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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
Huijie Yu, Lingfang Zhang, Songao Xu, Jun Xu, Hui Sun, Xiangyun Zhu, Xiaoqin Xu, Weizhong Cao
OBJECTIVE: To observe the effects of insulin caliper for blood glucose control on glycemic central tendency, fluctuation and incidence of hypoglycemia, etc., in emergent and critical patients to evaluate its application value. METHODS: A prospective single-blinded randomized parallel controlled intervention study was conducted. One hundred patients with severe hyperglycemia requiring treatment with insulin infusion admitted to emergency department and intensive care unit (ICU) of the First Hospital of Jiaxing from November 2015 to November 2017 were enrolled, and they were divided into the caliper group (used patented product insulin calipers for blood glucose control to adjust insulin dose for blood glucose control) and the conventional group (used paper-based insulin dose modification scheme to adjust insulin dose for blood glucose control) on average by random number table, 50 in each group...
August 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Zhonghua Wang, Shouhong Wang, Xiaolong Liao, Weixin Guo, Yan Wu, Shenglong Chen, Jun Liang, Daozheng Huang, Jie Li, Jianyi Wen, Hanbiao Li, Tiehe Qin
OBJECTIVE: To investigate the predictive value of central venous-to-arterial carbon dioxide difference (Pcv-aCO2 ) on the prognosis of elderly patients with sepsis. METHODS: 208 elderly patients who met the diagnostic criteria of the Sepsis-3 and with the age of more than 60 years old, and admitted to intensive care unit (ICU) of Guangdong General Hospital from January to December in 2017 were enrolled. According to the prognosis, the patients were divided into death group (n = 46) and survival group (n = 162)...
August 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Anna Włudarczyk, Kamil Polok, Jacek Górka, Andrzej Hałek, Grzegorz Biedroń, Paweł Krawczyk, Jacek Musiał, Wojciech Szczeklik
PURPOSE: Systemic autoimmune diseases are a heterogeneous group of disorders associated with dysfunction of multiple organs and unpredictable course. Complicated management and treatment become even more challenging when patients require critical care. This study aims to compare outcomes of small-vessel vasculitides (SVV) and other systemic autoimmune diseases (SAD) patients admitted to the intensive care unit (ICU). MATERIALS AND METHODS: Retrospective, observational study conducted in the ICU of Allergy and Immunology Department at the University Hospital in Krakow, Poland, between years 2001-2014, with 5-years follow-up and no lost to follow-up patients...
August 28, 2018: Journal of Critical Care
Yasushi Suzuki, Masahiro Kojika, Hisaho Sato, Yoshihiro Inoue, Shigeatsu Endo
Direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP) has been widely used for severe sepsis and septic shock. However, data are limited regarding the clinical experience and efficacy of PMX-DHP for septic shock resulting from urinary tract infection (UTI). At our institution, 15 patients with septic shock resulting from a UTI received PMX-DHP from January 2013 to July 2017. The cause of the urosepsis was mainly obstructive pyelonephritis secondary to ureterolithiasis or neurogenic bladder. Average Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were 25...
September 12, 2018: Therapeutic Apheresis and Dialysis
Tao Han Lee, Cheng-Chia Lee, Chau-Yee Ng, Ming-Yang Chang, Su-Wei Chang, Pei-Chun Fan, Wen-Hung Chung, Ya-Chung Tian, Yung-Chang Chen, Chih-Hsiang Chang
BACKGROUND: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome are severe drug-induced cutaneous adverse reactions with high mortality. Acute kidney injury (AKI) was a common complication in an SJS/TEN group and noted as an independent risk factor for mortality in patients with SJS/TEN. To determine whether AKI staging can predict the outcome of patients with SJS/TEN, we compared the discriminative power of an AKI KDIGO staging system with that of SCROTEN, APACHE II, APACHE III, and SOFA...
2018: PloS One
Dajana F Lendak, Dunja M Mihajlović, Aleksandra S Novakov-Mikić, Igor M Mitić, Jasmina M Boban, Snežana V Brkić
BACKGROUND: Members of TNFα superfamily, A proliferation inducing ligand (APRIL), B-cell activating factor (BAFF) and Transmembrane activator and calcium cyclophylin interactor (TACI) are main regulators of B-cell function. The aim of this study was to evaluate concentrations of APRIL, BAFF and soluble TACI (sTACI) receptor in septic patients compared to healthy controls and compare concentrations of these biomarkers depending on sepsis severity and outcome. MATERIALS AND METHODS: A total of 115 septic patients and 30 healthy volunteers were included and concentrations of APRIL, BAFF and sTACI were determined in all subjects at the admission (ELISA R&D Systems tests)...
August 21, 2018: Cytokine
Lei Zou, Xiaochun Song, Liang Hong, Xiao Shen, Jiakui Sun, Cui Zhang, Xinwei Mu
During the perioperative period of cardiac disease, as many risk factors exist, such as primary cardiac diseases, the use of vasopressors, ischemia-reperfusion injury during cardiopulmonary bypass (CPB), and surgical stress, the gut suffered from ischemia, anoxia and oxidative stress, which would lead to the enterocyte injury. The aim of this study was to explore whether serum intestinal fatty acid-binding protein (IFABP), which is excreted specifically from damaged intestinal enterocytes, as a predictor of prognosis in postoperative cardiac surgery patients...
August 2018: Medicine (Baltimore)
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)...
October 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]...
October 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
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