kwadwo Kyeremanteng
BACKGROUND: Following emergency department (ED) assessment, patients with infection may be directly admitted to the intensive care unit (ICU) or alternatively admitted to hospital wards or sent home. Those admitted to the hospital wards or sent home may experience future deterioration necessitating ICU admission. METHODS: We used a prospectively collected registry from two hospitals within a single tertiary care hospital network between 2011 and 2014. Patient information, outcomes, and costs were stored in the hospital data warehouse...
July 6, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29976250/use-of-ecmo-in-ards-does-the-eolia-trial-really-help
#6
EDITORIAL
Luciano Gattinoni, Francesco Vasques, Michael Quintel
No abstract text is available yet for this article.
July 5, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29976233/gastric-versus-postpyloric-enteral-nutrition-in-elderly-patients-age-%C3%A2-75-years-on-mechanical-ventilation-a-single-center-randomized-trial
#7
Youfeng Zhu, Haiyan Yin, Rui Zhang, Xiaoling Ye, Jianrui Wei
BACKGROUND: The risk of ventilator-associated pneumonia (VAP) is reduced when postpyloric enteral nutrition (EN) is administered compared to when gastric EN is administered in specific populations. In the present study, we tested the hypothesis that postpyloric EN is superior to gastric EN in reducing the incidence of VAP in elderly patients (age ≥ 75 years) who are admitted to the intensive care unit (ICU) and require mechanical ventilation. METHODS: We performed a single-center randomized clinical trial involving elderly patients (age ≥ 75 years) who were admitted to the ICU and required mechanical ventilation...
July 5, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29973245/anemia-prevalence-and-incidence-and-red-blood-cell-transfusion-practices-in-aneurysmal-subarachnoid-hemorrhage-results-of-a-multicenter-cohort-study
#8
Shane W English, Michaël Chassé, Alexis F Turgeon, François Lauzier, Donald Griesdale, Allan Garland, Dean Fergusson, Ryan Zarychanski, Carl van Walraven, Kaitlyn Montroy, Jennifer Ziegler, Raphael Dupont-Chouinard, Raphaëlle Carignan, Andy Dhaliwal, Ranjeeta Mallick, John Sinclair, Amélie Boutin, Giuseppe Pagliarello, Alan Tinmouth, Lauralyn McIntyre
BACKGROUND: Whether a restrictive strategy for red blood cell (RBC) transfusion is applied to patients with aneurysmal subarachnoid hemorrhage (aSAH) is unclear. To inform the design and conduct of a future clinical trial, we sought to describe transfusion practices, hemoglobin (Hb) triggers, and predictors of RBC transfusion in patients with aSAH. METHODS: This is a retrospective cohort study of all consecutively admitted adult patients with aSAH at four tertiary care centers from January 1, 2012, to December 31, 2013...
July 4, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29973233/postoperative-cellular-stress-in-the-kidney-is-associated-with-an-early-systemic-%C3%AE-%C3%AE-t-cell-immune-cell-response
#9
Ivan Göcze, Katharina Ehehalt, Florian Zeman, Paloma Riquelme, Karin Pfister, Bernhard M Graf, Thomas Bein, Edward K Geissler, Piotr Kasprzak, Hans J Schlitt, John A Kellum, James A Hutchinson, Elke Eggenhofer, Philipp Renner
BACKGROUND: Basic science data suggest that acute kidney injury (AKI) induced by ischemia-reperfusion injury (IRI) is an inflammatory process involving the adaptive immune response. Little is known about the T-cell contribution in the very early phase, so we investigated if tubular cellular stress expressed by elevated cell cycle biomarkers is associated with early changes in circulating T-cell subsets, applying a bedside-to-bench approach. METHODS: Our observational pilot study included 20 consecutive patients undergoing endovascular aortic repair for aortic aneurysms affecting the renal arteries, thereby requiring brief kidney hypoperfusion and reperfusion...
July 4, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29933756/improved-empirical-antibiotic-treatment-of-sepsis-after-an-educational-intervention-the-abiss-edusepsis-study
#10
Ricard Ferrer, María Luisa Martínez, Gemma Gomà, David Suárez, Luis Álvarez-Rocha, María Victoria de la Torre, Gumersindo González, Rafael Zaragoza, Marcio Borges, Jesús Blanco, Eduardo Palencia Herrejón, Antonio Artigas
BACKGROUND: Early appropriate antibiotic treatment is essential in sepsis. We aimed to evaluate the impact of a multifaceted educational intervention to improve antibiotic treatment. We hypothesized that the intervention would hasten and improve the appropriateness of empirical antibiotic administration, favor de-escalation, and decrease mortality. METHODS: We prospectively studied all consecutive patients with sepsis/septic shock admitted to 72 intensive care units (ICUs) throughout Spain in two 4-month periods (before and immediately after the 3-month intervention)...
June 22, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29929547/flexible-bronchoscopy-related-safety-in-patients-with-severe-ards
#11
LETTER
A Guillon, M-A Nay, T Kamel
No abstract text is available yet for this article.
June 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29925413/low-b-value-diffusion-weighted-imaging-is-promising-in-the-diagnosis-of-brain-death-and-hypoxic-ischemic-injury-secondary-to-cardiopulmonary-arrest
#12
Miriam E Peckham, Jeffrey S Anderson, Ulrich A Rassner, Lubdha M Shah, Peter J Hinckley, Adam de Havenon, Seong-Eun Kim, J Scott McNally
BACKGROUND: Cardiorespiratory arrest can result in a spectrum of hypoxic ischemic brain injury leading to global hypoperfusion and brain death (BD). Because up to 40% of patients with BD are viable organ donors, avoiding delayed diagnosis of this condition is critical. High b-value diffusion weighted imaging (DWI) measures primarily molecular self-diffusion; however, low b-values are sensitive to perfusion. We investigated the feasibility of low b-value DWI in discriminating the global hypoperfusion of BD and hypoxic ischemic encephalopathy (HIE)...
June 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29914530/early-fibrinogen-concentrate-therapy-for-major-haemorrhage-in-trauma-e-fit-1-results-from-a-uk-multi-centre-randomised-double-blind-placebo-controlled-pilot-trial
#13
Nicola Curry, Claire Foley, Henna Wong, Ana Mora, Elinor Curnow, Agne Zarankaite, Renate Hodge, Valerie Hopkins, Alison Deary, James Ray, Phil Moss, Matthew J Reed, Suzanne Kellett, Ross Davenport, Simon Stanworth
BACKGROUND: There is increasing interest in the timely administration of concentrated sources of fibrinogen to patients with major traumatic bleeding. Following evaluation of early cryoprecipitate in the CRYOSTAT 1 trial, we explored the use of fibrinogen concentrate, which may have advantages of more rapid administration in acute haemorrhage. The aims of this pragmatic study were to assess the feasibility of fibrinogen concentrate administration within 45 minutes of hospital admission and to quantify efficacy in maintaining fibrinogen levels ≥ 2 g/L during active haemorrhage...
June 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29907130/acute-kidney-injury-is-associated-with-a-decrease-in-cortical-renal-perfusion-during-septic-shock
#14
Anatole Harrois, Nicolas Grillot, Samy Figueiredo, Jacques Duranteau
BACKGROUND: Renal perfusion status remains poorly studied at the bedside during septic shock. We sought to measure cortical renal perfusion in patients with septic shock during their first 3 days of care using renal contrast enhanced ultrasound (CEUS). METHODS: We prospectively included 20 ICU patients with septic shock and 10 control patients (CL) without septic shock admitted to a surgical ICU. Cortical renal perfusion was evaluated with CEUS during continuous infusion of Sonovue (Milan, Italy) within the first 24 h (day 0), between 24 and 48 h (day 1) and after 72 h (day 3) of care...
June 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29907121/position-of-draining-venous-cannula-in-extracorporeal-membrane-oxygenation-for-respiratory-and-respiratory-circulatory-support-in-adult-patients
#15
B Frenckner, M Broman, M Broomé
Extracorporeal membrane oxygenation (ECMO) is used in critically ill patients with severe pulmonary and/or cardiac failure. Blood is drained from the venous system and pumped through a membrane oxygenator where it is oxygenated. For pulmonary support, the blood is returned to the patient via a vein (veno-venous ECMO) and for pulmonary/circulatory support it is returned via an artery (veno-arterial ECMO).Veno-venous ECMO can be performed either with a single dual-lumen cannula or with two separate single-lumen cannulas...
June 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29907120/shock-subtypes-by-left-ventricular-ejection-fraction-following-out-of-hospital-cardiac-arrest
#16
Ryan J Anderson, Sayuri P Jinadasa, Leeyen Hsu, Tiffany Bita Ghafouri, Sanjeev Tyagi, Jisha Joshua, Ariel Mueller, Daniel Talmor, Rebecca E Sell, Jeremy R Beitler
BACKGROUND: Post-resuscitation hemodynamic instability following out-of-hospital cardiac arrest (OHCA) may occur from myocardial dysfunction underlying cardiogenic shock and/or inflammation-mediated distributive shock. Distinguishing the predominant shock subtype with widely available clinical metrics may have prognostic and therapeutic value. METHODS: A two-hospital cohort was assembled of patients in shock following OHCA. Left ventricular ejection fraction (LVEF) was assessed via echocardiography or cardiac ventriculography within 1 day post arrest and used to delineate shock physiology...
June 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29898757/predictors-of-health-related-quality-of-life-after-burn-injuries-a-systematic-review
#17
REVIEW
Inge Spronk, Catherine M Legemate, Jan Dokter, Nancy E E van Loey, Margriet E van Baar, Suzanne Polinder
BACKGROUND: Identifying predictors of health-related quality of life (HRQL) following burns is essential for optimization of rehabilitation for burn survivors. This study aimed to systematically review predictors of HRQL in burn patients. METHODS: Medline, Embase, Web of Science, Cochrane, CINAHL, and Google Scholar were reviewed from inception to October 2016 for studies that investigated at least one predictor of HRQL after burns. The Quality in Prognostic Studies tool was used to assess risk of bias of included studies...
June 14, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29895302/the-mechanism-of-action-of-the-adrenomedullin-binding-antibody-adrecizumab
#18
LETTER
Christopher Geven, Peter Pickkers
No abstract text is available yet for this article.
June 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29895296/thrombocytopenia-in-the-icu-disseminated-intravascular-coagulation-and-thrombotic-microangiopathies-what-intensivists-need-to-know
#19
EDITORIAL
Jean-Louis Vincent, Pedro Castro, Beverley J Hunt, Achim Jörres, Manuel Praga, Jose Rojas-Suarez, Eizo Watanabe
No abstract text is available yet for this article.
June 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29895331/immunocompromised-patients-with-acute-respiratory-distress-syndrome-secondary-analysis-of-the-lung-safe-database
#20
Andrea Cortegiani, Fabiana Madotto, Cesare Gregoretti, Giacomo Bellani, John G Laffey, Tai Pham, Frank Van Haren, Antonino Giarratano, Massimo Antonelli, Antonio Pesenti, Giacomo Grasselli
BACKGROUND: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. METHODS: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents...
June 12, 2018: Critical Care: the Official Journal of the Critical Care Forum
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