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https://www.readbyqxmd.com/read/29677586/impact-of-sarcopenic-obesity-on-30-day-mortality-in-critically-ill-patients-with-intra-abdominal-sepsis
#1
Yun Ji, Baoli Cheng, Zhipeng Xu, Hui Ye, Weina Lu, Xiaoqian Luo, Shuiqiao Fu, Xiangming Fang
PURPOSE: This study aimed to investigate the association between sarcopenic obesity and 30-day mortality in critically ill patients with intra-abdominal sepsis. MATERIAL AND METHODS: We analyzed 236 surgical ICU patients with sepsis due to intra-abdominal infection who underwent urgent surgical intervention. Sarcopenia, visceral obesity and sarcopenic obesity were analyzed by computed tomography scans using the third lumbar vertebrae skeletal muscle index and visceral adipose tissue area, using previously reported cutoff values...
March 16, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29677008/evolution-of-acute-kidney-injury-and-its-association-with-systemic-hemodynamics-in-children-with-fluid-refractory-septic-shock
#2
Akash Deep, Hiremath Sagar, Chulananda Goonasekera, Palaniswamy Karthikeyan, Joe Brierley, Abdel Douiri
OBJECTIVES: There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock. DESIGN: Prospective cohort study. SETTING: PICU of a tertiary care hospital. PATIENTS: All patients with fluid-refractory septic shock (n = 61) between September 2010 and February 2014...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29677007/near-continuous-glucose-monitoring-makes-glycemic-control-safer-in-icu-patients
#3
Jean-Charles Preiser, Olivier Lheureux, Aurelie Thooft, Serge Brimioulle, Jacques Goldstein, Jean-Louis Vincent
OBJECTIVES: Tight glycemic control using intermittent blood glucose measurements is associated with a risk of hypoglycemia. Glucose concentrations can now be measured near continuously (every 5-15 min). We assessed the quality and safety of glycemic control guided by a near-continuous glucose monitoring system in ICU patients. DESIGN: Prospective, cluster-randomized, crossover study. SETTING: Thirty-five-bed medico-surgical department of intensive care with four separate ICUs...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29675987/the-usage-of-procalcitonin-in-finland
#4
B Tujula, M Kokki, K Pulkki, J Romppanen, S Sjövall, H Tuominen, H Kokki
BACKGROUND: We have surveyed the use of procalcitonin (PCT) in Finland with a specific emphasis on intensive care unit (ICU) patients. METHODS: The PCT use was surveyed from all 11 laboratories providing services for all 15 secondary and all five tertiary care hospitals in Finland. The laboratories reported the PCT use of each hospital in 2014 and 2015. Four hospitals were analysed for the first 100 adult ICU patients with PCT measurements in 2015. The indication for PCT measurement and whether PCT values affected antibiotic treatment were collected from patient records...
April 19, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29675561/de-escalation-of-antifungal-treatment-in-critically-ill-patients-with-suspected-invasive-candida-infection-incidence-associated-factors-and-safety
#5
Karim Jaffal, Julien Poissy, Anahita Rouze, Sébastien Preau, Boualem Sendid, Marjorie Cornu, Saad Nseir
BACKGROUND: Antifungal treatment is common in critically ill patients, but only a small proportion of patients receiving antifungals have a proven fungal infection. However, antifungal treatment has side effects such as toxicity, emergence of resistance, and high cost. Moreover, empirical antifungal treatment is still a matter for debate in these patients. Our study aimed to determine the incidence, associated factors, and safety of de-escalation of antifungals in critically ill patients...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29675023/increased-plasma-levels-of-danger-associated-molecular-patterns-are-associated-with-immune-suppression-and-postoperative-infections-in-patients-undergoing-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy
#6
Guus P Leijte, Hettie Custers, Jelle Gerretsen, Amon Heijne, Johannes Roth, Thomas Vogl, Gert J Scheffer, Peter Pickkers, Matthijs Kox
Introduction: Danger-associated molecular patterns (DAMPs) can elicit immune responses and may subsequently induce an immune-suppressed state. Previous work showed that increased plasma levels of DAMPs are associated with immune suppression and increased susceptibility toward infections in trauma patients. Like trauma, major surgical procedures, such as cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC), are also thought to cause profound DAMP release...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29673561/risk-factors-for-death-from-stenotrophomonas-maltophilia-bacteremia
#7
Kayo Osawa, Katsumi Shigemura, Koichi Kitagawa, Issei Tokimatsu, Masato Fujisawa
PURPOSE: Stenotrophomonas maltophilia has low pathogenicity potential, but if it causes bacteremia it can be fatal, because it has shown high resistance to many antibiotics and can be difficult to treat. Patient death from S. maltophilia bacteremia has increased since 2014 in our hospital. In this study, we investigated risk factors for death due to S. maltophilia bacteremia. METHODS: Seventy patients from the hospital database with S. maltophilia bacteremia between January 2010 and July 2017 were investigated...
April 16, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29673409/worldwide-audit-of-blood-transfusion-practice-in-critically-ill-patients
#8
Jean-Louis Vincent, Ulrich Jaschinski, Xavier Wittebole, Jean-Yves Lefrant, Stephan M Jakob, Ghaleb A Almekhlafi, Tommaso Pellis, Swagata Tripathy, Paolo N Rubatto Birri, Yasser Sakr
BACKGROUND: The aim was to describe transfusion practice in critically ill patients at an international level and evaluate the effects of red blood cell (RBC) transfusion on outcomes in these patients. METHODS: This was a pre-planned sub-study of the Intensive Care Over Nations audit, which involved 730 ICUs in 84 countries and included all adult patients admitted between 8 May and 18 May 2012, except admissions for routine postoperative surveillance. RESULTS: ICU and hospital outcomes were recorded...
April 19, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29673334/full-blood-count-values-as-a-predictor-of-poor-outcome-of-pneumonia-among-hiv-infected-patients
#9
S Camon, C Quiros, N Saubi, A Moreno, M A Marcos, Y Eto, S Rofael, E Monclus, J Brown, T D McHugh, J Mallolas, R Perello
BACKGROUND: To evaluate the predictive value of analytical markers of full blood count that can be assessed in the emergency department for HIV infected patients, with community-acquired pneumonia (CAP). METHODS: Prospective 3-year study including all HIV-infected patients that went to our emergency department with respiratory clinical infection, more than 24-h earlier they were diagnosed with CAP and required admission. We assessed the different values of the first blood count performed on the patient as follows; total white blood cells (WBC), neutrophils, lymphocytes (LYM), basophils, eosinophils (EOS), red blood cells (RBC), hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, red blood cell distribution width (RDW), platelets (PLT), mean platelet volume, and platelet distribution width (PDW)...
April 19, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29672418/perioperative-use-of-levosimendan-improves-clinical-outcomes-in-patients-post-cardiac-surgery-a-systematic-review-and-meta-analysis
#10
Hua Qiang, Xiu Luo, Jian-Hua Huo, Zhi-Quan Wang
Severe postoperative complications can affect cardiac surgery patients. Levosimendan is a novel calcium sensitizer commonly administered after cardiac surgery. However, the patient benefits are controversial. PubMed, Embase, and the Cochrane library were systematically searched for randomized controlled trials (RCTs) comparing levosimendan with control in adult cardiac surgery patients. Twenty-five studies (3247 patients) were included. Pooled data indicated that levosimendan reduced mortality after cardiac surgery (OR 0...
April 3, 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29672375/a-retrospective-study-of-non-ventilator-associated-hospital-acquired-pneumonia-incidence-and-missed-opportunities-for-nursing-care
#11
Mary Tesoro, Diane J Peyser, Farley Villarente
OBJECTIVE: To determine non-ventilator-associated hospital-acquired pneumonia (NV-HAP) incidence, assess negative impacts on patient outcomes and cost, and identify missed preventive nursing care opportunities. BACKGROUND: NV-HAP is inadequately studied and underreported. Missed nursing care opportunities, particularly oral care, may aid NV-HAP prevention. METHODS: This descriptive, observational, retrospective chart review identified adult NV-HAP cases and associated demographic and hospital care data...
May 2018: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29671865/diabetes-and-necrotizing-soft-tissue-infections-a-prospective-observational-cohort-study-statistical-analysis-plan
#12
A Rosén, P Arnell, M B Madsen, B G Nedrebø, A Norrby-Teglund, O Hyldegaard, V M Dos Santos, F Bergey, E Saccenti, S Skrede
BACKGROUND: Necrotizing soft tissue infections (NSTIs) are rare but carry a high morbidity and mortality. The multicenter INFECT project aims to improve the understanding of the pathogenesis, clinical characteristics, diagnosis, and prognosis of NSTIs. This article describes the study outline and statistical analyses that will be used. METHODS: Within the framework of INFECT project, patients with NSTI at 5 Scandinavian hospitals are enrolled in a prospective observational cohort study...
April 19, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29671764/evaluation-of-factors-associated-with-hypermetabolism-and-hypometabolism-in-critically-ill-aki-patients
#13
Cassiana R de Góes, André Luis Balbi, Daniela Ponce
Acute kidney injury (AKI) is a frequent and serious condition with high mortality. The presence of hypermetabolism may be a factor related to poorer prognosis. This study evaluated the resting energy expenditure (REE) of intensive care unit (ICU) patients with severe AKI using indirect calorimetry (IC) and identified factors associated with metabolism categories. Patients were evaluated through measurement of REE and estimation of basal energy expenditure (BEE) using the Harris⁻Benedict equation. Metabolism categories were as follows: hypermetabolism (REE/BEE > 1...
April 19, 2018: Nutrients
https://www.readbyqxmd.com/read/29671655/knowledge-and-agency-in-interprofessional-care-how-nurses-contribute-to-the-case-construction-in-an-intensive-care-unit
#14
Letizia Caronia, Marzia Saglietti
This paper focuses on the epistemic and interactional resources displayed by nurses participating in medical case construction and the ways through which they make a difference in the unfolding of this activity. This paper draws on an ethnographic research in an Italian Intensive Care Unit (ICU) selected according to a purposeful sampling approach out of a national sample of 40 ICUs participating in a larger research project. Our dataset, collected over a period of six months of ethnographic observations, consisted of the observers' field notes and log-books, audio and video-recordings of morning briefings, in-depth interviews, informal conversations and shadowing of bedside practices...
April 19, 2018: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29671149/biological-scoring-system-for-early-prediction-of-acute-bowel-ischemia-after-cardiac-surgery-the-palm-score
#15
Elie Zogheib, Cyril Cosse, Charles Sabbagh, Simon Marx, Thierry Caus, Marc Henry, Joseph Nader, Mathurin Fumery, Michael Bernasinski, Patricia Besserve, Faouzi Trojette, Cedric Renard, Pierre Duhaut, Said Kamel, Jean-Marc Regimbeau, Hervé Dupont
BACKGROUND: Bowel ischemia is a life-threatening emergency defined as an inadequate vascular perfusion leading to bowel inflammation resulting from impaired colonic/small bowel blood supply. Main issue for physicians regarding bowel ischemia diagnosis lies in the absence of informative and specific clinical or biological signs leading to delayed management, resulting in a poorer prognosis, especially after cardiac surgery. The aim of the present series was to propose a simple scoring system based on biological data for the diagnosis of bowel ischemia...
April 18, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29670677/clinical-outcomes-of-extended-spectrum-beta-lactamase-producing-enterobacteriaceae-infections-with-susceptibilities-among-levofloxacin-cefepime-and-carbapenems
#16
Kristy J Walker, Young R Lee, Amanda R Klar
Purpose: Highly resistant Gram-negative bacterial infections are associated with high mortality. Increasing resistance to standard therapy illustrates the need for alternatives when treating resistant organisms, especially extended-spectrum beta-lactamase- (ESBL-) producing Enterobacteriaceae . Methods: A retrospective chart review at a community hospital was performed. Patients who developed ESBL-producing infections were included. Patients less than eighteen years old, who were pregnant, or who were incarcerated were excluded...
2018: Canadian Journal of Infectious Diseases & Medical Microbiology
https://www.readbyqxmd.com/read/29670676/cost-analysis-of-noninvasive-helmet-ventilation-compared-with-use-of-noninvasive-face-mask-in-ards
#17
Kwadwo Kyeremanteng, Louis-Philippe Gagnon, Raphaëlle Robidoux, Kednapa Thavorn, Dipayan Chaudhuri, Daniel Kobewka, John P Kress
Intensive care unit (ICU) costs have doubled since 2000, totalling 108 billion dollars per year. Acute respiratory distress syndrome (ARDS) has a prevalence of 10.4% and a 28-day mortality of 34.8%. Noninvasive ventilation (NIV) is used in up to 30% of cases. A recent randomized controlled trial by Patel et al. (2016) showed lower intubation rates and 90-day mortality when comparing helmet to face mask NIV in ARDS. The population in the Patel et al. trial was used for cost analysis in this study. Projections of cost savings showed a decrease in ICU costs by $2527 and hospital costs by $3103 per patient, along with a 43...
2018: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29670613/innate-immunity-in-the-persistent-inflammation-immunosuppression-and-catabolism-syndrome-and-its-implications-for-therapy
#18
REVIEW
Hiroyuki Horiguchi, Tyler J Loftus, Russell B Hawkins, Steven L Raymond, Julie A Stortz, McKenzie K Hollen, Brett P Weiss, Elizabeth S Miller, Azra Bihorac, Shawn D Larson, Alicia M Mohr, Scott C Brakenridge, Hironori Tsujimoto, Hideki Ueno, Frederick A Moore, Lyle L Moldawer, Philip A Efron
Clinical and technological advances promoting early hemorrhage control and physiologic resuscitation as well as early diagnosis and optimal treatment of sepsis have significantly decreased in-hospital mortality for many critically ill patient populations. However, a substantial proportion of severe trauma and sepsis survivors will develop protracted organ dysfunction termed chronic critical illness (CCI), defined as ≥14 days requiring intensive care unit (ICU) resources with ongoing organ dysfunction...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29670484/when-the-waves-become-rainbows-improving-seizure-detection-in-the-pediatric-icu
#19
COMMENT
Mohamad Koubeissi
No abstract text is available yet for this article.
March 2018: Epilepsy Currents
https://www.readbyqxmd.com/read/29670226/analysis-for-patient-survival-after-open-abdomen-for-torso-trauma-and-the-impact-of-achieving-primary-fascial-closure-a-single-center-experience
#20
Yu-Pao Hsu, Yon-Cheong Wong, Chih-Yuan Fu, Shang-Yu Wang, Chien-Hung Liao, Chun-Hsiang Ou Yang, Kuo-Ching Yuan
Open abdomen indicates the abdominal fascia is unclosed to abbreviate surgery and to reduce physiological stress. However, complications and difficulties in patient care are often encountered after operation. During May 2008 to March 2013, we performed a prospective protocol-directed observation study regarding open abdomen use in trauma patients. Bogota bag is the temporary abdomen closure initially but negative pressure dressing is used later. A goal-directed ICU care is applied and primary fascial closure is the primary endpoint...
April 18, 2018: Scientific Reports
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