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Icu admission criteria

Andrea A Beckhaus, Jose A Castro-Rodriguez
CONTEXT: Down syndrome (DS) is the most common chromosomal condition in live-born infants worldwide, and lower respiratory infection caused by respiratory syncytial virus (RSV) is a leading cause of hospital admissions. OBJECTIVE: To evaluate RSV-associated morbidity among children with DS compared with a population without DS. DATA SOURCES: Four electronic databases were searched. STUDY SELECTION: All cohorts or case-control studies of DS with an assessment of RSV infection and the associated morbidity or mortality were included without language restriction...
August 9, 2018: Pediatrics
Ayobami T Akenroye, Abayomi Ajala, Elham Azimi-Nekoo, Gabriele S de Vos
BACKGROUND: In asthmatics, making a diagnosis of anaphylaxis could be challenging as respiratory symptoms are a common feature of both conditions. Identifying anaphylaxis is important to providing appropriate care. A prior study showed that anaphylaxis is sometimes misdiagnosed as acute asthma in children. We sought to identify the percentage of adults admitted to the intensive care unit (ICU) with asthma exacerbations who met criteria for anaphylaxis. METHODS: Retrospective chart review of adults admitted with acute asthma to the ICU at Jacobi Medical Center, a Level 1 trauma centre in Bronx, New York...
August 9, 2018: Emergency Medicine Journal: EMJ
Katrina Dunn, Anna Rumbach
The aim of the study is to investigate dysphagia incidence and establish factors which may reliably predict dysphagia risk in individuals presenting with non-traumatic subarachnoid hemorrhage (SAH). A retrospective chart audit of 250 patients (151 females and 99 males) consecutively admitted with non-traumatic SAH to a major, tertiary neurosurgery referral center in Australia was conducted. Demographics, medical, and surgical information, along with speech-language pathology (SLP) assessment data were collected...
August 7, 2018: Dysphagia
Jacob Folse, Charles E Hill, Matthew L Graves, George V Russell, Josie Hydrick, LaRita C Jones, William H Replogle, Patrick F Bergin, Clay A Spitler
OBJECTIVES: To evaluate all patients who received gentamicin for open fracture treatment and determine the incidence of, and risk factors for, kidney injury in this population. DESIGN: Retrospective, Case Control SETTING:: Single institution; Level 1 trauma center PATIENTS/PARTICIPANTS:: A retrospective chart review identified patients who received gentamicin for open fracture antibiotic treatment from January 2008-December 2012. Overall, 371 patients met inclusion criteria and were categorized into 2 groups using RIFLE criteria: normal kidney function (74...
July 30, 2018: Journal of Orthopaedic Trauma
Kristen Nelson McMillan, Narutoshi Hibino, Emily E Brown, Rajeev Wadia, Elizabeth A Hunt, Christi Marshall, Mayuri Alvarez-Machado, Diane Alejo, John D Coulson, William Ravekes, Luca A Vricella
OBJECTIVE: While pediatric HeartWare HVAD application has increased, determining candidacy and timing for initiation of pediatric VAD support has remained a challenge. We present our experience with a systematic approach to HVAD implantation as a bridge to pediatric heart transplantation. METHODS: We performed a retrospective, single center review of pediatric patients (n=11) who underwent HVAD implantation between September 2014 and January 2018. Primary endpoints evaluated were survival to heart transplantation, need for right ventricular assist device (RVAD) at any point, ongoing HVAD support or death...
August 7, 2018: Artificial Organs
Philip Yang, Perry Formanek, Steven Scaglione, Majid Afshar
AIM: Prior randomized controlled trials of acute respiratory distress syndrome (ARDS) excluded critically ill patients with cirrhosis. Data regarding risk factors for ARDS development and outcomes from ARDS in patients with cirrhosis are scarce. We sought to characterize outcomes from ARDS in patients with cirrhosis. METHODS: An observational cohort of patients with cirrhosis admitted to an intensive care unit (ICU) at a high-volume liver transplant center between January 1, 2012 and December 31, 2014 were reviewed...
August 7, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Esther Peters, Massimo Antonelli, Xavier Wittebole, Rahul Nanchal, Bruno François, Yasser Sakr, Jean-Louis Vincent, Peter Pickkers
BACKGROUND: Acute kidney injury (AKI) is a common complication of critical illness and is associated with worse outcomes. However, the influence of deterioration or improvement in renal function on clinical outcomes is unclear. Using a large international database, we evaluated the prevalence and evolution of AKI over a 7-day period and its effects on clinical outcomes in septic and non-septic critically ill patients worldwide. METHODS: From the 10,069 adult intensive care unit (ICU) patients in the Intensive Care Over Nations database, all those with creatinine and urine output data were included in this substudy...
August 3, 2018: Critical Care: the Official Journal of the Critical Care Forum
Mohammed Bashir, Manar E Abdel-Rahman, Mahmoud Aboulfotouh, Fatin Eltaher, Khalid Omar, Isaac Babarinsa, Kwabena Appiah-Sakyi, Tarek Sharaf, Eman Azzam, Mohammad Abukhalil, Malika Boumedjane, Wigdan Yousif, Warda Ahmed, Sadaf Khan, Justin C Konje, Abdul-Badi Abou-Samra
BACKGROUND: Diabetes first detected during pregnancy is currently divided into gestational diabetes mellitus (GDM) and diabetes mellitus (DM)- most of which are type 2 DM (T2DM). This study aims to define the prevalence and outcomes of diabetes first detected in pregnancy based on 75-gram oral glucose tolerance test (OGTT)using the recent WHO/IADPSG guidelines in a high-risk population. METHODS: This is a retrospective study that included all patients who underwent a 75 g (OGTT) between Jan 2016 and Apr 2016 and excluded patients with known pre-conception diabetes...
2018: PloS One
Muhammad Zeeshan, Mohammad Hamidi, Narong Kulvatunyou, Faisal Jehan, Terence O'Keeffe, Muhammad Khan, Lana Rashdan, Andrew Tang, El-Rasheid Zakaria, Bellal Joseph
INTRODUCTION: Coagulopathy of trauma(COT) is common and highly lethal. Prothrombin complex concentrate(PCC) has been advocated for correction of COT. However, the difference in efficacy between 3-factor PCC(3-PCC) vs. 4-factor PCC(4-PCC) remains unclear. The aim of our study was to compare efficacy of 3-PCC vs. 4-PCC in COT. METHODS: 5-year(2013-2017) review of coagulopathic trauma patients at our Level-I trauma center who received 3- or 4-PCC. Patients were divided into two groups(4-PCC and 3-PCC) and matched in 1:1 ratio using propensity-score-matching for demographics, injury parameters, admission vitals and hematological parameters...
August 2, 2018: Shock
Michael J Moss, Robert G Hendrickson
BACKGROUND: Amanita muscaria (AM) and A. pantherina (AP) contain ibotenic acid and muscimol and may cause both excitatory and sedating symptoms. Gastrointestinal (GI) symptoms are not classically described but have been reported. There are relatively few reported cases of poisoning with these mushrooms in North America. METHODS: This is a retrospective review of ingestions of ibotenic acid and muscimol containing mushrooms reported to a United States regional poison center from 2002-2016...
August 3, 2018: Clinical Toxicology
Steen K Fagerberg, Parth Patel, Lars W Andersen, Xiaowen Lui, Michael W Donnino, Helle A Praetorius
BACKGROUND: Pore-forming proteins released from bacteria or formed as result of complement activation are known to produce severe cell damage. Inhibition of purinergic P2X receptors markedly reduces damage inflicted by cytolytic bacterial toxin and after complement activation in both erythrocytes and monocytes. P2X expression generally shows variation throughout the population. Here, we investigate correlation between P2X receptor abundance in blood cell plasma membranes and haematocrit during sepsis, in patients admitted to the emergency department (ED) or intensive care unit (ICU)...
August 2, 2018: Critical Care: the Official Journal of the Critical Care Forum
Kathleen M O'Connell, D Alex Quistberg, Robert Tessler, Bryce R H Robinson, Joseph Cuschieri, Ronald V Maier, Frederick P Rivara, Monica S Vavilala, Paul I Bhalla, Saman Arbabi
OBJECTIVE: The aim of this study was to examine the risk of delirium in geriatric trauma patients with rib fractures treated with systemic opioids compared with those treated with regional analgesia (RA). SUMMARY OF BACKGROUND DATA: Delirium is a modifiable complication associated with increased morbidity and mortality. RA may reduce the need for opioid medications, which are associated with delirium in older adults. METHODS: Cohort study of patients ≥65 years admitted to a regional trauma center from 2011 to 2016...
September 2018: Annals of Surgery
Benji Wang, Yuqiang Gong, Binyu Ying, Bihuan Cheng
Background: Several studies have suggested that serum ionized calcium (iCa) is associated with mortality in critical illness. However, evidence regarding the predictive significance of serum total calcium (tCa) in critical illness remains scarce. The aim of this study was to assess the association of tCa levels with mortality in critical illness. Methods: We employed the MIMIC-III v1.3 database. tCa was measured upon ICU admission and its relationship with mortality was determined using smooth curve fitting...
2018: BioMed Research International
Boris Khodorkovsky, Elias Youssef, Frosso Adamakos, Tiffany Cina, Amanda Falco, Lauren LaMura, Anthony Marion, Samuel Nathan, Barry Hahn
BACKGROUND: Sepsis is a leading cause of morbidity and mortality in hospitalized patients. Prompt recognition and early treatment has been shown to improve mortality. Both low and high temperature are among the four elements of systemic inflammatory response required for the diagnosis of sepsis. We hypothesized that initial temperature has an effect on the identification, treatment, and outcomes of septic patients. OBJECTIVE: Our aim was to determine the prognostic and diagnostic utility of the initial recorded body temperature in patients presenting to the emergency department (ED) with sepsis...
July 21, 2018: Journal of Emergency Medicine
Peng Lan, Kong-Han Pan, Shuo-Jia Wang, Qiu-Cheng Shi, Yun-Xian Yu, Ying Fu, Yan Chen, Yan Jiang, Xiao-Ting Hua, Jian-Cang Zhou, Yun-Song Yu
Iron is an essential nutrient for bacterial survival and thus higher iron levels may precipitate bacterial infections. We investigated the association between the serum iron level and prognosis in patients with sepsis by using the single-centre Medical Information Mart for Intensive Care III (MIMIC-III) database. Sepsis patients with iron parameters measured on ICU admission were included and stratified according to quartiles of serum iron levels. A total of 1,891 patients diagnosed with sepsis according to the Sepsis-3 criteria were included in this study, 324 of whom were septic shock...
July 23, 2018: Scientific Reports
Filippo Annoni, Antonio Maria Dell'Anna, Federico Franchi, Jacques Creteur, Sabino Scolletta, Jean-Louis Vincent, Fabio Silvio Taccone
AIM: Which haemodynamic variable is the best predictor of neurological outcome remains unclear. We investigated the association of several haemodynamic variables with neurological outcome in CA patients. METHODS: Retrospective analysis of adult comatose survivors of CA admitted to the intensive care unit (ICU) of a University Hospital. Exclusion criteria were early death due to withdrawal of care, missing haemodynamic data and use of intra-aortic balloon pump or extracorporeal membrane oxygenation...
July 19, 2018: Resuscitation
K U Tobi, E O Ndokwu, N P Edomwonyi
BACKGROUND: The management and outcome of elderly patients aged 65 years and above admitted to the intensive care unit (ICU) are often complicated by the presence of co-morbidities and reduced physiological reserve. METHODOLOGY: This was a retrospective, case-control study. Patients aged 65 years and above admitted to the unit from January 2012 to June 2013 were included in the study. Admission and discharge register in the ICU was examined. A patient before and after each elderly patient were recruited to serve as controls in the study...
May 2018: West African Journal of Medicine
Özlem Ediboğlu, Sena Ataman, Cenk Kirakli
Introduction: Hypoxemic respiratory failure due to influenza pneumonia during epidemic seasons sometimes may require mechanical ventilation support and intensive care unit (ICU) stay. We aimed to evaluate the characteristics and risk factors of influenza pneumonia patients admitted to our ICU due to hypoxemic respiratory failure. Materials and Methods: Patients admitted to our ICU between December 2015 and March 2016 who had hypoxemic respiratory failure due to clinically and radiologically suspected influenza pneumonia were enrolled...
March 2018: Tüberküloz Ve Toraks
Byron C Drumheller, Deborah M Stein, Thomas M Scalea
BACKGROUND: Correction of hypothermia is a key component of the resuscitation of critically injured patients with hemorrhagic shock who require damage control surgery. External rewarming methods may not be sufficient in this population, while extracorporeal techniques lack widespread feasibility. Intravascular catheter-based temperature modulation is increasingly being employed in different critically ill patient populations but has not been described as part of a damage control resuscitation strategy in trauma patients...
July 8, 2018: Injury
Renyu Ding, Zhong Wang, Yuan Lin, Baoyan Liu, Zhidan Zhang, Xiaochun Ma
: Recently, new criteria for sepsis-induced coagulopathy (SIC) were developed, including the sequential organ failure assessment (SOFA) criteria. The objective of this study was to evaluate the new SIC criteria in patients diagnosed with sepsis 3.0. Data from patients diagnosed with sepsis 3.0 after ICU admission were retrospectively obtained from July 2013 to June 2014. Relevant demographic, clinical, and laboratory parameters were noted. This study included 252 patients. The International Society on Thrombosis and Haemostasis (ISTH) disseminated intravascular coagulation (DIC), modified ISTH-DIC, and SIC scores were higher among nonsurvivors (P < 0...
July 12, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
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