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Critical Care: the Official Journal of the Critical Care Forum

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https://www.readbyqxmd.com/read/28732512/prolonged-acute-care-and-post-acute-care-admission-and-recovery-of-physical-function-in-survivors-of-acute-respiratory-failure-a-secondary-analysis-of-a-randomized-controlled-trial
#1
Anna Neumeier, Amy Nordon-Craft, Dan Malone, Margaret Schenkman, Brendan Clark, Marc Moss
BACKGROUND: The proportion of survivors of acute respiratory failure is growing; yet, many do not regain full function and require prolonged admission in an acute or post-acute care facility. Little is known about their trajectory of functional recovery. We sought to determine whether prolonged admission influenced the trajectory of physical function recovery and whether patient age modified the recuperation rate. METHODS: We performed a secondary analysis of a randomized clinical trial of intensive physical therapy for patients with acute respiratory failure requiring mechanical ventilation for ≥4 days...
July 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28709458/markers-of-nitric-oxide-are-associated-with-sepsis-severity-an-observational-study
#2
Martin Sebastian Winkler, Stefan Kluge, Maximilian Holzmann, Eileen Moritz, Linda Robbe, Antonia Bauer, Corinne Zahrte, Marion Priefler, Edzard Schwedhelm, Rainer H Böger, Alwin E Goetz, Axel Nierhaus, Christian Zoellner
BACKGROUND: Nitric oxide (NO) regulates processes involved in sepsis progression, including vascular function and pathogen defense. Direct NO measurement in patients is unfeasible because of its short half-life. Surrogate markers for NO bioavailability are substrates of NO generating synthase (NOS): L-arginine (lArg) and homoarginine (hArg) together with the inhibitory competitive substrate asymmetric dimethylarginine (ADMA). In immune cells ADMA is cleaved by dimethylarginine-dimethylaminohydrolase-2 (DDAH2)...
July 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28709439/enhanced-antimicrobial-de-escalation-for-pneumonia-in-mechanically-ventilated-patients-a-cross-over-study
#3
Tracy Trupka, Kristen Fisher, Scott T Micek, Paul Juang, Marin H Kollef
BACKGROUND: Antibiotics are commonly administered to hospitalized patients with infiltrates for possible bacterial pneumonia, often leading to unnecessary treatment and increasing the risk for resistance emergence. Therefore, we performed a study to determine if an enhanced antibiotic de-escalation practice could improve antibiotic utilization in mechanically ventilated patients with suspected pneumonia cared for in an academic closed intensive care unit (ICU). METHODS: This was a prospective cross-over trial comparing routine antibiotic management (RAM) and enhanced antimicrobial de-escalation (EAD) performed within two medical ICUs (total 34 beds) at Barnes-Jewish Hospital, an academic referral center...
July 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28709443/severity-of-acute-gastrointestinal-injury-grade-is-a-predictor-of-all-cause-mortality-in-critically-ill-patients-a-multicenter-prospective-observational-study
#4
Bangchuan Hu, Renhua Sun, Aiping Wu, Yin Ni, Jingquan Liu, Feng Guo, Lijun Ying, Guoping Ge, Aijun Ding, Yunchao Shi, Changwen Liu, Lei Xu, Ronglin Jiang, Jun Lu, Ronghai Lin, Yannan Zhu, Weidong Wu, Bo Xie
BACKGROUND: In 2012, the European Society of Intensive Care Medicine proposed a definition for acute gastrointestinal injury (AGI) based on current medical evidence and expert opinion. The aim of the present study was to evaluate the feasibility of using the current AGI grading system and to investigate the association between AGI severity grades with clinical outcome in critically ill patients. METHODS: Adult patients at 14 general intensive care units (ICUs) with an expected ICU stay ≥24 h were prospectively studied...
July 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28705256/monocyte-programmed-death-ligand-1-expression-is-an-early-marker-for-predicting-infectious-complications-in-acute-pancreatitis
#5
Tingting Pan, Tianyun Zhou, Lei Li, Zhaojun Liu, Ying Chen, Enqiang Mao, Meiling Li, Hongping Qu, Jialin Liu
BACKGROUND: Acute pancreatitis (AP) is a life-threatening disease that requires early identification of patients at risk of developing infectious complications. Immunosuppression is an initial event that is key to AP pathogenesis. The programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) system is reported to mediate evasion of host immune surveillance in many diseases; however, the relationship between PD-1/PD-L1 expression and these parameters or infectious complications in AP has not been elucidated...
July 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28705247/detecting-impaired-myocardial-relaxation-in-sepsis-with-a-novel-tissue-doppler-parameter-septal-e-s
#6
David J Clancy, Michel Slama, Stephen Huang, Timothy Scully, Anthony S McLean, Sam R Orde
BACKGROUND: Left ventricular diastolic dysfunction is associated with mortality outcomes in severe sepsis and septic shock. There are ongoing issues with diagnosing diastolic dysfunction in this cohort, partly owing to the poor applicability of traditional parameters in the hyperdynamic circulation. In this feasibility study, we sought to assess the utility of a novel parameter (septal e'/s') to identify diastolic dysfunction in patients with severe sepsis and septic shock who had normal systolic function against the 2016 American Society Echocardiography and European Association of Cardiovascular Imaging (ASE/EACI) guidelines on diastolic dysfunction...
July 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28705251/erratum-to-shock-induced-endotheliopathy-shine-in-acute-critical-illness-a-unifying-pathophysiologic-mechanism
#7
Pär Ingemar Johansson, Jakob Stensballe, Sisse Rye Ostrowski
No abstract text is available yet for this article.
July 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28701223/low-dose-immunoglobulin-g-is-not-associated-with-mortality-in-patients-with-sepsis-and-septic-shock
#8
Yusuke Iizuka, Masamitsu Sanui, Yusuke Sasabuchi, Alan Kawarai Lefor, Mineji Hayakawa, Shinjiro Saito, Shigehiko Uchino, Kazuma Yamakawa, Daisuke Kudo, Kohei Takimoto, Toshihiko Mayumi, Takeo Azuhata, Fumihito Ito, Shodai Yoshihiro, Katsura Hayakawa, Tsuyoshi Nakashima, Takayuki Ogura, Eiichiro Noda, Yoshihiko Nakamura, Ryosuke Sekine, Yoshiaki Yoshikawa, Motohiro Sekino, Keiko Ueno, Yuko Okuda, Masayuki Watanabe, Akihito Tampo, Nobuyuki Saito, Yuya Kitai, Hiroki Takahashi, Iwao Kobayashi, Yutaka Kondo, Wataru Matsunaga, Sho Nachi, Toru Miike, Hiroshi Takahashi, Shuhei Takauji, Kensuke Umakoshi, Takafumi Todaka, Hiroshi Kodaira, Kohkichi Andoh, Takehiko Kasai, Yoshiaki Iwashita, Hideaki Arai, Masato Murata, Masahiro Yamane, Kazuhiro Shiga, Naoto Hori
BACKGROUND: The administration of low-dose intravenous immunoglobulin G (IVIgG) (5 g/day for 3 days; approximate total 0.3 g/kg) is widely used as an adjunctive treatment for patients with sepsis in Japan, but its efficacy in the reduction of mortality has not been evaluated. We investigated whether the administration of low-dose IVIgG is associated with clinically important outcomes including intensive care unit (ICU) and in-hospital mortality. METHODS: This is a post-hoc subgroup analysis of data from a retrospective cohort study, the Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study...
July 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28701217/association-of-baseline-steroid-use-with-long-term-rates-of-infection-and-sepsis-in-the-regards-cohort
#9
Ninad S Chaudhary, John P Donnelly, Justin X Moore, John W Baddley, Monika M Safford, Henry E Wang
BACKGROUND: Prior studies associate steroid use with infection risk but were limited to select populations and short follow-up periods. The association of steroid use with long-term risk of community-acquired infections is unknown. We sought to determine the association of steroid risk with long-term risks of community- acquired infections and sepsis. METHODS: We used data on 30,239 adults aged ≥ 45 years old from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort...
July 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28701227/high-flow-nasal-cannula-oxygen-therapy-is-superior-to-conventional-oxygen-therapy-but-not-to-noninvasive-mechanical-ventilation-on-intubation-rate-a-systematic-review-and-meta-analysis
#10
Huiying Zhao, Huixia Wang, Feng Sun, Shan Lyu, Youzhong An
BACKGROUND: High-flow nasal cannula oxygen (HFNC) is a relatively new therapy used in adults with respiratory failure. Whether it is superior to conventional oxygen therapy (COT) or to noninvasive mechanical ventilation (NIV) remains unclear. The aim of the present study was to investigate whether HFNC was superior to either COT or NIV in adult acute respiratory failure patients. METHODS: A review of the literature was conducted from the electronic databases from inception up to 20 October 2016...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28701178/the-future-of-mechanical-ventilation-lessons-from-the-present-and-the-past
#11
REVIEW
Luciano Gattinoni, John J Marini, Francesca Collino, Giorgia Maiolo, Francesca Rapetti, Tommaso Tonetti, Francesco Vasques, Michael Quintel
The adverse effects of mechanical ventilation in acute respiratory distress syndrome (ARDS) arise from two main causes: unphysiological increases of transpulmonary pressure and unphysiological increases/decreases of pleural pressure during positive or negative pressure ventilation. The transpulmonary pressure-related side effects primarily account for ventilator-induced lung injury (VILI) while the pleural pressure-related side effects primarily account for hemodynamic alterations. The changes of transpulmonary pressure and pleural pressure resulting from a given applied driving pressure depend on the relative elastances of the lung and chest wall...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28697802/outcomes-of-subsyndromal-delirium-in-icu-a-systematic-review-and-meta-analysis
#12
Rodrigo B Serafim, Marcio Soares, Fernando A Bozza, José R Lapa E Silva, Felipe Dal-Pizzol, Maria Carolina Paulino, Pedro Povoa, Jorge I F Salluh
BACKGROUND: Subsyndromal delirium (SSD) is a frequent condition and has been commonly described as an intermediate stage between delirium and normal cognition. However, the true frequency of SSD and its impact on clinically relevant outcomes in the intensive care unit (ICU) remains unclear. METHODS: We performed a systematic search in PubMed, Embase, CINAHL, Cochrane Library, and PsychINFO, with no language restrictions, up to 1 October 2016 to identify publications that evaluated SSD in ICU patients...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28697778/electrical-impedance-tomography-for-predicting-failure-of-spontaneous-breathing-trials-in-patients-with-prolonged-weaning
#13
Johannes Bickenbach, Michael Czaplik, Mareike Polier, Gernot Marx, Nikolaus Marx, Michael Dreher
BACKGROUND: Spontaneous breathing trials (SBTs) on a T-piece can be difficult in patients with prolonged weaning because of remaining de-recruitment phenomena and/or insufficient ventilation. There is no clinically established method existent other than experience for estimating whether an SBT is most probably beneficial. Electrical impedance tomography (EIT) is a clinical useful online monitoring technique during mechanical ventilation, particularly because it enables analysis of effects of regional ventilation distribution...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28693567/protocol-based-invasive-intracranial-pressure-monitoring-in-acute-liver-failure-feasibility-safety-and-impact-on-management
#14
Venkatakrishna Rajajee, Robert J Fontana, Anthony J Courey, Parag G Patil
BACKGROUND: Acute liver failure (ALF) may result in elevated intracranial pressure (ICP). While invasive ICP monitoring (IICPM) may have a role in ALF management, these patients are typically coagulopathic and at risk for intracranial hemorrhage (ICH). Contemporary ICP monitoring techniques and coagulopathy reversal strategies may be associated with a lower risk of hemorrhage. Our objective was to evaluate the safety, feasibility, impact on clinical management and outcomes associated with protocol-directed use of IICPM in ALF...
July 11, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28693606/combined-use-of-serum-1-3-%C3%AE-d-glucan-and-procalcitonin-for-the-early-differential-diagnosis-between-candidaemia-and-bacteraemia-in-intensive-care-units
#15
Daniele Roberto Giacobbe, Malgorzata Mikulska, Mario Tumbarello, Elisa Furfaro, Marzia Spadaro, Angela Raffaella Losito, Alessio Mesini, Gennaro De Pascale, Anna Marchese, Marco Bruzzone, Paolo Pelosi, Michele Mussap, Alexandre Molin, Massimo Antonelli, Brunella Posteraro, Maurizio Sanguinetti, Claudio Viscoli, Valerio Del Bono
BACKGROUND: This study aimed to assess the combined performance of serum (1,3)-β-D-glucan (BDG) and procalcitonin (PCT) for the differential diagnosis between candidaemia and bacteraemia in three intensive care units (ICUs) in two large teaching hospitals in Italy. METHODS: From June 2014 to December 2015, all adult patients admitted to the ICU who had a culture-proven candidaemia or bacteraemia, as well as BDG and PCT measured closely to the time of the index culture, were included in the study...
July 10, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28687084/how-to-remove-the-grey-area-between-ventilator-associated-pneumonia-and-ventilator-associated-tracheobronchitis
#16
LETTER
Yuetian Yu, Cheng Zhu, Chunyan Liu, Yuan Gao
No abstract text is available yet for this article.
July 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28687073/association-of-neuron-specific-enolase-values-with-outcomes-in-cardiac-arrest-survivors-is-dependent-on-the-time-of-sample-collection
#17
Dagmar Vondrakova, Andreas Kruger, Marek Janotka, Filip Malek, Vlasta Dudkova, Petr Neuzil, Petr Ostadal
BACKGROUND: Despite marked advances in intensive cardiology care, current options for outcome prediction in cardiac arrest survivors remain significantly limited. The aim of our study was, therefore, to compare the day-specific association of neuron-specific enolase (NSE) with outcomes in out-of-hospital cardiac arrest (OHCA) survivors treated with hypothermia. METHODS: Eligible patients were OHCA survivors treated with targeted temperature management at 33 °C for 24 h using an endovascular device...
July 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28683763/new-setting-of-neurally-adjusted-ventilatory-assist-for-noninvasive-ventilation-by-facial-mask-a-physiologic-study
#18
Federico Longhini, Chun Pan, Jianfeng Xie, Gianmaria Cammarota, Andrea Bruni, Eugenio Garofalo, Yi Yang, Paolo Navalesi, Haibo Qiu
BACKGROUND: Noninvasive ventilation (NIV) is generally delivered using pneumatically-triggered and cycled-off pressure support (PSP) through a mask. Neurally adjusted ventilatory assist (NAVA) is the only ventilatory mode that uses a non-pneumatic signal, i.e., diaphragm electrical activity (EAdi), to trigger and drive ventilator assistance. A specific setting to generate neurally controlled pressure support (PSN) was recently proposed for delivering NIV by helmet. We compared PSN with PSP and NAVA during NIV using a facial mask, with respect to patient comfort, gas exchange, and patient-ventilator interaction and synchrony...
July 7, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28683757/do-we-need-another-prognostic-score-for-cardiogenic-shock-patients-with-ecmo
#19
LETTER
Sébastien Champion
No abstract text is available yet for this article.
July 7, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28679406/the-common-promoter-polymorphism-rs11666254-downregulates-fpr2-alx-expression-and-increases-risk-of-sepsis-in-patients-with-severe-trauma
#20
Han Zhang, Yao Lu, Guixiang Sun, Fang Teng, Nian Luo, Jianxin Jiang, Aiqing Wen
BACKGROUND: Formyl peptide receptor 2-lipoxin receptor (FPR2/ALX) modulates the anti-inflammatory response and therefore may be a target for treating sepsis. The purpose of this study was to investigate the association between genetic variants of the FPR2/ALX gene and sepsis after severe trauma as well as to further analyze the functions of sepsis-related genetic polymorphisms. METHODS: Three tag single-nucleotide polymorphisms (tag SNPs) that captured all common alleles across the FPR2/ALX genomic region were genotyped using pyrosequencing in an initial sample consisting of 275 patients with severe trauma...
July 6, 2017: Critical Care: the Official Journal of the Critical Care Forum
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