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European society of intensive care

K M Olsson, M Halank, B Egenlauf, D Fistera, H Gall, C Kaehler, K Kortmann, T Kramm, M Lichtblau, A Marra, C Nagel, A Sablotzki, H-J Seyfarth, D Schranz, S Ulrich, M M Hoeper, T J Lange
The 2015 European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension are also valid for Germany. The guidelines contain detailed recommendations for the targeted treatment of pulmonary arterial hypertension (PAH). However, the practical implementation of the European Guidelines in Germany requires the consideration of several country-specific issues and already existing novel data. This requires a detailed commentary to the guidelines, and in some aspects an update already appears necessary. In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany...
October 2016: Deutsche Medizinische Wochenschrift
Flavia Petrini, Ida Di Giacinto, Rita Cataldo, Clelia Esposito, Vittorio Pavoni, Paolo Donato, Antonella Trolio, Guido Merli, Massimiliano Sorbello, Paolo Pelosi
Proper management of obese patients requires a team vision and appropriate behaviors by all health care providers in hospital. Specialist competencies are fundamental, as are specific clinical pathways and good clinical practices designed to deal with patients whose body mass index is ≥30 kg/m2. Standards of care for bariatric and non-bariatric surgery and for the critical care management of this population exist but are not well defined nor clearly followed in every hospital. Thus every anesthesiologist is likely to deal with this challenging population...
October 19, 2016: Minerva Anestesiologica
Karen E James, Rui Xiao, Peter A Merkel, Pamela F Weiss
OBJECTIVES: To characterise the clinical course and outcomes of a cohort of children with granulomatosis with polyangiitis (GPA). METHODS: Retrospective cohort study of children diagnosed with GPA in a tertiary care facility from 2000-2014. All subjects met the American College of Rheumatology 1990 criteria for GPA or the 2008 European League against Rheumatism/Paediatric Rheumatology International Trials Organisation/Paediatric Rheumatology European Society criteria for GPA...
October 6, 2016: Clinical and Experimental Rheumatology
Fabio Midulla, Enrico Lombardi, Marielle Pijnenburg, Ian M Balfour-Lynn, Jonathan Grigg, Kajsa Bohlin, Franca Rusconi, Petr Pohunek, Ernst Eber
The aim of this article is to describe paediatric highlights from the 2014 European Respiratory Society (ERS) International Congress in Munich, Germany. Abstracts from the seven groups of the ERS Paediatric Assembly (Respiratory Physiology and Sleep, Asthma and Allergy, Cystic Fibrosis, Respiratory Infection and Immunology, Neonatology and Paediatric Intensive Care, Respiratory Epidemiology, and Bronchology) are presented in the context of the current literature.
May 2015: ERJ Open Research
Luc Morin, Samiran Ray, Clare Wilson, Solenn Remy, Mohamed Rida Benissa, Nicolaas J G Jansen, Etienne Javouhey, Mark J Peters, Martin Kneyber, Daniele De Luca, Simon Nadel, Luregn Jan Schlapbach, Graeme Maclaren, Pierre Tissieres
PURPOSE: Although overall paediatric septic shock mortality is decreasing, refractory septic shock (RSS) is still associated with high mortality. A definition for RSS is urgently needed to facilitate earlier identification and treatment. We aim to establish a European society of paediatric and neonatal intensive care (ESPNIC) experts' definition of paediatric RSS. METHODS: We conducted a two-round Delphi study followed by an observational multicentre retrospective study...
October 5, 2016: Intensive Care Medicine
Dirk Schramm, Kerstin Ling, Antje Schuster, Thomas Nicolai
BACKGROUND: Task forces of the European Respiratory Society (ERS, 2003) and the American Thoracic Society (ATS, 2015) both recommend rigid bronchoscopy for foreign body removal in children. However, there is an increasing number of publications recommending flexible bronchoscopy as primary method for foreign body removal in children. METHODS: We therefore initiated a nationwide survey, investigating the routinely used method of foreign body removal in children in different centers in Germany...
September 20, 2016: Pediatric Pulmonology
Jan Menzenbach, Olaf Boehm
Before non-cardiac surgery, evaluation of cardiac function is no frequent part of surgical treatment. European societies of anesthesiology and cardiology published consensus-guidelines in 2014 to present a reasonable approach for preoperative evaluation. This paper intends to differentiate the composite of perioperative risk and to display the guidelines methodical approach to handle it. Features to identify patients at risk from an ageing population with comorbidities, are the classification of surgical risk, functional capacity and risk indices...
July 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Tommaso Mauri, Takeshi Yoshida, Giacomo Bellani, Ewan C Goligher, Guillaume Carteaux, Nuttapol Rittayamai, Francesco Mojoli, Davide Chiumello, Lise Piquilloud, Salvatore Grasso, Amal Jubran, Franco Laghi, Sheldon Magder, Antonio Pesenti, Stephen Loring, Luciano Gattinoni, Daniel Talmor, Lluis Blanch, Marcelo Amato, Lu Chen, Laurent Brochard, Jordi Mancebo
PURPOSE: Esophageal pressure (Pes) is a minimally invasive advanced respiratory monitoring method with the potential to guide management of ventilation support and enhance specific diagnoses in acute respiratory failure patients. To date, the use of Pes in the clinical setting is limited, and it is often seen as a research tool only. METHODS: This is a review of the relevant technical, physiological and clinical details that support the clinical utility of Pes. RESULTS: After appropriately positioning of the esophageal balloon, Pes monitoring allows titration of controlled and assisted mechanical ventilation to achieve personalized protective settings and the desired level of patient effort from the acute phase through to weaning...
September 2016: Intensive Care Medicine
C Louise Thwaites, Ganbold Lundeg, Arjen M Dondorp
No abstract text is available yet for this article.
June 21, 2016: Intensive Care Medicine
Jean-Louis Teboul, Bernd Saugel, Maurizio Cecconi, Daniel De Backer, Christoph K Hofer, Xavier Monnet, Azriel Perel, Michael R Pinsky, Daniel A Reuter, Andrew Rhodes, Pierre Squara, Jean-Louis Vincent, Thomas W Scheeren
Over the last decade, the way to monitor hemodynamics at the bedside has evolved considerably in the intensive care unit as well as in the operating room. The most important evolution has been the declining use of the pulmonary artery catheter along with the growing use of echocardiography and of continuous, real-time, minimally or totally non-invasive hemodynamic monitoring techniques. This article, which is the result of an agreement between authors belonging to the Cardiovascular Dynamics Section of the European Society of Intensive Care Medicine, discusses the advantages and limits of using such techniques with an emphasis on their respective place in the hemodynamic management of critically ill patients with hemodynamic instability...
September 2016: Intensive Care Medicine
Bernardo Costa, Conxa Castell, Xavier Cos, Claustre Solé, Santiago Mestre, Marta Canela, Antoni Boquet, Joan-Josep Cabré, Francisco Barrio, Gemma Flores-Mateo, Daniel Ferrer-Vidal, Jaana Lindström
BACKGROUND: Compelling evidence has been accumulated to support the effectiveness of intensive lifestyle intervention in delaying progression to Type 2 diabetes even in people identified as being at high risk determined by the Finnish diabetes risk score. The DE-PLAN-CAT project (diabetes in Europe-prevention using lifestyle, physical activity and nutritional intervention-Catalonia) evidenced that intensive lifestyle intervention was feasible and cost-effective on a short scale in real-life primary care settings, at least over 4 years...
2016: Journal of Translational Medicine
Julia Harris, Anne-Sylvie Ramelet, Monique van Dijk, Pavla Pokorna, Joke Wielenga, Lyvonne Tume, Dick Tibboel, Erwin Ista
BACKGROUND: This position statement provides clinical recommendations for the assessment of pain, level of sedation, iatrogenic withdrawal syndrome and delirium in critically ill infants and children. Admission to a neonatal or paediatric intensive care unit (NICU, PICU) exposes a child to a series of painful and stressful events. Accurate assessment of the presence of pain and non-pain-related distress (adequacy of sedation, iatrogenic withdrawal syndrome and delirium) is essential to good clinical management and to monitoring the effectiveness of interventions to relieve or prevent pain and distress in the individual patient...
June 2016: Intensive Care Medicine
Georg Hansmann, Christian Apitz, Hashim Abdul-Khaliq, Tero-Pekka Alastalo, Phillip Beerbaum, Damien Bonnet, Karl-Otto Dubowy, Matthias Gorenflo, Alfred Hager, Anne Hilgendorff, Michael Kaestner, Martin Koestenberger, Juha W Koskenvuo, Rainer Kozlik-Feldmann, Titus Kuehne, Astrid E Lammers, Heiner Latus, Ina Michel-Behnke, Oliver Miera, Shahin Moledina, Vivek Muthurangu, Joseph Pattathu, Dietmar Schranz, Gregor Warnecke, Peter Zartner
UNLABELLED: : The European Paediatric Pulmonary Vascular Disease (PVD) Network is a registered, non-profit organisation that strives to define and develop effective, innovative diagnostic methods and treatment options in all forms of paediatric pulmonary hypertensive vascular disease, including specific forms such as pulmonary arterial hypertension (PAH)-congenital heart disease, pulmonary hypertension (PH) associated with bronchopulmonary dysplasia, persistent PH of the newborn, and related cardiac dysfunction...
May 2016: Heart: Official Journal of the British Cardiac Society
M Schmidt-Hieber, G Silling, E Schalk, W Heinz, J Panse, O Penack, M Christopeit, D Buchheidt, U Meyding-Lamadé, S Hähnel, H H Wolf, M Ruhnke, S Schwartz, G Maschmeyer
Infections of the central nervous system (CNS) are infrequently diagnosed in immunocompetent patients, but they do occur in a significant proportion of patients with hematological disorders. In particular, patients undergoing allogeneic hematopoietic stem-cell transplantation carry a high risk for CNS infections of up to 15%. Fungi and Toxoplasma gondii are the predominant causative agents. The diagnosis of CNS infections is based on neuroimaging, cerebrospinal fluid examination and biopsy of suspicious lesions in selected patients...
July 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
David M Williams, Maire Gallagher, Joel Handley, Jeffrey W Stephens
Hyponatraemia is the most common electrolyte disorder seen in clinical practice and the consequences can range from minor symptoms to life-threatening complications including seizures and cardiorespiratory distress. These effects occur as a result of fluid shifts due to deranged serum tonicity and subsequent cerebral oedema. The appropriate assessment and management of patients with hyponatraemia is not always achieved in clinical practice, which is partly related to challenges in teaching with limited clinical guidance...
July 2016: Postgraduate Medical Journal
V R Belum, B Benhuri, M A Postow, M D Hellmann, A M Lesokhin, N H Segal, R J Motzer, S Wu, K J Busam, J D Wolchok, M E Lacouture
BACKGROUND: Dermatologic adverse events (AEs) are some of the most frequently observed toxicities of immune-checkpoint inhibitor therapy, but they have received little attention. The drugs, pembrolizumab and nivolumab are recently approved inhibitors of the programmed death (PD)-1 receptor that have overlapping AE profiles however, the incidence, relative risk (RR), and clinico-morphological pattern of the associated dermatologic AEs are not known. METHODS: We conducted a systematic review of the literature, and performed a meta-analysis of dermatologic AEs observed with the use of pembrolizumab and nivolumab in cancer patients...
June 2016: European Journal of Cancer
Sachin Sud, Maneesh Sud, Jan O Friedrich, Hannah Wunsch, Maureen O Meade, Niall D Ferguson, Neill K J Adhikari
BACKGROUND: High-frequency oscillation (HFO) is an alternative to conventional mechanical ventilation that is sometimes used to treat people with acute respiratory distress syndrome, but effects on oxygenation, mortality and adverse clinical outcomes are uncertain. This review was originally published in 2004 and was updated in 2013 and again in 2015. OBJECTIVES: To determine the effects of HFO compared to conventional mechanical ventilation on physiological outcomes, clinical outcomes, and mortality when used for the treatment of acute respiratory distress syndrome (ARDS)...
April 4, 2016: Cochrane Database of Systematic Reviews
Tomasz Czerw, Myriam Labopin, Christoph Schmid, Jan J Cornelissen, Patrice Chevallier, Didier Blaise, Jürgen Kuball, Stephane Vigouroux, Frédéric Garban, Bruno Lioure, Nathalie Fegueux, Laurence Clement, Anna Sandstedt, Johan Maertens, Gaëlle Guillerm, Dominique Bordessoule, Mohamad Mohty, Arnon Nagler
Inconsistent results have been reported regarding the influence of graft composition on the incidence of graft versus host disease (GVHD), disease control and survival after reduced-intensity conditioning (RIC) allogeneic peripheral blood stem cell transplantation (allo-PBSCT). These discrepancies may be at least in part explained by the differences in disease categories, disease status at transplant, donor type and conditioning. The current retrospective EBMT registry study aimed to analyze the impact of CD3+ and CD34+ cells dose on the outcome of RIC allo-PBSCT in patients with acute myelogenous leukemia (AML) in first complete remission, allografted from HLA-matched unrelated donors (10 of 10 match)...
May 10, 2016: Oncotarget
Robert W Taylor
Acute gastrointestinal injury (AGI) is common in critical illness and negatively affects outcome. A variety of definitions have been used to describe AGI, which has led to clinical confusion and hampered comparison of research studies across institutions. An international working group of the European Society of Intensive Care Medicine was convened to standardize definitions for AGI and provide current evidence-based understanding of its pathophysiology and management. This disorder is associated with a wide variety of signs and symptoms and may be difficult to detect, therefore a high index of suspicion is warranted...
April 2016: Critical Care Clinics
Bartosz Horosz, Katarzyna Nawrocka, Małgorzata Malec-Milewska
After many years of experience in surgery, a series of recommendations have been created by a group of European specialists to improve the quality of perioperative care and maximize postoperative outcomes. Early mobilization and oral feeding, preoperative oral intake of carbohydrate-rich fluids, proper fluid and pain management, intensive postoperative nausea and vomiting prophylaxis, and antimicrobial and thromboembolism prophylaxis are the interventions that may decrease surgery-induced metabolic stress and facilitate the return of bowel function and early discharge...
2016: Anaesthesiology Intensive Therapy
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