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Journal of Intensive Care

Shinichiro Ohshimo, Nobuaki Shime, Satoshi Nakagawa, Osamu Nishida, Shinhiro Takeda
Background: Since the 2009 pandemic influenza, we have nationally established a committee of the extracorporeal membrane oxygenation (ECMO) project. This project involves adequate respiratory management for severe respiratory failure using ECMO. This study aimed to investigate the correlations between changes in respiratory management using ECMO in Japan and outcomes of patients with influenza-associated acute respiratory failure between 2009 and 2016. Methods: We investigated the incidence, severity, characteristics, and prognosis of influenza-associated acute respiratory failure in 2016 by web-based surveillance...
2018: Journal of Intensive Care
Tomoya Hirose, Hiroshi Ogura, Hiroki Takahashi, Masahiro Ojima, Kang Jinkoo, Youhei Nakamura, Takashi Kojima, Takeshi Shimazu
Background: C1 inhibitor (C1-INH), which belongs to the superfamily of serine protease inhibitors, regulates the complement system and also the plasma kallikrein-kinin, fibrinolytic, and coagulation systems. The biologic activities of C1-INH can be divided into the regulation of vascular permeability and anti-inflammatory functions. The objective of this study was to clarify the serial change of C1-INH in patients with sepsis and evaluate the relationship with the shock severity. Methods: This was a single-center, prospective, observational study...
2018: Journal of Intensive Care
Hadrien Winiszewski, François Aptel, François Belon, Nicolas Belin, Claire Chaignat, Cyrille Patry, Cecilia Clermont, Elise David, Jean-Christophe Navellou, Guylaine Labro, Gaël Piton, Gilles Capellier
Background: While outcome improvement with extracorporeal CO2 removal (ECCO2 R) is not demonstrated, a strong pathophysiological rational supports its use in the setting of acute respiratory distress syndrome (ARDS) and COPD exacerbation. We aimed to describe our single-center experience of ECCO2 R indications and outcome. Methods: Patients treated with ECCO2 R in our medial ICU, from March 2014 to November 2017, were retrospectively enrolled. Primary end point was evolution of ventilator settings during the two first days following ECCO2 R start...
2018: Journal of Intensive Care
Sulagna Bhattacharjee, Kapil D Soni, Souvik Maitra
Background: Clinical benefits of recruitment maneuver in ARDS patients are controversial. A number of previous studies showed possible benefits; a large recent study reported that recruitment maneuver and PEEP titration may even be harmful. This meta-analysis was designed to compare the clinical utility of recruitment maneuver with low tidal volume ventilation in adult patients with ARDS. Methods: Randomized controlled trials comparing recruitment maneuver and lung protective ventilation strategy with lung protective strategy ventilation protocol alone in adult patients with ARDS has been included in this meta-analysis...
2018: Journal of Intensive Care
Jing Tao, Elena N Bukanova, Shamsuddin Akhtar
Background: Although factor Xa inhibitors have become a popular choice for chronic oral anticoagulation, effective drug reversal remains difficult due to a lack of specific antidote. Currently, 4-factor prothrombin complex concentrate (4F-PCC) is considered the treatment of choice for factor Xa inhibitor-related major bleeding. However, safety of 4F-PCC and its risk of thrombosis when used for this off-label purpose remain unclear. The purpose of this retrospective study is to determine the rate of thromboembolism when 4F-PCC is used for the emergent reversal of factor Xa inhibitors...
2018: Journal of Intensive Care
Takashi Mizutani, Norio Umemoto, Toshio Taniguchi, Hideki Ishii, Yuri Hiramatsu, Koji Arata, Horagaito Takuya, Sho Inoue, Tsuyoshi Sugiura, Toru Asai, Michiharu Yamada, Toyoaki Murohara, Kiyokazu Shimizu
Background: Serum lactate level can predict clinical outcomes in some critical cases. In the clinical setting, we noted that patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) and with poor serum lactate improvement often do not recover from cardiopulmonary arrest. Therefore, we investigated the association between lactate clearance and in-hospital mortality in cardiac arrest patients undergoing ECPR. Methods: Serum lactate levels were measured on admission and every hour after starting ECPR...
2018: Journal of Intensive Care
Ken Parhar, Victoria Millar, Vasileios Zochios, Emilia Bruton, Catherine Jaworski, Nick West, Alain Vuylsteke
[This corrects the article DOI: 10.1186/s40560-018-0275-y.].
2018: Journal of Intensive Care
Toru Hifumi, Yutaka Kondo, Keiki Shimizu, Yasufumi Miyake
Background: Heat stroke is a life-threatening injury requiring neurocritical care; however, heat stroke has not been completely examined due to several possible reasons, such as no universally accepted definition or classification, and the occurrence of heat wave victims every few years. Thus, in this review, we elucidate the definition/classification, pathophysiology, and prognostic factors related to heat stroke and also summarize the results of current studies regarding the management of heat stroke, including the use of intravascular balloon catheter system, blood purification therapy, continuous electroencephalogram monitoring, and anticoagulation therapy...
2018: Journal of Intensive Care
Yoshinori Kobayashi
[This corrects the article DOI: 10.1186/s40560-018-0292-x.].
2018: Journal of Intensive Care
Asadullah Naqvi, Derrick Clarence
Background: The case reinforces the importance of stepping back and looking at every possibility along with multiple co-existing pathologies. It takes into account the thought process of multiple systems and a multidisciplinary team approach. Learning points to take are that decompression illness can present atypically, but one must exclude other causes. Case presentation: We present the case of a 42-year-old male from the West Midlands, UK, who attended the emergency department post-scuba diving with confusion, light-headedness, left arm weakness, and bilateral paraesthesia of the hands...
2018: Journal of Intensive Care
Tomoya Okazaki, Yasuhiro Kuroda
Background: Aneurysmal subarachnoid hemorrhage is a life-threatening disease requiring neurocritical care. Delayed cerebral ischemia is a well-known complication that contributes to unfavorable neurological outcomes. Cerebral vasospasm has been thought to be the main cause of delayed cerebral ischemia, and although several studies were able to decrease cerebral vasospasm, none showed improved neurological outcomes. Our target is not cerebral vasospasm but improving neurological outcomes...
2018: Journal of Intensive Care
Gloria-Beatrice Wintermann, Jenny Rosendahl, Kerstin Weidner, Bernhard Strauß, Andreas Hinz, Katja Petrowski
Background: Protracted treatment on intensive care unit (ICU) sets the patients at increased risk for the development of chronic critical illness (CCI). Muscular and cardio-respiratory deconditioning are common long-term sequelae, going along with a state of chronic fatigue. At present, findings regarding the frequency, long-term course, and associated factors of self-reported fatigue following ICU treatment of CCI patients are lacking. Methods: CCI patients with the diagnosis of critical illness polyneuropathy/myopathy (CIP/CIM) were assessed at three time points...
2018: Journal of Intensive Care
Mitsuaki Nishikimi, Takayuki Ogura, Kota Matsui, Kunihiko Takahashi, Kenji Fukaya, Keibun Liu, Hideo Morita, Mitsunobu Nakamura, Shigeyuki Matsui, Naoyuki Matsuda
Background: Early brain CT is one of the most useful tools for estimating the prognosis in patients with post-cardiac arrest syndrome (PCAS) at the emergency department (ED). The aim of this study was to evaluate the prognosis-prediction accuracy of the emergency physicians' interpretation of the findings on early brain CT in PCAS patients treated by targeted temperature management (TTM). Methods: This was a double-center, retrospective, observational study. Eligible subjects were cardiac arrest patients admitted to the intensive care unit (ICU) for TTM between April 2011 and March 2017...
2018: Journal of Intensive Care
Pattarin Pirompanich, Sasithon Romsaiyut
[This corrects the article DOI: 10.1186/s40560-018-0277-9.].
2018: Journal of Intensive Care
Olga Rubio, Anna Arnau, Sílvia Cano, Carles Subirà, Begoña Balerdi, María Eugenía Perea, Miguel Fernández-Vivas, María Barber, Noemí Llamas, Susana Altaba, Ana Prieto, Vicente Gómez, Mar Martin, Marta Paz, Belen Quesada, Valentí Español, Juan Carlos Montejo, José Manuel Gomez, Gloria Miro, Judith Xirgú, Ana Ortega, Pedro Rascado, Juan María Sánchez, Alfredo Marcos, Ana Tizon, Pablo Monedero, Elisabeth Zabala, Cristina Murcia, Ines Torrejon, Kenneth Planas, José Manuel Añon, Gonzalo Hernandez, María-Del-Mar Fernandez, Consuelo Guía, Vanesa Arauzo, José Miguel Perez, Rosa Catalan, Javier Gonzalez, Rosa Poyo, Roser Tomas, Iñaki Saralegui, Jordi Mancebo, Charles Sprung, Rafael Fernández
Purpose: To determine the frequency of limitations on life support techniques (LLSTs) on admission to intensive care units (ICU), factors associated, and 30-day survival in patients with LLST on ICU admission. Methods: This prospective observational study included all patients admitted to 39 ICUs in a 45-day period in 2011. We recorded hospitals' characteristics (availability of intermediate care units, usual availability of ICU beds, and financial model) and patients' characteristics (demographics, reason for admission, functional status, risk of death, and LLST on ICU admission (withholding/withdrawing; specific techniques affected))...
2018: Journal of Intensive Care
Yoshinori Kobayashi
In the clinical practice of cardiovascular critical care, we often observe a variety of arrhythmias in the patients either with (secondary) or without (idiopathic) underlying heart diseases. In this manuscript, the clinical background and management of various arrhythmias treated in the CCU/ICU will be reviewed. The mechanism and background of lethal ventricular tachyarrhythmias vary as time elapses after the onset of MI that should be carefully considered to select a most suitable therapy. In the category of non-ischemic cardiomyopathy, several diseases are known to be complicated by the various ventricular tachyarrhythmias with some specific mechanisms...
2018: Journal of Intensive Care
De Wen Zhang, Jian He
Background: ILT4+ monocytes seem to be associated with poor prognosis of sepsis in humans, but the exact mechanisms are unknown. This study aimed to examine the biological behaviors and effects of immunoglobulin-like transcript-4 (ILT4) levels on monocytes during sepsis and on the prognosis of sepsis. Methods: ILT4+/+ (WT) and ILT4-knockout (ILT4-/- ) male BALB/c mice were used for sepsis modeling using cecal ligation puncture (CLP). Flow cytometry was used to measure the levels of ILT4 and major histocompatibility complex class II (MHC-II) on peripheral blood monocytes 24 h after CLP...
2018: Journal of Intensive Care
Bent-Are Hansen, Øyvind Bruserud
Background: Magnesium (Mg) is essential for life and plays a crucial role in several biochemical and physiological processes in the human body. Hypomagnesemia is common in all hospitalized patients, especially in critically ill patients with coexisting electrolyte abnormalities. Hypomagnesemia may cause severe and potential fatal complications if not timely diagnosed and properly treated, and associate with increased mortality. Main body: Mg deficiency in critically ill patients is mainly caused by gastrointestinal and/or renal disorders and may lead to secondary hypokalemia and hypocalcemia, and severe neuromuscular and cardiovascular clinical manifestations...
2018: Journal of Intensive Care
Takahiro Nakashima, Yoshio Tahara
Acute coronary syndrome (ACS) remains one of the leading causes of mortality worldwide. Appropriate management of ACS will lead to a lower incidence of cardiac arrest. Percutaneous coronary intervention (PCI) is the first-line treatment for patients with ACS. PCI techniques have become established. Thus, the establishment of a system of health care in the prehospital and emergency department settings is needed to reduce mortality in patients with ACS. In this review, evidence on how to achieve earlier diagnosis, therapeutic intervention, and decision to reperfuse with a focus on the prehospital and emergency department settings is systematically summarized...
2018: Journal of Intensive Care
Catherine M Dickinson, Brian W LeBlanc, Muhammad M Edhi, Daithi S Heffernan, Mohd Hafeez Faridi, Vineet Gupta, William G Cioffi, Xian O'Brien, Jonathan S Reichner
Background: Multi-organ failure occurs during critical illness and is mediated in part by destructive neutrophil-to-endothelial interactions. The β2 integrin receptor, CR3 (complement receptor 3; Mac-1; CD11b/CD18), which binds endothelial intercellular adhesion molecule-1 (ICAM-1), plays a key role in promoting the adhesion of activated neutrophils to inflamed endothelia which, when prolonged and excessive, can cause vascular damage. Leukadherin-1 (LA-1) is a small molecule allosteric activator of CR3 and has been shown to promote adhesion of blood neutrophils to inflamed endothelium and restrict tissue infiltration...
2018: Journal of Intensive Care
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