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Eleni N Sertaridou, Ioanna G Chouvarda, Konstantinos I Arvanitidis, Eirini K Filidou, George C Kolios, Ioannis N Pnevmatikos, Vasilios E Papaioannou
BACKGROUND: Septic shock has been found to disrupt circadian rhythms. Moreover, timing of onset has been associated with different circadian profiles in experimental studies. RESULTS: In this prospective study, we enrolled 26 patients divided into two groups: Group A (N = 15) included subjects who had septic shock at the time of ICU admission and Group B (N = 11) included patients who developed septic shock during ICU admission. 6-Sulfatoxymelatonin (aMT6s) and cortisol levels were measured in urine samples every 4 h over a 24-h period...
December 4, 2018: Annals of Intensive Care
Wei Gao, Yong Zhang, Haibin Ni, Jialiu Zhang, Dandan Zhou, Liping Yin, Feng Zhang, Hao Chen, Beibei Zhang, Wei Li
OBJECTIVE: To evaluate the prognostic value of the difference between peripheral venous and arterial partial pressure of carbon dioxide in patients with septic shock following early resuscitation. METHODS: This prospective study was conducted among the patients with septic shock treated in our department during the period from May, 2017 to May, 2018. Peripheral venous, peripheral arterial and central venous blood samples were collected simultaneously and analyzed immediately at bedside after 6-h bundle treatment...
November 30, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Amarja Ashok Havaldar
BACKGROUND: Sepsis is characterized by life threatening organ dysfunction with dysregulated immune response. Cardiac dysfunction seen in sepsis is unique as it is reversible within 7-10 days. Initial study by Parker et al. in 1984, showed, paradoxically lower ejection fraction in survivors of septic shock. Subsequent meta-analysis did not support that survivors had lower ejection fraction. Aim of our study was to assess the sepsis induced cardiac dysfunction by 2D echocardiography and Troponin I...
November 30, 2018: Cardiovascular Ultrasound
Saraschandra Vallabhajosyula, Jacob C Jentzer, Aditya A Kotecha, Dennis H Murphree, Erin F Barreto, Ashish K Khanna, Vivek N Iyer
BACKGROUND: Vasoactive medications are essential in septic shock, but are not fully incorporated into current mortality prediction risk scores. We sought to develop a novel mortality prediction model for septic shock incorporating quantitative vasoactive medication usage. METHODS: Quantitative vasopressor use was calculated in a cohort of 5352 septic shock patients and compared using norepinephrine equivalents (NEE), cumulative vasopressor index and the vasoactive inotrope score models...
November 22, 2018: Annals of Intensive Care
Alexander Aushev, Vicent Ribas Ripoll, Alfredo Vellido, Federico Aletti, Bernardo Bollen Pinto, Antoine Herpain, Emiel Hendrik Post, Eduardo Romay Medina, Ricard Ferrer, Giuseppe Baselli, Karim Bendjelid
Circulatory shock is a life-threatening disease that accounts for around one-third of all admissions to intensive care units (ICU). It requires immediate treatment, which is why the development of tools for planning therapeutic interventions is required to deal with shock in the critical care environment. In this study, the ShockOmics European project original database is used to extract attributes capable of predicting mortality due to shock in the ICU. Missing data imputation techniques and machine learning models were used, followed by feature selection from different data subsets...
2018: PloS One
Fei Teng, Xin Liu, Shu-Bin Guo, Zhuo Li, Wen-Qing Ji, Fang Zhang, Xiao-Mei Zhu
BACKGROUND: Influenza is frequently complicated by bacterial co-infection, causing additional hospitalization and mortality. We determined the incidence, risk factors and outcomes of patients with influenza-associated community-acquired bacterial co-infection. METHOD: This was a retrospective, observational study. Influenza was diagnosed using the polymerase chain reaction. Co-infection had to be confirmed using standard bacteriological tests. The primary endpoint was presence of community-acquired co-infection, and the secondary endpoint was in-hospital mortality...
November 15, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Xingjie Li, Jing Yu, Wenjuan Huang, Qi Huang, Jun Yan, Huaping Liang, Yu Sun
OBJECTIVE: To investigate the risk factors of acute respiratory distress syndrome (ARDS) occurrence in intensive care unit (ICU) traumatic patients. METHODS: Clinical data of traumatic patients in ICU of the People's Hospital of Liangping in Chongqing from January 1st, 2012 to June 30th, 2018 were retrospectively analyzed. According to the outcomes, the patients were divided into ARDS group and non-ARDS group. The differences of demographic indexes (gender, age), time of admission, type of injury, atrial fibrillation, trachea cannula, multiple injury, open injury, shock, surgery, blood transfusion, central venous indwelling catheter, infection, and blood routine indexes [white blood cell count (WBC), red blood cell count (RBC), platelet count (PLT), plateletcytocrit (PCT), hematocrit (Hct)], biochemical indexes [total bilirubin (TBil), albumin (Alb), serum creatinine (SCr), blood sodium, blood calcium, blood potassium, blood glucose], arterial blood gas analysis indexes [partial pressure of carbon dioxide (PaCO2 ), partial pressure of oxygen (PaO2 ), oxygenation index (PaO2 /FiO2 ), blood pH], coagulation indicators [activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), international normalized ratio (INR), fibrinogen (Fib)], injury severity score (ISS), new injury severity score (NISS), acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA), Glasgow coma scale (GCS) within 24 hours of admission, and the length of ICU stay between the two groups were analyzed, and the possible influencing factors were screened out...
October 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Chengfen Yin, Xinjing Gao, Zhibo Li, Jie Zhang, Lei Xu
OBJECTIVE: To investigate the effect of different appropriate modes of weaning from mechanical ventilation (MV) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: Patients with AECOPD and mechanically ventilated by orotracheal intubation, suitable for continuous positive airway pressure+proportional pressure support (CPAP+PPS) and CPAP+assisted spontaneous breath (ASB) ventilation mode for weaning from MV, admitted to intensive care unit (ICU) of Tianjin Third Central Hospital form January 1st, 2016 to December 31st, 2017 were enrolled...
October 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Huiying Zhao, Qi Wang, Peihua Wu, Guangjie Wang, Huixia Wang, Fengxue Zhu, Youzhong An
OBJECTIVE: To investigate the clinical characteristics and predictors of mortality in patients with candidemia in intensive care unit (ICU). METHODS: The patients with candidemia admitted to ICU of Peking University People's Hospital from January 2010 to December 2017 were enrolled. The general clinical data, indicators related to Candidia infection and prognosis were collected, and the clinical characteristics, infection characteristics and prognosis of patients with candidiasis were analyzed...
October 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
R Scott Eldredge, Yan Zhai, Amalia Cochran
INTRODUCTION: Acute respiratory distress syndrome (ARDS) is a complication that affects approximately 40% of burn patients and is associated with high mortality rates. Extracorporeal membrane oxygenation (ECMO) therapy is a management option for severe refractory hypoxemic respiratory failure; however, there is little literature reporting the effectiveness of this therapy in burns. Our study objective was to review patient outcomes in burns following severe ARDS treated with ECMO. METHODS: We retrospectively reviewed all patients treated with ECMO for ARDS who received their burn care at a single regional burn center between 9/1/2006 and 8/31/2016...
November 11, 2018: Burns: Journal of the International Society for Burn Injuries
Ling-Yu Xing, Jun Yin, Mian Shao, Yi-Lin Yang, Ke-Yong Li, Ming-Ming Xue, Su-Cheng Mu, Zhan Sun, Ya-Ping Zhang, Chen-Ling Yao, Xun Chu, Chao-Yang Tong, Zhen-Ju Song
BACKGROUND: Cavity effusion is common in patients with infectious diseases. However, the incidence rate and characteristics of serous cavity effusions (SCE) in septic patients are not clear to date. The objective of this study was to investigate the incidence and characteristics of SCE in septic patients and to explore the correlations between the bloody effusions and the illness severity/prognosis in septic patients. METHODS: From January 2010 to January 2015, a total of 214 patients with severe sepsis and septic shock were enrolled in this retrospective observational study...
November 14, 2018: BMC Anesthesiology
Aaron C Tan, Sarah K Jacques, Meredith Oatley, Alexander D Guminski
BACKGROUND: Patients with advanced malignancies have historically been considered poor candidates for admission to the intensive care unit (ICU), however prognosis is continually improving and requirements for ICU access is increasing. AIM: To understand the characteristics and outcomes of oncology unit patients admitted to an Australian ICU and identify potential prognostic factors. METHODS: A single-centre, retrospective, cohort study conducted at a tertiary public hospital with a quaternary ICU in Sydney, Australia...
November 8, 2018: Internal Medicine Journal
Prasanth Balasubramanian, Navneet Sharma, Manisha Biswal, Ashish Bhalla, Susheel Kumar, Vivek Kumar
Background and Aim: Scrub typhus (ST) is an acute infectious disease of variable severity caused by Orientia (formerly Rickettsia ) tsutsugamushi . The disease can be complicated by organ dysfunctions and the case fatality rate (CFR) is approximately 15%, which further rises with the development of severe complications. We studied the clinical features of the ST and the performance of critical illness scoring systems (CISSs) - Acute Physiology and Chronic Health Evaluation (APACHE) II, sequential organ failure assessment (SOFA), and quick SOFA (qSOFA) in predicting the clinical outcomes in complicated ST (cST) patients admitted to the emergency department...
October 2018: Indian Journal of Critical Care Medicine
Pham Thi Ngoc Thao, Ton Thanh Tra, Nguyen Truong Son, Koji Wada
BACKGROUND: Sepsis and septic shock are common problems in intensive care units (ICUs). The mortality of patients with sepsis or septic shock is high. We investigated if reduction in the serum concentration of the cytokines tumor necrosis factor α, interleukin (IL)-6 and IL-10, and the rate of change in the IL-6 level at 24 h after ICU admission were survival predictors for patients with sepsis and septic shock in a Vietnamese population. METHODS: This was a prospective study conducted at an ICU in Cho Ray Hospital, Vietnam, from October 2014 to October 2016...
November 6, 2018: BMC Emergency Medicine
Amartya Mukhopadhyay, Yanika Kowitlawakul, Jeyakumar Henry, Venetia Ong, Claudia Shu-Fen Leong, Bee Choo Tai
BACKGROUND & AIMS: Asians with similar body mass index (BMI) as the Caucasians are at higher health risk as compared to their counterparts. Although the mean weight of patients admitted to the intensive care unit (ICU) is increasing but the relation between BMI with 28-day mortality and length of stay (LOS) following ICU discharge in Asian patients is not well studied. METHODS: We included all adult patients admitted to the ICU of a tertiary hospital who received mechanical ventilation (MV) for at least 48 hours between October 2013 and September 2014...
December 2018: Clinical Nutrition ESPEN
Y Lee, S J Kim, Y S Kim, H Kim, D K Lee, J Lee, T H Go, Y S Cha
The rate of mortality from dapsone poisoning is high because of the long absorption half-life of dapsone. This study aimed to evaluate the usefulness of the sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation II (APACHE II) scoring systems for the early prediction of mortality in patients with dapsone poisoning. This is a retrospective and observational study of consecutive patients diagnosed with dapsone poisoning. The SOFA and APACHE II scores were obtained within the first 24 h of admission...
October 22, 2018: Human & Experimental Toxicology
Heng Fan, Yu Zhao, Guo-Dong Chen, Min Sun, Jian-Hua Zhu
Objective To investigate the relationship between health insurance status and outcomes of septic acute kidney injury (AKI) related hospitalizations in an intensive care unit (ICU) in Ningbo, China. Methods For this retrospective study, information was extracted from patients notes and billing records for patients >18 years of age with a diagnosis of AKI admitted to the ICU department, Ningbo First Hospital from April 2013 to March 2018. Results Of the 368 patients with sepsis admitted to ICU, 167 (45%) developed AKI; 95 patients were insured and 72 were uninsured...
October 17, 2018: Journal of International Medical Research
Hongsheng Ren, Bo Song, Pengcheng Li, Cheng Huan, Yufeng Chu, Min Ding, Yuping Wang, Qingchun Yao, Peng Wang, Guoqiang Qi, Chunting Wang
Background: We explored the effects of high-volume hemofiltration(HVHF) by different ultrasound directing on the plasma N-terminal pro-B-type natriuretic peptide(NT-Pro-BNP), extra vascular lung water index (EVLWI), liquid net balance quantity and prognosis in patients with septic shock. Methods: Overall, 107 intensive patients with septic shock were enrolled by retrospective analysis from Department of Intensive Care Unit (ICU) of the Shandong Provincial Hospital affiliated to Shandong University from 2014-2017...
September 2018: Iranian Journal of Public Health
Steven L Raymond, Russell B Hawkins, Julie A Stortz, Tyler J Murphy, Ricardo Ungaro, Marvin L Dirain, Dina C Nacionales, McKenzie K Hollen, Jaimar C Rincon, Shawn D Larson, Scott C Brakenridge, Frederick A Moore, Daniel Irimia, Phil A Efron, Lyle L Moldawer
Sepsis is a common and deadly complication among trauma and surgical patients. Neutrophils must mobilize to the site of infection to initiate an immediate immune response. To quantify the velocity of spontaneous migrating blood neutrophils, we utilized novel microfluidic approaches on whole blood samples from septic and healthy individuals. A prospective study at a level 1 trauma and tertiary care center was performed with peripheral blood samples collected at <12 hours, 4 days, and/or 14 days relative to study initiation...
2018: PloS One
B Nagaraju Naik, Ashish Bhalla, Navneet Sharma, Jitender Mokta, Surjit Singh, Prakamya Gupta, Ashutosh Rai, Sridhar Subbiah, Anil Bhansali, Pinaki Dutta
Purpose: Endocrinal insufficiency caused by vasculotoxic snake envenomation is under-recognized and is mostly confined to a specific geographic area. We conducted a prospective study to determine the prevalence and pattern of pituitary-target gland insufficiencies caused by snake envenomation. Materials and Methods: The hormonal evaluation of patients who had suffered from vasculotoxic snake envenomation was done at baseline and at 6 months of follow-up. Those patients with a documented hormonal insufficiency underwent magnetic resonance imaging (MRI) of the hypothalamo-pituitary area...
September 2018: Neurology India
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