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Journal of Intensive Care

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https://www.readbyqxmd.com/read/29340154/the-impact-of-sepsis-delirium-and-psychological-distress-on-self-rated-cognitive-function-in-icu-survivors-a-prospective-cohort-study
#1
Emily Brück, Anna Schandl, Matteo Bottai, Peter Sackey
Background: Many intensive care unit (ICU) survivors develop psychological problems and cognitive impairment. The relation between sepsis, delirium, and later cognitive problems is not fully elucidated, and the impact of psychological symptoms on cognitive function is poorly studied in ICU survivors. The primary aim of this study was to examine the relationship between sepsis, ICU delirium, and later self-rated cognitive function. A second aim was to investigate the association between psychological problems and self-rated cognitive function 3 months after the ICU stay...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29308208/early-versus-late-tracheostomy-after-decompressive-craniectomy-for-stroke
#2
Michael P Catalino, Feng-Chang Lin, Nathan Davis, Keith Anderson, Casey Olm-Shipman, J Dedrick Jordan
Background: Stroke patients requiring decompressive craniectomy are at high risk of prolonged mechanical ventilation and ventilator-associated pneumonia (VAP). Tracheostomy placement may reduce the duration of mechanical ventilation. Predicting which patients will require tracheostomy and the optimal timing of tracheostomy remains a clinical challenge. In this study, the authors compare key outcomes after early versus late tracheostomy and develop a useful pre-operative decision-making tool to predict post-operative tracheostomy dependence...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29299314/consideration-of-pain-felt-by-patients-in-the-icu
#3
EDITORIAL
Ryuichi Hasegawa
Patients in the ICU are often treated under extreme conditions, with the patient often fearful of losing his life or experiencing severe pain. As a result, high-quality pain management is required. However, response to pain is often inadequate due to continuous administration of sedatives, difficulties in communicating with intubated patients, and/or poor awareness of pain in patients not receiving surgery. Reports on difficulties in pain management in the ICU are many, but few consider the correlation between pain management and patient prognosis...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29299313/evolved-role-of-the-cardiovascular-intensive-care-unit-cicu
#4
REVIEW
Shunji Kasaoka
Cardiovascular intensive care refers to special systemic management for the patients with severe cardiovascular disease (CVD), which consists of heart disease and vascular disease. CVD is one of the leading causes of death in the world. In order to prevent death due to CVDs, an intensive care unit for severe CVD patients, so-called cardiovascular intensive care unit (CICU), has been developed in many general hospitals. The technological developments of clinical cardiology, such as invasive hemodynamic monitoring and intracoronary interventional procedures and devices, have resulted in evolution of intensive care for CVDs...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29299312/presence-of-chest-tubes-does-not-affect-the-hemodynamic-efficacy-of-standard-cardiopulmonary-resuscitation
#5
Gu Hyun Kang, Hyun Youk, Kyoung Chul Cha, Yoonsuk Lee, Hyung Il Kim, Yong Sung Cha, Oh Hyun Kim, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang
Background: During cardiopulmonary resuscitation (CPR), chest tubes can hinder increases in intrathoracic pressure by venting the pressure during chest compressions, thus reducing the blood flow generated by the thoracic pump effect. The aim of the present study was to investigate the effects of chest tubes on hemodynamic efficacy during standard CPR in a swine model of cardiac arrest. Methods: Twelve domestic male pigs weighing 39.6 ± 8.4 kg underwent bilateral tube thoracostomy and received a total of 12 min of standard manual CPR, which comprised of two 6-min courses of CPR after 2 min of electrically induced ventricular fibrillation...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29276608/lithium-one-drug-five-complications
#6
Jeremy Zaworski, Pierre-Yves Delannoy, Nicolas Boussekey, Damien Thellier, Hugues Georges, Olivier Leroy
Background: Lithium poisoning could trigger multiple complications. We report the case of a lithium poisoning with five complications that are described for the first time together. Case report: A 60-year-old woman was admitted in our intensive care unit for altered consciousness. Severe lithium intoxication was diagnosed (lithium plasmatic level 8.21 mmol/l) associated with acute oliguric kidney failure. Continuous renal replacement therapy was started immediately...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29276607/ventilator-associated-respiratory-infection-in-a-resource-restricted-setting-impact-and-etiology
#7
Vu Dinh Phu, Behzad Nadjm, Nguyen Hoang Anh Duy, Dao Xuan Co, Nguyen Thi Hoang Mai, Dao Tuyet Trinh, James Campbell, Dong Phu Khiem, Tran Ngoc Quang, Huynh Thi Loan, Ha Son Binh, Quynh-Dao Dinh, Duong Bich Thuy, Huong Nguyen Phu Lan, Nguyen Hong Ha, Ana Bonell, Mattias Larsson, Hoang Minh Hoan, Đang Quoc Tuan, Hakan Hanberger, Hoang Nguyen Van Minh, Lam Minh Yen, Nguyen Van Hao, Nguyen Gia Binh, Nguyen Van Vinh Chau, Nguyen Van Kinh, Guy E Thwaites, Heiman F Wertheim, H Rogier van Doorn, C Louise Thwaites
Background: Ventilator-associated respiratory infection (VARI) is a significant problem in resource-restricted intensive care units (ICUs), but differences in casemix and etiology means VARI in resource-restricted ICUs may be different from that found in resource-rich units. Data from these settings are vital to plan preventative interventions and assess their cost-effectiveness, but few are available. Methods: We conducted a prospective observational study in four Vietnamese ICUs to assess the incidence and impact of VARI...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29234495/response-of-letter-to-the-editor-on-procalcitonin-a-promising-diagnostic-marker-for-sepsis-and-antibiotic-therapy
#8
R Saikant, Shilpa Ravindran, Ashitha Vijayan, Vani Maya, S Lakshmi, R Kartik, Manoj G
In a letter to the editor, Raineri SM et al. have given an insight of another dimension of procalcitonin (PCT) use as a diagnostic tool in invasive candidiasis. But based on our preliminary information, PCT is reported as unconventional modes of diagnosis approach which yet to prove its stand-alone biomarker properties for invasive candidiasis.
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29225888/contribution-to-diagnosis-and-treatment-of-bone-marrow-aspirate-results-in-critically-ill-patients-undergoing-bone-marrow-aspiration-a-retrospective-study-of-193-consecutive-patients
#9
Laure Calvet, Bruno Pereira, Anne-Françoise Sapin, Gabrielle Mareynat, Alexandre Lautrette, Bertrand Souweine
Background: The purpose of the work was to assess the contribution to diagnosis and/or treatment (CDT) of bone marrow aspiration (BMA) in the critically ill patient. Methods: The retrospective study included 193 patients. On the basis of BMA findings, contribution to diagnosis was defined by one of four previously unestablished diagnoses (maturation arrest of granulocyte precursors, hemophagocytic lymphohistiocytosis, hematological malignancy, marrow infiltration with cancer cells) and to treatment as the initiation or withdrawal of a specific treatment including the decision to forgo life-sustaining treatment (DFLST)...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29209502/monitoring-diaphragm-function-in-a-patient-with-myasthenia-gravis-electrical-activity-of-the-diaphragm-vs-maximal-inspiratory-pressure
#10
Yukiko Koyama, Takeshi Yoshida, Akinori Uchiyama, Yuji Fujino
Background: Maximal inspiratory pressure (MIP) is used to assess respiratory muscle strength of patients with myasthenia gravis (MG) requiring ventilatory support. Electrical activity of the diaphragm (E-di) has been used to guide weaning. Case presentation: The MIP and tidal volume/ΔE-di (the patient-to-ventilator breath contribution) were monitored in a 12-year-old girl with MG requiring ventilator support. The same ventilatory settings were maintained until extubation...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29201378/time-to-re-think-the-use-of-dobutamine-in-sepsis
#11
Ryota Sato, Michitaka Nasu
Dobutamine is commonly used worldwide and included in the protocol for early goal-directed therapy (EGDT). Since the use of dobutamine in EGDT was reported, it has been considered to be an important component, especially in the treatment of septic patients with myocardial dysfunction. However, it is questionable whether dobutamine improves the mortality of sepsis and septic shock. In three recent randomized controlled trials (ProCESS, ProMISe, and ARISE trials), the frequency of dobutamine use was significantly higher in the EGDT group than in the standard care group, but there were no significant differences in the mortality between the groups...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29201377/use-of-wearable-devices-for-post-discharge-monitoring-of-icu-patients-a-feasibility-study
#12
Ryan R Kroll, Erica D McKenzie, J Gordon Boyd, Prameet Sheth, Daniel Howes, Michael Wood, David M Maslove
Background: Wearable devices generate signals detecting activity, sleep, and heart rate, all of which could enable detailed and near-continuous characterization of recovery following critical illness. Methods: To determine the feasibility of using a wrist-worn personal fitness tracker among patients recovering from critical illness, we conducted a prospective observational study of a convenience sample of 50 stable ICU patients. We assessed device wearability, the extent of data capture, sensitivity and specificity for detecting heart rate excursions, and correlations with questionnaire-derived sleep quality measures...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29158900/single-measurement-of-plasminogen-activator-inhibitor-1-in-sepsis-is-it-useful-for-evaluating-the-severity-or-prognosis-of-sepsis
#13
Kansuke Koyama, Shin Nunomiya
No abstract text is available yet for this article.
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29158899/diaphragm-thickening-fraction-to-predict-weaning-a-prospective-exploratory-study
#14
Sujay Samanta, Ratender Kumar Singh, Arvind K Baronia, Banani Poddar, Afzal Azim, Mohan Gurjar
Background: Diaphragm ultrasound (DUS) is a well-established point of care modality for assessment of dimensional and functional aspects of the diaphragm. Amongst various measures, diaphragmatic thickening fraction (DTf) is more comprehensive. However, there is still uncertainty about its capability to predict weaning from mechanical ventilation (MV). The present prospective observational exploratory study assessed the diaphragm at variable negative pressure triggers (NPTs) with US to predict weaning in ICU patients...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29142756/usefulness-of-central-venous-saturation-as-a-predictor-of-thiamine-deficiency-in-critically-ill-patients-a-case-report
#15
Genri Numata, Satoshi Kodera, Hiroyuki Kiriyama, Atsuko Nakayama, Eisuke Amiya, Arihiro Kiyosue, Masaru Hatano, Eiki Takimoto, Masafumi Watanabe, Issei Komuro
Background: Central venous oxygen saturation (ScvO2) reflects the balance of oxygen delivery and consumption. Low ScvO2 indicates the presence of inadequate oxygen delivery, while high ScvO2 indicates reduced oxygen consumption and is sometimes associated with a high mortality rate in critically ill patients from dysoxia. Thiamine is an essential cofactor in cellular aerobic metabolism. Thiamine deficiency is more prevalent than was previously thought, and underlies severe conditions in critically ill patients...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29075499/metformin-therapy-and-postoperative-atrial-fibrillation-in-diabetic-patients-after-cardiac-surgery
#16
Suresh Basnet, Andrzej Kozikowski, Haiyan Sun, Melissa Troup, Luis E Urrutia, Renee Pekmezaris
BACKGROUND: Postoperative atrial fibrillation (AF) commonly occurs in cardiac surgery patients. Studies suggest inflammation and oxidative stress contribute to postoperative AF development in this patient population. Metformin exerts an anti-inflammatory effect that reduces oxidative stress and thus may play a role in preventing postoperative AF. METHODS: We conducted a matched, retrospective cohort study of diabetic patients' age ≥18 undergoing a coronary artery bypass graft (CABG) and/or cardiac valve surgery from January 1, 2009, to November 30, 2014...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29046809/hospital-resuscitation-teams-a-review-of-the-risks-to-the-healthcare-worker
#17
REVIEW
Stephen M Vindigni, Juan N Lessing, David J Carlbom
BACKGROUND: "Code blue" events and related resuscitation efforts involve multidisciplinary bedside teams that implement specialized interventions aimed at patient revival. Activities include performing effective chest compressions, assessing and restoring a perfusing cardiac rhythm, stabilizing the airway, and treating the underlying cause of the arrest. While the existing critical care literature has appropriately focused on the patient, there has been a dearth of information discussing the various stresses to the healthcare team...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28975031/procalcitonin-for-the-diagnosis-of-invasive-candidiasis-what-is-the-evidence
#18
Santi Maurizio Raineri, Andrea Cortegiani, Filippo Vitale, Pasquale Iozzo, Antonino Giarratano
Procalcitonin is a widely used marker for the evaluation of infection and sepsis and to guide antibiotic therapy. During the last decade, several studies evaluated its role and diagnostic performance as a surrogate marker for the identification of Candida spp. in suspected invasive candidiasis. A low serum level and a favorable negative predictive value are the main findings for procalcitonin in this setting. The aim of this report is to provide an updated brief summary of the evidence supporting the use of PCT for the management of invasive candidiasis...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28932401/practical-approach-to-detection-and-management-of-acute-kidney-injury-in-critically-ill-patient
#19
REVIEW
Vahid Mohsenin
BACKGROUND: Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with high morbidity and mortality. This paper provides a critical review of the etiologies of AKI and a systematic approach toward its diagnosis and management with emphasis on fluid volume assessment and the use of urine biochemical profile and microscopy in identifying the nature and the site of kidney injury. MATERIALS AND METHODS: The search of PubMed and selection of papers had employed observational designs or randomized control trials relevant to AKI...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28904799/clinical-significance-of-measuring-plasminogen-activator-inhibitor-1-in-sepsis
#20
Toshiaki Iba, Jecko Thachil
BACKGROUND: Disseminated thrombotic process in the microcirculation is considered to be an important cause of multiple organ dysfunction in sepsis. The fundamental purpose of this prothrombotic change was believed to be in the host defense against microbial dissemination. In that process, antifibrinolytic property plays an important role. MAIN BODY: For the understanding of pathophysiology of sepsis, it is quite useful to grasp the alterations in coagulation/fibrinolytic parameters, i...
2017: Journal of Intensive Care
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