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Critical care sepsis

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https://www.readbyqxmd.com/read/28919614/use-of-acute-physiology-and-chronic-health-evaluation-apache-ii-and-red-cell-distribution-width-rdw-for-assessment-of-mortality-of-patients-with-sepsis-in-icu
#1
A Q Huda, M R Karim, M A Mahmud, M S Islam, M F Haque, M R Islam, M A Hossain
Critically ill patients of Intensive Care Unit (ICU) need highest level of monitoring, intense nursing care and integrated management which are very expensive and consume significant part of hospital resources. Prediction of outcome from disease has become an essential component of health science. So, various scoring systems have been developed to predict outcome of critically ill patients in ICU. There is no perfect model of severity score to predict ICU mortality. Search for new system is still remaining as continuous efforts to find the best model to get accurate information about the prognosis and outcome of critically ill patients...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28919596/outcome-of-pregnancy-related-acute-kidney-injury-observed-in-a-tertiary-care-hospital
#2
S U Ahammed, A A Chowdhury, A S Roy, M A Muqueet, M A Rahman, M S Kabir, M G Rabbani, M Asadujjaman, M B Hossain, M Akhtaruzzaman, S K Das, E H Khan, M A Islam, M J Hasan, M A Rahman, R K Talukder, J Ara, G C Barman, P P Roy, M K Saha, D Mondal
This prospective case control study was carried out in Mymensingh Medical College Hospital (MMCH) from April 2011 to March 2012. The main objective of the study was to determine the short term maternal outcome of pregnancy related Acute Kidney Injury and to identify aetiological factors and to observe clinical features of pregnancy related Acute Kidney Injury. Total 60 pregnant women with AKI were included in the study as sample and equal (60) number of pregnant women with normal renal function was taken as control...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28916175/early-sepsis-detection-in-critical-care-patients-using-multiscale-blood-pressure-and-heart-rate-dynamics
#3
Supreeth P Shashikumar, Matthew D Stanley, Ismail Sadiq, Qiao Li, Andre Holder, Gari D Clifford, Shamim Nemati
Sepsis remains a leading cause of morbidity and mortality among intensive care unit (ICU) patients. For each hour treatment initiation is delayed after diagnosis, sepsis-related mortality increases by approximately 8%. Therefore, maximizing effective care requires early recognition and initiation of treatment protocols. Antecedent signs and symptoms of sepsis can be subtle and unrecognizable (e.g., loss of autonomic regulation of vital signs), causing treatment delays and harm to the patient. In this work we investigated the utility of high-resolution blood pressure (BP) and heart rate (HR) times series dynamics for the early prediction of sepsis in patients from an urban, academic hospital, meeting the third international consensus definition of sepsis (sepsis-III) during their ICU admission...
August 16, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28905406/thiamine-content-of-f-75-therapeutic-milk-for-complicated-severe-acute-malnutrition-time-for-a-change
#4
Laurent Hiffler, Bola Adamolekun, Philip R Fischer, Aviva Fattal-Vavleski
Since community-based management of severe acute malnutrition has become the standard of care, the clinical profile of severe acutely malnourished patients admitted to hospitals or inpatient therapeutic feeding centers has changed significantly. These patients are usually very ill and often present with several comorbidities, such as shock, sepsis, and pneumonia. Complicated severe acute malnutrition patients are at risk of thiamine insufficiency, and critically ill patients have higher thiamine requirements...
September 14, 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28892951/outcomes-of-mechanically-ventilated-critically-ill-geriatric-patients-in-intensive-care-unit
#5
Vivek Aggarwal, Rajeshwar Singh, Jung Bahadur Singh, Jps Bawa, Nimish Gaur, Sandeep Kumar, I V Nagesh
INTRODUCTION: Increase in life expectancy across the globe has led to rise in geriatric population. Geriatric population is now living longer and healthier. This rise in geriatric population has also led to increase in the geriatric ailments leading to increased number of geriatric patients requiring intensive care including mechanical ventilation. Data on outcomes of geriatric patients requiring mechanical ventilation from India is scarce. AIM: To study the profile and outcome of geriatric patients more than equal to 60 years requiring mechanical ventilation in Intensive Care Unit (ICU)...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28885390/epidemiology-of-admissions-from-the-emergency-department-among-febrile-infants-younger-than-90-days-in-the-united-states-2002-to-2012
#6
Diana K Nguyen, Ross J Fleischman, Scott Friedlander, Kenneth M Zangwill
BACKGROUND AND OBJECTIVES: Febrile infants younger than 90 days are often subjected to invasive diagnostic evaluation and hospitalization to monitor for serious bacterial infection (SBI) despite recent changes in SBI risk and advances in diagnostics. Nationwide provider practices, over time, are unknown for this group. Our objective was to determine the likelihood of admission and associated complications of care for such infants, particularly those at lowest risk for SBI. METHODS: This is a retrospective cohort study including multisite emergency department (ED) visits using administrative data from the Pediatric Emergency Care Applied Research Network Core Data Project...
September 5, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28884304/cell-cycle-arrest-biomarkers-in-urine-to-predict-acute-kidney-injury-in-septic-and-non-septic-critically-ill-patients
#7
M Cuartero, J Ballús, J Sabater, X Pérez, N Nin, J Ordonez-Llanos, A J Betbesé
PURPOSE: To analyse the usefulness of the composite index of the tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) as urinary biomarkers for the early prediction of AKI in septic and non-septic patients. METHODS: This is a prospective, observational study including patients admitted to ICU from acute care departments and hospital length of stay <48 h. The main exclusion criteria were pre-existing eGFR <30 mL/min/1...
September 7, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28882128/institutional-maternal-and-perinatal-deaths-a-review-of-40-low-and-middle-income-countries
#8
Patricia E Bailey, Wasihun Andualem, Michel Brun, Lynn Freedman, Sourou Gbangbade, Malick Kante, Emily Keyes, Edwin Libamba, Allisyn C Moran, Halima Mouniri, Dahada Ould El Joud, Kavita Singh
BACKGROUND: Understanding the magnitude and clinical causes of maternal and perinatal mortality are basic requirements for positive change. Facility-based information offers a contextualized resource for clinical and organizational quality improvement. We describe the magnitude of institutional maternal mortality, causes of death and cause-specific case fatality rates, as well as stillbirth and pre-discharge neonatal death rates. METHODS: This paper draws on secondary data from 40 low and middle income countries that conducted emergency obstetric and newborn care assessments over the last 10 years...
September 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28878814/thoracic-trauma-severity-contributes-to-differences-in-intensive-care-therapy-and-mortality-of-severely-injured-patients-analysis-based-on-the-traumaregister-dgu%C3%A2
#9
Jörg Bayer, Rolf Lefering, Sylvia Reinhardt, Jan Kühle, Jörn Zwingmann, Norbert P Südkamp, Thorsten Hammer
BACKGROUND: Thoracic trauma is a relevant source of comorbidity throughout multiply-injured patient care. We aim to determine a measurable influence of chest trauma's severity on early resuscitation, intensive care therapy, and mortality in severely injured patients. METHODS: Patients documented between 2002 and 2012 in the TraumaRegister DGU®, aged ≥ 16 years, injury severity score (ISS) ≥ 16 are analyzed. Isolated brain injury and severe head injury led to exclusion...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28875277/-critical-illness-myopathy-and-polyneuropathy
#10
REVIEW
D Senger, F Erbguth
An average of 50-80% of patients treated in the intensive care unit is affected by disturbances of neuromuscular functions due to damage to the nerves and muscles, which has led to the terms critical illness polyneuropathy and myopathy. Both components occur in 30-50% of patients, while the others predominantly show a pure myopathy, while pure neuropathy is rare. Meanwhile, the descriptive term of the concept as intensive care unit-acquired weakness (ICUAW) is preferred. The most significant risk factors for the development of ICUAW are sepsis, multiorgan dysfunction and acute respiratory distress syndrome (ARDS)...
September 5, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28871391/hemofiltration-induces-generation-of-leukocyte-derived-cd31-cd41-microvesicles-in-sepsis
#11
Georg Franz Lehner, Ulrich Harler, Clemens Feistritzer, Viktoria Maria Haller, Julia Hasslacher, Romuald Bellmann, Michael Joannidis
BACKGROUND: Microvesicles (MV) are extracellular vesicles known to be associated with cellular activation and inflammation. Hemofiltration is an effective blood purification technique for patients with renal failure and possibly also eliminates inflammatory mediators in the setting of sepsis. On the other hand, proinflammatory stimuli are induced by blood contacting the artificial membrane during extracorporeal blood purification. In chronic dialysis patients a systemic increase in MV has been described...
September 4, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28869492/the-lactate-albumin-ratio-a-valuable-tool-for-risk-stratification-in-septic-patients-admitted-to-icu
#12
Michael Lichtenauer, Bernhard Wernly, Bernhard Ohnewein, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Alexander Lauten, Paul Christian Schulze, Uta C Hoppe, Malte Kelm, Christian Jung
The lactate/albumin ratio has been reported to be associated with mortality in pediatric patients with sepsis. We aimed to evaluate the lactate/albumin ratio for its prognostic relevance in a larger collective of critically ill (adult) patients admitted to an intensive care unit (ICU). A total of 348 medical patients admitted to a German ICU for sepsis between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013. The association of the lactate/albumin ratio (cut-off 0...
September 2, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28866970/calprotectin-as-an-early-biomarker-of-bacterial-infections-in-critically-ill-patients-an-exploratory-cohort-assessment
#13
Niklas Jonsson, Tom Nilsen, Patrik Gille-Johnson, Max Bell, Claes-Roland Martling, Anders Larsson, Johan Mårtensson
BACKGROUND: Calprotectin is the most abundant protein in the cytosolic fraction of neutrophils, and neutrophil degranulation is a major response to bacterial infections. OBJECTIVES: To assess the value of plasma calprotectin as an early marker of bacterial infections in critically ill patients and compare it with the corresponding values for procalcitonin (PCT), C-reactive protein (CRP) and white blood cell count (WBC). METHODS: We measured daily plasma calprotectin levels in 110 intensive care unit patients using a newly developed turbidimetric assay run on clinical chemistry analysers...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28861270/phosphate-disturbance-in-critically-ill-children-incidence-associated-risk-factors-and-clinical-outcomes
#14
Ahmed Nabih El Shazly, Doaa Refaey Soliman, Effat Hussien Assar, Eman Gamal Behiry, Ibrahim Abd El Naby Gad Ahmed
BACKGROUND: Hypophosphatemia is one of the common disorders that develop in critically ill patients. It has potential complications and is often unrecognized in those patients. OBJECTIVE: Determining the incidence of hypophosphatemia in critically ill children, its association with clinical outcomes and the possible risk factors. METHODS: 50 patients were enrolled in the study. Levels of serum phosphate were measured on day 1 and day 7 of PICU (Pediatric intensive care unit) stay...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28858917/why-do-we-fail-to-deliver-evidence-based-practice-in-critical-care-medicine
#15
Curtis H Weiss
PURPOSE OF REVIEW: The use of evidence-based practices in clinical practice is frequently inadequate. Recent research has uncovered many barriers to the implementation of evidence-based practices in critical care medicine. Using a comprehensive conceptual framework, this review identifies and classifies the barriers to implementation of several major critical care evidence-based practices. RECENT FINDINGS: The many barriers that have been recently identified can be classified into domains of the consolidated framework for implementation research (CFIR)...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28857121/assessment-of-plasma-endostatin-to-predict-acute-kidney-injury-in-critically-ill-patients
#16
J Mårtensson, S T Vaara, V Pettilä, T Ala-Kokko, S Karlsson, O Inkinen, A Uusaro, A Larsson, M Bell
BACKGROUND: We evaluated whether plasma endostatin predicts acute kidney injury (AKI), need for renal replacement therapy (RRT), or death. METHODS: Prospective, observational, multicenter study from 1 September 2011 to 1 February 2012 with data from 17 intensive care units (ICUs) in Finland. RESULTS: A total of 1112 patients were analyzed. We measured plasma endostatin within 2 h of ICU admission. Early AKI (KDIGO stage within 12 h of ICU admission) was found in 20% of the cohort, and 18% developed late AKI (KDIGO criteria > 12 h from ICU admission)...
August 31, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28845902/persistence-of-delirium-after-cessation-of-sedatives-and-analgesics-and-impact-on-clinical-outcomes-in-critically-ill-patients
#17
Michael T Kenes, Joanna L Stollings, Li Wang, Timothy D Girard, E Wesley Ely, Pratik P Pandharipande
STUDY OBJECTIVE: As delirium is a common manifestation in critically ill patients and is associated with worse clinical outcomes, we sought to characterize the reversibility of delirium after discontinuation of sedation and to determine whether sedation-associated delirium that rapidly reverses impacts clinical outcomes. DESIGN: Post hoc subgroup analysis of prospectively collected data from a previously published study. PATIENTS: Seventy adults admitted to a medical intensive care unit (ICU) between March and July 2012 who required mechanical ventilation with continuous analgesia and/or sedation and underwent a spontaneous awakening trial (SAT)...
August 28, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28845215/ppar-%C3%AE-activation-prevents-septic-cardiac-dysfunction-via-inhibition-of-apoptosis-and-necroptosis
#18
Shiyan Peng, Junmei Xu, Wei Ruan, Suobei Li, Feng Xiao
Sepsis-induced cardiac dysfunction remains one of the major causes of death in intensive care units. Overwhelmed inflammatory response and unrestrained cell death play critical roles in sepsis-induced cardiac dysfunction. Peroxisome proliferator-activated receptor- (PPAR-) γ has been proven to be cardioprotective in sepsis. However, the mechanism of PPAR-γ-mediated cardioprotection and its relationship with inflammation and cell death are unclear. We hypothesized that activation of PPAR-γ by reducing cardiac inflammation, myocardial apoptosis, and necroptosis may prevent myocardial dysfunction in sepsis...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28844504/unsuspected-critical-illness-among-emergency-department-patients-presenting-for-acute-alcohol-intoxication
#19
Lauren R Klein, Jon B Cole, Brian E Driver, Christopher Battista, Ryan Jelinek, Marc L Martel
STUDY OBJECTIVE: Emergency department (ED) visits for acute alcohol intoxication are common, but this population is at risk for decompensation and occult critical illness. The purpose of this study is to describe the incidence and predictors of unsuspected critical illness among patients with acute alcohol intoxication. METHODS: This was a retrospective observational study of ED patients from 2011 to 2016 with acute alcohol intoxication. The study cohort included patients presenting for alcohol intoxication, whose initial assessment was uncomplicated alcohol intoxication without any other active acute medical or traumatic complaints...
August 23, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28838678/critical-care-polyneuropathy-in-burn-injuries-an-integrative-review
#20
REVIEW
A Mc Kittrick, R Kornhaber, M Harats, M Cleary, D C Visentin, J Haik
Polyneuropathy is a debilitating condition which may be associated with large burns. The aim of this integrative review is to identify factors that contribute to the development of critical care polyneuropathy in patients admitted to an intensive care unit with a severe burn injury. PubMed, Scopus, CINHAL and EMBASE were searched up until July 2016. Studies/case reports focusing on critical care polyneuropathy for burn injured patients were included. The ten studies, included a total of 2755 burns subjects and identified 128 critical care polyneuropathy patients with an incidence of 4...
August 21, 2017: Burns: Journal of the International Society for Burn Injuries
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