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Journal of Intensive Care

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https://www.readbyqxmd.com/read/29760928/aneurysmal-subarachnoid-hemorrhage-intensive-care-for-improving-neurological-outcome
#1
REVIEW
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
https://www.readbyqxmd.com/read/29744108/self-reported-fatigue-following-intensive-care-of-chronically-critically-ill-patients-a-prospective-cohort-study
#2
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
https://www.readbyqxmd.com/read/29721320/accuracy-of-the-first-interpretation-of-early-brain-ct-images-for-predicting-the-prognosis-of-post-cardiac-arrest-syndrome-patients-at-the-emergency-department
#3
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
https://www.readbyqxmd.com/read/29714351/correction-to-use-of-diaphragm-thickening-fraction-combined-with-rapid-shallow-breathing-index-for-predicting-success-of-weaning-from-mechanical-ventilator-in-medical-patients
#4
Pattarin Pirompanich, Sasithon Romsaiyut
[This corrects the article DOI: 10.1186/s40560-018-0277-9.].
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29686878/limitation-of-life-support-techniques-at-admission-to-the-intensive-care-unit-a-multicenter-prospective-cohort-study
#5
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
https://www.readbyqxmd.com/read/29686877/how-to-manage-various-arrhythmias-and-sudden-cardiac-death-in-the-cardiovascular-intensive-care
#6
REVIEW
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
https://www.readbyqxmd.com/read/29662678/interleukin-6-is-a-key-factor-for-immunoglobulin-like-transcript-4-mediated-immune-injury-in-sepsis
#7
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
https://www.readbyqxmd.com/read/29610664/hypomagnesemia-in-critically-ill-patients
#8
REVIEW
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
https://www.readbyqxmd.com/read/29568528/achieving-the-earliest-possible-reperfusion-in-patients-with-acute-coronary-syndrome-a-current-overview
#9
REVIEW
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
https://www.readbyqxmd.com/read/29568527/leukadherin-1-ameliorates-endothelial-barrier-damage-mediated-by-neutrophils-from-critically-ill-patients
#10
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
https://www.readbyqxmd.com/read/29564137/regional-overdistension-during-prone-positioning-in-a-patient-with-acute-respiratory-failure-who-was-ventilated-with-a-low-tidal-volume-a-case-report
#11
Toru Kotani, Masanori Hanaoka, Shinya Hirahara, Hisashi Yamanaka, Eckhard Teschner, Atsuko Shono
Background: Prone positioning may provide a uniform distribution of transpulmonary pressure and contribute to prevent ventilator-induced lung injury. However, despite moderate positive end-expiratory pressure and low tidal volumes, there is still a risk of regional overdistension. Case presentation: A man with refractory hypoxemia was mechanically ventilated with prone positioning. Although prone positioning with a plateau pressure of 18 cmH2 O and a positive end-expiratory pressure of 8 cmH2 O promptly improved oxygenation, regional ventilation monitoring using electrical impedance tomography initially detected decreased distribution in the dorsal region but increased in the ventral, suggesting overdistension...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29556399/towards-the-second-stage-journal-of-intensive-care
#12
EDITORIAL
Hiroshi Morisaki
No abstract text is available yet for this article.
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29515808/seizure-prophylaxis-in-the-neuroscience-intensive-care-unit
#13
REVIEW
Sushma Yerram, Nakul Katyal, Keerthivaas Premkumar, Premkumar Nattanmai, Christopher R Newey
Background: Seizures are a considerable complication in critically ill patients. Their incidence is significantly high in neurosciences intensive care unit patients. Seizure prophylaxis with anti-epileptic drugs is a common practice in neurosciences intensive care unit. However, its utility in patients without clinical seizure, with an underlying neurological injury, is somewhat controversial. Body: In this article, we have reviewed the evidence for seizure prophylaxis in commonly encountered neurological conditions in neurosciences intensive care unit and discussed the possible prognostic role of continuous electroencephalography monitoring in detecting early seizures in critically ill patients...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29511564/management-of-patients-with-high-risk-pulmonary-embolism-a-narrative-review
#14
REVIEW
Takeshi Yamamoto
High-risk pulmonary embolism (PE) is a life-threatening disorder associated with high mortality and morbidity. Most deaths in patients with shock occur within the first few hours after presentation, and rapid diagnosis and treatment is therefore essential to save patients' lives. The main manifestations of major PE are acute right ventricular (RV) failure and hypoxia. RV pressure overload is predominantly related to the interaction between the mechanical pulmonary vascular obstruction and the underlying cardiopulmonary status...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29507729/management-of-acute-aortic-dissection-and-thoracic-aortic-rupture
#15
REVIEW
Toshihiro Fukui
Background: Both acute aortic dissection and ruptured aortic aneurysm are leading causes of death in cardiovascular disease. These life-threatening conditions have recently been categorized as acute aortic syndrome. This review describes the etiology, clinical presentation, and therapeutic options for acute aortic syndrome including acute aortic dissection and ruptured aortic aneurysm. Main body: Several diagnostic tools for detecting these critical conditions have been developed including computed tomography, ultrasonography, magnetic resonance imaging, and laboratory tests...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29507728/predictors-associated-with-unplanned-hospital-readmission-of-medical-and-surgical-intensive-care-unit-survivors-within-30-days-of-discharge
#16
Tetsu Ohnuma, Daisuke Shinjo, Alan M Brookhart, Kiyohide Fushimi
Background: Reducing the 30-day unplanned hospital readmission rate is a goal for physicians and policymakers in order to improve quality of care. However, data on the readmission rate of critically ill patients in Japan and knowledge of the predictors associated with readmission are lacking. We investigated predictors associated with 30-day rehospitalization for medical and surgical adult patients separately. Methods: Patient data from 502 acute care hospitals with intensive care unit (ICU) facilities in Japan were retrospectively extracted from the Japanese Diagnosis Procedure Combination (DPC) database between April 2012 and February 2014...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29497535/effect-of-norepinephrine-dosage-on-mortality-in-patients-with-septic-shock
#17
Hitoshi Yamamura, Yu Kawazoe, Kyohei Miyamoto, Tomonori Yamamoto, Yoshinori Ohta, Takeshi Morimoto
Background: Use of high-dose norepinephrine is thought to have an immunosuppressive action that increases mortality. This study aimed to evaluate the correlation between norepinephrine dosage and prognosis of patients with septic shock. Methods: This study was a nested cohort of the DExmedetomidine for Sepsis in Intensive Care Unit Randomized Evaluation (DESIRE) trial. We evaluated 112 patients with septic shock and an initial Sequential Organ Failure Assessment Cardiovascular (SOFA-C) category score > 2 and initial lactate level > 2 mmol/L...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29497534/intravenous-immunoglobulin-fails-to-improve-ards-in-patients-undergoing-ecmo-therapy
#18
Stefanie Prohaska, Andrea Schirner, Albina Bashota, Andreas Körner, Gunnar Blumenstock, Helene A Haeberle
Background: Acute respiratory distress syndrome (ARDS) is associated with high mortality rates. ARDS patients suffer from severe hypoxemia, and extracorporeal membrane oxygenation (ECMO) therapy may be necessary to ensure oxygenation. ARDS has various etiologies, including trauma, ischemia-reperfusion injury or infections of various origins, and the associated immunological responses may vary. To support the immunological response in this patient collective, we used intravenous IgM immunoglobulin therapy to enhance the likelihood of pulmonary recovery...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29484188/the-safety-of-a-novel-early-mobilization-protocol-conducted-by-icu-physicians-a-prospective-observational-study
#19
Keibun Liu, Takayuki Ogura, Kunihiko Takahashi, Mitsunobu Nakamura, Hiroaki Ohtake, Kenji Fujiduka, Emi Abe, Hitoshi Oosaki, Dai Miyazaki, Hiroyuki Suzuki, Mitsuaki Nishikimi, Alan Kawarai Lefor, Takashi Mato
Background: There are numerous barriers to early mobilization (EM) in a resource-limited intensive care unit (ICU) without a specialized team or an EM culture, regarding patient stability while critically ill or in the presence of medical devices. We hypothesized that ICU physicians can overcome these barriers. The aim of this study was to investigate the safety of EM according to the Maebashi EM protocol conducted by ICU physicians. Methods: This was a single-center prospective observational study...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29468069/utility-of-sofa-score-management-and-outcomes-of-sepsis-in-southeast-asia-a-multinational-multicenter-prospective-observational-study
#20
Khie Chen Lie, Chuen-Yen Lau, Nguyen Van Vinh Chau, T Eoin West, Direk Limmathurotsakul
Background: Sepsis is a global threat but insufficiently studied in Southeast Asia. The objective was to evaluate management, outcomes, adherence to sepsis bundles, and mortality prediction of maximum Sequential Organ Failure Assessment (SOFA) scores in patients with community-acquired sepsis in Southeast Asia. Methods: We prospectively recruited hospitalized adults within 24 h of admission with community-acquired infection at nine public hospitals in Indonesia ( n  = 3), Thailand ( n  = 3), and Vietnam ( n  = 3)...
2018: Journal of Intensive Care
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