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Vasopressor use with tube feeds

Laura Mercer-Rosa, Okan U Elci, Nelangi M Pinto, Ronn E Tanel, Elizabeth Goldmuntz
Deletion of 22q11.2 (del22q11) is associated with adverse outcomes in patients with tetralogy of Fallot (TOF). We sought to investigate its contribution to perioperative outcome in patients with a severe form of TOF characterized by pulmonary atresia (PA) or severe pulmonary stenosis (PS) and major aortopulmonary collateral arteries (MAPCAS). We conducted a retrospective review of patients with TOF/MAPCAS who underwent staged surgical reconstruction between 1995 and 2006. Groups were compared according to 22q11...
March 8, 2018: Pediatric Cardiology
Wafa Ibn Saied, Bertrand Souweine, Maité Garrouste-Orgeas, Stéphane Ruckly, Michael Darmon, Sébastien Bailly, Yves Cohen, Elie Azoulay, Carole Schwebel, Aguila Radjou, Hatem Kallel, Christophe Adrie, Anne-Sylvie Dumenil, Laurent Argaud, Guillaume Marcotte, Samir Jamali, Laurent Papazian, Dany Goldgran-Toledano, Lila Bouadma, Jean-Francois Timsit
RATIONALE: The impact of prevention strategies and risk factors for early-onset (EOP) versus late-onset (LOP) ventilator-associated pneumonia (VAP) are still debated. OBJECTIVES: To evaluate, in a multicenter cohort, the risk factors for EOP and LOP, as the evolution of prevention strategies. METHODS: 7,784 patients with mechanical ventilation (MV) for at least 48 hours were selected into the multicenter prospective OUTCOMEREA database (1997-2016)...
2017: PloS One
Deborah Bly, Marilyn Schallom, Carrie Sona, Dean Klinkenberg
BACKGROUND: Although most intensive care patients are at risk for pressure ulcers, not all experience such ulcers. OBJECTIVE: To examine a model of variables related to extrinsic and intrinsic pressure on skin and underlying tissues, oxygenation, perfusion, and baseline comorbid conditions to identify risk factors associated with pressure ulcers in critically ill adults. METHOD: A retrospective chart review was conducted on patients identified by weekly rounds from January 2010 through October 2010 to determine the prevalence of pressure ulcers...
March 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Debra T Liu, Dorothy C Brown, Deborah C Silverstein
OBJECTIVE: To determine whether the timing and route of nutritional support strategy affect length of hospitalization in dogs with naturally occurring septic peritonitis. DESIGN: Retrospective study encompassing cases from 2000 to 2009. SETTING: University teaching hospital. ANIMALS: Forty-five dogs that survived septic peritonitis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Nutritional strategy for each dog was categorized as either enteral nutrition (EN: free choice voluntary eating or assisted tube feeding) or central parenteral nutrition (CPN)...
August 2012: Journal of Veterinary Emergency and Critical Care
Brian S Smith, Dinesh Yogaratnam, Kimberly E Levasseur-Franklin, Allison Forni, Jeffrey Fong
Despite regular use of drugs for critically ill patients, overall data are limited regarding the impact of critical illness on pharmacokinetics (PK). Designing safe and effective drug regimens for patients with critical illness requires an understanding of PK. This article reviews general principles of PK, including absorption, distribution, metabolism, and elimination, and how critical illness can influence these parameters. In the area of drug absorption, we discuss the impact of vasopressor use, delayed gastric emptying and feeding tubes, and nutrient interactions...
May 2012: Chest
Huang-Chi Chen, Wen-Chi Chen, Kai-Huang Lin, Yung-Hsiang Chen, Lun-Chien Lo, Tsung-Chieh Lee, Te-Chun Hsia, Chu-Hsien Wang, Shin-Hwar Wu, Hsin-Whae Hsu, Yu-Jun Chang, Yu-Chuen Huang, Tien-Hsiung Ku, Ming-Hwarng Horng
BACKGROUND: Even though there are continually upgraded recommendations for managing sepsis, such as "Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock", mortality is still high. Si-ni-tang, a remedy documented in Shanghan Lun, a medical collection from ancient China, is used for treating patients with sepsis and septic shock. Using a well-designed clinical trial, we are eager to survey the effectiveness of the concurrent use of this remedy in restoring these patients' hemodynamic status, or "Yang Qi"...
August 24, 2011: Trials
Katharine W Markell, Evan M Renz, Christopher E White, Michael E Albrecht, Lorne H Blackbourne, Myung S Park, David A Barillo, Kevin K Chung, Rosemary A Kozar, Joseph P Minei, Stephen M Cohn, David N Herndon, Leopoldo C Cancio, John B Holcomb, Steven E Wolf
BACKGROUND: Abdominal catastrophe in the severely burned patient without abdominal injury has been described. We perceived an alarming recent incidence of this complication in our burn center, both during acute resuscitation and later in the hospital course. We sought to define incidence, outcomes, and associated factors, such as excessive resuscitation volume and treatment issues. STUDY DESIGN: We examined all severely burned military and civilian patients with abdominal pathology between March 2003 and February 2008...
May 2009: Journal of the American College of Surgeons
Carol McGinnis, Janet Fischer, Georgia Larson
Nutrition support in the critically ill patient is challenging but is even more difficult in a morbidly obese patient. This case report chronicles the care of a 6-foot-tall, 256-kg male (body mass index 76.5 kg/m(2)) who spent over a month in the intensive care unit for respiratory failure, sepsis, and acute renal failure. Parenteral nutrition was provided throughout his critical care course. One of the major difficulties encountered was determining his nutritional needs. A hypocaloric nutritional regimen was used, along with moderate protein provisions...
June 2004: Nutrition in Clinical Practice
Yoshihisa Hirakawa, Yuichiro Masuda, Takaya Kimata, Kazumasa Uemura, Masafumi Kuzuya, Akihisa Iguchi
A byproduct of the aging of the population has been a dramatic rise in patients with dementia. The aim of the present study is to clarify the use of aggressive and palliative treatments, artificial nutrition and sedation in long-term care hospitals in Japan. We assessed 123 deaths in people aged 65 and older who died in two long-term care hospitals in and around Nagoya from January 2001 to December 2002. All deceased were divided into two groups according to their diagnosis of dementia. Data on the particular characteristics of the deceased, diagnosis of dementia, aggressive treatments (including CPR, intubation, mechanical ventilation, the use of systemic antibiotics and blood transfusion), palliative treatments (including oxygen, narcotic and nonnarcotic pain medication) artificial nutrition (including hyperalimentation and tube feeding) and sedation during the last six months of their lives were collected from medical charts...
January 2004: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
M B Hamel, R B Davis, J M Teno, W A Knaus, J Lynn, F Harrell, A N Galanos, A W Wu, R S Phillips
BACKGROUND: Older age is associated with less aggressive treatment and higher short-term mortality due to serious illness. It is not known whether less aggressive care contributes to this survival disadvantage in elderly persons. OBJECTIVE: To determine the effect of age on short-term survival, independent of baseline patient characteristics and aggressiveness of care. DESIGN: Secondary analysis of data from a prospective cohort study. SETTING: Five academic medical centers participating in SUPPORT (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments)...
November 16, 1999: Annals of Internal Medicine
D A Asch, K Faber-Langendoen, J A Shea, N A Christakis
PURPOSE: To describe the observed sequence of withdrawal of eight different forms of life-sustaining treatment and to determine whether aspects of those treatments determine the order of withdrawal. SUBJECTS AND METHODS: We observed 211 consecutive patients dying in four midwestern US hospitals from whom at least one of eight specific life-sustaining treatments was or could have been withdrawn. We used a parametric statistical technique to explain the order of withdrawal based on selected characteristics of the forms of life support, including cost, scarcity, and discomfort...
August 1999: American Journal of Medicine
N A Christakis, D A Asch
We have investigated biases in physicians' decisions regarding the form of life support to withdraw from critically ill patients in whom the decision to withdraw has already been made. Using a specially designed instrument that solicited both self-reported preferences and also responses to experimentally varied clinical vignettes, we surveyed 862 American internists, of whom 481 (56%) responded. Physicians do have preferences about the form of life support withdrawn. From most likely to least likely the order is: blood products, haemodialysis, intravenous vasopressors, total parenteral nutrition, antibiotics, mechanical ventilation, tube feedings, and intravenous fluids...
September 11, 1993: Lancet
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