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World Journal of Critical Care Medicine

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https://www.readbyqxmd.com/read/29152465/reproducibility-of-diaphragm-thickness-measurements-by-ultrasonography-in-patients-on-mechanical-ventilation
#1
Ashesh Dhungana, Gopi Khilnani, Vijay Hadda, Randeep Guleria
AIM: To prospectively evaluate the reproducibility of diaphragm thickness measurement by ultrasonography at the bedside by critical care physicians in patients on invasive mechanical ventilation. METHODS: In a prospective observational study of 64 invasively ventilated patients, diaphragmatic thickness measurement was taken by 2 different observers at the same site. Three measurements were taken by each observer and averaged. The intraobserver and interobserver variability was assessed by estimation of intraclass correlation coefficient...
November 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29152464/intensivist-based-deep-sedation-using-propofol-for-pediatric-outpatient-flexible-bronchoscopy
#2
Kamal Abulebda, Samer Abu-Sultaneh, Sheikh Sohail Ahmed, Elizabeth A S Moser, Renee C McKinney, Riad Lutfi
AIM: To evaluate the safety and efficacy of sedating pediatric patients for outpatient flexible bronchoscopy. METHODS: A retrospective chart review was conducted for all children, age 17 years or under who underwent flexible bronchoscopy under deep sedation in an outpatient hospital-based setting. Two sedation regimens were used; propofol only or ketamine prior to propofol. Patients were divided into three age groups; infants (less than 12 mo), toddlers (1-3 years) and children (4-17 years)...
November 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28828302/algorithm-based-arterial-blood-sampling-recognition-increasing-safety-in-point-of-care-diagnostics
#3
Jörg Peter, Wilfried Klingert, Kathrin Klingert, Karolin Thiel, Daniel Wulff, Alfred Königsrainer, Wolfgang Rosenstiel, Martin Schenk
AIM: To detect blood withdrawal for patients with arterial blood pressure monitoring to increase patient safety and provide better sample dating. METHODS: Blood pressure information obtained from a patient monitor was fed as a real-time data stream to an experimental medical framework. This framework was connected to an analytical application which observes changes in systolic, diastolic and mean pressure to determine anomalies in the continuous data stream. Detection was based on an increased mean blood pressure caused by the closing of the withdrawal three-way tap and an absence of systolic and diastolic measurements during this manipulation...
August 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28828301/effects-of-intrapulmonary-percussive-ventilation-on-airway-mucus-clearance-a-bench-model
#4
Lorena Fernandez-Restrepo, Lauren Shaffer, Bravein Amalakuhan, Marcos I Restrepo, Jay Peters, Ruben Restrepo
AIM: To determine the ability of intrapulmonary percussive ventilation (IPV) to promote airway clearance in spontaneously breathing patients and those on mechanical ventilation. METHODS: An artificial lung was used to simulate a spontaneously breathing patient (Group 1), and was then connected to a mechanical ventilator to simulate a patient on mechanical ventilation (Group 2). An 8.5 mm endotracheal tube (ETT) connected to the test lung, simulated the patient airway...
August 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28828300/generalizable-items-and-modular-structure-for-computerised-physician-staffing-calculation-on-intensive-care-units
#5
REVIEW
Manfred Weiss, Gernot Marx, Thomas Iber
Intensive care medicine remains one of the most cost-driving areas within hospitals with high personnel costs. Under the scope of limited budgets and reimbursement, realistic needs are essential to justify personnel staffing. Unfortunately, all existing staffing models are top-down calculations with a high variability in results. We present a workload-oriented model, integrating quality of care, efficiency of processes, legal, educational, controlling, local, organisational and economic aspects. In our model, the physician's workload solely related to the intensive care unit depends on three tasks: Patient-oriented tasks, divided in basic tasks (performed in every patient) and additional tasks (necessary in patients with specific diagnostic and therapeutic requirements depending on their specific illness, only), and non patient-oriented tasks...
August 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28828299/immunomodulatory-effects-of-anesthetics-in-obese-patients
#6
REVIEW
Luciana Boavista Barros Heil, Pedro Leme Silva, Paolo Pelosi, Patricia Rieken Macedo Rocco
Anesthesia and surgery have an impact on inflammatory responses, which influences perioperative homeostasis. Inhalational and intravenous anesthesia can alter immune-system homeostasis through multiple processes that include activation of immune cells (such as monocytes, neutrophils, and specific tissue macrophages) with release of pro- or anti-inflammatory interleukins, upregulation of cell adhesion molecules, and overproduction of oxidative radicals. The response depends on the timing of anesthesia, anesthetic agents used, and mechanisms involved in the development of inflammation or immunosuppression...
August 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28529915/hemolytic-uremic-syndrome-in-adults-a-case-report
#7
Fabiel Gerardo Pérez-Cruz, Patricia Villa-Díaz, María Consuelo Pintado-Delgado, María Loreto Fernández Rodríguez, Ana Blasco-Martínez, María Pérez-Fernández
Thrombotic microangiopathies (TMA) are microvascular occlusive disorders characterized by platelet aggregation and mechanical damage to erythrocytes, clinically characterized by microangiopatic haemolytic anemia, thrombocytopenia and organ injury. We are reporting a case of a woman patient with severe hemolytic uremic syndrome associated to infectious diarrhoea caused by Shiga toxin-producing pathogen, who were admitted to our intensive care unit. The patient described developed as organ injury, neurological failure and acute renal failure, with need of haemodialysis technique...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28529914/characteristics-of-postintensive-care-syndrome-in-survivors-of-pediatric-critical-illness-a-systematic-review
#8
Elizabeth A Herrup, Beth Wieczorek, Sapna R Kudchadkar
AIM: To synthesize the available evidence focusing on morbidities in pediatric survivors of critical illness that fall within the defined construct of postintensive care syndrome (PICS) in adults, including physical, neurocognitive and psychological morbidities. METHODS: A comprehensive search was conducted in MEDLINE, EMBASE, the Cochrane Library, PsycINFO, and CINAHL using controlled vocabulary and key word terms to identify studies reporting characteristics of PICS in pediatric intensive care unit (PICU) patients...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28529913/critical-care-management-and-intensive-care-unit-outcomes-following-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy
#9
Sumit Kapoor, Adel Bassily-Marcus, Rafael Alba Yunen, Parissa Tabrizian, Sabrine Semoin, Joseph Blankush, Daniel Labow, John Oropello, Anthony Manasia, Roopa Kohli-Seth
AIM: To study the early postoperative intensive care unit (ICU) management and complications in the first 2 wk of patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Our study is a retrospective, observational study performed at Icahn School of Medicine at Mount Sinai, quaternary care hospital in New York City. All adult patients who underwent CRS and HIPEC between January 1, 2007 and December 31, 2012 and admitted to ICU postoperatively were studied...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28529912/female-gonadal-hormone-effects-on-microglial-activation-and-functional-outcomes-in-a-mouse-model-of-moderate-traumatic-brain-injury
#10
Odera Umeano, Haichen Wang, Hana Dawson, Beilei Lei, Afoma Umeano, Dawn Kernagis, Michael L James
AIM: To address the hypothesis that young, gonad-intact female mice have improved long-term recovery associated with decreased neuroinflammation compared to male mice. METHODS: Eight to ten week-old male, female, and ovariectomized (OVX) mice underwent closed cranial impact. Gonad-intact female mice were injured only in estrus state. After injury, between group differences were assessed using complementary immunohistochemical staining for microglial cells at 1 h, mRNA polymerase chain reaction for inflammatory markers at 1 h after injury, Rotarod over days 1-7, and water maze on days 28-31 after injury...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28529911/severe-trauma-in-the-geriatric-population
#11
REVIEW
Juan Antonio Llompart-Pou, Jon Pérez-Bárcena, Mario Chico-Fernández, Marcelino Sánchez-Casado, Joan Maria Raurich
Geriatric trauma constitutes an increasingly recognized problem. Aging results in a progressive decline in cellular function which leads to a loose of their capacity to respond to injury. Some medications commonly used in this population can mask or blunt the response to injury. Falls constitute the most common cause of trauma and the leading cause of trauma-related deaths in this population. Falls are complicated by the widespread use of antiplatelets and anticoagulants, especially in patients with brain injury...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28529910/generalizable-items-of-quantitative-and-qualitative-cornerstones-for-personnel-requirement-of-physicians-in-anesthesia
#12
REVIEW
Manfred Weiss, Rolf Rossaint, Thomas Iber
Anesthesiologists perform a broad spectrum of tasks. However, in many countries, there is no legal basis for personnel staffing of physicians in anesthesia. Also, the German diagnosis related groups system for refunding does not deliver such a basis. Thus, in 2006 a new calculation base for the personnel requirement that included an Excel calculation sheet was introduced by the German Board of Anesthesiologists (BDA) and the German Society of Anesthesiology and Intensive Care Medicine (DGAI), and updated in 2009 and 2015...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224112/intravenous-vitamin-c-as-adjunctive-therapy-for-enterovirus-rhinovirus-induced-acute-respiratory-distress-syndrome
#13
Alpha A Fowler Iii, Christin Kim, Lawrence Lepler, Rajiv Malhotra, Orlando Debesa, Ramesh Natarajan, Bernard J Fisher, Aamer Syed, Christine DeWilde, Anna Priday, Vigneshwar Kasirajan
We report a case of virus-induced acute respiratory distress syndrome (ARDS) treated with parenteral vitamin C in a patient testing positive for enterovirus/rhinovirus on viral screening. This report outlines the first use of high dose intravenous vitamin C as an interventional therapy for ARDS, resulting from enterovirus/rhinovirus respiratory infection. From very significant preclinical research performed at Virginia Commonwealth University with vitamin C and with the very positive results of a previously performed phase I safety trial infusing high dose vitamin C intravenously into patients with severe sepsis, we reasoned that infusing identical dosing to a patient with ARDS from viral infection would be therapeutic...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224111/attributable-cost-of-a-nosocomial-infection-in-the-intensive-care-unit-a-prospective-cohort-study
#14
Binila Chacko, Kurien Thomas, Thambu David, Hema Paul, Lakshmanan Jeyaseelan, John Victor Peter
AIM: To study the impact of hospital-acquired infections (HAIs) on cost and outcome from intensive care units (ICU) in India. METHODS: Adult patients (> 18 years) admitted over 1-year, to a 24-bed medical critical care unit in India, were enrolled prospectively. Treatment cost and outcome data were collected. This cost data was merged with HAI data collected prospectively by the Hospital Infection Control Committee. Only infections occurring during ICU stay were included...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224110/comparison-of-inhaled-milrinone-nitric-oxide-and-prostacyclin-in-acute-respiratory-distress-syndrome
#15
Martin Albert, Daniel Corsilli, David R Williamson, Marc Brosseau, Patrick Bellemare, Stéphane Delisle, Anne Qn Nguyen, France Varin
AIM: To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome (ARDS). METHODS: Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of iNO (20 ppm) or nebulized epoprostenol (10 μg/mL) was done in all patients...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224109/timing-method-and-discontinuation-of-hydrocortisone-administration-for-septic-shock-patients
#16
Miguel A Ibarra-Estrada, Quetzalcóatl Chávez-Peña, Claudia I Reynoso-Estrella, Jorge Rios-Zermeño, Pável E Aguilera-González, Miguel A García-Soto, Guadalupe Aguirre-Avalos
AIM: To characterize the prescribing patterns for hydrocortisone for patients with septic shock and perform an exploratory analysis in order to identify the variables associated with better outcomes. METHODS: This prospective cohort study included 59 patients with septic shock who received stress-dose hydrocortisone. It was performed at 2 critical care units in academic hospitals from June 1st, 2015, to July 31st, 2016. Demographic data, comorbidities, medical management details, adverse effects related to corticosteroids, and outcomes were collected after the critical care physician indicated initiation of hydrocortisone...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224108/implementation-of-enteral-feeding-protocol-in-an-intensive-care-unit-before-and-after-study
#17
Martin Padar, Gerli Uusvel, Liis Starkopf, Joel Starkopf, Annika Reintam Blaser
AIM: To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients. METHODS: An uncontrolled, observational before-and-after study was performed in a tertiary mixed medical-surgical intensive care unit (ICU). In 2013, a nurse-driven enteral feeding protocol was developed and implemented in the ICU. Nutrition and outcome-related data from patients who were treated in the study unit from 2011-2012 (the Before group) and 2014-2015 (the After group) were obtained from a local electronic database, the national Population Registry and the hospital's Infection Control Service...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224107/risk-factors-for-mortality-in-postoperative-peritonitis-in-critically-ill-patients
#18
Yoann Launey, Benjamin Duteurtre, Raphaëlle Larmet, Nicolas Nesseler, Audrey Tawa, Yannick Mallédant, Philippe Seguin
AIM: To identify the risk factors for mortality in intensive care patients with postoperative peritonitis (POP). METHODS: This was a retrospective analysis using a prospective database that includes all patients hospitalized in a surgical intensive care unit for POP from September 2006 to August 2011. The data collected included demographics, comorbidities, postoperative severity parameters, bacteriological findings, adequacy of antimicrobial therapy and surgical treatments...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224106/impact-of-high-dose-vitamin-c-on-platelet-function
#19
Bassem M Mohammed, Kimberly W Sanford, Bernard J Fisher, Erika J Martin, Daniel Contaifer, Urszula Osinska Warncke, Dayanjan S Wijesinghe, Charles E Chalfant, Donald F Brophy, Alpha A Fowler Iii, Ramesh Natarajan
AIM: To examine the effect of high doses of vitamin C (VitC) on ex vivo human platelets (PLTs). METHODS: Platelet concentrates collected for therapeutic or prophylactic transfusions were exposed to: (1) normal saline (control); (2) 0.3 mmol/L VitC (Lo VitC); or (3) 3 mmol/L VitC (Hi VitC, final concentrations) and stored appropriately. The VitC additive was preservative-free buffered ascorbic acid in water, pH 5.5 to 7.0, adjusted with sodium bicarbonate and sodium hydroxide...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224105/nutrient-stimulation-of-mesenteric-blood-flow-implications-for-older-critically-ill-patients
#20
REVIEW
Thu An Nguyen, Yasmine Ali Abdelhamid, Liza K Phillips, Leeanne S Chapple, Michael Horowitz, Karen L Jones, Adam M Deane
Nutrient ingestion induces a substantial increase in mesenteric blood flow. In older persons (aged ≥ 65 years), particularly those with chronic medical conditions, the cardiovascular compensatory response may be inadequate to maintain systemic blood pressure during mesenteric blood pooling, leading to postprandial hypotension. In older ambulatory persons, postprandial hypotension is an important pathophysiological condition associated with an increased propensity for syncope, falls, coronary vascular events, stroke and death...
February 4, 2017: World Journal of Critical Care Medicine
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