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Annals of Intensive Care

Patrick M Honore, Herbert D Spapen
No abstract text is available yet for this article.
December 2016: Annals of Intensive Care
Marije Smit, Maureen J M Werner, Annemieke Oude Lansink-Hartgring, Willem Dieperink, Jan G Zijlstra, Matijs van Meurs
BACKGROUND: Intra-abdominal hypertension (IAH) is frequently present in critically ill patients and is an independent predictor for mortality. Better recognition of clinically important thresholds is necessary. Increased intra-abdominal pressure (IAP) is associated with renal dysfunction, and renal failure is one of the most consistently described organ dysfunctions associated with IAH. Obesity is also associated with kidney injury. The underlying mechanisms are not yet fully understood...
December 2016: Annals of Intensive Care
Oliver Karam, Pierre Demaret, Alain Duhamel, Alison Shefler, Philip C Spinella, Simon J Stanworth, Marisa Tucci, Stéphane Leteurtre
BACKGROUND: Organ dysfunction scores, based on physiological parameters, have been created to describe organ failure. In a general pediatric intensive care unit (PICU) population, the PEdiatric Logistic Organ Dysfunction-2 score (PELOD-2) score had both a good discrimination and calibration, allowing to describe the clinical outcome of critically ill children throughout their stay. This score is increasingly used in clinical trials in specific subpopulation. Our objective was to assess the performance of the PELOD-2 score in a subpopulation of critically ill children requiring plasma transfusions...
December 2016: Annals of Intensive Care
Gabor Zilahi, Antonio Artigas, Ignacio Martin-Loeches
Over the last several decades, antibacterial drug use has become widespread with their misuse being an ever-increasing phenomenon. Consequently, antibacterial drugs have become less effective or even ineffective, resulting in a global health security emergency. The prevalence of multidrug-resistant organisms (MDROs) varies widely among regions and countries. The primary aim of antibiotic stewardship programs is to supervise the three most influential factors contributing to the development and transmission of MDROs, namely: (1) appropriate antibiotic prescribing; (2) early detection and prevention of cross-colonization of MDROs; and (3) elimination of reservoirs...
December 2016: Annals of Intensive Care
Cécile Aubron, Joris DePuydt, François Belon, Michael Bailey, Matthieu Schmidt, Jayne Sheldrake, Deirdre Murphy, Carlos Scheinkestel, D Jamie Cooper, Gilles Capellier, Vincent Pellegrino, David Pilcher, Zoe McQuilten
BACKGROUND: Bleeding is the most frequent complication associated with extracorporeal membrane oxygenation (ECMO) support in critically ill patients. Nonetheless, risk factors for bleeding have been poorly described especially those associated with coagulation anomalies and anticoagulant therapy during ECMO support. The aim of this study is to describe bleeding complications in critically ill patients undergoing ECMO and to identify risk factors for bleeding events. METHODS: We retrospectively analysed ICU charts of adults who received either veno-venous (VV) or veno-arterial (VA) ECMO support in two participating ICUs between 2010 and 2013...
December 2016: Annals of Intensive Care
Nara Aline Costa, Ana Lúcia Gut, Paula Schmidt Azevedo, Suzana Erico Tanni, Natália Baraldi Cunha, Eloá Siqueira Magalhães, Graziela Biude Silva, Bertha Furlan Polegato, Leonardo Antonio Mamede Zornoff, Sergio Alberto Rupp de Paiva, André Luís Balbi, Daniela Ponce, Marcos Ferreira Minicucci
BACKGROUND: Oxidative stress is a key feature of sepsis and could be a common pathophysiological pathway between septic shock and acute kidney injury (AKI) Our objective was to evaluate the erythrocyte superoxide dismutase (SOD1) activity as predictor of AKI in patients with septic shock. METHODS: This is a prospective observational study that evaluated 175 consecutive patients over the age of 18 years with septic shock upon intensive care unit (ICU) admission...
December 2016: Annals of Intensive Care
Gaël Piton, Claire Chaignat, Mikhael Giabicani, Jean-Paul Cervoni, Fabienne Tamion, Emmanuel Weiss, Catherine Paugam-Burtz, Gilles Capellier, Vincent Di Martino
BACKGROUND: The prognosis of cirrhotic patients admitted to the ICU is considered to be poor but has been mainly reported in liver ICU. We aimed to describe the prognosis of cirrhotic patients admitted to a general ICU, to assess the predictors of mortality in this population, and, finally, to identify a subgroup of patients in whom intensive care escalation might be discussed. RESULTS: We performed a retrospective monocentric study of all cirrhotic patients consecutively admitted between 2002 and 2014 in a general ICU in a regional university hospital...
December 2016: Annals of Intensive Care
Anahita Rouzé, Julien De Jonckheere, Farid Zerimech, Julien Labreuche, Erika Parmentier-Decrucq, Benoit Voisin, Emmanuelle Jaillette, Patrice Maboudou, Malika Balduyck, Saad Nseir
BACKGROUND: Despite intermittent control of tracheal cuff pressure (P cuff) using a manual manometer, cuff underinflation (<20 cmH2O) and overinflation (>30 cmH2O) frequently occur in intubated critically ill patients, resulting in increased risk of microaspiration and tracheal ischemic lesions. The primary objective of our study was to determine the efficiency of an electronic device in continuously controlling P cuff. The secondary objective was to determine the impact of this device on the occurrence of microaspiration of gastric or oropharyngeal secretions...
December 2016: Annals of Intensive Care
Kevin J Solverson, Christopher Grant, Christopher J Doig
BACKGROUND: Prior studies of physical functioning after critical illness have been mostly limited to survivors of acute respiratory distress syndrome. The purpose of this study was to objectively assess muscle strength and physical functioning in survivors of critical illness from a general ICU and the associations of these measures to health-related quality of life (HRQL), mental health and critical illness variables. METHODS: This was a prospective cohort study of 56 patients admitted to a medical ICU (length of stay ≥4 days) from April 1, 2009, and March 31, 2010...
December 2016: Annals of Intensive Care
Niels Van Regenmortel, Walter Verbrugghe, Tim Van den Wyngaert, Philippe G Jorens
BACKGROUND: Abnormal chloride levels are commonly observed in critically ill patients, but their clinical relevance remains a matter of debate. We examined the association between abnormal chloremia and ICU and hospital mortality. To further refine findings and integrate them into the ongoing discussion on the detrimental effects of chloride-rich solutions, the impact of strong ion difference (SID) on the same end points was assessed. METHODS: Retrospective cohort study in an academic tertiary intensive care unit on 8830 adult patients who stayed at least 24 h in the ICU was carried out...
December 2016: Annals of Intensive Care
David Schnell, Elie Azoulay, Dominique Benoit, Benjamin Clouzeau, Pierre Demaret, Stéphane Ducassou, Pierre Frange, Matthieu Lafaurie, Matthieu Legrand, Anne-Pascale Meert, Djamel Mokart, Jérôme Naudin, Frédéric Pene, Antoine Rabbat, Emmanuel Raffoux, Patricia Ribaud, Jean-Christophe Richard, François Vincent, Jean-Ralph Zahar, Michael Darmon
Neutropenia is defined by either an absolute or functional defect (acute myeloid leukemia or myelodysplastic syndrome) of polymorphonuclear neutrophils and is associated with high risk of specific complications that may require intensive care unit (ICU) admission. Specificities in the management of critically ill neutropenic patients prompted the establishment of guidelines dedicated to intensivists. These recommendations were drawn up by a panel of experts brought together by the French Intensive Care Society in collaboration with the French Group for Pediatric Intensive Care Emergencies, the French Society of Anesthesia and Intensive Care, the French Society of Hematology, the French Society for Hospital Hygiene, and the French Infectious Diseases Society...
December 2016: Annals of Intensive Care
Lieuwe D Bos, Laura R Schouten, Olaf L Cremer, David S Y Ong, Marcus J Schultz
BACKGROUND: A recently developed prediction score based on age, arterial oxygen partial pressure to fractional inspired oxygen ratio (PaO2/FiO2) and plateau pressure (abbreviated as 'APPS') was shown to accurately predict mortality in patients diagnosed with the acute respiratory distress syndrome (ARDS). After thorough temporal external validation of the APPS, we tested the spatial external validity in a cohort of ARDS patients recruited during 3 years in two hospitals in the Netherlands...
December 2016: Annals of Intensive Care
Antoine J Marchand, Philippe Seguin, Yannick Malledant, Marion Taleb, Hélène Raoult, Jean Yves Gauvrit
BACKGROUND: Computed tomography angiography (CTA) is largely performed in European countries as an ancillary test for diagnosing brain death. However, CTA suffers from a lack of sensitivity, especially in patients who have previously undergone decompressive craniectomy. The aim of this study was to assess the performance of a revised four-point venous CTA score, including non-opacification of the infratentorial venous circulation, for diagnosing brain death. METHODS: A preliminary study of 43 control patients with normal CTAs confirmed that the infratentorial superior petrosal vein (SPV) was consistently visible...
December 2016: Annals of Intensive Care
Sabri Soussi, Benjamin Deniau, Axelle Ferry, Charlotte Levé, Mourad Benyamina, Véronique Maurel, Maïté Chaussard, Brigitte Le Cam, Alice Blet, Maurice Mimoun, Jêrome Lambert, Marc Chaouat, Alexandre Mebazaa, Matthieu Legrand
BACKGROUND: Impact of early systemic hemodynamic alterations and fluid resuscitation on outcome in the modern burn care remains controversial. We investigate the association between acute-phase systemic hemodynamics, timing of fluid resuscitation and outcome in critically ill burn patients. METHODS: Retrospective, single-center cohort study was conducted in a university hospital. Forty critically ill burn patients with total body surface area (TBSA) burn-injured >20 % with invasive blood pressure and cardiac output monitoring (transpulmonary thermodilution technique) within 8 h from trauma were included...
December 2016: Annals of Intensive Care
M Cressoni, Davide Chiumello
No abstract text is available yet for this article.
December 2016: Annals of Intensive Care
Catharina E van Ewijk, Gabriel E Jacobs, Armand R J Girbes
BACKGROUND: Delirium is a frequently occurring syndrome in patients admitted to the intensive care unit (ICU) or medium care unit (MCU), yet the pathophysiology remains poorly understood. An excess of central serotonin can lead to an altered mental status, associated with autonomic hyperactivity, and neuromuscular excitation. Drugs with serotonergic properties are frequently and for prolonged periods administered to ICU/MCU patients. Therefore, central serotonergic toxicity may constitute a predisposing, contributing or precipitating factor in the emergence of delirium...
December 2016: Annals of Intensive Care
Christophe Guervilly, Jean-Marie Forel, Sami Hraiech, Antoine Roch, Daniel Talmor, Laurent Papazian
BACKGROUND: High-frequency oscillatory ventilation (HFOV) has not been shown to be beneficial in the management of moderate-to-severe acute respiratory distress syndrome (ARDS). There is uncertainty about the actual pressure applied into the lung during HFOV. We therefore performed a study to compare the transpulmonary pressure (P L) during conventional mechanical ventilation (CMV) and different levels of mean airway pressure (mPaw) during HFOV. METHODS: This is a prospective randomized crossover study in a university teaching hospital...
December 2016: Annals of Intensive Care
Pierre-Louis Declercq, Michael Bubenheim, Stéphanie Gelinotte, Kévin Guernon, Jean-Baptiste Michot, Vincent Royon, Dorothée Carpentier, Gaëtan Béduneau, Fabienne Tamion, Christophe Girault
BACKGROUND: Different video-laryngoscopes (VDLs) for endotracheal intubation (ETI) have recently been developed. We compared the performance of the VDL Airway Scope (AWS) with the direct laryngoscopy by Macintosh (DLM) for ETI success, time and learning. METHODS: We performed an experimental manikin controlled study. Twenty experienced (experts) and 40 inexperienced operators (novices) for DLM-ETI were enrolled. None of them had experience with the use of AWS-VDL...
December 2016: Annals of Intensive Care
Maité Garrouste-Orgeas, Isabelle Vinatier, Alexis Tabah, Benoit Misset, Jean-François Timsit
BACKGROUND: The relatives of intensive care unit (ICU) patients must cope with both the severity of illness of their loved one and the unfamiliar and stressful ICU environment. This hardship may lead to post-intensive care syndrome. French guidelines provide recommendations on welcoming and informing families of ICU patients. We questioned whether and how they are applied 5 years after their publication. METHODS: We conducted a large survey among French ICUs to evaluate their visiting policies and how information was provided to patient's family...
December 2016: Annals of Intensive Care
Hernan Aguirre-Bermeo, Indalecio Morán, Maurizio Bottiroli, Stefano Italiano, Francisco José Parrilla, Eugenia Plazolles, Ferran Roche-Campo, Jordi Mancebo
BACKGROUND: End-inspiratory pause (EIP) prolongation decreases dead space-to-tidal volume ratio (Vd/Vt) and PaCO2. We do not know the physiological benefits of this approach to improve respiratory system mechanics in acute respiratory distress syndrome (ARDS) patients when mild hypercapnia is of no concern. METHODS: The investigation was conducted in an intensive care unit of a university hospital, and 13 ARDS patients were included. The study was designed in three phases...
December 2016: Annals of Intensive Care
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