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Annals of Intensive Care

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https://www.readbyqxmd.com/read/29980962/large-volume-paracentesis-effects-plasma-disappearance-rate-of-indo-cyanine-green-in-critically-ill-patients-with-decompensated-liver-cirrhosis-and-intraabdominal-hypertension
#1
Ulrich Mayr, Leonie Fahrenkrog-Petersen, Gonzalo Batres-Baires, Alexander Herner, Sebastian Rasch, Roland M Schmid, Wolfgang Huber, Tobias Lahmer
BACKGROUND: Ascites is a major complication of decompensated liver cirrhosis. Intraabdominal hypertension and structural alterations of parenchyma involve decisive changes in hepatosplanchnic blood flow. Clearance of indo-cyanine green (ICG) is mainly dependent on hepatic perfusion and hepatocellular function. As a consequence, plasma disappearance rate of ICG (ICG-PDR) is rated as a useful dynamic parameter of liver function. This study primarily evaluates the impact of large-volume paracentesis (LVP) on ICG-PDR in critically ill patients with decompensated cirrhosis...
July 6, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29980953/how-useful-are-hemoglobin-concentration-and-its-variations-to-predict-significant-hemorrhage-in-the-early-phase-of-trauma-a-multicentric-cohort-study
#2
S Figueiredo, C Taconet, A Harrois, S Hamada, T Gauss, M Raux, J Duranteau
BACKGROUND: The diagnostic value of hemoglobin (Hb) for detecting a significant hemorrhage (SH) in the early phase of trauma remains controversial. The present study aimed to assess the abilities of Hb measurements taken at different times throughout trauma management to identify patients with SH. METHODS: All consecutive adult trauma patients directly admitted to six French level-1 trauma centers with at least one prehospital Hb measurement were analyzed. The abilities of the following variables to identify SH (≥ 4 units of red blood cells in the first 6 h and/or death related to uncontrolled bleeding within 24 h) were determined and compared to that of shock index (SI): Hb as measured with a point-of-care (POC) device by the prehospital team on scene (POC-Hbprehosp ) and upon patient's admission to the hospital (POC-Hbhosp ), the difference between POC-Hbhosp and POC-Hbprehosp (DeltaPOC-Hb) and Hb as measured by the hospital laboratory on admission (Hb-Labhosp )...
July 6, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29980878/prediction-of-chronic-kidney-disease-after-acute-kidney-injury-in-icu-patients-study-protocol-for-the-predict-multicenter-prospective-observational-study
#3
Guillaume Geri, Bénédicte Stengel, Christian Jacquelinet, Philippe Aegerter, Ziad A Massy, Antoine Vieillard-Baron
BACKGROUND: Acute kidney injury (AKI) is frequent and associated with poor outcome in intensive care unit (ICU) patients. Besides the association with short- and long-term mortality, the increased risk of chronic kidney disease (CKD) has been recently highlighted in non-ICU patients. This study aims to describe the incidence and determinants of CKD after AKI and to develop a prediction score for CKD in ICU patients. METHODS: Prospective multicenter (n = 17) observational study included 1200 ICU patients who suffered from AKI (defined by an AKIN stage ≥ 1) during their ICU stay and were discharged alive from ICU...
July 6, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29974284/clinical-impact-of-upper-gastrointestinal-endoscopy-in-critically-ill-patients-with-suspected-bleeding
#4
Sylvain Jean-Baptiste, Jonathan Messika, David Hajage, Stéphane Gaudry, Julie Barbieri, Henri Duboc, Didier Dreyfuss, Benoit Coffin, Jean-Damien Ricard
BACKGROUND AND AIMS: Upper gastrointestinal endoscopies' (UGE) profitability is undisputable in patients admitted for an overt upper digestive tract bleeding. In critically ill subjects admitted for other causes, its performances have scarcely been investigated despite its broad use. We sought to question the performance of bedside UGE in intensive care unit (ICU) patients, admitted for another reason than overt bleeding. METHODS: This was a six-year (January 2007-December 2012) retrospective observational study of all UGE performed in a medico-surgical ICU...
July 4, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29956057/impact-of-fluid-challenge-increase-in-cardiac-output-on-the-relationship-between-systemic-and-cerebral-hemodynamics-in-severe-sepsis-compared-to-brain-injury-and-controls
#5
Matthieu Le Dorze, Florian Huché, Clément Coelembier, Christophe Rabuel, Didier Payen
BACKGROUND: Cognitive dysfunction and delirium after ICU are frequent and may partially result from brain ischemia episodes. We hypothesized that systemic inflammation (severe sepsis or septic shock) modifies the control of brain circulation and the relation between systemic and cerebral hemodynamic after a positive response to fluid challenge (FC). METHODS: Three groups of patients were studied if they increased stroke volume (SV) > 10% after 250 or 500 ml of crystalloids: control group: patients free of comorbidity anesthetized for orthopedic surgery; sepsis group: patients with severe sepsis or septic shock (classic definition); brain injury (BI) group: trauma brain jury or hemorrhagic stroke with no detectable systemic inflammation...
June 28, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29926230/estimating-mean-circulatory-filling-pressure-in-clinical-practice-a-systematic-review-comparing-three-bedside-methods-in-the-critically-ill
#6
REVIEW
Marije Wijnberge, Daniko P Sindhunata, Michael R Pinsky, Alexander P Vlaar, Else Ouweneel, Jos R Jansen, Denise P Veelo, Bart F Geerts
The bedside hemodynamic assessment of the critically ill remains challenging since blood volume, arterial-venous interaction and compliance are not measured directly. Mean circulatory filling pressure (Pmcf ) is the blood pressure throughout the vascular system at zero flow. Animal studies have shown Pmcf provides information on vascular compliance, volume responsiveness and enables the calculation of stressed volume. It is now possible to measure Pmcf at the bedside. We performed a systematic review of the current Pmcf measurement techniques and compared their clinical applicability, precision, accuracy and limitations...
June 20, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29916091/vascular-complications-in-adult-postcardiotomy-cardiogenic-shock-patients-receiving-venoarterial-extracorporeal-membrane-oxygenation
#7
Feng Yang, Dengbang Hou, Jinhong Wang, Yongchao Cui, Xiaomeng Wang, Zhichen Xing, Chunjing Jiang, Xing Hao, Zhongtao Du, Xiaofang Yang, Yu Jiang, Xiaotong Hou
BACKGROUND: The rate, prognostic impacts, and predisposing factors of major vascular complications (MVCs) in patients underwent venoarterial extracorporeal membrane oxygenation (VA-ECMO) by surgical cut-down are poorly understood. The purpose of this study was to identify these parameters in adult VA-ECMO patients. METHODS: Adult postcardiotomy cardiogenic shock (PCS) patients receiving VA-ECMO by femoral surgical cut-down cannulation from January 2004 to December 2015 were enrolled in this study...
June 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29904809/effectiveness-of-antimicrobial-coated-central-venous-catheters-for-preventing-catheter-related-blood-stream-infections-with-the-implementation-of-bundles-a-systematic-review-and-network-meta-analysis
#8
REVIEW
Hongliang Wang, Hongshuang Tong, Haitao Liu, Yao Wang, Ruitao Wang, Hong Gao, Pulin Yu, Yanji Lv, Shuangshuang Chen, Guiyue Wang, Miao Liu, Yuhang Li, Kaijiang Yu, Changsong Wang
BACKGROUND: Catheter-related blood-stream infections (CRBSIs) are the most common complication when using central venous catheters (CVCs). Whether coating CVCs under bundles could further reduce the incidence of CRBSIs is unclear. We aimed to assess the effectiveness of implementing the use of bundles with antimicrobial-coated CVCs for preventing catheter-related blood-stream infections. METHODS: In this systematic review and network meta-analyses, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library in addition to the EMBASE, MEDLINE, CINAHL, and Web of Science databases for studies published before July 2017...
June 15, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29881956/the-safety-and-efficacy-of-nicotine-replacement-therapy-in-the-intensive-care-unit-a-randomised-controlled-pilot-study
#9
Ben de Jong, Anne Sophie Schuppers, Arriette Kruisdijk-Gerritsen, Maurits Erwin Leo Arbouw, Hubertus Laurentius Antonius van den Oever, Arthur R H van Zanten
BACKGROUND: Studies evaluating nicotine replacement therapy (NRT) to prevent nicotine withdrawal symptoms in ICU patients have yielded conflicting results. We performed a randomised controlled double-blind pilot study to assess the safety and efficacy of NRT in critically ill patients. Mechanically ventilated patients admitted to two medical-surgical intensive care units and smoking more than 10 cigarettes per day before ICU admission were enrolled in this study. Participants were randomised to transdermal NRT (14 or 21 mg per day) or placebo until ICU discharge or day 30...
June 7, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29869095/comparative-effectiveness-of-elemental-formula-in-the-early-enteral-nutrition-management-of-acute-pancreatitis-a-retrospective-cohort-study
#10
Akira Endo, Atsushi Shiraishi, Kiyohide Fushimi, Kiyoshi Murata, Yasuhiro Otomo
BACKGROUND: Although enteral nutrition has become one of the standard therapies for patients with acute pancreatitis, the optimal formulae for enteral nutrition have been under debate. Elemental formula is assumed to be suitable in the treatment of patients with acute pancreatitis because it has less stimulating effects for exocrine secretions of the pancreas, simultaneously maintaining gut immunity; however, clinical studies corroborating this assumption have been scarce. METHODS: We conducted a retrospective cohort study using a Japanese national administrative database between 2010 and 2015...
June 5, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29869120/adherence-to-a-procalcitonin-guided-antibiotic-treatment-protocol-in-patients-with-severe-sepsis-and-septic-shock
#11
Andreas Hohn, Nina Balfer, Bernhard Heising, Sabine Hertel, Jan C Wiemer, Marcel Hochreiter, Stefan Schröder
BACKGROUND: In randomised controlled trials, procalcitonin (PCT)-guided antibiotic treatment has been proven to significantly reduce length of antibiotic therapy in intensive care unit (ICU) patients. However, concern was raised on low protocol adherence and high rates of overruling, and thus the value of PCT-guided treatment in real clinical life outside study conditions remains unclear. In this study, adherence to a PCT protocol to guide antibiotic treatment in patients with severe sepsis and septic shock was analysed...
June 4, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29845417/carotid-and-femoral-doppler-do-not-allow-the-assessment-of-passive-leg-raising-effects
#12
Valentina Girotto, Jean-Louis Teboul, Alexandra Beurton, Laura Galarza, Thierry Guedj, Christian Richard, Xavier Monnet
BACKGROUND: The hemodynamic effects of the passive leg raising (PLR) test must be assessed through a direct measurement of cardiac index (CI). We tested whether changes in Doppler common carotid blood flow (CBF) and common femoral artery blood flow (FBF) could detect a positive PLR test (increase in CI ≥ 10%). We also tested whether CBF and FBF changes could track simultaneous changes in CI during PLR and volume expansion. In 51 cases, we measured CI (PiCCO2), CBF and FBF before and during a PLR test (one performed for CBF and another for FBF measurements) and before and after volume expansion, which was performed if PLR was positive...
May 29, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29789983/principles-of-fluid-management-and-stewardship-in-septic-shock-it-is-time-to-consider-the-four-d-s-and-the-four-phases-of-fluid-therapy
#13
REVIEW
Manu L N G Malbrain, Niels Van Regenmortel, Bernd Saugel, Brecht De Tavernier, Pieter-Jan Van Gaal, Olivier Joannes-Boyau, Jean-Louis Teboul, Todd W Rice, Monty Mythen, Xavier Monnet
In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and timing of intravenous fluid administration. There are only four major indications for intravenous fluid administration: aside from resuscitation, intravenous fluids have many other uses including maintenance and replacement of total body water and electrolytes, as carriers for medications and for parenteral nutrition...
May 22, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29785504/impact-of-a-vap-bundle-in-belgian-intensive-care-units
#14
Laurent Jadot, Luc Huyghens, Annick De Jaeger, Marc Bourgeois, Dominique Biarent, Adeline Higuet, Koen de Decker, Margot Vander Laenen, Baudewijn Oosterlynck, Patrick Ferdinande, Pascal Reper, Serge Brimioulle, Sophie Van Cromphaut, Stéphane Clement De Clety, Thierry Sottiaux, Pierre Damas
BACKGROUND: In order to decrease the incidence of ventilator-associated pneumonia (VAP) in Belgium, a national campaign for implementing a VAP bundle involving assessment of sedation, cuff pressure control, oral care with chlorhexidine and semirecumbent position, was launched in 2011-2012. This report will document the impact of this campaign. METHODS: On 1 day, once a year from 2010 till 2016, except in 2012, Belgian ICUs were questioned about their ventilated patients...
May 21, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29766322/microdaimon-study-microcirculatory-daily-monitoring-in-critically-ill-patients-a-prospective-observational-study
#15
Claudia Scorcella, Elisa Damiani, Roberta Domizi, Silvia Pierantozzi, Stefania Tondi, Andrea Carsetti, Silvia Ciucani, Valentina Monaldi, Mara Rogani, Benedetto Marini, Erica Adrario, Rocco Romano, Can Ince, E Christiaan Boerma, Abele Donati
BACKGROUND: Until now, the prognostic value of microcirculatory alterations in critically ill patients has been mainly evaluated in highly selected subgroups. Aim of this study is to monitor the microcirculation daily in mixed group of Intensive Care Unit (ICU)-patients and to establish the association between (the evolution of) microcirculatory alterations and outcome. METHODS: This is a prospective longitudinal observational single-centre study in adult patients admitted to a 12-bed ICU in an Italian teaching hospital...
May 15, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29740777/severe-metabolic-acidosis-after-out-of-hospital-cardiac-arrest-risk-factors-and-association-with-outcome
#16
Matthieu Jamme, Omar Ben Hadj Salem, Lucie Guillemet, Pierre Dupland, Wulfran Bougouin, Julien Charpentier, Jean-Paul Mira, Frédéric Pène, Florence Dumas, Alain Cariou, Guillaume Geri
BACKGROUND: Metabolic acidosis is frequently observed as a consequence of global ischemia-reperfusion after out-of-hospital cardiac arrest (OHCA). We aimed to identify risk factors and assess the impact of metabolic acidosis on outcome after OHCA. METHODS: We included all consecutive OHCA patients admitted between 2007 and 2012. Using admission data, metabolic acidosis was defined by a positive base deficit and was categorized by quartiles. Main outcome was survival at ICU discharge...
May 8, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29740716/increase-in-intra-abdominal-pressure-during-airway-suctioning-induced-cough-after-a-successful-spontaneous-breathing-trial-is-associated-with-extubation-outcome
#17
Yasuhiro Norisue, Jun Kataoka, Yosuke Homma, Takaki Naito, Junpei Tsukuda, Kentaro Okamoto, Takeshi Kawaguchi, Lonny Ashworth, Shimada Yumiko, Yuiko Hoshina, Eiji Hiraoka, Shigeki Fujitani
BACKGROUND: A patient's ability to clear secretions and protect the airway with an effective cough is an important part of the pre-extubation evaluation. An increase in intra-abdominal pressure (IAP) is important in generating the flow rate necessary for a cough. This study investigated whether an increase from baseline in IAP during a coughing episode induced by routine pre-extubation airway suctioning is associated with extubation outcome after a successful spontaneous breathing trial (SBT)...
May 8, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29740704/association-of-intensive-care-unit-delirium-with-sleep-disturbance-and-functional-disability-after-critical-illness-an-observational-cohort-study
#18
Marcus T Altman, Melissa P Knauert, Terrence E Murphy, Amy M Ahasic, Zeeshan Chauhan, Margaret A Pisani
BACKGROUND: In medical intensive care unit (MICU) patients, the predictors of post-discharge sleep disturbance and functional disability are poorly understood. ICU delirium is a risk factor with a plausible link to sleep disturbance and disability. This study evaluated the prevalence of self-reported post-ICU sleep disturbance and increased functional disability, and their association with MICU delirium and other ICU factors. METHODS: This was an observational cohort study of MICU patients enrolled in a biorepository and assessed upon MICU admission by demographics, comorbidities, and baseline characteristics...
May 8, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29725778/skin-microcirculatory-reactivity-assessed-using-a-thermal-challenge-is-decreased-in-patients-with-circulatory-shock-and-associated-with-outcome
#19
Diego Orbegozo, Wasineenart Mongkolpun, Gianni Stringari, Nikolaos Markou, Jacques Creteur, Jean-Louis Vincent, Daniel De Backer
BACKGROUND: Shock states are characterized by impaired tissue perfusion and microcirculatory alterations, which are directly related to outcome. Skin perfusion can be noninvasively evaluated using skin laser Doppler (SLD), which, when coupled with a local thermal challenge, may provide a measure of microcirculatory reactivity. We hypothesized that this microvascular reactivity would be impaired in patients with circulatory shock and would be a marker of severity. METHODS: We first evaluated skin blood flow (SBF) using SLD on the forearm and on the palm in 18 healthy volunteers to select the site with maximal response...
May 3, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29721820/hypothermic-total-liquid-ventilation-after-experimental-aspiration-associated-acute-respiratory-distress-syndrome
#20
Jérôme Rambaud, Fanny Lidouren, Michaël Sage, Matthias Kohlhauer, Mathieu Nadeau, Étienne Fortin-Pellerin, Philippe Micheau, Luca Zilberstein, Nicolas Mongardon, Jean-Damien Ricard, Megumi Terada, Patrick Bruneval, Alain Berdeaux, Bijan Ghaleh, Hervé Walti, Renaud Tissier
BACKGROUND: Ultrafast cooling by total liquid ventilation (TLV) provides potent cardio- and neuroprotection after experimental cardiac arrest. However, this was evaluated in animals with no initial lung injury, whereas out-of-hospital cardiac arrest is frequently associated with early-onset pneumonia, which may lead to acute respiratory distress syndrome (ARDS). Here, our objective was to determine whether hypothermic TLV could be safe or even beneficial in an aspiration-associated ARDS animal model...
May 2, 2018: Annals of Intensive Care
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