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https://www.readbyqxmd.com/read/28203019/-investigation-of-risk-factors-of-acute-kidney-injury-after-off-pump-coronary-artery-bypass-grafting-and-3-years-follow-up
#1
X H Li, F Xiao, S Y Zhang
OBJECTIVE: To investigate the incidence rate and risk factors of acute kidney injury (AKI) after off-pump coronary artery bypass grafting (CABG),and to compare the effects of AKI on complications after operation and major adverse cardiovascular and cerebrovascular events (MACCE) after 3 years' follow-up. METHODS: In the study, 299 consecutive patients who underwent scheduled off-pump CABG from January 2010 to March 2012 were included. The patients were divided into AKI group with AKI and control group without AKI after operation...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28178922/risk-factors-for-excessively-prolonged-meropenem-use-in-the-intensive-care-setting-a-case-contol-study
#2
Juri Katchanov, Benno Kreuels, Florian P Maurer, Kai Wöstmann, Johannes Jochum, Christina König, Kariem Seoudy, Holger Rohde, Ansgar W Lohse, Dominic Wichmann, Michael Baehr, Camilla Rothe, Stefan Kluge
BACKGROUND: Inappropriate use of broad-spectrum antimicrobials affects adversely both the individual patient and the general public. The aim of the study was to identify patients at risk for excessively prolonged carbapenem treatment in the ICU as a target for antimicrobial stewardship interventions. METHODS: Case-control study in a network of 11 ICUs of a university hospital. Patients with uninterrupted meropenem therapy (MT) > 4 weeks were compared to controls...
February 8, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28173962/prevalence-of-healthcare-associated-infections-in-polish-adult-intensive-care-units-summary-data-from-the-ecdc-european-point-prevalence-survey-of-hospital-associated-infections-and-antimicrobial-use-in-poland-2012-2014
#3
A Deptuła, E Trejnowska, G Dubiel, M Żukowski, A Misiewska-Kaczur, T Ozorowski, W Hryniewicz
BACKGROUND: Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. Local epidemiological studies need to be conducted to set the priorities for surveillance and prevention programmes. AIM: To investigate the epidemiology of hospital-acquired infections (HAIs) among patients admitted to Polish adult ICUs over a three-year period. METHODS: Data were collected according to the European Centre for Disease Prevention and Control (ECDC) European Union Point Prevalence Survey of Healthcare-associated Infections and Antimicrobial Use in European Acute Care Hospitals (EU-PPS HAI & AU) protocol for 39,318 patients within 160 acute care hospitals...
January 4, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28162098/the-effect-of-universal-decolonization-with-screening-in-critical-care-to-reduce-mrsa-across-an-entire-hospital
#4
Craig W Bradley, Martyn A C Wilkinson, Mark I Garvey
OBJECTIVE To describe the effect of universal methicillin-resistant Staphylococcus aureus (MRSA) decolonization therapy in a large intensive care unit (ICU) on the rates of MRSA cases and acquisitions in a UK hospital. DESIGN Descriptive study. SETTING University Hospitals Birmingham (UHB) NHS Foundation Trust is a tertiary referral teaching hospital in Birmingham, United Kingdom, that provides clinical services to nearly 1 million patients every year. METHODS A break-point time series analysis and kernel regression models were used to detect significant changes in the cumulative monthly numbers of MRSA bacteremia cases and acquisitions from April 2013 to August 2016 across the UHB system...
February 6, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28161384/hospitalization-costs-and-clinical-outcomes-in-cabg-patients-treated-with-intensive-insulin-therapy
#5
Saumeth Cardona, Francisco J Pasquel, Maya Fayfman, Limin Peng, Sol Jacobs, Priyathama Vellanki, Jeff Weaver, Michael Halkos, Robert A Guyton, Vinod H Thourani, Guillermo E Umpierrez
BACKGROUND: The financial impact of intensive (blood glucose [BG] 100-140mg/dl [5.5-7.8mM] vs. conservative (141-180mg/dl (7.9-10.0mM) glucose control in the ICU in patients, with and without diabetes, undergoing coronary artery bypass graft (CABG) surgery is not known. METHODS: This post-hoc cost analysis determined differences in hospitalization costs, resource utilization and perioperative complications in 288 CABG patients with diabetes (n=143) and without diabetes (n=145), randomized to intensive (n=143) and conservative (n=145) glucose control...
January 20, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28159015/a-randomized-placebo-controlled-phase-ii-study-of-a-pseudomonas-vaccine-in-ventilated-icu-patients
#6
Jordi Rello, Claus-Georg Krenn, Gottfried Locker, Ernst Pilger, Christian Madl, Laura Balica, Thierry Dugernier, Pierre-Francois Laterre, Herbert Spapen, Pieter Depuydt, Jean-Louis Vincent, Lajos Bogár, Zsuzsanna Szabó, Barbara Völgyes, Rafael Máñez, Nahit Cakar, Atilla Ramazanoglu, Arzu Topeli, Maria A Mastruzzo, Abel Jasovich, Christian G Remolif, Liliana Del Carmen Soria, Max A Andresen Hernandez, Carolina Ruiz Balart, Ildikó Krémer, Zsolt Molnár, Frank von Sonnenburg, Arthur Lyons, Michael Joannidis, Heinz Burgmann, Tobias Welte, Anton Klingler, Romana Hochreiter, Kerstin Westritschnig
BACKGROUND: Currently, no vaccine against Pseudomonas is available. IC43 is a new, recombinant, protein (OprF/I)-based vaccine against the opportunistic pathogen, Pseudomonas aeruginosa, a major cause of serious hospital-acquired infections. IC43 has proven immunogenicity and tolerability in healthy volunteers, patients with burns, and patients with chronic lung diseases. In order to assess the immunogenicity and safety of IC43 in patients who are most at risk of acquiring Pseudomonas infections, it was evaluated in mechanically ventilated ICU patients...
February 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28155624/past-recent-progresses-and-future-perspectives-of-nanotechnology-applied-to-antifungals-agents
#7
Luís Roque, Jesús Molpeceres, Cláudia Reis, Patrícia Rijo, Catarina Pinto Reis
Candida species remain a significant cause of nosocomial bloodstream infections, associated with prolonged hospital stay in the ICU and high healthcare cost. The incidence of Candida is very high in certain risk groups of patients (AIDS, diabetes, cancer, etc.). Recent developments of nanotechnology have strongly contributed to the design of new multifunctional drug carriers that improve drug bioavailability through a controlled and prolonged release profile or even through a more specific targeted delivery of the antifungal agent...
February 1, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28155226/propofol-versus-thiopental-sodium-for-the-treatment-of-refractory-status-epilepticus
#8
REVIEW
Hemanshu Prabhakar, Mani Kalaivani
BACKGROUND: This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (Issue 6, 2015).Failure to respond to antiepileptic drugs in patients with uncontrolled seizure activity such as refractory status epilepticus (RSE) has led to the use of anaesthetic drugs. Coma is induced with anaesthetic drugs to achieve complete control of seizure activity. Thiopental sodium and propofol are popularly used for this purpose. Both agents have been found to be effective...
February 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28155020/risks-factors-and-outcomes-of-clostridium-difficile-infection-in-patients-with-cancer-a-matched-case-control-study
#9
Andrew I T Hebbard, Monica A Slavin, Caroline Reed, Jason A Trubiano, Benjamin W Teh, Gabrielle M Haeusler, Karin A Thursky, Leon J Worth
PURPOSE: Clostridium difficile infection (CDI) is the leading cause of diarrhoea in hospitalised patients. Cancer populations are at high-risk for infection, but comprehensive evaluation in the current era of cancer care has not been performed. The objective of this study was to describe characteristics, risk factors, and outcomes of CDI in cancer patients. METHODS: Fifty consecutive patients with CDI at a large Australian cancer centre (2013-2015) were identified from the hospital pathology database...
February 2, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28153504/effect-of-omega-3-polyunsaturated-fatty-acids-derived-from-fish-oil-in-major-burn-patients-a-prospective-randomized-controlled-pilot-trial
#10
Serrana Tihista, Estrella Echavarría
BACKGROUND & AIMS: The burn patient is the clearest example of prolonged inflammatory response. Various nutrients, particularly omega-3 polyunsaturated fatty acids (ω-3 PUFAs), have been demonstrated as attenuating the inflammatory response, and reduce infectious complications. In absence of definitive evidence in major burns the study aimed at investigating the effect particularly on infectious complications of enteral nutrition enriched with ω-3 PUFAs. METHOD: Prospectively randomized controlled trial...
January 16, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28149487/clinical-response-and-outcome-of-pneumonia-due-to-multi-drug-resistant-acinetobacter-baumannii-in-critically-ill-patients
#11
Lida Shojaei, Mostafa Mohammadi, Mohammad-Taghi Beigmohammadi, Mahsa Doomanlou, Alireza Abdollahi, Mohammad Mehdi Feizabadi, Hossein Khalili
BACKGROUND AND OBJECTIVES: The frequency of multi-drug resistant Acinetobacter spp. infections is increasing in Iran. Considering availability of limited therapeutic options, clinical response and outcome of ventilator-associated pneumonia due to multi-drug resistant A.baumannii were evaluated in critically ill patients. MATERIALS AND METHODS: In this prospective study, 29 patients with carbapenem resistance A. baumannii ventilator-associated pneumonia were enrolled...
October 2016: Iranian Journal of Microbiology
https://www.readbyqxmd.com/read/28149146/antifungal-susceptibility-and-risk-factors-in-patients-with-candidemia
#12
Cigdem Mermutluoglu, Ozcan Deveci, Saim Dayan, Emel Aslan, Fatma Bozkurt, Recep Tekin
OBJECTIVE: This study aimed to investigate the antifungal susceptibility, typology, and risk factors of candidemia among adult and pediatric inpatients at a university hospital. MATERIALS AND METHODS: A case-control study was designed, and data collected between December 2013 and December 2014 were retrospectively evaluated. The case group consisted of patients with candidemia. The control group was selected from the inpatients that did not develop candidemia but were admitted in the same clinic and during the same period as the candidemia group...
October 2016: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28122513/drug-resistance-dynamics-of-staphylococcus-aureus-between-2008-and-2014-at-a-tertiary-teaching-hospital-jiangxi-province-china
#13
Kaisen Chen, Yanfang Huang, Qiuyue Song, Chenhui Wu, Xiaowen Chen, Lingbing Zeng
BACKGROUND: To understand the relationship between the Staphylococcus aureus infection rate and the reasonable usage of antibiotics, which will help in the effective control of MRSA infection. METHODS: All data were obtained by the application of the nosocomial infection surveillance network. Drug resistance, departmental sources, and isolated sites as well as infection rate variations of S. aureus were analyzed in the 7-year period in key departments. RESULTS: Between 2008 and 2014, 2525 strains of S...
January 25, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28121032/update-on-surgical-sepsis-syndrome
#14
REVIEW
J-L Vincent
BACKGROUND: Sepsis is a serious complication in surgical patients, and is associated with prolonged hospital stay and high mortality rates. The definitions of sepsis have been revisited recently. This article reviews how definitions have changed over the years, and provides an update on basic pathobiology and essential aspects of treatment. METHODS: PubMed was searched for reports published in English before October 2016, using the search terms 'surgical sepsis' AND 'surgical ICU'...
January 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28118549/tight-glycemic-control-in-critically-ill-children
#15
Michael S D Agus, David Wypij, Eliotte L Hirshberg, Vijay Srinivasan, E Vincent Faustino, Peter M Luckett, Jamin L Alexander, Lisa A Asaro, Martha A Q Curley, Garry M Steil, Vinay M Nadkarni
Background In multicenter studies, tight glycemic control targeting a normal blood glucose level has not been shown to improve outcomes in critically ill adults or children after cardiac surgery. Studies involving critically ill children who have not undergone cardiac surgery are lacking. Methods In a 35-center trial, we randomly assigned critically ill children with confirmed hyperglycemia (excluding patients who had undergone cardiac surgery) to one of two ranges of glycemic control: 80 to 110 mg per deciliter (4...
24, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28114979/impact-of-the-duration-of-antibiotics-on-clinical-events-in-patients-with-pseudomonas-aeruginosa-ventilator-associated-pneumonia-study-protocol-for-a-randomized-controlled-study
#16
Adrien Bouglé, Arnaud Foucrier, Hervé Dupont, Philippe Montravers, Alexandre Ouattara, Pierre Kalfon, Pierre Squara, Tabassome Simon, Julien Amour
BACKGROUND: Ventilator-associated pneumonia (VAP) accounts for 25% of infections in intensive care units. Compared to a long duration (LD) of antibiotic therapy, a short duration (SD) has a comparable clinical efficacy with less antibiotic use and less multidrug-resistant (MDR) pathogen emergence, with the exception of documented VAP of non-fermenting Gram-negative bacilli (NF-GNB), including Pseudomonas aeruginosa (PA). These results have led the American Thoracic Society to recommend SD therapy for VAP, except for PA-VAP...
January 23, 2017: Trials
https://www.readbyqxmd.com/read/28110287/aspirin-to-inhibit-sepsis-antisepsis-randomised-controlled-trial-protocol
#17
Damon P Eisen, Elizabeth M Moore, Karin Leder, Jessica Lockery, Emma S McBryde, John J McNeil, David Pilcher, Rory Wolfe, Robyn L Woods
INTRODUCTION: Sepsis is a leading global cause of morbidity and mortality, and is more common at the extremes of age. Moreover, the cost of in-hospital care for elderly patients with sepsis is significant. There are indications from experimental and observational studies that aspirin may reduce inflammation associated with infection. This paper describes the rationale and design of the AspiriN To Inhibit SEPSIS (ANTISEPSIS) trial, a substudy of ASPirin in Reducing Events in the Elderly (ASPREE)...
January 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28110095/prophylaxis-for-stress-ulcers-with-proton-pump-inhibitors-is-not-associated-with-increased-risk-of-bloodstream-infections-in-the-intensive-care-unit
#18
Margot E Cohen, Joanne M Hathway, Hojjat Salmasian, Jianfang Liu, Melissa Terry, Julian A Abrams, Daniel E Freedberg
BACKGROUND & AIMS: Proton pump inhibitors (PPIs) have been associated with increased risk of infection, likely due to changes in intestinal epithelial permeability and the gastrointestinal microbiome. PPIs are frequently given to patients in the intensive care unit (ICU) to prevent stress ulcers. These patients are at risk for bloodstream infections (BSIs), so we investigated the relationship between PPI use and BSIs among patients in the ICU. METHODS: We performed a retrospective cohort study of adults (≥18 years) admitted to 1 of 14 ICUs within a hospital network of 3 large hospitals from 2008 through 2014...
January 18, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28107096/implementation-of-an-aggressive-enteral-nutrition-protocol-and-the-effect-on-clinical-outcomes
#19
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/28105127/clinical-study-on-cluster-care-to-prevent-multi-drug-resistant-infection-in-icu-patients-with-severe-encephalopathy
#20
Liu Qiong, Zhu Hui
The value of clinical cluster nursing in the prevention of multi-drug resistant (MDR) infection in patients with severe encephalopathy in ICU was evaluated. ICU patients (n=129) diagnosed with severe encephalopathy between 2012 and 2014 were selected as the study group, while 106 cases of ICU patients diagnosed with severe encephalopathy between 2010 and 2012 were retrospectively selected as the control group. Control group patients were offered conventional integrated nursing care, while the study group patients were offered cluster nursing care...
December 2016: Experimental and Therapeutic Medicine
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