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https://www.readbyqxmd.com/read/28107357/vasopressor-use-for-severe-hypotension-a-multicentre-prospective-observational-study
#1
Francois Lamontagne, Deborah J Cook, Maureen O Meade, Andrew Seely, Andrew G Day, Emmanuel Charbonney, Karim Serri, Yoanna Skrobik, Paul Hebert, Charles St-Arnaud, Hector Quiroz-Martinez, Michaël Mayette, Daren K Heyland
BACKGROUND: The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/28107096/implementation-of-an-aggressive-enteral-nutrition-protocol-and-the-effect-on-clinical-outcomes
#2
Daniel Dante Yeh, Catrina Cropano, Sadeq A Quraishi, Eva Fuentes, Haytham M A Kaafarani, Jarone Lee, Yuchiao Chang, George Velmahos
BACKGROUND: Macronutrient deficiency in critical illness is associated with worse outcomes. We hypothesized that an aggressive enteral nutrition (EN) protocol would result in higher macronutrient delivery and fewer late infections. METHODS: We enrolled adult surgical intensive care unit (ICU) patients receiving >72 hours of EN from July 2012 to June 2014. Our intervention consisted of increasing protein prescription (2.0-2.5 vs 1.5-2.0 g/kg/d) and compensatory feeds for EN interruption...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28101785/acinetobacter-baumannii-bacteraemia-in-patients-with-haematological-malignancy-a-multicentre-retrospective-study-from-the-infection-working-party-of-jiangsu-society-of-hematology
#3
X Wang, L Zhang, A Sun, X Yang, W Sang, Y Jiang, J Cheng, J Wang, M Zhou, B Chen, J Ouyang
Acinetobacter baumannii (Ab) bacteraemia in patients with haematological malignancies is fatal but rarely reported. We explored the clinical characteristics, drug resistances and prognostic factors in these patients. This multicentre, retrospective study was conducted at the department of haematology wards of 18 tertiary hospitals in China from January 2014 to June 2015. The total clinical isolates from every source were collected from patients with haematological malignancy. Haematological malignancy patients diagnosed with Ab bacteraemia were analysed...
January 18, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28096999/decreasing-skeletal-muscle-as-a-risk-factor-for-mortality-in-elderly-patients-with-sepsis-a-retrospective-cohort-study
#4
Keita Shibahashi, Kazuhiro Sugiyama, Masahiro Kashiura, Yuichi Hamabe
BACKGROUND: Older patients account for the majority of patients with sepsis. The objective of this study was to determine if decreased skeletal muscle mass is associated with outcomes in elderly patients with sepsis. METHODS: Patients (60 years and older) who were admitted to a tertiary medical center intensive care unit with a primary diagnosis of sepsis between January 2012 and February 2016 were included. Patients who had not undergone abdominal computed tomography on the day of admission, had cardiopulmonary arrest on arrival, or had iliopsoas abscess were excluded from the analyses...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28096834/does-the-apache-ii-score-predict-performance-of-activities-of-daily-living-in-patients-discharged-from-a-weaning-center
#5
Anna Rojek-Jarmuła, Rainer Hombach, Łukasz J Krzych
INTRODUCTION: Data regarding the functional status of patients after prolonged mechanical ventilation are scarce, and little is known about its clinical predictors. AIM: To investigate whether the Acute Physiology and Chronic Health Evaluation (APACHE) II score on admission may predict performance in activities of daily living on discharge from a weaning center. MATERIAL AND METHODS: All consecutive patients admitted between January 1, 2012 and December 31, 2013 were enrolled (n = 130)...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28096000/effects-of-oral-care-with-glutamine-in-preventing-ventilator-associated-pneumonia-in-neurosurgical-intensive-care-unit-patients
#6
Hatice Kaya, Yüksel Turan, Yusuf Tunalı, Gülsün Özdemir Aydın, Neslihan Yüce, Şengül Gürbüz, Keziban Tosun
PURPOSE: The study was designed as a randomized, controlled, experimental study aiming to determine the effects of oral care with glutamine in preventing ventilator-associated pneumonia in patients admitted to neurosurgical intensive care unit. METHODS: The universe consisted of patients who are admitted to neurosurgical intensive care unit between January 2014 and August 2015, while the sample consisted of 88 patients who fulfilled the inclusion criteria and were randomly selected...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28094429/a-comparison-between-the-effectiveness-of-full-outline-of-unresponsiveness-and-glasgow-coma-score-at-neurosurgical-intensive-care-unit-patients
#7
Nail Caglar Temiz, Gulsah Kose, Ozkan Tehli, Cengizhan Acikel, Sevgi Hatipoglu
AIM: To evaluate the effectiveness and the use of Glasgow Coma Score (GCS) and Full Outline of Unresponsiveness (FOUR) score by nurses in the follow-up and evaluation of patients who admitted to neurosurgical intensive care unit for cranial surgery or head trauma. MATERIAL AND METHODS: The study was performed at a neurosurgical intensive care unit. Sample size was calculated 47 patients as 5% a, 95% Power and values less than 0.5 at correlation were accepted nonsense...
December 21, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28088209/pulmonary-embolism-in-non-brain-tumor-patients-after-surgery-a-retrospective-study-in-china
#8
Ren-Xiong Chen, Hong-Zhi Wang, Jun Dong, Hong Ren, Xiao-Jie Chen, Jia-Xuan Xu, Yong Yang, Guo-Dong Wang
BACKGROUND: The incidence rate of pulmonary emboli (PE) is high in tumor patients; however, the morbidity and mortality associated with the development of PE after tumor surgery are unknown. We studied the clinical profiles and outcomes of patients with PE after non-brain tumor surgery. METHODS: We retrospectively screened 55,967 patients who underwent non-brain tumor surgery at the Peking University Cancer Hospital from January 2008 to June 2015. Among them, 76 patients who were diagnosed with PE were enrolled in our study...
January 14, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28078833/clinical-profile-and-outcome-of-patients-with-severe-sepsis-treated-in-an-intensive-care-unit-in-india
#9
T T Paary, M S Kalaiselvan, M K Renuka, A S Arunkumar
Introduction: Sepsis is the leading cause of intensive care unit (ICU) admissions and is associated with high mortality. Objectives: To identify the incidence, risk factors and outcome of patients with severe sepsis and septic shock. Methods: A prospective observational study was done in a multidisciplinary ICU over a period of 18 months. We included all adult patients admitted to ICU with features of severe sepsis and septic shock as per SCCM/ACCP guidelines...
30, 2016: Ceylon Medical Journal
https://www.readbyqxmd.com/read/28078828/biomarkers-upon-discontinuation-of-renal-replacement-therapy-predict-60-day-survival-and-renal-recovery-in-critically-ill-patients-with-acute-kidney-injury
#10
Tingting Yang, Si Sun, Yuliang Zhao, Qiang Liu, Mei Han, Liping Lin, Baihai Su, Songmin Huang, Lichuan Yang
Introduction There is no consensus on the specific indications for weaning critically ill patients with acute kidney injury (AKI) off renal replacement therapy (RRT). This study aimed to explore the prognostic value of several biomarkers measured upon discontinuation of RRT for their value in predicting 60-day survival and renal recovery in an effort to add knowledge to the decision-making process regarding RRT withdrawal. Methods We prospectively enrolled 102 patients with AKI who required RRT from the intensive care unit...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28073994/vibrating-mesh-nebulizer-compared-with-metered-dose-inhaler-in-mechanically-ventilated-subjects
#11
Meagan N Dubosky, Yi-Fan Chen, Mary E Henriksen, David L Vines
BACKGROUND: The impact of various aerosol delivery devices on patient outcomes during mechanical ventilation is unknown. If one method of delivery results in a higher ventilator-associated pneumonia (VAP) rate than another, multiple patient outcomes may be affected. This study aimed to determine whether there was a difference in VAP occurrence and patient outcomes (days receiving ventilation and in-hospital mortality) between the vibrating mesh nebulizer (AeroNeb Solo) and the metered-dose inhaler (MDI)...
January 10, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28073594/analysis-of-readmission-rates-to-the-intensive-care-unit-after-implementation-of-a-rapid-response-team-in-a-university-hospital
#12
R Bergamasco E Paula, M T Tanita, J Festti, L T Queiroz Cardoso, C M Carvalho Grion
OBJECTIVES: To compare readmission rates to the intensive care unit (ICU) before and after the implementation of a rapid response team (RRT), and to identify risk factors for readmission. DESIGN: A quasi-experimental before-after study was carried out. SETTING: A University Hospital. PATIENTS: All patients discharged from the ICU from January to December 2008 (control group) and from January 2010 to December 2012 (intervention group)...
January 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28072937/prognosis-of-patients-with-rheumatic-diseases-admitted-to-intensive-care
#13
M Beil, S Sviri, V de la Guardia, I Stav, E Ben-Chetrit, P V van Heerden
Variable mortality rates have been reported for patients with rheumatic diseases admitted to an intensive care unit (ICU). Due to the absence of appropriate control groups in previous studies, it is not known whether the presence of a rheumatic disease constitutes a risk factor. Moreover, the accuracy of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score for predicting outcome in this group of patients has been questioned. The primary goal of this study was to compare outcome of patients with rheumatic diseases admitted to a medical ICU to those of controls...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28069319/effect-of-ulinastatin-combined-with-thymosin-alpha1-on-sepsis-a-systematic-review-and-meta-analysis-of-chinese-and-indian-patients
#14
REVIEW
Dadong Liu, Zongying Yu, Jiangtao Yin, Yikun Chen, Hao Zhang, Fan Xin, Haiyan Fu, Bing Wan
PURPOSE: To assess the effects of urinary trypsin inhibitor (UTI) ulinastatin combined with thymosin alpha1 (Tα1) on sepsis. MATERIALS AND METHODS: The meta-analysis included 8 randomized controlled trials (N=1112 patients) on UTI-based therapy for sepsis published before July 10, 2016. Two investigators independently extracted data and assessed the quality of each study. The short-term mortality rate, duration of mechanical ventilator and vasopressor use, length of intensive care unit stay, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and differences in inflammatory cytokines (interleukin [IL]-6, IL-10, and tumor necrosis factor α) were assessed using statistical software...
December 27, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28056821/impact-of-colistin-plasma-levels-on-the-clinical-outcome-of-patients-with-infections-caused-by-extremely-drug-resistant-pseudomonas-aeruginosa
#15
Luisa Sorlí, Sonia Luque, Concepción Segura, Nuria Campillo, Milagro Montero, Erika Esteve, Sabina Herrera, Natividad Benito, Francisco Alvarez-Lerma, Santiago Grau, Juan Pablo Horcajada
BACKGROUND: Colistin has a narrow therapeutic window with nephrotoxicity being the major dose-limiting adverse effect. Currently, the optimal doses and therapeutic plasma levels are unknown. METHODS: Prospective observational cohort study, including patients infected by colistin-susceptible P. aeruginosa treated with intravenous colistimethate sodium (CMS). Clinical data and colistin plasma levels at steady-state (Css) were recorded. The primary and secondary end points were clinical cure and 30-day all-cause mortality...
January 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28054290/treatment-of-hyponatremia-in-patients-with-acute-neurological-injury
#16
Theresa Human, Aaron M Cook, Brian Anger, Kathleen Bledsoe, Amber Castle, David Deen, Haley Gibbs, Christine Lesch, Norah Liang, Karen McAllen, Christopher Morrison, Dennis Parker, A Shaun Rowe, Denise Rhoney, Kiranpal Sangha, Elena Santayana, Scott Taylor, Eljim Tesoro, Gretchen Brophy
BACKGROUND: Little data exist regarding the practice of sodium management in acute neurologically injured patients. This study describes the practice variations, thresholds for treatment, and effectiveness of treatment in this population. METHODS: This retrospective, multicenter, observational study identified 400 ICU patients, from 17 centers, admitted for ≥48 h with subarachnoid hemorrhage (SAH), traumatic brain injury (TBI), intraparenchymal hemorrhage, or intracranial tumors between January 1, 2011 and July 31, 2012...
January 4, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28043418/the-effectiveness-of-patient-tailored-treatment-for-acute-organophosphate-poisoning
#17
Chih-Chuan Lin, Dong-Zong Hung, Hsien-Yi Chen, Kuang-Hung Hsu
BACKGROUND: To determine a new pralidoxime (PAM) treatment guideline based on the severity of acute organophosphate intoxication patients, APACHE II score, and dynamic changes in serum butyrylcholinesterase (BuChE) activity. METHODS: This is a randomization trial. All patients received supportive care measurements and atropinization. Each enrolled patient was treated with 2 gm PAM intravenously as the loading dose. The control group was treated according to the WHO's recommended PAM regimen, and the experimental group was treated according to their APACHE II scores and dynamic changes in BuChE activity...
December 2016: Biomedical Journal
https://www.readbyqxmd.com/read/28043308/diagnostic-accuracy-of-modified-ct-severity-index-in-assessing-severity-of-acute-pancreatitis
#18
Amna Rehan, Zonaira Shabbir, Asim Shaukat, Osman Riaz
OBJECTIVE: To determine the diagnostic accuracy of modified CT severity index in assessing the severe acute pancreatitis keeping APACHE II as gold standard. STUDY DESIGN: Cross-sectional (validation) study. PLACE AND DURATION OF STUDY: Department of Radiology, Allied Hospital, Faisalabad, from February to August 2014. METHODOLOGY: A total of 120 patients of either gender aged 20-60 years with epigastric pain radiating to back and having sonographic findings (decreased or heterogeneous pancreatic echogenicity, pancreatic enlargement, peripancreatic fluid collection), supportive of acute pancreatitis were taken...
December 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28042074/a-communications-bundle-to-improve-satisfaction-for-critically-ill-patients-and-their-families-a-prospective-cohort-pilot-study
#19
Rana L Awdish, Dana Buick, Maria Kokas, Hanan Berlin, Catherine Jackman, Cari Williamson, Michael P Mendez, Kristen Chasteen
CONTEXT: Communication skills training with simulated patients is used by many academic centers, but how to translate skills learned in simulated settings to improve communication in real encounters has not been described. OBJECTIVE: We developed a communications bundle to facilitate skill transfer from simulation to real encounters and improve patient and/or family satisfaction with physician communication. We tested the feasibility of its use in our hospital's medical intensive care unit (MICU)...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28040752/predictors-for-quality-of-life-of-patients-with-a-portable-out-of-centre-implanted-extracorporeal-membrane-oxygenation-device
#20
Florian Rückert, Thomas Steinke, Lilit Flöther, Michael Bucher, Dietrich Metz, Stefan Frantz, Efstratios I Charitos, Hendrik Treede, Christoph Raspé
OBJECTIVES: Despite progress in the treatment of cardiopulmonary organ failure, the mortality rate for patients with acute respiratory distress syndrome (ARDS) and cardiogenic shock remains high. Extracorporeal membrane oxygenation (ECMO) is a promising treatment option, but long-term outcomes and health-related quality of life (HRQOL) are unknown. METHODS: Detailed information related to pre- and post-device data and outcomes from a consecutive sample of 71 patients treated with ECMO was analysed...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
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