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Annals of Intensive Care

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https://www.readbyqxmd.com/read/29766322/microdaimon-study-microcirculatory-daily-monitoring-in-critically-ill-patients-a-prospective-observational-study
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/29721786/data-driving-methods-more-than-merely-trendy-buzzwords
#7
REVIEW
Julien Textoris, Fabio Silvio Taccone, Lara Zafrani, Antoine Guillon, Sébastien Gibot, Fabrice Uhel, Eric Azabou, Guillaume Monneret, Frédéric Pène, Nicolas de Prost, Stein Silva
No abstract text is available yet for this article.
May 2, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29721722/proceedings-of-r%C3%A3-animation-2018-the-french-intensive-care-society-international-congress-physiotherapists-communications
#8
(no author information available yet)
No abstract text is available yet for this article.
May 2, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29721645/midazolam-increases-preload-dependency-during-endotoxic-shock-in-rabbits-by-affecting-venous-vascular-tone
#9
Jianxiao Chen, Tao Yu, Federico Longhini, Xiwen Zhang, Songqiao Liu, Ling Liu, Yi Yang, Haibo Qiu
BACKGROUND: Septic patients often require sedation in intensive care unit, and midazolam is one of the most frequently used sedatives among them. But the interaction between midazolam and septic shock is not known. The aim of this study is to investigate the effects of midazolam on preload dependency in an endotoxic shock model by evaluating systemic vascular tone and cardiac function. METHODS: Eighteen rabbits were randomly divided into three groups: Control group, MID1 group and MID2 group...
May 2, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29717382/iron-metabolism-in-critically-ill-patients-developing-anemia-of-inflammation-a-case-control-study
#10
Margit Boshuizen, Jan M Binnekade, Benjamin Nota, Kirsten van de Groep, Olaf L Cremer, Pieter R Tuinman, Janneke Horn, Marcus J Schultz, Robin van Bruggen, Nicole P Juffermans
BACKGROUND: Anemia occurring as a result of inflammatory processes (anemia of inflammation, AI) has a high prevalence in critically ill patients. Knowledge on changes in iron metabolism during the course of AI is limited, hampering the development of strategies to counteract AI. This case control study aimed to investigate iron metabolism during the development of AI in critically ill patients. METHODS: Iron metabolism in 30 patients who developed AI during ICU stay was compared with 30 septic patients with a high Hb and 30 non-septic patients with a high Hb...
May 2, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29704160/there-is-more-to-septic-shock-than-arterial-hypotension-and-elevated-lactate-levels-another-appeal-to-rethink-current-resuscitation-strategies
#11
REVIEW
Martin W Dünser, Arnaldo Dubin
No abstract text is available yet for this article.
April 27, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29691755/my-patient-has-received-fluid-how-to-assess-its-efficacy-and-side-effects
#12
REVIEW
Xavier Monnet, Jean-Louis Teboul
Many efforts have been made to predict, before giving fluid, whether it will increase cardiac output. Nevertheless, after fluid administration, it is also essential to assess the therapeutic efficacy and to look for possible adverse effects. Like for any drug, this step should not be missed. Basically, volume expansion is aimed at improving tissue oxygenation and organ function. To assess this final result, clinical signs are often unhelpful. The increase in urine output in case of acute kidney injury is a poor marker of the kidney perfusion improvement...
April 24, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29687277/early-goal-directed-therapy-using-a-physiological-holistic-view-the-andromeda-shock-a-randomized-controlled-trial
#13
Glenn Hernández, Alexandre Biasi Cavalcanti, Gustavo Ospina-Tascón, Fernando Godinho Zampieri, Arnaldo Dubin, F Javier Hurtado, Gilberto Friedman, Ricardo Castro, Leyla Alegría, Maurizio Cecconi, Jean-Louis Teboul, Jan Bakker
BACKGROUND: Septic shock is a highly lethal condition. Early recognition of tissue hypoperfusion and its reversion are key factors for limiting progression to multiple organ dysfunction and death. Lactate-targeted resuscitation is the gold-standard under current guidelines, although it has several pitfalls including that non-hypoxic sources of lactate might predominate in an unknown proportion of patients. Peripheral perfusion-targeted resuscitation might provide a real-time response to increases in flow that could lead to a more timely decision to stop resuscitation, thus avoiding fluid overload and the risks of over-resuscitation...
April 23, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29687276/diaphragm-function-and-weaning-from-mechanical-ventilation-an-ultrasound-and-phrenic-nerve-stimulation-clinical-study
#14
Martin Dres, Ewan C Goligher, Bruno-Pierre Dubé, Elise Morawiec, Laurence Dangers, Danielle Reuter, Julien Mayaux, Thomas Similowski, Alexandre Demoule
BACKGROUND: Diaphragm dysfunction is defined by a value of twitch tracheal pressure in response to magnetic phrenic stimulation (twitch pressure) amounting to less than 11 cmH2 O. This study assessed whether this threshold or a lower one would predict accurately weaning failure from mechanical ventilation. Twitch pressure was compared to ultrasound measurement of diaphragm function. METHODS: In patients undergoing a first spontaneous breathing trial, diaphragm function was evaluated by twitch pressure and by diaphragm ultrasound (thickening fraction)...
April 23, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29675758/the-prognostic-impact-of-abdominal-surgery-in-cancer-patients-with-neutropenic-enterocolitis-a-systematic-review-and-meta-analysis-on-behalf-the-groupe-de-recherche-en-r%C3%A3-animation-respiratoire-du-patient-d-onco-h%C3%A3-matologie-grrr-oh
#15
REVIEW
Colombe Saillard, Lara Zafrani, Michael Darmon, Magali Bisbal, Laurent Chow-Chine, Antoine Sannini, Jean-Paul Brun, Jacques Ewald, Olivier Turrini, Marion Faucher, Elie Azoulay, Djamel Mokart
Neutropenic enterocolitis (NE) is a diagnostic and therapeutic challenge associated with high mortality rates, with controversial opinions on its optimal management. Physicians are usually reluctant to select surgery as the first-choice treatment, concerns being raised regarding the potential risks associated with abdominal surgery during neutropenia. Nevertheless, no published studies comforted this idea, literature is scarce and surgery has never been compared to medical treatment. This review and meta-analysis aimed to determine the prognostic impact of abdominal surgery on outcome of neutropenic cancer patients presenting with NE, versus medical conservative treatment...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29675709/acid-base-status-and-its-clinical-implications-in-critically-ill-patients-with-cirrhosis-acute-on-chronic-liver-failure-and-without-liver-disease
#16
Andreas Drolz, Thomas Horvatits, Kevin Roedl, Karoline Rutter, Richard Brunner, Christian Zauner, Peter Schellongowski, Gottfried Heinz, Georg-Christian Funk, Michael Trauner, Bruno Schneeweiss, Valentin Fuhrmann
BACKGROUND: Acid-base disturbances are frequently observed in critically ill patients at the intensive care unit. To our knowledge, the acid-base profile of patients with acute-on-chronic liver failure (ACLF) has not been evaluated and compared to critically ill patients without acute or chronic liver disease. RESULTS: One hundred and seventy-eight critically ill patients with liver cirrhosis were compared to 178 matched controls in this post hoc analysis of prospectively collected data...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29675561/de-escalation-of-antifungal-treatment-in-critically-ill-patients-with-suspected-invasive-candida-infection-incidence-associated-factors-and-safety
#17
Karim Jaffal, Julien Poissy, Anahita Rouze, Sébastien Preau, Boualem Sendid, Marjorie Cornu, Saad Nseir
BACKGROUND: Antifungal treatment is common in critically ill patients, but only a small proportion of patients receiving antifungals have a proven fungal infection. However, antifungal treatment has side effects such as toxicity, emergence of resistance, and high cost. Moreover, empirical antifungal treatment is still a matter for debate in these patients. Our study aimed to determine the incidence, associated factors, and safety of de-escalation of antifungals in critically ill patients...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29671149/biological-scoring-system-for-early-prediction-of-acute-bowel-ischemia-after-cardiac-surgery-the-palm-score
#18
Elie Zogheib, Cyril Cosse, Charles Sabbagh, Simon Marx, Thierry Caus, Marc Henry, Joseph Nader, Mathurin Fumery, Michael Bernasinski, Patricia Besserve, Faouzi Trojette, Cedric Renard, Pierre Duhaut, Said Kamel, Jean-Marc Regimbeau, Hervé Dupont
BACKGROUND: Bowel ischemia is a life-threatening emergency defined as an inadequate vascular perfusion leading to bowel inflammation resulting from impaired colonic/small bowel blood supply. Main issue for physicians regarding bowel ischemia diagnosis lies in the absence of informative and specific clinical or biological signs leading to delayed management, resulting in a poorer prognosis, especially after cardiac surgery. The aim of the present series was to propose a simple scoring system based on biological data for the diagnosis of bowel ischemia...
April 18, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29666961/a-novel-sampling-method-to-detect-airborne-influenza-and-other-respiratory-viruses-in-mechanically-ventilated-patients-a-feasibility-study
#19
Alicia B Mitchell, Benjamin Tang, Maryam Shojaei, Lachlan S Barnes, Marek Nalos, Brian G Oliver, Anthony S McLean
BACKGROUND: Respiratory viruses circulate constantly in the ambient air. The risk of opportunistic infection from these viruses can be increased in mechanically ventilated patients. The present study evaluates the feasibility of detecting airborne respiratory viruses in mechanically ventilated patients using a novel sample collection method involving ventilator filters. METHODS: We collected inspiratory and expiratory filters from the ventilator circuits of mechanically ventilated patients in an intensive care unit over a 14-month period...
April 17, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29616433/mortality-and-detailed-characteristics-of-pre-icu-qsofa-negative-patients-with-suspected-sepsis-an-observational-study
#20
Izumi Nakayama, Junichi Izawa, Hideyuki Mouri, Tetsuhisa Kitamura, Junji Shiotsuka
BACKGROUND: Recent studies have suggested that quick Sequential Organ Failure Assessment (qSOFA) scores have limited utility in early prognostication in high-mortality populations. The purpose of this study was to investigate the association between pre-ICU qSOFA scores and in-hospital mortality among patients admitted to the ICU with suspected sepsis. This study also aimed to describe detailed clinical characteristics of qSOFA-negative (< 2) patients. METHODS: This single center, observational study, conducted in a Japanese tertiary care teaching hospital between May 2012 and June 2016, enrolled all consecutive adult patients admitted to the ICU with suspected sepsis...
April 3, 2018: Annals of Intensive Care
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