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https://www.readbyqxmd.com/read/28296993/clinical-characteristics-and-outcomes-of-patients-with-cellulitis-requiring-intensive-care
#1
Duncan R Cranendonk, Lonneke A van Vught, Maryse A Wiewel, Olaf L Cremer, Janneke Horn, Marc J Bonten, Marcus J Schultz, Tom van der Poll, W Joost Wiersinga
Importance: Cellulitis is a commonly occurring skin and soft tissue infection and one of the most frequently seen dermatological diseases in the intensive care unit (ICU). However, clinical characteristics of patients with cellulitis requiring intensive care treatment are poorly defined. Necrotizing fasciitis is often confused for cellulitis at initial presentation and is considered to be more severe and thus has previously been described in more detail. Objective: To describe the clinical presentation and outcomes of patients with ICU-necessitating cellulitis and to compare them with patients with necrotizing fasciitis...
March 15, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28292572/effects-of-hypertonic-saline-vs-normal-saline-in-lactate-depuration-after-cardiovascular-surgery
#2
Luis Horacio Atehortúa-López, Ray Mendoza-Franco, José Fernando Escobar-Serna, Luis Alejandro Urrego, Fernando Alzate, Fabian Jaimes
BACKGROUND: The postoperative care of patients exposed to cardiac surgery frequently require a thorough reanimation with intravenous fluids but crystalloid solutions like normal saline may increase the interstitial edema, and also it is well known that fluid overload increases mortality. OBJECTIVE: To compare the effect of 7.5% hypertonic saline (HS) with 0.9% normal saline (NS) in the lactate depuration and the hemodynamic response of patients during the first day after on-pump cardiovascular surgery...
March 11, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28287056/the-total-inotrope-exposure-score-an-extension-of-the-vasoactive-inotrope-score-as-a-predictor-of-adverse-outcomes-after-paediatric-cardiac-surgery
#3
Harish Bangalore, Michael Gaies, Elena C Ocampo, Jeffrey S Heinle, Danielle Guffey, Charles G Minard, Paul Checchia, Lara S Shekerdemian
OBJECTIVE: The aim of the present study was to explore and compare the association between a new vasoactive score - the Total Inotrope Exposure Score - and outcome and the established Vasoactive Inotrope Score in children undergoing cardiac surgery with cardiopulmonary bypass DESIGN: The present study was a single-centre, retrospective study. SETTING: The study was carried out at a 21-bed cardiovascular ICU in a Tertiary Children's Hospital between September, 2010 and May, 2011 METHODS: The Total Inotrope Exposure Score is a new vasoactive score that brings together cumulative vasoactive drug exposure and incorporates dose adjustments over time...
March 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28265164/passive-exercise-of-the-lower-limbs-and-trunk-alleviates-decreased-intestinal-motility-in-patients-in-the-intensive-care-unit-after-cardiovascular-surgery
#4
Tomoyuki Morisawa, Tetsuya Takahashi, Naoki Sasanuma, Satoshi Mabuchi, Kenta Takeda, Naoto Hori, Naotsugu Ohashi, Takeshi Ide, Kazuhisa Domen, Shinichi Nishi
[Purpose] The purpose of this study was to clarify the effects of passive exercise of the lower limbs and trunk (PELT) in ICU patients after cardiovascular surgery with decreased bowel motility. [Subjects and Methods] Ten ICU patients with clinically-apparent decreased bowel motility during the period of April to July 2016 were enrolled this study. Bowel sounds (BS) for 5 minutes at rest and 5 minutes after PELT were recorded through an electronic stethoscope. A frequency analysis was performed and the BS before and after PELT were compared...
February 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28259366/mechanical-support-with-venoarterial-extracorporeal-membrane-oxygenation-ecmo-va-short-term-and-long-term-prognosis-after-a-successful-weaning
#5
R García-Gigorro, E Renes-Carreño, J L Pérez-Vela, H Marín-Mateos, J Gutiérrez, M A Corrés-Peiretti, J F Delgado, E Pérez-de la Sota, J M Cortina-Romero, J C Montejo-González
OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) affords mechanical circulatory assistance associated to high mortality. However, weaning from such mechanical support may not imply improved short- or long-term survival. This study describes the characteristics and evolution of patients with refractory cardiogenic shock (RCS) subjected to venoarterial ECMO (VA-ECMO) in a hospital with a heart transplant program. DESIGN: A single-center, retrospective cohort study was carried out...
March 2, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28257336/preadmission-oral-corticosteroids-are-associated-with-reduced-risk-of-acute-respiratory-distress-syndrome-in-critically-ill-adults-with-sepsis
#6
Andrew C McKown, Erin M McGuinn, Lorraine B Ware, Li Wang, David R Janz, Todd W Rice, Matthew W Semler
OBJECTIVES: To determine the association between preadmission oral corticosteroid receipt and the development of acute respiratory distress syndrome in critically ill patients with sepsis. DESIGN: Retrospective observational study. SETTING: Medical, surgical, trauma, and cardiovascular ICUs of an academic medical center. PATIENTS: A total of 1,080 critically ill patients with sepsis. INTERVENTIONS: None...
March 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28253466/self-poisoning-by-older-australians-a-cohort-study
#7
Peter I Pillans, Colin B Page, Sivarajah Ilango, Anna Kashchuk, Geoffrey K Isbister
OBJECTIVE: To examine the epidemiology and severity of self-poisoning by older people in Australia; to compare these data with those for overdoses in younger adults. DESIGN, SETTING, PARTICIPANTS: A cohort study of people presenting to a tertiary toxicology centre after self-poisoning over 26 years (1987-2012). MAIN OUTCOME MEASURES: Hospital length of stay (LOS); types of drug ingested; intensive care unit (ICU) admissions; in-hospital deaths...
March 6, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#8
Luregn J Schlapbach, Graeme MacLaren, Marino Festa, Janet Alexander, Simon Erickson, John Beca, Anthony Slater, Andreas Schibler, David Pilcher, Johnny Millar, Lahn Straney
PURPOSE: The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. METHODS: Multicenter cohort study including children <16 years admitted with sepsis or septic shock to ICUs in Australia and New Zealand in the period 2012-2015. We assessed septic shock criteria at ICU admission to define sepsis severity, using 30-day mortality as outcome. Through multivariable logistic regression, a pediatric sepsis score was derived using variables available within 60 min of ICU admission...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28203417/clinical-factors-associated-with-weaning-failure-in-patients-requiring-prolonged-mechanical-ventilation
#9
Hong-Joon Shin, Jin-Sun Chang, Seong Ahn, Tae-Ok Kim, Cheol-Kyu Park, Jung-Hwan Lim, In-Jae Oh, Yu-Il Kim, Sung-Chul Lim, Young-Chul Kim, Yong-Soo Kwon
BACKGROUND: For patients requiring prolonged mechanical ventilation (PMV), weaning is difficult and mortality is very high. PMV has been defined recently, by consensus, as constituting ≥21 consecutive days of mechanical ventilation (MV) for ≥6 hours per day. This study aimed to evaluate the clinical factors predicting weaning failure in patients undergoing PMV in medical intensive care unit (ICU). METHODS: We retrospectively reviewed the clinical and laboratory characteristics of 127 patients who received MV for more than 21 days in the medical ICU at Chonnam National University Hospital in South Korea between January 2005 and December 2014...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28203019/-investigation-of-risk-factors-of-acute-kidney-injury-after-off-pump-coronary-artery-bypass-grafting-and-3-years-follow-up
#10
X H Li, F Xiao, S Y Zhang
OBJECTIVE: To investigate the incidence rate and risk factors of acute kidney injury (AKI) after off-pump coronary artery bypass grafting (CABG),and to compare the effects of AKI on complications after operation and major adverse cardiovascular and cerebrovascular events (MACCE) after 3 years' follow-up. METHODS: In the study, 299 consecutive patients who underwent scheduled off-pump CABG from January 2010 to March 2012 were included. The patients were divided into AKI group with AKI and control group without AKI after operation...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28190429/the-scope-of-neurology-of-critical-illness
#11
E F M Wijdicks
Critical illness increases the probability of a neurologic complication. There are many reasons to consult a neurologist in a critically ill patient and most often it is altered alertness with no intuitive plausible explanation. Other common clinical neurologic problems facing the intensive care specialist and consulting neurologist in everyday decisions are coma following prolonged cardiovascular surgery, newly perceived motor asymmetry, seizures or other abnormal movements, and generalized muscle weakness...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28179097/octogenarian-donors-in-liver-transplantation-grant-an-equivalent-perioperative-course-than-ideal-young-donors
#12
Gianni Biancofiore, Maria Bindi, Davide Ghinolfi, Quirino Lai, Massimo Bisa, Massimo Esposito, Luca Meacci, Roberto Mozzo, Alicia Spelta, Franco Filipponi
BACKGROUND: Use of grafts from very old donors for liver transplantation is controversial. AIM: To compare the perioperative course of patients receiving liver grafts from young ideal vs octogenarian donors. METHODS: Analysis of the perioperative course of patients receiving liver grafts from young, ideal (18-39 years) vs octogenarian (≥80years) deceased donors between 2001 and 2014. RESULTS: 346 patients were studied: 179 (51...
January 21, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28164259/five-year-mortality-in-patients-treated-for-severe-community-acquired-pneumonia-a-retrospective-study
#13
H Lenz, G O Norby, V Dahl, T E Ranheim, R E Haagensen
BACKGROUND: The mortality rate in patients with severe community-acquired pneumonia (SCAP) is high. We investigated the 5-year mortality rate and causes of death in a patient population treated for SCAP in our intensive care unit (ICU), and compared the mortality rate in patients with or without chronic obstructive pulmonary disease (COPD) as comorbidity. METHODS: This retrospective study, which covers a period of 10 years, included patients aged > 18 years admitted to our ICU with SCAP as primary diagnosis and in need of mechanical ventilation for more than 24 h...
April 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28161384/hospitalization-costs-and-clinical-outcomes-in-cabg-patients-treated-with-intensive-insulin-therapy
#14
Saumeth Cardona, Francisco J Pasquel, Maya Fayfman, Limin Peng, Sol Jacobs, Priyathama Vellanki, Jeff Weaver, Michael Halkos, Robert A Guyton, Vinod H Thourani, Guillermo E Umpierrez
BACKGROUND: The financial impact of intensive (blood glucose [BG] 100-140mg/dl [5.5-7.8mM] vs. conservative (141-180mg/dl (7.9-10.0mM) glucose control in the ICU in patients, with and without diabetes, undergoing coronary artery bypass graft (CABG) surgery is not known. METHODS: This post-hoc cost analysis determined differences in hospitalization costs, resource utilization and perioperative complications in 288 CABG patients with diabetes (n=143) and without diabetes (n=145), randomized to intensive (n=143) and conservative (n=145) glucose control...
April 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28139304/development-and-implementation-of-a-comprehensive-multidisciplinary-emergency-department-extracorporeal-membrane-oxygenation-program
#15
Joseph E Tonna, Craig H Selzman, Michael P Mallin, Brigham R Smith, Scott T Youngquist, Antigoni Koliopoulou, Frederick Welt, Kathleen Diane Stoddard, Ram Nirula, Richard Barton, James Franklin Fair, James C Fang, Stephen McKellar
Despite advances in the medical and surgical management of cardiovascular disease, greater than 350,000 patients experience out-of-hospital cardiac arrest in the United States annually, with only a 12% neurologically favorable survival rate. Of these patients, 23% have an initial shockable rhythm of ventricular fibrillation/pulseless ventricular tachycardia (VF/VT), a marker of high probability of acute coronary ischemia (80%) as the precipitating factor. However, few patients (22%) will experience return of spontaneous circulation and sufficient hemodynamic stability to undergo cardiac catheterization and revascularization...
January 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28138011/systematic-review-of-%C3%AE-blocker-aspirin-and-statin-in-critically-ill-patients-importance-of-severity-of-illness-and-cardiac-troponin
#16
Florence G Rothenberg, Michael B Clay, Hina Jamali, Robin H Vandivier-Pletsch
Non-cardiac critically ill patients with type II myocardial infarction (MI) have a high risk of mortality. There are no evidence-based interventions to mitigate this risk. We systematically reviewed the literature regarding the use of medications known to reduce mortality in patients with cardiac troponin (cTn) elevation due to type I MI (β blockers, statin, and aspirin) in studies of critically ill patients without Type I MI. All PubMed publications between 1976-2/19/16 were reviewed. Search terms included: β blocker or aspirin or statin and intensive care unit (ICU) or critically ill or sepsis; 497 primary references were obtained...
January 30, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28135750/-ophthalmic-plastic-surgery-of-exposure-keratopathy-in-the-intensive-care-unit
#17
C Siebert, A Menges, F H Tost
Critically ill patients in the intensive care unit (ICU) may develop eye problems, due to impaired ocular protective mechanisms or direct involvement of the eye in severe systemic diseases. If eye infections or ocular surface disorders are not identified in time, endophthalmitis or corneal ulcer may develop and can cause permanent functional injuries of the eye. A retrospective analysis was performed and a total of 283 complete intensive care courses of treatment were evaluated, taking into account ophthalmic medical consultations for frequent cardinal symptoms...
January 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28121832/central-venous-to-arterial-co2-difference-after-cardiac-surgery-in-infants-and-neonates
#18
Leslie A Rhodes, W Clinton Erwin, Santiago Borasino, David C Cleveland, Jeffrey A Alten
OBJECTIVES: Venous to arterial CO2 difference correlates with cardiac output in critically ill adults, but its utility in pediatric patients is unclear. We sought to correlate venous to arterial CO2 difference with other cardiac output surrogates (arteriovenous oxygen saturation difference, central venous oxygen saturation, and lactate) and investigate its capacity to predict poor outcomes associated with low cardiac output (low cardiac output syndrome) in infants after cardiac surgery with cardiopulmonary bypass...
March 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28110639/amitraz-poisoning-a-case-report-of-an-unusual-pesticide-poisoning-in-sri-lanka-and-literature-review
#19
H M M T B Herath, S P Pahalagamage, Nilukshana Yogendranathan, M D M S Wijayabandara, Aruna Kulatunga
BACKGROUND: Amitraz is a pesticide used worldwide on animals and in agriculture. It contains triazapentadiene, which is a centrally acting alpha-2 adrenergic agonist. Amitraz poisoning is fairly uncommon in humans and occurs via oral, dermal or inhalational routes. Only a limited number of case reports of human intoxication have been published and most of them are of accidental ingestion by children. CASE PRESENTATION: A twenty-year-old Sri Lankan female presented following self-ingestion of 20 ml of amitraz resulting in 37...
January 23, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28107263/the-severity-of-hypoxic-ischemic-encephalopathy-correlates-with-multiple-organ-dysfunction-in-the-hypothermia-era
#20
Miguel Alsina, Ana Martín-Ancel, Ana Alarcon-Allen, Gemma Arca, Francisco Gayá, Alfredo García-Alix
OBJECTIVES: The objectives are to 1) determine whether there is a positive correlation between the severity of hypoxic-ischemic encephalopathy and multiple organ dysfunction and 2) evaluate the organ dysfunction pattern in infants with hypoxic-ischemic encephalopathy in the hypothermia era. DESIGN: Retrospective observational study of prospective data collected between April 2009 and December 2012. SETTING: The study took place in the neonatal ICU of Hospital Sant Joan de Déu-Hospital Clínic of Barcelona...
March 2017: Pediatric Critical Care Medicine
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