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Daozheng Huang, Huan Ma, Zhiyuan Xiao, Michael Blaivas, Ying Chen, Jianyi Wen, Weixin Guo, Jun Liang, Xiaolong Liao, Zhonghua Wang, Hanbiao Li, Jie Li, Yangong Chao, Xiao Ting Wang, Yan Wu, Tiehe Qin, Ke Su, Shouhong Wang, Ning Tan
BACKGROUND: Lung ultrasound and echocardiography are mainly applied in critical care and emergency medicine. However, the diagnostic value of cardiopulmonary ultrasound in elderly patients with acute respiratory distress syndrome (ARDS) is still unclear. METHODS: Consecutive patients admitted to ICU with the diagnosis of suspected ARDS based on clinical grounds were enrolled. Cardiopulmonary ultrasound was performed as part of monitoring on day 1, day 2 and day 3...
August 13, 2018: BMC Pulmonary Medicine
Guanggui Shen, Hongzhen Yin, Yingya Cao, Meijun Zhang, Jingyi Wu, Xiaogan Jiang, Tao Yu, Weihua Lu
BACKGROUND: To determine whether fibre optic bronchoscopy-guided percutaneous dilatational tracheostomy (FOB-PDT) is a better option in critically ill patients, we compared the efficacy and incidence of procedure complications between PDT with and without FOB. METHODS: We included 90 patients with oral intubation and mechanical ventilation who received PDT with (n = 45, FOB-PDT group) and without (n = 45, PDT group) FOB. For all patients, a simplification of the Griggs technique was used in this study with a central venous catheter set and dilating forceps...
August 11, 2018: Irish Journal of Medical Science
Rebecca Brundin-Mather, Andrea Soo, Danny J Zuege, Daniel J Niven, Kirsten Fiest, Christopher J Doig, David Zygun, Jamie M Boyd, Jeanna Parsons Leigh, Sean M Bagshaw, Henry T Stelfox
PURPOSE: This study measured the quality of data extracted from a clinical information system widely used for critical care quality improvement and research. MATERIALS AND METHODS: We abstracted data from 30 fields in a random sample of 207 patients admitted to nine adult, medical-surgical intensive care units. We assessed concordance between data collected: (1) manually from the bedside system (eCritical MetaVision) by trained auditors, and (2) electronically from the system data warehouse (eCritical TRACER)...
July 22, 2018: Journal of Critical Care
L Amas Gómez, F Zubia Olaskoaga
OBJECTIVE: To determine whether the implementation of a protocol for the management of patients with acute pancreatitis (AP) in an Intensive Care Unit (ICU) improves the clinical outcomes. DESIGN: A retrospective, before-after observational case series study was carried out. STUDY PERIOD: 1 January 2001 to 31 December 2016, divided in 2 periods (pre-protocol 2001-2007, post-protocol 2008-2016). SCOPE: An ICU with 48 beds and a recruitment population of 700,000 inhabitants...
July 30, 2018: Medicina Intensiva
S L Liu, X Sun, H Xu, D G Zhao, X J Yang, J Jin, J Wang, J H Fu, G H Guo, Q Guo
Objective: To investigate the clinical characteristics of extremely severe burn patients complicated with severe inhalation injury caused by dust explosion. Methods: The medical records of 13 extremely severe burn patients complicated with severe inhalation injury in August 2nd Kunshan factory aluminum dust explosion accident, who were admitted to the First Affiliated Hospital of Soochow University on August 2nd, 2014, were retrospectively analyzed. The following indicators were collected: (1) Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and Sequential Organ Failure Assessment (SOFA) score at post admission hour (PAH) 24...
July 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Sehveta Mustafić, Selmira Brkić, Besim Prnjavorac, Albina Sinanović, Humera Porobić Jahić, Sabina Salkić
Aim To investigate predictive value of procalcitonin in diagnosis of sepsis in predicting positive blood culture, and possibility to predict final outcome in septic patients. Method This prospective study involved 106 hospitalized patients who met two or more criteria for systemic inflammatory response syndrome (SIRS). In comparison to Sepsis Related Organ Failure Assessment score (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II score procalcitonin (PCT), C-reactive protein and lactate levels were used to predict final outcome in septic patients (recorded as 28-day survival or non-survival)...
August 1, 2018: Medicinski Glasnik
Zeliang Qiu, Kan Shen, Ming Shu, Dongwei Xu, Xingqi Deng, Dechang Chen
OBJECTIVE: To investigate the diagnostic value of Hepcidin as a sepsis biomarker in critically ill adults. METHODS: An observational study was conducted. The patients with suspected or proven infection admitted to intensive care unit (ICU) of Zhoupu Hospital Affiliated to Shanghai University of Medicine and Health Sciences from March 2016 to November 2017 were enrolled. According to the third international consensus definitions for sepsis and septic shock (Sepsis-3), the patients were divided into non-sepsis group and sepsis group, and the septic patients were subdivided into general sepsis subgroup and septic shock subgroup according to the severity of disease...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Nara Aline Costa, Ana Lúcia Gut, Paula Schmidt Azevedo, Bertha Furlan Polegato, Eloá Siqueira Magalhães, Larissa Lumi Watanabe Ishikawa, Rita de Cassia Siqueira Bruder, Evelyn Aparecida da Silva, Renan Braga Gonçalves, Suzana Erico Tanni, Marcelo Macedo Rogero, Marina Maintinguer Norde, Natália Baraldi Cunha, Leonardo Antonio Mamede Zornoff, Sergio Alberto Rupp de Paiva, Marcos Ferreira Minicucci
The objective of our study was to evaluate the association between peptidylarginine deiminase 4 (PAD4) concentration and its polymorphisms with mortality in patients with septic shock. We prospectively evaluated 175 patients aged over 18 years with septic shock upon intensive care unit (ICU) admission. However, 48 patients were excluded. Thus, 127 patients were enrolled in the study. At the time of the patients' enrollment, demographic information was recorded. Blood samples were taken within the first 24 hours of the patient's admission to determine serum PAD4 concentrations and its polymorphism PADI4_89 [rs11203366], PADI4_94 [rs2240340] and PADI4_104 [rs1748033]...
July 25, 2018: Journal of Cellular and Molecular Medicine
Günseli Orhun, Figen Esen, Perihan Ergin Özcan, Serra Sencer, Başar Bilgiç, Canan Ulusoy, Handan Noyan, Melike Küçükerden, Achmet Ali, Mehmet Barburoğlu, Erdem Tüzün
BACKGROUND: Incidence and patterns of brain lesions of sepsis-induced brain dysfunction (SIBD) have been well defined. Our objective was to investigate the associations between neuroimaging features of SIBD patients and well-known neuroinflammation and neurodegeneration factors. METHODS: In this prospective observational study, 93 SIBD patients (45 men, 48 women; 50.6 ± 12.7 years old) were enrolled. Patients underwent a neurological examination and brain magnetic resonance imaging (MRI)...
July 19, 2018: Neurocritical Care
L Gai, Y Tong, B-Q Yan
OBJECTIVE: To investigate the diagnostic effect of procalcitonin level in serum for patients with sepsis due to different pathogenic causes. PATIENTS AND METHODS: The clinical data of 132 sepsis patients were analyzed. Those patients were admitted to the Affiliated Hospital of Medical School of Ningbo University from January 2014 to January 2017. According to the blood culture results before antimicrobial therapy, patients were divided into two groups: Gram-negative bacteria group (G- group) and Gram-positive bacteria group (G+ group)...
July 2018: European Review for Medical and Pharmacological Sciences
Lin Zhang, Kuan-Peng Guo, Yi Mo, Su-Wu Yi, Cai-Zhi Huang, Cai-Xia Long, Li-Ya Mo
OBJECTIVE: To study the clinical value of red blood cell distribution width (RDW) in the early prediction of acute kidney injury (AKI) in children with sepsis. METHODS: A total of 126 children with sepsis were divided into an AKI group (n=66) and a non-AKI group (n=60) according to the presence or absence of AKI. These patients were also classified into high-RDW and low-RDW groups according to the mean RDW. The groups were compared in terms of age, male-to-female ratio, body mass index (BMI), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, serum blood urea nitrogen (BUN), creatinine (Cr), uric acid (UA), serum C-reactive protein (CRP), and routine blood test results...
July 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Wenqiang Jiang, Wenhong Zhong, Yiyu Deng, Chunbo Chen, Qiaosheng Wang, Maohua Zhou, Xusheng Li, Cheng Sun, Hongke Zeng
BACKGROUND: A major challenge in sepsis intervention is unclear risk stratification. We postulated that a panel of biomarkers of lymphocyte apoptosis and immune function, termed the "lymphocyte apoptosis model," would be an effective tool for predicting 28-day survival for sepsis patients. METHODS: A total of 52 consecutive sepsis patients were enrolled. Peripheral blood samples were collected on day 1 of admission for quantification of biomarkers of lymphocyte apoptosis and immune function, including lymphocyte count, lymphocyte apoptotic percentage, expression on monocyte HLA-DR, CD4+ /CD8+ T cell ratio, T helper type 1 to type 2 ratio (Th1/Th2), cytochrome c levels, and various proinflammatory cytokine levels...
July 18, 2018: BMC Anesthesiology
Xiuju Qin, Huiyan Lin, Tingxing Liu, Lili Zhao, Hailing Li
OBJECTIVE: To investigate the predictive value of quick sequential organ failure assessment (qSOFA) score on the prognosis of adult patients with infection in intensive care unit (ICU). METHODS: A retrospective analysis was conducted on the clinical data of the infected patients in the ICU of the 401st Hospital of the People's Liberation Army from August 1st, 2000 to December 31st, 2017. The clinical data included patients' gender, age, basic diseases, etc.; the worst values of vital signs and laboratory test results within 24 hours of admission were recorded, the scores of the qSOFA, sequential organ failure assessment (SOFA), acute physiology and chronic health evaluation II (APACHE II) were calculated separately; the outcome of ICU was recorded...
June 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Johanna M Muessig, Amir M Nia, Maryna Masyuk, Alexander Lauten, Anne Lena Sacher, Thorsten Brenner, Marcus Franz, Frank Bloos, Henning Ebelt, Stefan J Schaller, Kristina Fuest, Christian Rabe, Thorben Dieck, Stephan Steiner, Tobias Graf, Rolf A Jánosi, Patrick Meybohm, Philipp Simon, Stefan Utzolino, Tim Rahmel, Eberhard Barth, Michael Schuster, Malte Kelm, Christian Jung
BACKGROUND: In intensive care units (ICU) octogenarians become a routine patients group with aggravated therapeutic and diagnostic decision-making. Due to increased mortality and a reduced quality of life in this high-risk population, medical decision-making a fortiori requires an optimum of risk stratification. Recently, the VIP-1 trial prospectively observed that the clinical frailty scale (CFS) performed well in ICU patients in overall-survival and short-term outcome prediction. However, it is known that healthcare systems differ in the 21 countries contributing to the VIP-1 trial...
July 13, 2018: BMC Geriatrics
Tobias Wengenmayer, Daniel Duerschmied, Erika Graf, Marco Chiabudini, Christoph Benk, Sven Mühlschlegel, Alois Philipp, Matthias Lubnow, Christoph Bode, Dawid Leander Staudacher
AIMS: Several scoring systems have been introduced for prognostication after initiating venoarterial extracorporeal membrane oxygenation (VA-ECMO) therapy. However, static scores offer limited guidance once VA-ECMO is implanted, although continued allocation of healthcare resources is critical. Patients requiring continued VA-ECMO support are extremely unstable, with minimal heart function and multi-organ failure in most cases. The aim of the present study was to develop and validate a dynamic prognostic model for patients treated with VA-ECMO...
July 1, 2018: European Heart Journal. Acute Cardiovascular Care
Yongpeng Zhang, Liying Yan, Wang Han
Circulating microRNAs have the potential to be noninvasive biomarkers for assessing disease progression. MicroRNA-551b-5p (miR-551b-5p) was previously reported to be differentially expressed in pancreatic patients. The serum miR-551b-5p level was measured in patients with mild acute pancreatitis (MAP), severe acute pancreatitis (SAP), and healthy controls using quantitative real-time polymerase chain reaction (RT-PCR) analysis to evaluate its impact on inflammatory response. Acute Physiology and Chronic Health Evaluation II (APACHE II), Multiple Organ Dysfunction Score (MODS), Sequential Organ Assessment Score (SOFA), and Ranson's scores were recorded...
July 10, 2018: Therapeutic Apheresis and Dialysis
Martin Sauer, Cristof Haubner, Georg Richter, Johannes Ehler, Thomas Mencke, Steffen Mitzner, Stefan Margraf, Jens Altrichter, Sandra Doß, Gabriele Nöldge-Schomburg
Liver dysfunction (LD) and liver failure are associated with poor outcome in critically ill patients. In patients with severe sepsis or septic shock, LD occurred in nearly 19% of patients. An early diagnosis of LD at time of initial damage of the liver can lead to a better prognosis of these patients because an early start of therapy is possible. We performed a second prospective study with septic patients to test a new cell-based cytotoxicity device (biosensor) to evaluate clinical relevance for early diagnosis of LD and prognostic capacity...
2018: Frontiers in Immunology
Dushyant Iyer, Leanne Hunt, Steven A Frost, Anders Aneman
BACKGROUND: Elevated intra-abdominal pressure (IAP) is a common occurrence in mechanically ventilated patients in the intensive care unit (ICU). This study was undertaken to determine the relationship between IAP, pulmonary compliance and the duration of mechanical ventilation. METHODS: A prospective study of 220 consecutively enrolled mechanically ventilated patients admitted to a mixed surgical-medical ICU in a tertiary referral hospital. The IAP was measured at least twice daily, benchmarked against consensus guidelines...
July 5, 2018: Acta Anaesthesiologica Scandinavica
J H Lee, Y W Kim
BACKGROUND: Glufosinate-containing herbicide is increasingly used in agriculture. Its poisoning is a worldwide concern. More and more patients are poisoned by glufosinate. The aim of this study was to determine the factors associated with mortality of patients with acute poisoning of glufosinate. METHODS: This was a retrospective cohort study conducted from January 1998 to October 2015. Using a multivariate logistic analysis, data for the total population were retrospectively analyzed to determine the factors associated with mortality...
January 1, 2018: Human & Experimental Toxicology
Koroush Ebrahimi, Ali Akbar Vaisi Raigani, Rostam Jalali, Mansour Rezaei
Introduction: Today, poisoning is one of the problems of society and it is always one of the ten leading causes of death among youth. This study aimed to determine and compare the predictive and intensity value of three standard criteria of "Sequential Organ Failure Assessment (SOFA) score," "Acute Physiology and Chronic Health Evaluation (APACHE) 4," and "Poisoning Severity Score (PSS)" in short-term clinical outcome of poisoned patients. Methods: The prospective study conducted on 120 patients of critical care units...
June 2018: Indian Journal of Critical Care Medicine
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