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https://www.readbyqxmd.com/read/28550722/inflammasome-expression-and-cytomegalovirus-viremia-in-critically-ill-patients-with-sepsis
#1
Nina Singh, Makoto Inoue, Ryosuke Osawa, Marilyn M Wagener, Mari L Shinohara
BACKGROUND: CMV viremia is a contributor to poor outcomes in critically ill patients with sepsis. OBJECTIVES: To assess the expression levels of genes encoding inflammasome-related proteins in the development of CMV viremia in critically ill patients with sepsis. STUDY DESIGN: A cohort of CMV-seropositive critically ill patients with sepsis due to bloodstream infection underwent weekly testing for CMV viremia. Blood samples to evaluate mRNA levels of genes encoding CASP1, ASC, NLRP1, NLRP3, and NLRP12 were collected at the time of enrollment...
May 18, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28550403/healthcare-utilization-and-costs-in-ards-survivors-a-1-year-longitudinal-national-us-multicenter-study
#2
A Parker Ruhl, Minxuan Huang, Elizabeth Colantuoni, Taruja Karmarkar, Victor D Dinglas, Ramona O Hopkins, Dale M Needham
PURPOSE: To evaluate (1) post-discharge healthcare utilization and estimated costs in ARDS survivors, and (2) the association between patient and intensive care-related variables, and 6-month patient status, with subsequent hospitalization and costs. METHODS: Longitudinal cohort study enrolling from four ARDSNet trials in 44 US hospitals. Healthcare utilization was collected via structured interviews at 6 and 12 months post-ARDS, and hospital costs estimated via the Medical Expenditure Panel Survey...
May 26, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28549877/heat-map-for-data-visualization-in-infection-control-epidemiology-an-application-describing-the-relationship-between-hospital-acquired-infections-simplified-acute-physiological-score-ii-and-length-of-stay-in-adult-intensive-care-units
#3
Robin Ohannessian, Thomas Bénet, Laurent Argaud, Claude Guérin, Céline Guichon, Vincent Piriou, Thomas Rimmelé, Raphaele Girard, Solweig Gerbier-Colomban, Philippe Vanhems
BACKGROUND: Hospital-acquired infections (HAIs) in intensive care units (ICUs) are associated with increased length of stay (LOS). The objective of this study was to graphically describe by heat mapping LOS of patients hospitalized in ICUs related to the occurrence of HAI and severity at admission measured by the Simplified Acute Physiological Score II (SAPSII). METHODS: Adult patients hospitalized in ICUs of Lyon University Hospitals (France) were included in an active standardized surveillance study of HAI from January 1, 1995-December 31, 2012...
May 23, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28549793/clinical-residual-symptomatology-and-associated-factors-in-multiple-organ-failure-survivors-a-long-term-mortgage
#4
S Rodríguez-Villar, J L Rodríguez-García, J Arévalo-Serrano, M Sánchez-Casado, H Fletcher
PURPOSE: To evaluate which clinical residual symptoms, multiorgan failure (MOF) patients may exhibit following discharge from intensive care unit (ICU) and to identify the associated factors. MATERIAL AND METHODS: A total of 545 consecutively admitted adult patients with MOF on admission were included in the study. Patients were assesed by a survey 6 and 12 months after discharge from a medical-surgical ICU in Spain. A telephone survey was conducted concerning the clinical symptoms of their stay in ICU...
May 23, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28549778/stepwise-introduction-of-the-best-care-always-central-line-associated-bloodstream-infection-prevention-bundle-in-a-network-of-south-african-hospitals
#5
Guy A Richards, Adrian J Brink, Angeliki P Messina, Charles Feldman, Karin Swart, Dena van den Bergh
BACKGROUND: Health care associated infection (HAI) remains a major international problem. AIM: The "Best Care Always!" (BCA) campaign, was launched in South Africa to reduce common preventable HAI, including catheter associated bloodstream infection (CLABSI). METHODS: The intervention occurred in 43 Netcare Private Hospitals increasing later to 49 with 958 ICU and 439 high care (HC) beds and 1207 ICU and 493 HC beds, respectively. .Phase 1: April 2010-March 2011: ICU Infection Prevention and Control (IPC) nurse driven change: Commitment from management and doctors and training of IPC nurses...
May 23, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28549644/maximizing-interhospital-transfer-resources-for-neurosurgical-patients
#6
Zane Schnurman, Robert Chin, Edward R Fishkin, Paul P Huang
BACKGROUND: Delays in patient transfers are associated with worse outcomes for some neurosurgical conditions. One of the primary causes of transfer delay is lack of neurosurgery ICU bed availability. In this study, we characterize the results of implementing an interhospital transfer protocol to reduce unnecessary transfers and improve bed availability. METHODS: A transfer protocol was implemented in July 2012 at the Bellevue Hospital Department of Neurosurgery that screened for and prevented transfer of low-risk patients that were unlikely to require specialized inpatient neurosurgical care...
May 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28549527/vitamin-d-supplementation-in-the-critically-ill-a-systematic-review-and-meta-analysis
#7
Pascal L Langlois, Celeste Szwec, Frédérick D'Aragon, Daren K Heyland, William Manzanares
INTRODUCTION: Vitamin D insufficiency is reported in up to 50% of the critically ill patients and is associated with increased mortality, length of stay (LOS) in intensive care unit (ICU) and hospital, and respiratory disorders with prolonged ventilation. Benefits of vitamin D supplementation remain unclear. The aim of this systematic review was to evaluate the clinical benefits of vitamin D administration in critically ill patients. METHODS: We searched Medline, Embase, CINAHL and Cochrane database for randomized controlled trials (RCT) conducted on heterogeneous ICU patients comparing vitamin D administration to placebo...
May 11, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28549273/body-weight-supported-bedside-treadmill-training-facilitates-ambulation-in-icu-patients-an-interventional-proof-of-concept-study
#8
Juultje Sommers, Denise C Wieferink, Dave A Dongelmans, Frans Nollet, Raoul H H Engelbert, Marike van der Schaaf
PURPOSE: Early mobilisation is advocated to improve recovery of intensive care unit (ICU) survivors. However, severe weakness in combination with tubes, lines and machinery are practical barriers for the implementation of ambulation with critically ill patients. The aim of this study was to explore the feasibility of Body Weight-Supported Treadmill Training (BWSTT) in critically ill patients in the ICU. METHODS: A custom build bedside Body Weight-Supported Treadmill was used and evaluated in medical and surgical patients in the ICU...
May 13, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28548993/muscle-metabolism
#9
Nicolas Tardif, Jonathan Grip, Olav Rooyackers
PURPOSE OF REVIEW: To review the recent findings on metabolic derangements leading to loss of muscle mass and function. RECENT FINDINGS: Several recent studies investigated methods to assess muscle mass and function and its clinical relevance. These are also included. A few studies confirm that a low muscle mass is related to a worse outcome but also a compromised muscle function at discharge is related to long-term survival. A low quality of muscle assessed by the density of muscle from a computed tomography scan is related to mortality...
May 25, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28548991/protein-nutrition-and-exercise-survival-kit-for-critically-ill
#10
Peter J M Weijs
PURPOSE OF REVIEW: Protein delivery as well as exercise of critically ill in clinical practice is still a highly debated issue. Here we discuss only the most recent updates in the literature concerning protein nutrition and exercise of the critically ill. RECENT FINDINGS: By lack of randomized controlled trial (RCTs) in protein nutrition we discuss four post-hoc analyses of nutrition studies and one experimental study in mice. Studies mainly confirm some insights that protein and energy effects are separate and that the trajectory of the patient in the ICU might change these effects...
May 25, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28548476/is-cold-blood-cardioplegia-absolutely-superior-to-cold-crystalloid-cardioplegia-in-aortic-valve-surgery
#11
Daniel A Lerman, Matilde Otero-Losada, Kiddy Ume, Pablo A Salgado, Sai Prasad, Kelvin Lim, Bruno Péault, Nasri Alotti
BACKGROUND: Experimental evidence suggests that blood cardioplegia (BCP) may be superior to cold crystalloid cardioplegia (CCP) for myocardial protection. However, robust clinical data are lacking. We compared post-operative outcome of patients undergoing aortic valve replacement (AVR) using cold anterograde-retrograde intermittent BCP versus anterograde (CCP). METHODS: Adult consecutive isolated AVR performed between April 2006 and February 2011 at the Royal Infirmary Hospital of Edinburgh were retrospectively analyzed...
May 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28548368/developing-minimum-clinical-standards-for-physiotherapy-in-south-african-icus-a-qualitative-study
#12
Heleen van Aswegen, Shane Patman, Natascha Plani, Susan Hanekom
RATIONALE, AIMS, AND OBJECTIVES: Physiotherapists are integral members of the intensive care unit (ICU) team. Clinicians working in ICU are dependent on their own experience when making decisions regarding individual patient management thus resulting in variation in clinical practice. No formalized clinical practice guidelines or standards exist for the educational profile or scope of practice requirements for ICU physiotherapy. This study explored perceptions of physiotherapists on minimum clinical standards that ICU physiotherapists should adhere to for delivering safe, effective physiotherapy services to critically ill patients...
May 26, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28548310/diagnostic-and-prognostic-values-of-club-cell-protein-16-cc16-in-critical-care-patients-with-acute-respiratory-distress-syndrome
#13
Jinle Lin, Wenwu Zhang, Lijun Wang, Fang Tian
BACKGROUND: Acute respiratory distress syndrome (ARDS) is a critical condition characterized by bilateral pulmonary infiltrates and severe hypoxemia. This study aimed to evaluate the diagnostic and prognostic values of Club cell protein 16 (CC16) in critical care patients with ARDS. METHODS: In this retrospective observational study, 83 patients with ARDS and 129 non-ARDS patients on ICU admission were enrolled. The differences in serum CC16 and other laboratory indicators between two groups were analyzed...
May 26, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28547318/a-systematic-review-of-alpha-2-agonists-for-sedation-in-mechanically-ventilated-neurocritical-care-patients
#14
Alexandre Tran, Henrietta Blinder, Brian Hutton, Shane W English
The use of sedative medications is commonplace in intensive care units (ICUs) and an invaluable clinical tool for the intensive care physician. Sedation for critically ill, mechanically ventilated patients provides an opportunity to reduce anxiety, discomfort as well as ventilator intolerance and dyssynchrony. Alpha-2 agonists in particular have become increasingly popular for use in the neurocritical care population due to their proposed effectiveness in facilitating examinations and procedures as well as reducing the need for adjunctive agents...
May 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28546861/association-between-recurrence-of-acute-kidney-injury-and-mortality-in-intensive-care-unit-patients-with-severe-sepsis
#15
Emilio Rodrigo, Borja Suberviola, Miguel Santibáñez, Lara Belmar, Álvaro Castellanos, Milagros Heras, Juan Carlos Rodríguez-Borregán, Angel Luis Martín de Francisco, Claudio Ronco
BACKGROUND: Acute kidney injury (AKI) occurs in more than half critically ill patients admitted in intensive care units (ICU) and increases the mortality risk. The main cause of AKI in ICU is sepsis. AKI severity and other related variables such as recurrence of AKI episodes may influence mortality risk. While AKI recurrence after hospital discharge has been recently related to an increased risk of mortality, little is known about the rate and consequences of AKI recurrence during the ICU stay...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28546747/the-direct-and-indirect-costs-of-managing-chronic-obstructive-pulmonary-disease-in-greece
#16
Kyriakos Souliotis, Hara Kousoulakou, Georgios Hillas, Nikos Tzanakis, Michalis Toumbis, Theodoros Vassilakopoulos
OBJECTIVE: COPD is associated with significant economic burden. The objective of this study was to explore the direct and indirect costs associated with COPD and identify the key cost drivers of disease management in Greece. METHODS: A Delphi panel of Greek pulmonologists was conducted, which aimed at eliciting local COPD treatment patterns and resource use. Resource use was translated into costs using official health insurance tariffs and Diagnosis-Related Groups (DRGs)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28546381/adjunct-therapies-for-refractory-status-asthmaticus-in-children
#17
Kyle J Rehder
Asthma exacerbation is a common reason for children to present to the emergency department. If primary therapies fail to halt the progression of an asthma flare, status asthmaticus often leads to hospital, and potentially ICU, admission. Following the initial administration of inhaled β agonists and systemic corticosteroids, a wide array of adjunct medical therapies may be used to treat status asthmaticus. Unfortunately, the data supporting the use of these adjunct therapies are often unclear, conflicting, or absent...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546379/tracheostomy-in-infants-and-children
#18
Karen F Watters
Over the last decade, tracheostomy has been increasingly performed in children, aligned with the improvements in neonatal and pediatric ICU care. Nowadays, the majority of children with tracheostomy represent a very complex cohort of patients with sustained reliance on tracheostomy and related medical technology for long-term survival. Tracheostomy is one of the most commonly performed procedures in the adult ICU. Contrary to adult practice, tracheostomy is a much less common procedure in the pediatric ICU, being performed in < 3% of patients...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546372/inhaled-pulmonary-vasodilators-are-there-indications-within-the-pediatric-icu
#19
Bradley A Kuch, Alvin L Saville, Joan Sanchez De Toledo, Shekhar T Venkataraman
Inhaled nitric oxide (INO) is only FDA-cleared for neonates (> 34 weeks gestation) with hypoxic respiratory failure-associated pulmonary hypertension. Off-label use of INO is common in the pediatric population despite a lack of evidence regarding survival benefit, questioning whether the therapy should be considered outside the neonatal period. A lack of definitive evidence combined with increasing health-care costs has led to the use of less costly inhaled prostacyclin as an alternative to INO, presenting unique patient safety concerns...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28546120/local-anesthesia-for-endovascular-treatment-of-unruptured-intracranial-aneurysms-feasibility-safety-and-periprocedural-complications
#20
Jihye Song
OBJECTIVE: The aim of the study is to report the feasibility, safety and outcomes associated with endovascular treatment (EVT) of unruptured intracranial aneurysms (UIA) under local anesthesia (LA). METHODS: Between March 2011 and December 2016, 184 consecutive patients with 198 UIA were treated with coil embolization under LA at the author's center. The data about medical comorbidities according to American Society of Anesthesiologists (ASA) grade, procedural details, and clinical and radiographic outcomes were reviewed...
May 22, 2017: World Neurosurgery
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