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Annals of Intensive Care

Jean-Louis Vincent, Nathan D Nielsen, Nathan I Shapiro, Margaret E Gerbasi, Aaron Grossman, Robin Doroff, Feng Zeng, Paul J Young, James A Russell
BACKGROUND: Maintenance of mean arterial pressure (MAP) at levels sufficient to avoid tissue hypoperfusion is a key tenet in the management of distributive shock. We hypothesized that patients with distributive shock sometimes have a MAP below that typically recommended and that such hypotension is associated with increased mortality. METHODS: In this retrospective analysis of the Medical Information Mart for Intensive Care (MIMIC-III) database from Beth Israel Deaconess Medical Center, Boston, USA, we included all intensive care unit (ICU) admissions between 2001 and 2012 with distributive shock, defined as continuous vasopressor support for ≥ 6 h and no evidence of low cardiac output shock...
November 8, 2018: Annals of Intensive Care
Gert Warncke, Florian Hoffmann, Michael Sasse, Georg Singer, Istvan Szilagyi, Holger Till, Christoph Castellani
BACKGROUND: The aim of the present study was to assess whether paediatric intensive care units (PICUs) in three central European countries comply with guidelines concerning infrastructure provided by the European Society of Intensive Care Medicine (ESICM). Between July 2016 and May 2017, a survey was conducted based on the ESICM guidelines. The questionnaire was structured into four categories: structural quality, diagnostic/therapeutic equipment, personnel and organization. All PICUs treating paediatric patients in the D-A-CH region [Germany (D), Austria (A) and Switzerland (CH)] were researched through the national societies...
November 6, 2018: Annals of Intensive Care
F Sanfilippo, S Scolletta, A Morelli, A Vieillard-Baron
In the original article [1], the authors noticed a typographical error in Figure 2. The top left box should have included "E/A <0.8 and E <50 cm/s". Please see below the corrected figure.
November 6, 2018: Annals of Intensive Care
Marc Leone, Lila Bouadma, Bélaïd Bouhemad, Olivier Brissaud, Stéphane Dauger, Sébastien Gibot, Sami Hraiech, Boris Jung, Eric Kipnis, Yoann Launey, Charles-Edouard Luyt, Dimitri Margetis, Fabrice Michel, Djamel Mokart, Philippe Montravers, Antoine Monsel, Saad Nseir, Jérôme Pugin, Antoine Roquilly, Lionel Velly, Jean-Ralph Zahar, Rémi Bruyère, Gérald Chanques
BACKGROUND: The French Society of Anaesthesia and Intensive Care Medicine and the French Society of Intensive Care edited guidelines focused on hospital-acquired pneumonia (HAP) in intensive care unit. The goal of 16 French-speaking experts was to produce a framework enabling an easier decision-making process for intensivists. RESULTS: The guidelines were related to 3 specific areas related to HAP (prevention, diagnosis and treatment) in 4 identified patient populations (COPD, neutropenia, post-operative and paediatric)...
November 3, 2018: Annals of Intensive Care
Keyvan Razazi, Florence Boissier, Mathilde Neuville, Sébastien Jochmans, Martial Tchir, Faten May, Nicolas de Prost, Christian Brun-Buisson, Guillaume Carteaux, Armand Mekontso Dessap
BACKGROUND: Pleural effusion is common during invasive mechanical ventilation, but its role during weaning is unclear. We aimed at assessing the prevalence and risk factors for pleural effusion at initiation of weaning. We also assessed its impact on weaning outcomes and its evolution in patients with difficult weaning. METHODS: We performed a prospective multicenter study in five intensive care units in France. Two hundred and forty-nine patients were explored using ultrasonography...
November 1, 2018: Annals of Intensive Care
Damien Roux, Richard Moreau, Didier Dreyfuss
No abstract text is available yet for this article.
October 29, 2018: Annals of Intensive Care
Olivier Lesur, Eugénie Delile, Pierre Asfar, Peter Radermacher
BACKGROUND: Improving sepsis support is one of the three pillars of a 2017 resolution according to the World Health Organization (WHO). Septic shock is indeed a burden issue in the intensive care units. Hemodynamic stabilization is a cornerstone element in the bundle of supportive treatments recommended in the Surviving Sepsis Campaign (SSC) consecutive biannual reports. MAIN BODY: The "Pandera's box" of septic shock hemodynamics is an eternal debate, however, with permanent contentious issues...
October 29, 2018: Annals of Intensive Care
F Sanfilippo, S Scolletta, A Morelli, A Vieillard-Baron
There is growing evidence both in the perioperative period and in the field of intensive care (ICU) on the association between left ventricular diastolic dysfunction (LVDD) and worse outcomes in patients. The recent American Society of Echocardiography and European Association of Cardiovascular Imaging joint recommendations have tried to simplify the diagnosis and the grading of LVDD. However, both an often unknown pre-morbid LV diastolic function and the presence of several confounders-i.e., use of vasopressors, positive pressure ventilation, volume loading-make the proposed parameters difficult to interpret, especially in the ICU...
October 29, 2018: Annals of Intensive Care
Woo Jin Jang, Yang Hyun Cho, Taek Kyu Park, Young Bin Song, Jin-Oh Choi, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Eun-Seok Jeon, Woo Jung Chun, Ju Hyeon Oh, Jeong Hoon Yang
BACKGROUND: Limited data are available regarding prevention of limb ischemia in femorally cannulated patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO). We investigated the association between strategy of distal perfusion catheter (DPC) insertion and vascular complications like limb ischemia in patients undergoing VA-ECMO. METHODS: We evaluated 230 patients from two tertiary hospitals who received VA-ECMO via femoral cannulation between August 2014 and July 2017...
October 29, 2018: Annals of Intensive Care
Charles Chin Han Lew, Gabriel Jun Yung Wong, Ka Po Cheung, Robert J L Fraser, Ai Ping Chua, Mary Foong Fong Chong, Michelle Miller
BACKGROUND: The timing and dose of exclusive nutrition support (ENS) have not been investigated in previous studies aimed at validating the modified Nutrition Risk in Critically Ill (mNUTRIC) score. We therefore evaluated the mNUTRIC score by determining the association between dose of nutrition support and 28-day mortality in high-risk patients who received short- and longer-term ENS (≤ 6 days vs. ≥ 7 days). METHODS: A prospective cohort study included data from 252 adult patients with > 48 h of mechanical ventilation in a tertiary care institution in Singapore...
October 22, 2018: Annals of Intensive Care
Lara Hessels, Annemieke Oude Lansink-Hartgring, Miriam Zeillemaker-Hoekstra, Maarten W Nijsten
BACKGROUND: Nonosmotic sodium storage has been reported in animals, healthy individuals and patients with hypertension, hyperaldosteronism and end-stage kidney disease. Sodium storage has not been studied in ICU patients, who frequently receive large amounts of sodium chloride-containing fluids. The objective of our study was to estimate sodium that cannot be accounted for by balance studies in critically ill patients. Chloride was also studied. We used multiple scenarios and assumptions for estimating sodium and chloride balances...
October 11, 2018: Annals of Intensive Care
Alessandro Putzu, Carolina Maria Pinto Domingues de Carvalho E Silva, Juliano Pinheiro de Almeida, Alessandro Belletti, Tiziano Cassina, Giovanni Landoni, Ludhmila Abrahao Hajjar
BACKGROUND: The effects of perioperative statin therapy on clinical outcome after cardiac or non-cardiac surgery are controversial. We aimed to assess the association between perioperative statin therapy and postoperative outcome. METHODS: Electronic databases were searched up to May 1, 2018, for randomized controlled trials of perioperative statin therapy versus placebo or no treatment in adult cardiac or non-cardiac surgery. Postoperative outcomes were: myocardial infarction, stroke, acute kidney injury (AKI), and mortality...
September 27, 2018: Annals of Intensive Care
Patrick M Honore, David De Bels, Herbert D Spapen
No abstract text is available yet for this article.
September 27, 2018: Annals of Intensive Care
Kuo-Chin Kao, Ko-Wei Chang, Ming-Cheng Chan, Shinn-Jye Liang, Ying-Chun Chien, Han-Chung Hu, Li-Chung Chiu, Wei-Chih Chen, Wen-Feng Fang, Yu-Mu Chen, Chau-Chyun Sheu, Ming-Ju Tsai, Wann-Cherng Perng, Chung-Kan Peng, Chieh-Liang Wu, Hao-Chien Wang, Kuang-Yao Yang
BACKGROUND: Patients with influenza complicated with pneumonia are at high risk of rapid progression to acute respiratory distress syndrome (ARDS). Prone positioning with longer duration and lung-protective strategies might reduce the mortality level in ARDS. The aim of this study is to investigate the survival predictors of prone positioning in patients with ARDS caused by influenza pneumonia. METHODS: This retrospective study was conducted by eight tertiary referral centers in Taiwan...
September 24, 2018: Annals of Intensive Care
(no author information available yet)
BACKGROUND: Although oversedation has been associated with increased morbidity in ventilated critically ill patients, it is unclear whether prevention of oversedation improves mortality. We aimed to assess 90-day mortality in patients receiving a bundle of interventions to prevent oversedation as compared to usual care. METHODS: In this randomized multicentre trial, all adult patients requiring mechanical ventilation for more than 48 h were included. Two groups were compared: patients managed according to usual sedation practices (control), and patients receiving sedation according to an algorithm which provided a gradual multilevel response to pain, agitation, and ventilator dyssynchrony with no specific target to alter consciousness and no use of sedation scale and promoted the use of alternatives to continuous infusion of midazolam or propofol (intervention)...
September 21, 2018: Annals of Intensive Care
Julian Flükiger, Alexa Hollinger, Benjamin Speich, Vera Meier, Janna Tontsch, Tatjana Zehnder, Martin Siegemund
BACKGROUND: To determine the preventive and therapeutic effect of dexmedetomidine on intensive care unit (ICU) delirium. METHODS: The literature search using PubMed and the Cochrane Central Register of Controlled Trials was performed (August 1, 2018) to detect all randomized controlled trials (RCTs) of adult ICU patients receiving dexmedetomidine. Articles were included if they assessed the influence of dexmedetomidine compared to a sedative agent on incidence of ICU delirium or treatment of this syndrome...
September 20, 2018: Annals of Intensive Care
Xiukai Chen, Xiaoting Wang, Patrick M Honore, Herbert D Spapen, Dawei Liu
The central venous pressure (CVP) is traditionally used as a surrogate of intravascular volume. CVP measurements therefore are often applied at the bedside to guide fluid administration in postoperative and critically ill patients. Pursuing high CVP levels has recently been challenged. A high CVP might impede venous return to the heart and disturb microcirculatory blood flow which may cause tissue congestion and organ failure. By imposing an increased "afterload" on the kidney, an elevated CVP will particularly harm kidney hemodynamics and promote acute kidney injury (AKI) even in the absence of volume overload...
September 20, 2018: Annals of Intensive Care
Nicolas Libert, Guillaume Chenegros, Anatole Harrois, Nathalie Baudry, Gilles Cordurie, Ryad Benosman, Eric Vicaut, Jacques Duranteau
BACKGROUND: Closed-loop resuscitation can improve personalization of care, decrease workload and bring expert knowledge in isolated areas. We have developed a new device to control the administration of fluid or simultaneous co-administration of fluid and norepinephrine using arterial pressure. METHOD: We evaluated the performance of our prototype in a rodent model of haemorrhagic shock. After haemorrhagic shock, rats were randomized to five experimental groups: three were resuscitated with fluid and two with co-administration of fluid and norepinephrine...
September 17, 2018: Annals of Intensive Care
Julien Demiselle, Martin Wepler, Clair Hartmann, Peter Radermacher, Frédérique Schortgen, Ferhat Meziani, Mervyn Singer, Valérie Seegers, Pierre Asfar
BACKGROUND: Criteria for the Sepsis-3 definition of septic shock include vasopressor treatment to maintain a mean arterial pressure > 65 mmHg and a lactate concentration > 2 mmol/L. The impact of hyperoxia in patients with septic shock using these criteria is unknown. METHODS: A post hoc analysis was performed of the HYPER2S trial assessing hyperoxia versus normoxia in septic patients requiring vasopressor therapy, in whom a plasma lactate value was available at study inclusion...
September 17, 2018: Annals of Intensive Care
Marylin Schmitz, Xavier Roux, Benedikt Huttner, Jérôme Pugin
The streptococcal toxic shock syndrome is a severe complication associated with invasive infections by group A streptococci. In spite of medical progresses in the care of patients with septic shock during the last decades, this condition has remained associated with a high mortality. Early recognition and multidisciplinary management are key to the care of patients with streptococcal toxic shock syndrome, with intensive and appropriate intensive support of failing organs, rapid diagnosis of infectious source(s), and surgical management...
September 17, 2018: Annals of Intensive Care
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