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corticosteroids in icu

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https://www.readbyqxmd.com/read/29342251/kinetics-of-serological-responses-in-critically-ill-patients-hospitalized-with-influenza-a-h1n1-pdm09-virus-infection-in-canada-2009-2011
#1
Melissa A Rolfes, F Liaini Gross, Brendan Flannery, Adrienne F A Meyers, Ma Luo, Nathalie Bastien, Robert A Fowler, Jacqueline M Katz, Min Z Levine, Anand Kumar, Timothy M Uyeki
Background: The kinetics of the antibody response during severe influenza are not well documented. Methods: Critically ill patients with influenza A(H1N1)pdm09 virus infection, confirmed by RT-PCR or seroconversion (≥4-fold rise in titers), during 2009-2011 in Canada were prospectively studied. Antibody titers in serially collected sera were determined using hemagglutinin inhibition (HAI) and microneutralization assays. Average antibody curves were estimated using linear mixed effects models and compared by patient outcome, age, and corticosteroid treatment...
January 12, 2018: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29310372/acute-kidney-injury-due-to-povidone-iodine-ingestion-a-case-report
#2
Chang Seong Kim, Sung Sun Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
RATIONALE: Povidone-iodine is a broad-spectrum antiseptic applied topically to treat wounds and prevent their infection. There have been several case reports of acute kidney injury (AKI) in burn patients after povidone-iodine irrigation and in patients receiving the substance as a sclerotherapy agent for management of lymphocele after renal transplantation. However, biopsy-confirmed AKI after ingestion of povidone-iodine has not previously been described. PATIENT CONCERNS: A 47-year-old man who had apparently ingested povidone-iodine solution and presented with nausea, vomiting, and reduced urine output...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29298095/six-month-outcome-of-immunocompromised-severe-ards-patients-rescued-by-ecmo-an-international-multicenter-retrospective-study
#3
Matthieu Schmidt, Peter Schellongowski, Nicolò Patroniti, Fabio Silvio Taccone, Dinis Reis Miranda, Jean Reuter, Helène Prodanovic, Marc Pierrot, Amandine Dorget, Sunghoon Park, Martin Balik, Alexandre Demoule, Ilaria Alice Crippa, Alain Mercat, Philipp Wohlfarth, Romain Sonneville, Alain Combes
OBJECTIVES: To report outcomes of immunocompromised patients treated with extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) and to identify their pre-ECMO predictors of 6-month mortality and main ECMO-related complications. METHODS: Retrospective multicenter study in 10 international intensive care units (ICUs) with high ECMO-case volumes. Immunocompromised patients, defined as having hematological malignancies, active solid tumor, solid-organ transplant, acquired immunodeficiency syndrome, or long-term or high-dose corticosteroid or immunosuppressant use, and severe ECMO-treated ARDS from 2008 to 2015 were included Measurements and Main Results: We collected demographics, clinical, ECMO-related complications, ICU- and 6-month-outcome data for 203 patients (median APACHE II 28 [25th ;75th percentile, 20;33]; age 51 [38;59] years, PaO2/FiO2 60 [50;82] mmHg before ECMO) who fulfilled our inclusion criteria...
January 3, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29236286/corticosteroids-for-pneumonia
#4
REVIEW
Anat Stern, Keren Skalsky, Tomer Avni, Elena Carrara, Leonard Leibovici, Mical Paul
BACKGROUND: Pneumonia is a common and potentially serious illness. Corticosteroids have been suggested for the treatment of different types of infection, however their role in the treatment of pneumonia remains unclear. This is an update of a review published in 2011. OBJECTIVES: To assess the efficacy and safety of corticosteroids in the treatment of pneumonia. SEARCH METHODS: We searched the Cochrane Acute Respiratory Infections Group's Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS on 3 March 2017, together with relevant conference proceedings and references of identified trials...
December 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29184413/near-fatal-asthma-responsive-to-mepolizumab-after-failure-of-omalizumab-and-bronchial-thermoplasty
#5
Francesco Menzella, Carla Galeone, Mirco Lusuardi, Anna Simonazzi, Claudia Castagnetti, Patrizia Ruggiero, Nicola Facciolongo
Severe asthma affects between 5% and 10% of patients with asthma worldwide and requires best standard therapies at maximal doses, but there is a subgroup of patients refractory to all treatments. We share a case report of a 53-year-old woman with a history of severe allergic asthma that progressively worsened over the years despite the best therapy. She had been hospitalized 35 times, including nine admissions to the respiratory intensive care unit due to severe exacerbations. To rule out other possible diagnoses, several investigations were performed, such as computed tomography scan of the chest and neck, fiberoptic laryngoscopy, antineutrophil cytoplasmic antibodies, and complete blood cell count...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29175821/post-traumatic-stress-after-picu-and-corticosteroid-use
#6
Georgina Corbet Burcher, Maria D Picouto, Lorraine C Als, Mehrengise Cooper, Christine M Pierce, Simon Nadel, M Elena Garralda
AIM: To examine the association between corticosteroid use in paediatric intensive care units (PICU) and subsequent symptoms of post-traumatic stress disorder (PTSD). METHODS: The subjects were children aged 8-16 years admitted to PICU with sepsis, meningoencephalitis (ME) and other disorders. Illness information was extracted from case notes; 3-6 months post discharge children completed a PTSD symptom questionnaire (eight-item Impact of Events Scale (IES-8)) assessing intrusion and avoidance symptoms...
November 25, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29161935/extended-versus-short-course-corticosteroid-taper-regimens-in-the-management-of-chronic-obstructive-pulmonary-disease-exacerbations-in-critically-ill-patients
#7
Teresa Poon, Daryl Glick Paris, Samuel L Aitken, Paru Patrawalla, Eric Bondarsky, Jerry Altshuler
BACKGROUND: Previous literature has suggested that a short course of corticosteroids is similarly effective as an extended course for managing an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, there are limited data regarding the optimal corticosteroid regimen in critically ill patients and the dosing strategies remain highly variable in this population. METHODS: This retrospective cohort study evaluated patients with AECOPD admitted to the intensive care unit within a 2-year period...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29161116/corticosteroid-therapy-for-critically-ill-patients-with-the-middle-east-respiratory-syndrome
#8
Yaseen M Arabi, Yasser Mandourah, Fahad Al-Hameed, Anees A Sindi, Ghaleb A Al Mekhlafi, Mohamed A Hussein, Jesna Jose, Ruxandra Pinto, Awad Al-Omari, Ayman Kharaba, Abdullah Almotairi, Kasim Al Khatib, Basem Alraddadi, Sarah Shalhoub, Ahmed Abdulmomen, Ismael Qushmaq, Ahmed Mady, Othman Solaiman, Abdulsalam M Al-Aithan, Rajaa Al-Raddadi, Ahmed Ragab, Hanan H Balkhy, Abdulrahman Al Harthy, Ahmad M Deeb, Hanan Al Mutairi, Abdulaziz Al-Dawood, Laura Merson, Frederick G Hayden, Robert A Fowler
RATIONALE: Corticosteroid therapy is commonly used among critically ill patients with the Middle East Respiratory Syndrome (MERS), but its impact on outcomes is uncertain. Analyses of observational studies often do not account for patients' clinical condition at the time of corticosteroid therapy initiation. OBJECTIVES: To investigate the association of corticosteroid therapy on mortality and on MERS coronavirus RNA clearance in critically ill patients with MERS...
November 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29149469/cuffed-versus-uncuffed-endotracheal-tubes-for-general-anaesthesia-in-children-aged-eight-years-and-under
#9
REVIEW
Flavia A De Orange, Rebeca Gac Andrade, Andrea Lemos, Paulo Sgn Borges, José N Figueiroa, Pete G Kovatsis
BACKGROUND: Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29127622/the-joint-effects-of-antenatal-steroids-and-gestational-age-on-improved-outcomes-in-neonates
#10
Neal D Goldstein, Kaitlin M Kenaley, Robert Locke, David A Paul
OBJECTIVES: Antenatal corticosteroids are standard of care for women at risk of a preterm birth and demonstrated to be protective against poor outcomes in neonates including respiratory disorders, mortality and intraventricular hemorrhage (IVH). Its benefits may vary by gestational age, and accurate estimation is needed in a single-center population to account for practice variation. METHODS: A retrospective cohort of infants admitted to the hospital's neonatal intensive care unit, 1997-2015...
November 10, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29109870/acute-onset-panhypopituitarism-nearly-missed-by-initial-cosyntropin-testing
#11
Claudine A Blum, Daniel Schneeberger, Matthias Lang, Janko Rakic, Marc Philippe Michot, Beat Müller
Introduction: Diagnosis of adrenal crisis and panhypopituitarism in patients with septic shock is difficult but crucial for outcome. Case: A 66-year-old woman with metastasized breast cancer presented to the ED with respiratory insufficiency and septic shock after a 2-day history of the flu. After transfer to the ICU, corticosteroids were started in addition to antibiotics, as the patient was vasopressor-nonresponsive. Diabetes insipidus was diagnosed due to polyuria and treated with 4 mg desmopressin...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29066591/the-role-of-rescue-therapies-in-the-treatment-of-severe-ards
#12
REVIEW
Francesco Alessandri, Francesco Pugliese, V Marco Ranieri
ARDS is characterized by a non-cardiogenic pulmonary edema with bilateral chest radiograph opacities and hypoxemia refractory to oxygen therapy. It is a common cause of admission to the ICU due to hypoxemic respiratory failure requiring mechanical ventilation. Corticosteroids are not recommended in ARDS patients. Rescue therapies alleviate hypoxemia in patients unable to maintain reasonable oxygenation: recruitment maneuvers, prone positioning, inhaled nitric oxide, high-frequency oscillatory ventilation, and extracorporeal membrane oxygenation improve oxygenation, but their impact on mortality remains unproven...
January 2018: Respiratory Care
https://www.readbyqxmd.com/read/29066147/heart-type-fatty-acid-binding-protein-and-high-dose-methylprednisolone-in-pediatric-cardiac-surgery
#13
Eero Pesonen, Juho Keski-Nisula, Arie Passov, Raisa Vähätalo, Juha Puntila, Sture Andersson, Pertti K Suominen
OBJECTIVES: Corticosteroids possess cardioprotection in experimental cardiac ischemia/reperfusion. The authors hypothesized that if cardioprotection of corticosteroids occured during pediatric cardiac surgery, then methylprednisolone used in cardiopulmonary bypass prime would reduce postoperative concentrations of heart-type fatty-acid-binding protein, a cardiac biomarker. DESIGN: A double-blind, placebo-controlled, randomized clinical trial. SETTING: Operating room and pediatric intensive care unit of a university hospital...
May 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29063585/early-8-days-systemic-postnatal-corticosteroids-for-prevention-of-bronchopulmonary-dysplasia-in-preterm-infants
#14
REVIEW
Lex W Doyle, Jeanie L Cheong, Richard A Ehrenkranz, Henry L Halliday
BACKGROUND: Bronchopulmonary dysplasia remains a major problem in neonatal intensive care units. Persistent inflammation in the lungs is the most likely underlying pathogenesis. Corticosteroids have been used to prevent or treat bronchopulmonary dysplasia because of their potent anti-inflammatory effects. OBJECTIVES: To examine the relative benefits and adverse effects of systemic postnatal corticosteroids commenced within the first seven days of life for preterm infants at risk of developing bronchopulmonary dysplasia...
October 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29044308/heart-conduction-system-defects-and-sustained-ventricular-tachycardia-complications-in-a-patient-with-granulomatosis-with-polyangiitis-a-case-report-and-literature-review
#15
Laryssa Passos Sarmento Santos, Victor Guerreiro Bomfim, Camila Fagundes Bezerra, Natália Vieira Costa, Rafael Barreto Paes de Carvalho, Ricardo Sobral de Carvalho, Rogério da Hora Passos, Olivia Carla Bomfim Boaventura, André Luiz Nunes Gobatto
Granulomatosis with polyangiitis is a rare systemic inflammatory disorder characterized by vasculitis of the small arteries, the arterioles and the capillaries together with necrotizing granulomatous lesions. This case reports on a young female patient, previously diagnosed with granulomatosis with polyangiitis, who was admitted to the intensive care unit with seizures and hemodynamic instability due to a complete atrioventricular heart block. The event was associated with multiple episodes of sustained ventricular tachycardia without any structural heart changes or electrolyte disturbances...
July 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29028104/the-influence-of-ovulation-induction-and-assisted-conception-on-maternal-and-perinatal-outcomes-of-twin-pregnancies
#16
G Bordi, A D'Ambrosio, I Gallotta, L Di Benedetto, A Frega, F Torcia, M Schimberni, M Bonito, D Caserta
OBJECTIVE: To compare obstetrical and neonatal outcomes of twin pregnancies conceived via assisted reproductive technology (ART) with those of naturally conceived ones and to investigate the influence of the ART procedure type on these parameters. PATIENTS AND METHODS: This observational study included 450 ART and 647 spontaneous twin pregnancies delivered over 15 years at a single university-based hospital of Rome, Italy. Logistic and linear regression models adjusted for confounding factors were used to evaluate the effect of ART and the type of assisted conception (IVF/ICSI, ovulation induction ± intrauterine insemination, egg/embryo donation) on maternal and perinatal outcomes...
September 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29026296/trends-in-health-care-resource-utilization-and-pharmacological-management-of-copd-in-taiwan-from-2004-to-2010
#17
Ying-Huang Tsai, Tsung-Ming Yang, Chieh-Mo Lin, Shu-Yi Huang, Yu-Wen Wen
RATIONALE: COPD has attracted widespread attention worldwide. The prevalence of COPD in Taiwan has been reported, but little is known about trends in health care resource utilization and pharmacologic management in COPD treatment. OBJECTIVE: The objective of this article was to study trends in health care resource utilization, pharmacologic management, and medical costs of COPD treatment in Taiwan. MATERIALS AND METHODS: Reimbursement claims in the Taiwan National Health Insurance System from 2004 to 2010 were collected...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28991048/is-inappropriate-response-to-cosyntropin-stimulation-test-an-indication-of-corticosteroid-resistance-in-septic-shock
#18
Hervé Hyvernat, Denis Doyen, Rémy Barel, Michel Kaidomar, Bernard Goubaux, Christian Pradier, Patricia Panaïa-Ferrari, Jean Dellamonica, Gilles Bernardin
PURPOSE: We recently published a comparison of two hydrocortisone dosage regimens in patients with septic shock. We compare the results conferred by the two regimens as a function of the response to cosyntropin stimulation test (CST). METHOD: Patients with septic shock were treated by one of two hydrocortisone regimens: either a 50-mg intravenous bolus every six hours during seven days (200 mg group; n = 49), or a 100-mg initial bolus followed by a continuous infusion of 300 mg daily for five days (300 mg group; n = 50)...
October 4, 2017: Shock
https://www.readbyqxmd.com/read/28990896/acute-eosinophilic-pneumonia-secondary-to-heroin-inhalation
#19
Damla Eyüpoğlu, Ebru Ortaç Ersoy, Kazım Rollas, Arzu Topeli
Smoking heroin (chasing the dragon), is a method of inhaling heroin via heating the drug on a tin-foil above a flame. It also has been associated both with the indirect effects of heroin overdose and with direct pulmonary toxicity. We describe a case of acute eosinophilic pneumonia secondary to heroin inhalation in our medical intensive care unit. She presented with fever, cough, dyspnea and pleuritic chest pain. Chest radiograph showed bilateral infiltrations. Examination of bronchoalveolar lavage fluid revealed significant eosinophilia...
June 2017: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/28973344/effect-of-inhaled-nitric-oxide-on-survival-without-bronchopulmonary-dysplasia-in-preterm-infants-a-randomized-clinical-trial
#20
Shabih U Hasan, Jim Potenziano, Girija G Konduri, Jose A Perez, Krisa P Van Meurs, M Whit Walker, Bradley A Yoder
Importance: Bronchopulmonary dysplasia (BPD) occurs in approximately 40% of infants born at younger than 30 weeks' gestation and is associated with adverse pulmonary and neurodevelopmental outcomes. Objective: To test whether administration of inhaled nitric oxide to preterm infants requiring positive pressure respiratory support on postnatal days 5 to 14 improves the rate of survival without BPD. Design, Setting, and Participants: This intent-to-treat study was a randomized clinical trial performed at 33 US and Canadian neonatal intensive care units...
November 1, 2017: JAMA Pediatrics
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