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Critical Care: the Official Journal of the Critical Care Forum

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https://www.readbyqxmd.com/read/28645302/untangling-glycaemia-and-mortality-in-critical-care
#1
Vincent Uyttendaele, Jennifer L Dickson, Geoffrey M Shaw, Thomas Desaive, J Geoffrey Chase
BACKGROUND: Hyperglycaemia is associated with adverse outcomes in the intensive care unit, and initial studies suggested outcome benefits of glycaemic control (GC). However, subsequent studies often failed to replicate these results, and they were often unable to achieve consistent, safe control, raising questions about the benefit or harm of GC as well as the nature of the association of glycaemia with mortality and clinical outcomes. In this study, we evaluated if non-survivors are harder to control than survivors and determined if glycaemic outcome is a function of patient condition and eventual outcome or of the glycaemic control provided...
June 24, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28641580/marked-regional-endothelial-dysfunction-in-mottled-skin-area-in-patients-with-severe-infections
#2
Simon Bourcier, Jérémie Joffre, Vincent Dubée, Gabriel Preda, Jean-Luc Baudel, Naïke Bigé, Guillaume Leblanc, Bernard I Levy, Bertrand Guidet, Eric Maury, Hafid Ait-Oufella
BACKGROUND: Mottling around the knee, reflecting a reduced skin blood flow, is predictive of mortality in patients with septic shock. However, the causative pathophysiology of mottling remains unknown. We hypothesized that the cutaneous hypoperfusion observed in the mottled area is related to regional endothelial dysfunction. METHODS: This was a prospective, observational study in a medical ICU in a tertiary teaching hospital. Consecutive adult patients with sepsis admitted to ICU were included...
June 23, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28637497/influence-of-low-flow-time-on-survival-after-extracorporeal-cardiopulmonary-resuscitation-ecpr
#3
Tobias Wengenmayer, Stephan Rombach, Florian Ramshorn, Paul Biever, Christoph Bode, Daniel Duerschmied, Dawid L Staudacher
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) support under extracorporeal cardiopulmonary resuscitation (eCPR) is the last option and may be offered to selected patients. Several factors predict outcome in these patients, including initial heart rhythm, comorbidities, and bystander cardiopulmonary resuscitation (CPR). We evaluated outcomes of all VA-ECMO patients treated within the last 5 years at our center in respect to low-flow duration during CPR. METHODS: We report retrospective registry data on all patients with eCPR treated at a university hospital between October 2010 and May 2016...
June 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28633658/nucleated-red-blood-cells-critical-illness-survivors-and-postdischarge-outcomes-a-cohort-study
#4
Steven W Purtle, Clare M Horkan, Takuhiro Moromizato, Fiona K Gibbons, Kenneth B Christopher
BACKGROUND: Little is known about risk factors associated with out-of-hospital outcomes in survivors of critical illness. We hypothesized that the presence of nucleated red blood cells in patients who survived critical care would be associated with adverse outcomes following hospital discharge. METHODS: We performed a two-center observational cohort study of patients treated in medical and surgical intensive care units in Boston, Massachusetts. All data were obtained from the Research Patient Data Registry at Partners HealthCare...
June 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28629472/protein-s100-as-outcome-predictor-after-out-of-hospital-cardiac-arrest-and-targeted-temperature-management-at-33%C3%A2-%C3%A2-c-and-36%C3%A2-%C3%A2-c
#5
Pascal Stammet, Josef Dankiewicz, Niklas Nielsen, François Fays, Olivier Collignon, Christian Hassager, Michael Wanscher, Johan Undèn, Jorn Wetterslev, Tommaso Pellis, Anders Aneman, Jan Hovdenes, Matt P Wise, Georges Gilson, David Erlinge, Janneke Horn, Tobias Cronberg, Michael Kuiper, Jesper Kjaergaard, Yvan Gasche, Yvan Devaux, Hans Friberg
BACKGROUND: We aimed to investigate the diagnostic performance of S100 as an outcome predictor after out-of-hospital cardiac arrest (OHCA) and the potential influence of two target temperatures (33 °C and 36 °C) on serum levels of S100. METHODS: This is a substudy of the Target Temperature Management after Out-of-Hospital Cardiac Arrest (TTM) trial. Serum levels of S100 were measured a posteriori in a core laboratory in samples collected at 24, 48, and 72 h after OHCA...
June 20, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28629397/optimal-timing-of-renal-replacement-therapy-initiation-in-acute-kidney-injury-the-elephant-felt-by-the-blindmen
#6
Chih-Chung Shiao, Tao-Min Huang, Herbert D Spapen, Patrick M Honore, Vin-Cent Wu
Renal replacement therapy (RRT) is a key component in the management of severe acute kidney injury (AKI) in critically ill patients. Many cohort studies, meta-analyses, and two recent large randomized prospective trials which evaluated the relationship between the timing of RRT initiation and patient outcome remain inconclusive due to substantial differences in study design, patient population, AKI definition, and RRT indication. A cause-specific diagnosis of AKI based on current staging criteria plus a sensitive biomarker (panel) that allows creating a homogeneous study population is definitely needed to assess the impact of early versus late initiation of RRT on patient outcome...
June 20, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28625168/human-leukocyte-antigen-dr-expression-might-predict-outcomes-in-severe-sepsis-but-diabetes-mellitus-cannot-be-ignored
#7
LETTER
Jun Li, Xianshi Zhou, Ye Ye, Guanghua Guanghua
No abstract text is available yet for this article.
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28625167/assessment-of-pulmonary-mechanics-in-mechanical-ventilation
#8
LETTER
Federico Gordo, Beatriz Lobo-Valbuena
No abstract text is available yet for this article.
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28625166/impact-of-gram-stain-results-on-initial-treatment-selection-in-patients-with-ventilator-associated-pneumonia-a-retrospective-analysis-of-two-treatment-algorithms
#9
Jumpei Yoshimura, Takahiro Kinoshita, Kazuma Yamakawa, Asako Matsushima, Naoki Nakamoto, Toshimitsu Hamasaki, Satoshi Fujimi
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common and serious problem in intensive care units (ICUs). Several studies have suggested that the Gram stain of endotracheal aspirates is a useful method for accurately diagnosing VAP. However, the usefulness of the Gram stain in predicting which microorganisms cause VAP has not been established. The purpose of this study was to evaluate whether a Gram stain of endotracheal aspirates could be used to determine appropriate initial antimicrobial therapy for VAP...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28625165/transpulmonary-thermodilution-advantages-and-limits
#10
REVIEW
Xavier Monnet, Jean-Louis Teboul
BACKGROUND: For complex patients in the intensive care unit or in the operating room, many questions regarding their haemodynamic management cannot be answered with simple clinical examination. In particular, arterial pressure allows only a rough estimation of cardiac output. Transpulmonary thermodilution is a technique that provides a full haemodynamic assessment through cardiac output and other indices. MAIN BODY: Through the analysis of the thermodilution curve recorded at the tip of an arterial catheter after the injection of a cold bolus in the venous circulation, transpulmonary thermodilution intermittently measures cardiac output...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28623953/early-versus-late-initiation-of-renal-replacement-therapy-impacts-mortality-in-patients-with-acute-kidney-injury-post-cardiac-surgery-a-meta-analysis
#11
Honghong Zou, Qianwen Hong, Gaosi Xu
BACKGROUND: Acute kidney injury (AKI) is a common clinical complication of cardiac surgery and increases mortality and hospitalization. We aimed to explore and perform an updated meta-analysis of qualitative and quantitative evaluations of the relationship between early renal replacement therapy (RRT) and mortality. METHODS: We searched the Chinese Biomedical Database, the Cochrane Library, EMBASE, Global Health, MEDLINE and PubMed. RESULTS: Fifteen studies (five randomized controlled trials (RCTs), one prospective cohort and nine retrospective cohorts) including 1479 patients were identified for detailed evaluation...
June 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28623949/hemoglobin-concentrations-and-rbc-transfusion-thresholds-in-patients-with-acute-brain-injury-an-international-survey
#12
Rafael Badenes, Mauro Oddo, José I Suarez, Massimo Antonelli, Jeffrey Lipman, Giuseppe Citerio, Fabio Silvio Taccone
BACKGROUND: The optimal hemoglobin (Hb) threshold at which to initiate red blood cell (RBC) transfusion in patients with acute brain injury is unknown. The aim of this survey was to investigate RBC transfusion practices used with these patients. METHODS: We conducted a web-based survey within various societies of critical care medicine for intensive care unit (ICU) physicians who currently manage patients with primary acute brain injury. RESULTS: A total of 868 responses were obtained from around the world, half of which (n = 485) were from European centers; 204 (24%) respondents had a specific certificate in neurocritical care, and most were specialists in anesthesiology or intensive care and had less than 15 years of practice experience...
June 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28623946/antiarrhythmic-drugs-in-out-of-hospital-cardiac-arrest-is-there-a-place-for-potassium-chloride
#13
LETTER
Romain Jouffroy, Benoît Vivien
No abstract text is available yet for this article.
June 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28623931/retinal-involvement-in-sepsis-from-the-eye-of-the-patient-to-the-eye-of-the-beholder
#14
EDITORIAL
E Christiaan Boerma
No abstract text is available yet for this article.
June 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28623939/on-line-plasma-lactate-concentration-monitoring-in-critically-ill-patients
#15
LETTER
Christian De Tymowski, Sabri Soussi, François Depret, Matthieu Legrand
No abstract text is available yet for this article.
June 16, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28623938/transcriptome-modulation-by-hydrocortisone-in-severe-burn-shock-ancillary-analysis-of-a-prospective-randomized-trial
#16
Jonathan Plassais, Fabienne Venet, Marie-Angélique Cazalis, Diane Le Quang, Alexandre Pachot, Guillaume Monneret, Sylvie Tissot, Julien Textoris
BACKGROUND: Despite shortening vasopressor use in shock, hydrocortisone administration remains controversial, with potential harm to the immune system. Few studies have assessed the impact of hydrocortisone on the transcriptional response in shock, and we are lacking data on burn shock. Our objective was to assess the hydrocortisone-induced transcriptional modulation in severe burn shock, particularly modulation of the immune response. METHODS: We collected whole blood samples during a randomized controlled trial assessing the efficacy of hydrocortisone administration in burn shock...
June 16, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28623930/systematic-assessment-of-advanced-respiratory-physiology-precision-medicine-entering-real-life-icu
#17
EDITORIAL
Tommaso Mauri, Giacomo Grasselli, Antonio Pesenti
No abstract text is available yet for this article.
June 16, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28602158/effect-of-perioperative-goal-directed-hemodynamic-therapy-on-postoperative-recovery-following-major-abdominal-surgery-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
Yanxia Sun, Fang Chai, Chuxiong Pan, Jamie Lee Romeiser, Tong J Gan
BACKGROUND: Goal-directed hemodynamic therapy (GDHT) has been used in the clinical setting for years. However, the evidence for the beneficial effect of GDHT on postoperative recovery remains inconsistent. The aim of this systematic review and meta-analysis was to evaluate the effect of perioperative GDHT in comparison with conventional fluid therapy on postoperative recovery in adults undergoing major abdominal surgery. METHODS: Randomized controlled trials (RCTs) in which researchers evaluated the effect of perioperative use of GDHT on postoperative recovery in comparison with conventional fluid therapy following abdominal surgery in adults (i...
June 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28599662/a-randomized-controlled-pilot-study-to-evaluate-the-effect-of-an-enteral-formulation-designed-to-improve-gastrointestinal-tolerance-in-the-critically-ill-patient-the-spirit-trial
#19
Stephan M Jakob, Lukas Bütikofer, David Berger, Michael Coslovsky, Jukka Takala
BACKGROUND: Diarrhea is frequent in patients in intensive care units (ICU) and is associated with discomfort and complications and may increase the length of stay and nursing workload. METHODS: This was a prospective, double-blind, randomized, controlled single-center pilot study to assess the incidence and frequency of diarrhea and the respective effects of a modified enteral diet (intervention: Peptamen® AF, rich in proteins, medium chain triglycerides and fish oil) compared to a standard diet (control: Isosource® Energy) in 90 randomized adult patients (intervention, n = 46; control, n = 44) with an ICU stay ≥5 days and tube feeding ≥3 days...
June 10, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28599676/a-randomized-trial-of-supplemental-parenteral-nutrition-in-underweight-and-overweight-critically-ill-patients-the-top-up-pilot-trial
#20
Paul E Wischmeyer, Michel Hasselmann, Christine Kummerlen, Rosemary Kozar, Demetrios James Kutsogiannis, Constantine J Karvellas, Beth Besecker, David K Evans, Jean-Charles Preiser, Leah Gramlich, Khursheed Jeejeebhoy, Rupinder Dhaliwal, Xuran Jiang, Andrew G Day, Daren K Heyland
BACKGROUND: Nutrition guidelines recommendations differ on the use of parenteral nutrition (PN), and existing clinical trial data are inconclusive. Our recent observational data show that amounts of energy/protein received early in the intensive care unit (ICU) affect patient mortality, particularly for inadequate nutrition intake in patients with body mass indices (BMIs) of <25 or >35. Thus, we hypothesized increased nutrition delivery via supplemental PN (SPN) + enteral nutrition (EN) to underweight and obese ICU patients would improve 60-day survival and quality of life (QoL) versus usual care (EN alone)...
June 9, 2017: Critical Care: the Official Journal of the Critical Care Forum
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