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https://www.readbyqxmd.com/read/29353120/phase-angle-assessment-in-critically-ill-cancer-patients-relationship-with-the-nutritional-status-prognostic-factors-and-death
#1
Tatiana Cathoud do Amaral Paes, Kátia Cansanção Correa de Oliveira, Patrícia de Carvalho Padilha, Wilza Arantes Ferreira Peres
PURPOSE: To evaluate the relationship between phase angle (PA) and nutritional status and the prognostic significance of PA in critically ill cancer patients. METHODS: 31 patients that had been admitted to the intensive care unit (ICU) of a center on oncology were evaluated. Their PA was obtained from their bioelectrical impedance within 48 h of the ICU admission. The logistic regression analysis of Cox was used in order to identify the independent predictors of the outcomes...
January 10, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29353117/exposure-keratopathy-incidence-risk-factors-and-impact-of-protocolised-care-on-exposure-keratopathy-in-critically-ill-adults
#2
Obaid Kousha, Zubaid Kousha, Jonathan Paddle
PURPOSE: We aimed to determine the rate of exposure keratopathy (EK) in critically ill patients, identify risk factors for developing EK and ascertain the effectiveness of a protocol to prevent EK. MATERIALS AND METHODS: We undertook a two-phase prospective cohort study in a general adult ICU with first-phase being observational and an eye care protocol was introduced in the second-phase. Daily ophthalmic assessment was carried out along with recording of various risk factors...
November 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29353024/outcomes-and-mortality-prediction-model-of-critically-ill-adults-with-acute-respiratory-failure-and-interstitial-lung-disease
#3
Whitney Gannon, David J Lederer, Mauer Biscotti, Azka Javaid, Nina Patel, Daniel Brodie, Matthew Bacchetta, Matthew Baldwin
BACKGROUND: We aimed to examine short- and long-term mortality in a mixed population of interstitial lung disease (ILD) patients with acute respiratory failure, and to identify those at lower versus higher risk of in-hospital death. METHODS: We conducted a single-center retrospective cohort study of 126 consecutive adults with ILD admitted to an intensive care unit (ICU) for respiratory failure at a tertiary care hospital between 2010 and 2014 who did not undergo lung transplantation during their hospitalization...
January 15, 2018: Chest
https://www.readbyqxmd.com/read/29353023/diaphragm-excursion-time-index-a-new-parameter-using-ultrasonography-to-predict-extubation-outcome
#4
Atul Palkar, Mangala Narasimhan, Harly Greenberg, Karan Singh, Seth Koenig, Paul Mayo, Eric Gottesman
INTRODUCTION: The diaphragmatic response to increased mechanical load following withdrawal of mechanical ventilation (MV) is critical in determining the outcome of extubation. Using ultrasonography, we aimed to evaluate the performance of excursion-time (E-T) index- a product of diaphragm excursion and inspiratory time, to predict the outcome of extubation. METHODS: Right hemidiaphragm excursion, inspiratory time (Ti) and E-T index were measured using ultrasonography during MV: (1) On assist control mode (A/C) during consistent patient triggered ventilation (2) Following 30 minutes during a spontaneous breathing trial (SBT) (3) Between 4-24 hours following extubation...
January 15, 2018: Chest
https://www.readbyqxmd.com/read/29352425/safety-and-efficacy-of-nanocurcumin-as-add-on-therapy-to-riluzole-in-patients-with-amyotrophic-lateral-sclerosis-a-pilot-randomized-clinical-trial
#5
Mona Ahmadi, Elmira Agah, Shahriar Nafissi, Mahmoud Reza Jaafari, Mohammad Hossein Harirchian, Payam Sarraf, Sara Faghihi-Kashani, Seyed Jalal Hosseini, Abdolreza Ghoreishi, Vajiheh Aghamollaii, Mostafa Hosseini, Abbas Tafakhori
The objective of present study was to assess the safety and efficacy of nanocurcumin as an anti-inflammatory and antioxidant agent in adults with amyotrophic lateral sclerosis (ALS). We conducted a 12-month, double-blind, randomized, placebo-controlled trial at a neurological referral center in Iran. Eligible patients with a definite or probable ALS diagnosis were randomly assigned to receive either nanocurcumin (80 mg daily) or placebo in a 1:1 ratio. A computerized random number generator was used to prepare the randomization list...
January 19, 2018: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/29352361/the-modified-ravitch-approach-for-the-management-of-severe-anterior-flail-chest-with-bilateral-sternochondral-dislocations-a-case-report
#6
Gabriel Estremera, Ellen Chieko Omi, Eduardo Smith-Singares
The management of flail chest continues to evolve as scientific evidence and surgical experience accumulates. Flail chest injuries that span the sternum present a rare and complicated injury pattern that can be challenging to manage both medically and surgically. Our patient is a 69-year-old involved in a high-speed motor vehicle crash with respiratory failure secondary to an anterior flail chest. Tomographic examination confirmed a sternal fracture with bilateral sternochondral dislocations and multiple rib fractures...
January 19, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29351596/freedom-solo%C3%A2-versus-trifecta%C3%A2-bioprostheses-clinical-and-haemodynamic-evaluation-after-propensity-score-matching
#7
Rui J Cerqueira, Renata Raimundo, Soraia Moreira, Francisca A Saraiva, Marta Andrade, Elson Salgueiro, Jorge Almeida, Mário Jorge Amorim, Paulo Pinho, André P Lourenço, Adelino Leite-Moreira
OBJECTIVES: The goal of this study was to compare the stentless Freedom Solo® (FS) and the stented Trifecta® (TF) aortic bioprostheses with regard to haemodynamic profile, left ventricular mass regression and early and late postoperative outcomes and survival. METHODS: A longitudinal cohort study of consecutive patients undergoing aortic valve replacement (2009-16) with either the FS or TF at 1 centre was performed. Local databases and national records were queried...
January 16, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29350673/glyphosate-ingestion-causing-multiple-organ-failure-a-near-fatal-case-report
#8
Edoardo Picetti, Michela Generali, Francesca Mensi, Giampaolo Neri, Roberta Damia, Giuseppe Lippi, Gianfranco Cervellin
A 55 years old man self-presented to our Emergency Department (ED) reporting an attempted suicide by cutting the left forearm veins and ingesting approximately 200 mL of an herbicide (Myrtos®, containing 36% of glyphosate as isopropylamine salt). Laboratory tests showed metabolic acidosis. Hydration with normal saline and alkalinization with sodium bicarbonate was started according to suggestion of the poison control center, since an antidote was unavailable. Cardiorespiratory condition gradually worsened, so that non-invasive positive pressure ventilation (NIPPV) was applied and infusion of fluids was established...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29350333/deltoid-muscle-morphometry-as-an-index-of-impaired-skeletal-muscularity-in-neonatal-intensive-care
#9
Theodore Dassios, Ourania Kaltsogianni, Miltiadis Krokidis, Ann Hickey, Anne Greenough
We hypothesised that extremely premature infants would have decreased muscle mass at term-corrected age compared to term-born infants and that the degree of reduced muscle mass acquisition would correlate with the duration of invasive mechanical ventilation. The MRI brain scans of infants admitted in the neonatal unit at King's College Hospital between 1 January 2010 and 1 June 2016 were retrospectively reviewed. The coronal cross-sectional area of the left deltoid muscle (DCSA) was measured in 17 infants born < 28 weeks of gestation and in 20 infants born at term...
January 19, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29350241/the-airway-occlusion-pressure-p0-1-to-monitor-respiratory-drive-during-mechanical-ventilation-increasing-awareness-of-a-not-so-new-problem
#10
Irene Telias, Felipe Damiani, Laurent Brochard
No abstract text is available yet for this article.
January 19, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29350170/atypical-lower-motor-neuron-disease-with-enlargement-of-nissl-substance-report-of-an-autopsy-case
#11
Masayuki Shintaku, Daita Kaneda, Kiyomitsu Oyanagi
The patient was an 81-year-old woman diagnosed with atypical motor neuron disease who died after a long clinical course (7.5 years without mechanical assistance of ventilation) characterized by lower motor neuron signs and symptoms. Upper motor neuron signs and cognitive impairment were not apparent. Autopsy demonstrated severe neuronal loss in the anterior horn of the spinal cord, and some of the remaining neurons showed enlargement of Nissl substance and apparent thickening of the nuclear envelopes. No Bunina bodies, skein-like inclusions, or structures immunoreactive for phosphorylated transactivation response DNA-binding protein 43 were found...
January 19, 2018: Clinical Neuropathology
https://www.readbyqxmd.com/read/29349777/in-bed-cycling-in-the-icu-patient-safety-and-recollections-with-motivational-effects
#12
M Ringdal, M Warren Stomberg, K Egnell, E Wennberg, R Zätterman, C Rylander
BACKGROUND: In-bed cycling (IBC) is gaining interest for implementation in intensive care units. Our main objective was to explore patient recollections and experiences of early mobilization, including IBC. Secondly, we aimed to examine if IBC was safe and feasible. METHODS: Eleven participants were interviewed about their experiences during their critical illnesses and active mobilization in the intensive care unit. The interviews were analyzed thematically. Six participants were also monitored for physiological reactions and adverse events during IBC while mechanically ventilated...
January 18, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29347987/determinants-of-long-term-outcome-in-icu-survivors-results-from-the-frog-icu-study
#13
Etienne Gayat, Alain Cariou, Nicolas Deye, Antoine Vieillard-Baron, Samir Jaber, Charles Damoisel, Qin Lu, Xavier Monnet, Isabelle Rennuit, Elie Azoulay, Marc Léone, Heikel Oueslati, Bertrand Guidet, Diane Friedman, Antoine Tesnière, Romain Sonneville, Philippe Montravers, Sébastien Pili-Floury, Jean-Yves Lefrant, Jacques Duranteau, Pierre-François Laterre, Nicolas Brechot, Karine Chevreul, Morgane Michel, Bernard Cholley, Matthieu Legrand, Jean-Marie Launay, Eric Vicaut, Mervyn Singer, Matthieu Resche-Rigon, Alexandre Mebazaa
BACKGROUND: Intensive care unit (ICU) survivors have reduced long-term survival compared to the general population. Identifying parameters at ICU discharge that are associated with poor long-term outcomes may prove useful in targeting an at-risk population. The main objective of the study was to identify clinical and biological determinants of death in the year following ICU discharge. METHODS: FROG-ICU was a prospective, observational, multicenter cohort study of ICU survivors followed 1 year after discharge, including 21 medical, surgical or mixed ICUs in France and Belgium...
January 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29347982/emergency-department-hyperoxia-is-associated-with-increased-mortality-in-mechanically-ventilated-patients-a-cohort-study
#14
David Page, Enyo Ablordeppey, Brian T Wessman, Nicholas M Mohr, Stephen Trzeciak, Marin H Kollef, Brian W Roberts, Brian M Fuller
BACKGROUND: Providing supplemental oxygen is fundamental in the management of mechanically ventilated patients. Increasing amounts of data show worse clinical outcomes associated with hyperoxia. However, these previous data in the critically ill have not focused on outcomes associated with brief hyperoxia exposure immediately after endotracheal intubation. Therefore, the objectives of this study were to evaluate the impact of isolated early hyperoxia exposure in the emergency department (ED) on clinical outcomes among mechanically ventilated patients with subsequent normoxia in the intensive care unit (ICU)...
January 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29347874/adjunctive-glucocorticoid-therapy-in-patients-with-septic-shock
#15
Balasubramanian Venkatesh, Simon Finfer, Jeremy Cohen, Dorrilyn Rajbhandari, Yaseen Arabi, Rinaldo Bellomo, Laurent Billot, Maryam Correa, Parisa Glass, Meg Harward, Christopher Joyce, Qiang Li, Colin McArthur, Anders Perner, Andrew Rhodes, Kelly Thompson, Steve Webb, John Myburgh
Background Whether hydrocortisone reduces mortality among patients with septic shock is unclear. Methods We randomly assigned patients with septic shock who were undergoing mechanical ventilation to receive hydrocortisone (at a dose of 200 mg per day) or placebo for 7 days or until death or discharge from the intensive care unit (ICU), whichever came first. The primary outcome was death from any cause at 90 days. Results From March 2013 through April 2017, a total of 3800 patients underwent randomization. Status with respect to the primary outcome was ascertained in 3658 patients (1832 of whom had been assigned to the hydrocortisone group and 1826 to the placebo group)...
January 19, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29346372/ceramides-in-tracheal-aspirates-of-preterm-infants-marker-for-bronchopulmonary-dysplasia
#16
Esther van Mastrigt, Salomé Zweekhorst, Bas Bol, Jeroen Tibboel, Joost van Rosmalen, Janneke N Samsom, André A Kroon, Johan C de Jongste, Irwin K M Reiss, Martin Post, Mariëlle W Pijnenburg
BACKGROUND: In an experimental mouse model we showed that ceramides play a role in the pathogenesis of bronchopulmonary dysplasia (BPD) and are a potential target for therapeutic intervention. We investigated whether ceramides are detectable in tracheal aspirates (TAs) of preterm infants and differ between infants with or without BPD. METHODS: Infants born ≤ 32 weeks of gestational age in need of mechanical ventilation in the first week of life were included. TAs were obtained directly after intubation and at day 1, 3, 5, 7, and 14...
2018: PloS One
https://www.readbyqxmd.com/read/29346133/dexmedetomidine-impairs-diaphragm-function-and-increases-oxidative-stress-but-does-not-aggravate-diaphragmatic-atrophy-in-mechanically-ventilated-rats
#17
Thomas Breuer, Christian Bleilevens, Rolf Rossaint, Gernot Marx, Julian Gehrenkemper, Henning Dierksen, Antoine Delpierre, Joachim Weis, Ghislaine Gayan-Ramirez, Christian S Bruells
BACKGROUND: Anesthetics in ventilated patients are critical as any cofactor hampering diaphragmatic function may have a negative impact on the weaning progress and therefore on patients' mortality. Dexmedetomidine may display antioxidant and antiproteolytic properties, but it also reduced glucose uptake by the muscle, which may impair diaphragm force production. This study tested the hypothesis that dexmedetomidine could inhibit ventilator-induced diaphragmatic dysfunction. METHODS: Twenty-four rats were separated into three groups (n = 8/group)...
January 18, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29344689/early-versus-late-tracheostomy-in-trauma-patients-a-propensity-matched-cohort-study-of-5-years-data-at-a-single-institution-in-korea
#18
Byung Hee Kang, Jayun Cho, John Cook-Jong Lee, Kyoungwon Jung
BACKGROUND: Although there have been many studies dealing with tracheostomy timing in trauma patients, the optimal timing is still being debated. This study aimed to compare outcomes between early tracheostomy (ET) and late tracheostomy (LT) in trauma populations to estimate the optimal timing of tracheostomy after intubation. METHODS: We retrospectively reviewed the 5 years' data of trauma patients who underwent tracheostomy during their acute intensive care unit (ICU) stay...
January 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29343186/association-between-palliative-care-and-life-sustaining-treatments-for-patients-with-dementia-a-nationwide-5-year-cohort-study
#19
Ping-Jen Chen, Fu-Wen Liang, Chung-Han Ho, Shao-Yi Cheng, Yi-Chen Chen, Yu-Han Chen, Yueh-Chun Chen
BACKGROUND: The association between palliative care and life-sustaining treatments for patients with dementia is unclear in Asian countries. AIM: To analyse the use of palliative care and its association with aggressive treatments based on Taiwanese national data. DESIGN: A matched cohort study was conducted. The association between intervention and outcome was evaluated using conditional logistic regression analyses. SETTING/PARTICIPANTS: The source population comprised 239,633 patients with dementia diagnosed between 2002 and 2013...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29343034/-a-study-on-the-effects-and-safety-of-sequential-humidified-high-flow-nasal-cannula-oxygenation-therapy-on-the-copd-patients-after-extubation
#20
J C Zhang, F X Wu, L L Meng, C Y Zeng, Y Q Lu
Objective: To investigate and compare the effect and safety of nasal high-flow oxygen therapy (HFNCO) and noninvasive ventilation (NIV) therapy after extubation in patients with chronic obstructive pulmonary disease (COPD). Methods: All COPD patients subjected to mechanical ventilation in the Emergency Intensive Unit of the First Affiliated Hospital of Zhejiang University during January 2015 to June 2016 were included in the study. The patients were divided into two groups after extubation and HFNCO and NIV were adopted on each group respectively...
January 9, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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