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"Intensive Care" OR "ICU"

Salam Abbara, Aurélia Pitsch, Sébastien Jochmans, Kyann Hodjat, Dr Pascale Cherrier, Mehran Monchi, Christophe Vinsonneau, Sylvain Diamantis
OBJECTIVES: To assess if the postprescription review and feedback (PPRF) of all antibiotics with restriction of carbapenems, fluoroquinolones and third generation cephalosporins, along with a change of medical standard of care, impacted the consumption of antibiotics and bacterial resistance in a medical/surgical intensive care unit (MSICU). METHODS: A four years before (2007-2010) and after (2011-2014) retrospective comparative study. Antibiotics consumption was evaluated in Defined Daily Doses per 1000 patient days...
December 8, 2018: International Journal of Antimicrobial Agents
Rachel Rosenblum, Ran Huo, Bethann Scarborough, Nathan Goldstein, Cardinale B Smith
PURPOSE: The Quality Oncology Practice Initiative (QOPI) is a quality measurement and improvement program designed to assess practice performance for various consensus-based and evidence-based measures. In this study, we evaluated differences in QOPI metrics met among patients with advanced solid cancer receiving routine oncologic care alone (routine care) compared with patients receiving integrated oncology and specialty-level palliative care (supportive care). METHODS: We conducted a retrospective chart review of 100 randomly selected patients treated between June 2013 and June 2015 from our supportive care group and matched these patients to 100 routine care group patients on the basis of tumor type and initial oncology visit date...
December 2018: Journal of Oncology Practice
Yusmiati Liau, Ignatius Chua, Martin A Kennedy, Simran Maggo
Angioedema is a rare adverse effect of the commonly used angiotensin converting enzyme inhibitors (ACEi) and is reported to occur with a prevalence of 0.1 - 0.7%. Although most ACEi-induced angioedema (ACEi-A) cases are mild, severe cases requiring intensive care and even resulting in death have been reported in the literature. The mechanisms underlying ACEi-A are not yet fully understood, but bradykinin and/or substance P accumulation resulting from inhibition of ACE, is believed to play a crucial role. ACEi-A occurs at variable frequencies across different racial groups, suggesting a genetic association to the development of ACEi-A...
December 8, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Andréa Araujo de Oliveira Cortines, Patrícia Corrêa-Faria, Liselotte Paulsson, Paulo Sucasas Costa, Luciane Rezende Costa
OBJECTIVE: Developmental defects of enamel (DDE) in preterm infants still require clarification and may favour dental caries, lower food intake, and greater difficulty with weight-height gain. We evaluated factors associated with DDE in preterm infants. SUBJECTS AND METHODS: In this prospective cohort study, we monitored 54 prematurely born infants from birth to 24 months of age. Trained and calibrated dentists examined the oral cavity of these children to identify and categorize DDE...
December 7, 2018: Oral Diseases
Zunjia Wen, Li Wei, Junyu Chen, Ailing Xie, Mei Li, Lanzheng Bian
AIM: To compare and evaluate the efficacy and safety of continuous and intermittent control of Pcuff . METHODS: We performed a comprehensive and systematic meta-analysis of randomized controlled trials (RCTs) assessing the continuous and intermittent control of Pcuff by searching PUBMED, EMBASE and other such databases (from inception to 31 March 2018). Summary odds ratios or mean differences with 95% confidence intervals were calculated using a fixed- or random-effects model...
December 9, 2018: Nursing in Critical Care
Zoe C Bedford, Suzanne Bench
BACKGROUND: Having a child admitted to a paediatric intensive care unit (PICU) is a highly stressful experience, and post-traumatic stress among parents is well documented. How best to support these parents is currently unclear. AIM: To review research on interventions to support the psychological well-being of parents after their child's discharge from paediatric intensive care. METHODS: Searches were conducted using Medline, PsycINFO, PubMed, CINAHL and The Cochrane library in January 2017...
December 10, 2018: Nursing in Critical Care
Reinhard Strametz, Martin N Bergold, Tobias Weberschock
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) is one of the most common bedside surgical procedures performed in critically ill adults, on intensive care units (ICUs), who require long-term ventilation. PDT is associated with relevant life-threatening complications: Cuff rupture or accidental extubation may lead to hypoxia, aspiration or loss of airway. Puncture of the oesophagus, or creating a false passage during dilatation or replacement of the tracheostomy tube, can lead to pneumothorax or emphysema...
November 15, 2018: Cochrane Database of Systematic Reviews
Léanne Swart, Elise Schapkaitz, Johnny N Mahlangu
INTRODUCTION: Thrombotic thrombocytopenic purpura (TTP) is associated with high mortality if not managed timeously with therapeutic plasma exchange (TPE). TTP secondary to human immunodeficiency virus (HIV) infection is unique to sub-Saharan Africa. The management and outcome of TTP in the era of improved access to therapy has not been described. METHODS: The present study describes the clinical presentation, treatment, therapeutic endpoints, and outcome of TTP patients at the Charlotte Maxeke Johannesburg Academic Hospital, South Africa...
December 8, 2018: Journal of Clinical Apheresis
Claire E Kelly, Deanne K Thompson, Jeanie Ly Cheong, Jian Chen, Joy E Olsen, Abbey L Eeles, Jennifer M Walsh, Marc L Seal, Peter J Anderson, Lex W Doyle, Alicia J Spittle
AIM: To examine: (1) relationships between brain structure, and concurrently assessed neurological and behavioural functioning, in infants born preterm at term-equivalent age (TEA; approximately 38-44wks); and (2) whether brain structure-function relationships differ between infants born very (24-29wks) and moderate-late (32-36wks) preterm. METHOD: A total of 257 infants (91 very preterm, 166 moderate-late preterm; 120 males, 137 females) had structural magnetic resonance imaging (MRI) and neurological and behavioural assessments (Prechtl's general movements assessment, Neonatal Intensive Care Unit Network Neurobehavioral Scale [NNNS] and Hammersmith Neonatal Neurological Examination [HNNE])...
December 10, 2018: Developmental Medicine and Child Neurology
Y-M Li, Y Jiang, S-D Feng, Z-H Lin
OBJECTIVE: Infection can be caused by severe burnt, trauma and hypoxia, further causing systemic inflammatory syndrome or sepsis. The sepsis occurs in about 2% of all hospitalizations and ranges from 6% to 30% in intensive care unit (ICU) in developed countries This study aimed to investigate the effects of normal lymph fluid on sepsis complicated with pulmonary injury. MATERIALS AND METHODS: Wistar rats were prepared for sepsis complicated with acute pulmonary model via cecal ligation and puncture, and received normal lymph fluid injection 60 min later...
November 2018: European Review for Medical and Pharmacological Sciences
H-G Ding, H-F Zhou, M-Y Diao, Y Xu, Q-M Pan, X-H Shen
OBJECTIVE: Histidine-Rich Glycoprotein (HRG) has been reported to be associated with idiopathic pulmonary fibrosis, cancer, and sepsis as a novel biomarker. However, there is limited evidence regarding its value in diagnosing or prognosis evaluating of ventilator-associated pneumonia (VAP). PATIENTS AND METHODS: A total of 186 patients intubated in ICU and 65 healthy volunteers were enrolled in this study. Patients were divided into VAP group (n = 116), non-VAP group (n = 70) and control group (n = 65)...
November 2018: European Review for Medical and Pharmacological Sciences
Joana Gomes de Amorim, Manuel Rocha Abecasis, Filipa Maria Nogueira Lança Rodrigues
Thrombocytopenia is the most common hemostatic change in pregnancy, but severe thrombocytopenia is rare. One of the causes, immune thrombocytopenic purpura (ITP), is characterized by increased platelet destruction by immunoglobulin G (IgG) antibodies, presenting a high risk of hemorrhage for the patient, but also for the fetus, since antibodies may cross the placenta. We present the case of a 23-year-old pregnant woman with a history of Langerhans cell histiocytosis of the mandible submitted to surgery and chemotherapy when she was 10 years old, with diagnosis of ITP since then...
December 2018: Revista Brasileira de Ginecologia e Obstetrícia
Maxens Decavèle, Isabelle Rivals, Clémence Marois, Marie Cantier, Nicolas Weiss, Léa Lemasle, Hélène Prodanovic, Khe Hoang-Xuan, Ahmed Idbaih, Thomas Similowski, Alexandre Demoule
PURPOSE: Acute respiratory failure (ARF) is common and potentially fatal in patients with primary malignant brain tumors (PMBT). However, few data are available regarding its precipitating factors and prognosis. We sought to: (1) compare the causes of ARF and the outcome between patients with PMBT and patients with other peripheral solid tumors (PST), (2) identify the factors influencing ICU survival in PMBT patients. METHODS: Two-center retrospective case-control study from March 1996 to May 2014...
December 7, 2018: Journal of Neuro-oncology
Antoine Lafarge, R Bertinchamp, C Pichereau, S Valade, A Chermak, I Theodose, E Canet, V Lemiale, B Schlemmer, L Galicier, E Azoulay, E Mariotte
Patients with autoimmune hemolytic anemia (AIHA) may require intensive care unit (ICU) admission. In order to describe the characteristics of AIHA patients in ICU and identify prognosis factors, clinical and biological data from 44 patients admitted in one ICU between 2002 and 2015 were retrospectively analyzed. The main reasons for ICU admission were profound anemia without any organ failure in 19 patients (either for safer transfusion or continuous monitoring only). Twenty-five (57%) patients had a past history of hemopathy...
December 10, 2018: Annals of Hematology
Peter Pickkers, Tom van der Poll
The original version of this article unfortunately contained two mistakes.
December 7, 2018: Intensive Care Medicine
Giorgio Berlot, Claudio Michele Vassallo, Nicola Busetto, Margarita Nieto Yabar, Tatiana Istrati, Silvia Baronio, Giada Quarantotto, Mattia Bixio, Giulia Barbati, Roberto Dattola, Irene Longo, Antonino Chillemi, Alice Scamperle, Fulvio Iscra, Ariella Tomasini
BACKGROUND: The administration of endovenous immunoglobulins in patients with septic shock could be beneficial and preparations enriched with IgA and IgM (ivIgGAM) seem to be more effective than those containing only IgG. In a previous study Berlot et al. demonstrated that early administration of ivIgGAM was associated with lower mortality rate. We studied a larger population of similar patients aiming either to confirm or not this finding considering also the subgroup of patients with septic shock by multidrug-resistant (MDR) pathogens...
December 10, 2018: Annals of Intensive Care
Ana Navas, Ricard Ferrer, Maria Luisa Martínez, Gemma Gomà, Gisela Gili, Jordi Masip, David Suárez, Antonio Artigas
BACKGROUND: Septic shock is a leading cause of death in critical patients. In patients with gram-negative septic shock, hemoperfusion with polymyxin B aims to remove endotoxins from plasma. We analyzed the clinical and biological response to hemoperfusion in patients with septic shock and acute kidney injury. METHODS: This prospective case-control study in the medical-surgical intensive care unit of a university hospital included consecutive adults patients with septic shock and suspected gram-negative bacteria infection with elevated plasma endotoxin activity (EAA > 0...
December 7, 2018: Annals of Intensive Care
Graham R McClure, Emilie P Belley-Cote, John Harlock, Andre Lamy, Michael Stacey, P J Devereaux, Richard P Whitlock
PURPOSE: Postoperative infection, particularly in cardiac surgery, results in significant morbidity, mortality, and healthcare cost. Identification of novel predictors of postoperative infection can target high-risk populations for prophylactic intervention. METHODS: Steroids in cardiac surgery (SIRS) was a multi-centre randomized-controlled trial assessing intraoperative administration of methylprednisone during cardiac surgery, which enrolled 7,507 patients across 80 centres in 18 countries...
December 10, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Rosanna Vaschetto, Federico Longhini, Paolo Persona, Carlo Ori, Giulia Stefani, Songqiao Liu, Yang Yi, Weihua Lu, Tao Yu, Xiaoming Luo, Rui Tang, Maoqin Li, Jiaqiong Li, Gianmaria Cammarota, Andrea Bruni, Eugenio Garofalo, Zhaochen Jin, Jun Yan, Ruiqiang Zheng, Jingjing Yin, Stefania Guido, Francesco Della Corte, Tiziano Fontana, Cesare Gregoretti, Andrea Cortegiani, Antonino Giarratano, Claudia Montagnini, Silvio Cavuto, Haibo Qiu, Paolo Navalesi
PURPOSE: Noninvasive ventilation (NIV) may facilitate withdrawal of invasive mechanical ventilation (i-MV) and shorten intensive care unit (ICU) length of stay (LOS) in hypercapnic patients, while data are lacking on hypoxemic patients. We aim to determine whether NIV after early extubation reduces the duration of i-MV and ICU LOS in patients recovering from hypoxemic acute respiratory failure. METHODS: Highly selected non-hypercapnic hypoxemic patients were randomly assigned to receive NIV after early or standard extubation...
December 10, 2018: Intensive Care Medicine
Nader Najafi, Russ Cucina, Bruce Pierre, Raman Khanna
Importance: Physicians frequently use cardiac monitoring, or telemetry, beyond the duration recommended by published practice standards, resulting in "alarm fatigue" and excess cost. Prior studies have demonstrated an association between multicomponent quality improvement interventions and safe reduction of telemetry duration. Objective: To determine if a single-component intervention, a targeted electronic health record (EHR) alert, could achieve similar gains to multicomponent interventions and safely reduce unnecessary monitoring...
December 10, 2018: JAMA Internal Medicine
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