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https://www.readbyqxmd.com/read/28930918/neutrophil-to-lymphocyte-ratio-predicts-death-in-acute-on-chronic-liver-failure-patients-admitted-to-the-intensive-care-unit-a-retrospective-cohort-study
#1
Nicolas Moreau, Xavier Wittebole, Yvan Fleury, Patrice Forget, Pierre-François Laterre, Castanares-Zapatero Diego
The neutrophil-to-lymphocyte ratio (NLR) is an inflammation score recognized as associated with outcome. While inflammation has been shown to correlate with the development of acute-on-chronic liver failure (ACLF), we sought to investigate the role of NLR in predicting 90-day mortality in cirrhotic patients experiencing ACLF.We performed a retrospective cohort study involving a total of 108 consecutive cirrhotic patients admitted in the intensive care unit (ICU). NLR, clinical and biological data were recorded...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28928275/development-of-diagnostic-criteria-and-a-prognostic-score-for-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#2
Tianzhou Wu, Jiang Li, Li Shao, Jiaojiao Xin, Longyan Jiang, Qian Zhou, Dongyan Shi, Jing Jiang, Suwan Sun, Linfeng Jin, Ping Ye, Lingling Yang, Yinyun Lu, Tan Li, Jianrong Huang, Xiaowei Xu, Jiajia Chen, Shaorui Hao, Yuemei Chen, Shaojie Xin, Zhiliang Gao, Zhongping Duan, Tao Han, Yuming Wang, Jianhe Gan, Tingting Feng, Chen Pan, Yongping Chen, Hai Li, Yan Huang, Qing Xie, Shumei Lin, Lanjuan Li, Jun Li
OBJECTIVE: The definition of acute-on-chronic liver failure (ACLF) based on cirrhosis, irrespective of aetiology, remains controversial. This study aimed to clarify the clinicopathological characteristics of patients with hepatitis B virus-related ACLF (HBV-ACLF) in a prospective study and develop new diagnostic criteria and a prognostic score for such patients. DESIGN: The clinical data from 1322 hospitalised patients with acute decompensation of cirrhosis or severe liver injury due to chronic hepatitis B (CHB) at 13 liver centres in China were used to develop new diagnostic and prognostic criteria...
September 19, 2017: Gut
https://www.readbyqxmd.com/read/28923305/risk-factors-for-mortality-in-patients-with-low-lactate-level-and-septic-shock
#3
Dong Hyun Oh, Moo Hyun Kim, Woo Yong Jeong, Yong Chan Kim, Eun Jin Kim, Je Eun Song, In Young Jung, Su Jin Jeong, Nam Su Ku, Jun Yong Choi, Young Goo Song, June Myung Kim
BACKGROUND: According to the new definition of septic shock, vasopressor therapy and hyperlactatemia are essential for diagnosis. However, there is controversy regarding the cutoff value for lactate, and prognostic factors in patients with septic shock and hypolactatemia. This study evaluated the prognostic significance of the cutoff value for lactate level in septic shock patients. METHODS: The retrospective observational cohort study enrolled 1043 patients aged ≥18 years who meet the revised definition of septic shock...
August 26, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28921629/validation-of-prognostic-scores-to-predict-short-term-mortality-in-patients-with-acute-on-chronic-liver-failure
#4
Do Seon Song, Tae Yeob Kim, Dong Joon Kim, Hee Yeon Kim, Dong Hyun Sinn, Eileen L Yoon, Chang Wook Kim, Young Kul Jung, Ki Tae Suk, Sang Soo Lee, Chang Hyeong Lee, Tae Hun Kim, Won Hyeok Choe, Hyung Joon Yim, Sung Eun Kim, Soon Koo Baik, Jae Young Jang, Hyoung Su Kim, Sang Gyune Kim, Jin Mo Yang, Joo Hyun Sohn, Eun Hee Choi, Hyun Chin Cho, Soung Won Jeong, Moon Young Kim
BACKGROUND AND AIM: The aim of this study was to validate the Chronic Liver Failure-Sequential Organ Failure Assessment score (CLIF-SOFAs), CLIF consortium organ failure score (CLIF-C OFs), CLIF-C acute-on-chronic liver failure score (CLIF-C ACLFs), and CLIF-C acute decompensation score (CLIF-C ADs) in Korean chronic liver disease patients with acute deterioration. METHODS: ACLF was defined by either the Asian Pacific Association for the Study of the Liver ACLF Research Consortium (AARC) or CLIF-C criteria...
September 16, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28915395/effects-of-polymyxin-b-hemoperfusion-on-hemodynamics-and-prognosis-in-septic-shock-patients
#5
Chen-Tse Lee, Yu-Kang Tu, Yi-Chun Yeh, Tzu Chang, Po-Yuan Shih, Anne Chao, Hsing-Hao Huang, Ya-Jung Cheng, Yu-Chang Yeh
PURPOSE: We designed this study to examine the clinical effects of polymyxin B hemoperfusion (PMX-HP) in septic shock patients. MATERIAL AND METHODS: We retrospectively examined the effects of PMX-HP in septic shock patients with intra-abdominal or gram-negative bacterial infection during October 2013-May 2016. A one-to-one matching between the PMX-HP and conventional groups was performed, and 28-day mortality, and change in inotropic score, Sequential Organ Failure Assessment (SOFA) score, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score at 24h in the two groups were compared...
April 25, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28914210/-sepsis-new-insights-new-definition
#6
W J Wiersinga, A R H van Zanten, K A Kaasjager, T van der Poll
- Incidence of sepsis is increasing, partly due to an ageing population, increased use of immunosuppressants, and antibiotic resistance. Sepsis survival has improved substantially, in part because of continuously improving intensive care and implementation of evidence-based guidelines.- Sepsis is defined as 'life-threatening organ dysfunction due to a dysregulated host response to infection'. The Sequential Organ Failure Assessment (SOFA) score can be used to estimate organ dysfunction severity.- In this article, we discuss the new sepsis definitions - including reactions to these definitions, an overview of current insights in sepsis pathogenesis, and the new treatment guidelines...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28910913/-effect-of-transcutaneous-oximetry-on-prognosis-of-patients-with-severe-acute-respiratory-failure-receiving-extracorporeal-membrane-oxygenation
#7
L Dong, X H Zhang, F M Liang, T Yang, J Yan, Z Yan, L Li
Objective: To investigate the prognostic value of transcutaneous oximetry in patients with severe acute respiratory failure receiving extracorporeal membrane oxygenation(ECMO). Methods: Forty-nine patients diagnosed as severe acute respiratory failure receiving Venous-Venous(V-V)ECMO were enrolled from January 2013 to December 2015 in intensive care unit(ICU) of Wuxi People's Hospital Affiliated to Nanjing Medical University.The 10-min oxygen challenge test was performed using transcutaneous oximetry 6 h after the initiation of ECMO, and the 10-min oxygen challenge test value(OCT(10)) and oxygen challenge index(OCI) were calculated...
September 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28903168/-sharing-bacterial-microbiota-between-owners-and-their-pets-dogs-cats
#8
Jan Wipler, Zuzana Čermáková, Tomáš Hanzálek, Hana Horáková, Helena Žemličková
INTRODUCTION: The microbiological aspect of a relationship between pets (dogs/cats) and their owners is mainly concerned with the incidence of shared bacterial species, in particular potential pathogens. Given the great popularity of sharing homes with pets (dogs/cats) in the Czech Republic, there is an increased possibility of communication between microbiota of the two macroorganisms (pet and owner). The aim of the study was to determine the biodiversity of shared bacteria and possibility of exchange of genes of resistance to antimicrobial agents between potential pathogens based on the close relationship between pets and humans...
June 2017: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28903084/sepsis-mortality-score-for-the-prediction-of-mortality-in-septic-patients
#9
Wan Fadzlina Wan Muhd Shukeri, Azrina Md Ralib, Nor Zamzila Abdulah, Mohd Basri Mat-Nor
PURPOSE: To derive a prediction equation for 30-day mortality in sepsis using a multi-marker approach and compare its performance to the Sequential Organ Failure Assessment (SOFA) score. METHODS: This study included 159 septic patients admitted to an intensive care unit. Leukocytes count, procalcitonin (PCT), interleukin-6 (IL-6), and paraoxonase (PON) and arylesterase (ARE) activities of PON-1 were assayed from blood obtained on ICU presentation. Logistic regression was used to derive sepsis mortality score (SMS), a prediction equation describing the relationship between biomarkers and 30-day mortality...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28900902/derivation-and-validation-of-a-prognostic-model-for-postoperative-risk-stratification-of-critically-ill-patients-with-faecal-peritonitis
#10
Ascanio Tridente, Julian Bion, Gary H Mills, Anthony C Gordon, Geraldine M Clarke, Andrew Walden, Paula Hutton, Paul A H Holloway, Jean-Daniel Chiche, Frank Stuber, Christopher Garrard, Charles Hinds
BACKGROUND: Prognostic scores and models of illness severity are useful both clinically and for research. The aim of this study was to develop two prognostic models for the prediction of long-term (6 months) and 28-day mortality of postoperative critically ill patients with faecal peritonitis (FP). METHODS: Patients admitted to intensive care units with faecal peritonitis and recruited to the European GenOSept study were divided into a derivation and a geographical validation subset; patients subsequently recruited to the UK GAinS study were used for temporal validation...
September 12, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28900072/no-awakening-in-supratentorial-intracerebral-hemorrhage-is-potentially-caused-by-sepsis-associated-encephalopathy
#11
Dao-Ming Tong, Ye-Ting Zhou
BACKGROUND Acute supratentorial intracerebral hemorrhage (sICH) with secondary sepsis is increasing in frequency. We investigated whether no awakening (NA) after sICH with coma is potentially caused by sepsis-associated encephalopathy (SAE). MATERIAL AND METHODS A case-control study of 147 recruited sICH cases with NA and 198 sICH controls with subsequent awakening (SA) was performed at 2 centers in China. All patients underwent brain computed tomography (CT) scans on admission. The odds ratio (OR) of NA was calculated using logistic regression...
September 13, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28892669/development-of-a-prediction-model-for-long-term-quality-of-life-in-critically-ill-patients
#12
Sandra Oeyen, Karel Vermeulen, Dominique Benoit, Lieven Annemans, Johan Decruyenaere
PURPOSE: We developed a prediction model for quality of life (QOL) 1 year after intensive care unit (ICU) discharge based upon data available at the first ICU day to improve decision-making. METHODS: The database of a 1-year prospective study concerning long-term outcome and QOL (assessed by EuroQol-5D) in critically ill adult patients consecutively admitted to the ICU of a university hospital was used. Cases with missing data were excluded. Utility indices at baseline (UIb) and at 1 year (UI1y) were surrogates for QOL...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28888058/increased-expression-of-programmed-cell-death-1-in-regulatory-t-cells-of-patients-with-severe-sepsis-and-septic-shock-an-observational-clinical-study
#13
Qiang Liu, Le An, Zhijiang Qi, Yongzhen Zhao, Chunsheng Li
While regulatory T-cells (Tregs) constitutively express programmed cell death-1 (PD-1), the role of PD-1 expression in Tregs of patients with sepsis remains unclear. Thus, we determined PD-1 expression in Tregs from the peripheral blood of patients with severe sepsis and septic shock Seventy-eight patients with severe sepsis and 40 with septic shock, as well as 21 healthy subjects, were enrolled in this study. The percentage of peripheral blood PD-1+ Tregs, as well as absolute Treg counts, were compared between these 3 groups...
September 9, 2017: Scandinavian Journal of Immunology
https://www.readbyqxmd.com/read/28887766/short-term-effects-of-passive-mobilization-on-the-sublingual-microcirculation-and-on-the-systemic-circulation-in-patients-with-septic-shock
#14
Tuanny Teixeira Pinheiro, Flávio Geraldo Rezende de Freitas, Karla Tuanny Fiorese Coimbra, Vanessa Marques Ferreira Mendez, Heloísa Baccaro Rossetti, Paulo Vinicius Talma, Antônio Tonete Bafi, Flávia Ribeiro Machado
BACKGROUND: Active mobilization is not possible in patients under deep sedation and unable to follow commands. In this scenario, passive therapy is an interesting alternative. However, in patients with septic shock, passive mobilization may have risks related to increased oxygen consumption. Our objective was to evaluate the impact of passive mobilization on sublingual microcirculation and systemic hemodynamics in patients with septic shock. METHODS: We included patients who were older than 18 years, who presented with septic shock, and who were under sedation and mechanical ventilation...
September 8, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28884313/endocan-as-an-early-biomarker-of-severity-in-patients-with-acute-respiratory-distress-syndrome
#15
Diego Orbegozo, Lokmane Rahmania, Marian Irazabal, Manuel Mendoza, Filippo Annoni, Daniel De Backer, Jacques Creteur, Jean-Louis Vincent
BACKGROUND: Plasma concentrations of endocan, a proteoglycan preferentially expressed in the pulmonary vasculature, may represent a biomarker of lung (dys)function. We sought to determine whether the measurement of plasma endocan levels early in the course of acute respiratory distress syndrome (ARDS) could help predict risk of death or of prolonged ventilation. METHODS: All patients present in the department of intensive care during a 150-day period were screened for ARDS (using the Berlin definition)...
September 7, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28871441/international-registry-on-the-use-of-the-cytosorb%C3%A2-adsorber-in-icu-patients-study-protocol-and-preliminary-results
#16
REVIEW
S Friesecke, K Träger, G A Schittek, Z Molnar, F Bach, K Kogelmann, R Bogdanski, A Weyland, A Nierhaus, F Nestler, D Olboeter, D Tomescu, D Jacob, H Haake, E Grigoryev, M Nitsch, A Baumann, M Quintel, M Schott, J T Kielstein, A Meier-Hellmann, F Born, U Schumacher, M Singer, J Kellum, F M Brunkhorst
INTRODUCTION: The aim of this clinical registry is to record the use of CytoSorb® adsorber device in critically ill patients under real-life conditions. METHODS: The registry records all relevant information in the course of product use, e. g., diagnosis, comorbidities, course of the condition, treatment, concomitant medication, clinical laboratory parameters, and outcome (ClinicalTrials.gov Identifier: NCT02312024). Primary endpoint is in-hospital mortality as compared to the mortality predicted by the APACHE II and SAPS II score, respectively...
September 4, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28868069/urinary-neutrophil-gelatinase-associated-lipocalin-as-a-predictor-of-acute-kidney-injury-severe-kidney-injury-and-the-need-for-renal-replacement-therapy-in-the-intensive-care-unit
#17
Fatma I Albeladi, Haifa M Algethamy
BACKGROUND: Recent attempts were made to identify early indicators of acute kidney injury (AKI) in order to accelerate treatment and hopefully improve outcomes. This study aims to assess the value of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a predictor of AKI, severe AKI, and the need for renal replacement therapy (RRT). METHODS: We conducted a prospective study and included adults admitted to our intensive care unit (ICU) at King Abdulaziz University Hospital (KAUH), between May 2012 and June 2013, who had at least 1 major risk factor for AKI...
May 2017: Nephron Extra
https://www.readbyqxmd.com/read/28866112/hemodynamic-assessment-of-septic-shock-patients-using-transpulmonary-thermodilution-and-critical-care-echocardiography-a-comparative-study
#18
Philippe Vignon, Emmanuelle Begot, Arnaud Mari, Stein Silva, Loïc Chimot, Pierre Delour, Frédéric Vargas, Bruno Filloux, David Vandroux, Julien Jabot, Bruno François, Nicolas Pichon, Marc Clavel, Bruno Levy, Michel Slama, Béatrice Riu-Poulenc
BACKGROUND: To assess the agreement between transpulmonary thermodilution (TPT) and critical care echocardiography (CCE) in ventilated septic shock patients. METHODS: Ventilated patients in sinus rhythm requiring advanced hemodynamic assessment for septic shock were included in this prospective multicenter descriptive study. Patients were assessed successively using TPT and CCE in random order. Data were interpreted independently at bedside by two investigators who proposed therapeutic changes based on predefined algorithms...
August 30, 2017: Chest
https://www.readbyqxmd.com/read/28863968/nucleosomes-and-neutrophil-extracellular-traps-in-septic-and-burn-patients
#19
Tomás Kaufman, Débora Magosevich, María Carolina Moreno, María Alejandra Guzman, Lina Paola D'Atri, Agostina Carestia, María Eugenia Fandiño, Carlos Fondevila, Mirta Schattner
NETosis is a host defense mechanism associated with inflammation and tissue damage. Experimental models show that platelets and von Willebrand factor (VWF) are key elements for intravascular NETosis. We determined NETosis in septic and burn patients at 1 and 4days post-admission (dpa). Nucleosomes were elevated in patients. In septics, they correlated with Human Neutrophil Elastase (HNE)-DNA complexes and SOFA score at 1dpa, and were associated with mortality. Patient's neutrophils had spontaneous NETosis and were unresponsive to stimulation...
August 29, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
https://www.readbyqxmd.com/read/28863283/the-role-of-propionic-acid-at-diagnosis-predicts-mortality-in-patients-with-septic-shock
#20
Jie Weng, He Wu, Zhe Xu, Haitao Xi, Chan Chen, Daqing Chen, Yuqiang Gong, Ying Hua, Zhiyi Wang
PURPOSE: This study aims to assess the diagnostic and prognostic value of propionic acid in patients with septic shock on a medical intensive care unit (ICU). METHODS: Serum propionic acid and clinical common cytokines levels were measured within 24h after the diagnosis of sepsis, and the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, and Mortality were recorded in ICU. A 28-day and 90-day follow-up was performed for all patients...
August 5, 2017: Journal of Critical Care
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