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Critical ill

Sara Bermejo de Las Heras, Licia De la Calle de la Rosa, Javier Arias Díaz, Manuel Giner, Antonio Luis Blesa Malpica
BACKGROUND: Malnutrition is particularly prevalent among intensive care unit (ICU) patients, being associated with poor clinical results. Enteral nutrition (EN) offers multiple benefits on critically ill patients and its monitoring was established by the Spanish Society of Critical Care (SEMICYUC) as a clinical quality indicator (CQI; EN patients correctly monitorized / all EN patients, as %). However, no results have been published on its regulated monitoring. OBJECTIVES: Assessing CQI's compliance, identifying difficulties and possibilities for its use...
January 10, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Szu-Huei Su, Li-Min Wu
BACKGROUND: The severity of diseases and high mortality rates that typify the intensive care unit often make it difficult for surrogate decision makers to make decisions for critically ill patients regarding whether to continue medical treatments or to accept palliative care. PURPOSE: To explore the behavioral intentions that underlie the medical decisions of surrogate decision makers of critically ill patients and the related factors. METHODS: A cross-sectional, correlation study design was used...
April 2018: Hu Li za Zhi the Journal of Nursing
Fabienne D Simonis, Carmen S V Barbas, Antonio Artigas-Raventós, Jaume Canet, Rogier M Determann, James Anstey, Goran Hedenstierna, Sabrine N T Hemmes, Greet Hermans, Michael Hiesmayr, Markus W Hollmann, Samir Jaber, Ignacio Martin-Loeches, Gary H Mills, Rupert M Pearse, Christian Putensen, Werner Schmid, Paolo Severgnini, Roger Smith, Tanja A Treschan, Edda M Tschernko, Marcos F Vidal Melo, Hermann Wrigge, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz, Ary Serpa Neto
BACKGROUND: The majority of critically ill patients do not suffer from acute respiratory distress syndrome (ARDS). To improve the treatment of these patients, we aimed to identify potentially modifiable factors associated with outcome of these patients. METHODS: The PRoVENT was an international, multicenter, prospective cohort study of consecutive patients under invasive mechanical ventilatory support. A predefined secondary analysis was to examine factors associated with mortality...
March 21, 2018: Annals of Intensive Care
Antonis Targoutzidis
The cost of lost output is a major component of the total cost of illness estimates, especially those for the cost of workplace accidents and diseases. The two main methods for estimating this output, namely the human capital and the friction cost method, lead to very different results, particularly for cases of long-term absence, which makes the choice of method a critical dilemma. Two hidden assumptions, one for each method, are identified in this paper: for human capital method, the assumption that had the accident not happened the individual would remain alive, healthy and employed until retirement, and for friction cost method, the assumption that any created vacancy is covered by an unemployed person...
March 21, 2018: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
S Blecha, H J Schlitt, B M Graf, M Leitzmann, T Bein
BACKGROUND: In critical illnesses low socioeconomic status (SES) is associated with higher morbidity and mortality. In addition to the SES, further factors at an individual level (e.g., sex, health insurance status and place of residence) may influence the severity of illness and medical treatment. We investigated these additional parameters in a secondary analysis of the ECSSTASI data. METHODS: Within the framework of the ECSSTASI study, 996 patients were recruited from a surgical intensive care unit...
March 21, 2018: Der Anaesthesist
Jessica Y Ng, Jennie Gu
Acute acalculous cholecystitis is an uncommon disease in children and is usually associated with trauma, burns, and infections. Whereas acute acalculous cholecystitis is only seen in 10% of cholecystitis in adults, it is uncommon in the paediatric population. A seven-year-old male presented to the emergency department of a regional hospital with a 36-hour history of right-upper-quadrant abdominal pain. He had associated symptoms of anorexia, nausea, and vomiting. He was septic with raised white cell count and inflammatory markers...
January 20, 2018: Curēus
Yun Tae Jung, Jiyeon Jeon, Jung Yun Park, Myung Jun Kim, Seung Hwan Lee, Jae Gil Lee
Background: The quick sequential organ failure assessment (qSOFA) alone has a poor sensitivity for predicting mortality in patients with complicated intra-abdominal infections, and plasma lactate levels have been shown to have a strong association with mortality in critically ill patients. Therefore, this study aimed to compare the performance of qSOFA with a score derived from a combination of qSOFA and serum lactate levels for predicting mortality in surgical patients with complicated intra-abdominal infections...
2018: World Journal of Emergency Surgery: WJES
Gaurang S Shah
BACKGROUND Streptococcus acidominimus, which belongs to the viridans streptococci group, is rarely considered pathogenic in humans. However, over the past 10 years, this bacterium has been reported to cause serious infections in humans, particularly among the critically ill. This article is the first case report of pyogenic ventriculitis (PV) and meningitis caused by S. acidominimus in North America. CASE REPORT A 49-year-old Asian male presented to the emergency department with complaints of a headache, fever greater than 37...
March 22, 2018: American Journal of Case Reports
Gabor Erdoes, Dominik E Uehlinger, Beatrice Kobel, Monika P Stucki, Roland Wiest, Frank Stueber, Niklaus Fankhauser, Stephan M Jakob, Joerg C Schefold
BACKGROUND: Microembolism is a frequent pathological event during extracorporeal renal replacement therapy (RRT). Some previous data indicate that microemboli are generated in patients who are undergoing RRT and that these may contribute to increased cerebrovascular and neurocognitive morbidity in patients with end-stage renal disease. The current trial aims to quantify the microembolic load and respective qualitative composition that effectively reaches the intracerebral circulation in critically ill patients treated with different RRT modalities for acute kidney injury (AKI)...
March 21, 2018: Trials
Arthur H Owora
Contradictory evidence exists on the role of Major depression disorder (MDD) as a predictor of human immunodeficiency virus (HIV) disease progression, particularly regarding the effect of MDD presence versus pattern of illness. The objective of this study was to examine whether MDD status and pattern of illness differentially predict HIV disease progression. Retrospective cohort data from a six-year follow-up of HIV patients at an outpatient clinic were analyzed. MDD trajectories were identified by latent class growth analysis and generalized linear mixed models were used to examine their relation to low CD4+ T-lymphocyte counts (<200 cells/μL) during follow-up...
March 2018: Medicine (Baltimore)
Sabri Soussi, Marina Taccori, Christian De Tymowski, François Depret, Maïté Chaussard, Alexandre Fratani, Marion Jully, Alexandru Cupaciu, Axelle Ferry, Mourad Benyamina, Kevin Serror, David Boccara, Marc Chaouat, Maurice Mimoun, Pierre Cattan, Anne-Marie Zagdanski, James Anstey, Alexandre Mebazaa, Matthieu Legrand
OBJECTIVES: Burn-induced shock can lead to tissue hypoperfusion, including the gut. We performed this study to describe burn patients at risk of acute mesenteric ischemia (AMI) with the aim to identify potential modifiable risk factors. METHODS: Retrospective case-control study including adult severely burned patients between August 2012 and March 2017. Patients who developed AMI were matched to severely burned patients without AMI at a ratio of 1:3 (same year of admission, Abbreviated Burn Severity Index (ABSI) and Simplified Acute Physiology Score II (SAPSII))...
March 20, 2018: Shock
Thomas W L Scheeren, Jannis N Wicke, Jean-Louis Teboul
PURPOSE OF REVIEW: The current review attempts to demonstrate the value of several forms of carbon dioxide (CO2) gaps in resuscitation of the critically ill patient as monitor for the adequacy of the circulation, as target for fluid resuscitation and also as predictor for outcome. RECENT FINDINGS: Fluid resuscitation is one of the key treatments in many intensive care patients. It remains a challenge in daily practice as both a shortage and an overload in intravascular volume are potentially harmful...
March 20, 2018: Current Opinion in Critical Care
Raghav Bansal, Bhanu Singh, Melik Tiba, Joel Baum, Ishita Rajnish
No abstract text is available yet for this article.
July 2017: Acta Gastro-enterologica Belgica
Matthew R Greer, Scott Carney, Rick A McPheeters, Phillip Aguiniga, Stephanie Rubio, Jason Lee
Introduction: Arterial lines are important for monitoring critically ill patients. They are placed most commonly in either femoral or radial sites, though there is little evidence to guide site preference. Methods: This is an ambispective, observational, cohort study to determine variance in failure rates between femoral and radial arterial lines. This study took place from 2012 to 2016 and included all arterial lines placed in adult patients at a single institution...
March 2018: Western Journal of Emergency Medicine
Lauren D Aarreberg, Courtney Wilkins, Hilario J Ramos, Richard Green, Michael A Davis, Kwan Chow, Michael Gale
Induction of interferon beta (IFN-β), IFN-stimulated genes (ISGs), and inflammatory responses is critical for control of viral infection. We recently identified an essential linkage of stimulation of the inflammatory cytokine interleukin-1β (IL-1β) and induction of ISGs that function as host restriction pathways against the emerging flavivirus West Nile virus (WNV) in vivo Here we utilized ex vivo global transcriptome analysis of primary dendritic cells, known targets of WNV replication, to define gene signatures required for this IL-1β-driven antiviral response...
March 20, 2018: MBio
Ali H Hakim, Usman Ahmad, Kenneth R McCurry, Douglas R Johnston, Gosta B Pettersson, Marie Budev, Sudish Murthy, Eugene H Blackstone, Michael Z Tong
BACKGROUND: Extracorporeal membrane oxygenation (ECMO), when used as bridge to lung transplantation (BTT) identifies high-risk candidates. Recent advances in cannula design and patient selection fosters "awake ambulatory ECMO" as a viable option for critically ill candidates in an attempt to retard deconditioning while awaiting allografts. METHODS: From 2012 to 2015, 30 patients underwent ECMO as BTT. Candidacy for ECMO was determined prior to listing for transplant...
March 17, 2018: Annals of Thoracic Surgery
Jared Brazg, Phyllis Huang, Corey Weiner, Guneet Singh, Antonios Likourezos, Linda Salem, Eitan Dickman, John Marshall
IMPORTANCE: Emergency Physicians often rely on Lactic Acid (LA) values to make important clinical decisions. Accuracy of LA values improve when blood gas analysis is performed in the emergency department (ED) as opposed to a satellite laboratory (SL). OBJECTIVE: To investigate an association between blood gas laboratory location and accuracy of ED lactic acid samples. METHODS: The study team evaluated lactic acid values from venous and arterial blood gas samples drawn between June 1, 2015 and September 30, 2016...
March 12, 2018: American Journal of Emergency Medicine
Lauren E Ferrante, Margaret A Pisani, Terrence E Murphy, Evelyne A Gahbauer, Linda S Leo-Summers, Thomas M Gill
BACKGROUND: Frailty is a strong indicator of vulnerability among older persons, but its association with ICU outcomes has not been evaluated prospectively (i.e., with objective measurements obtained prior to ICU admission). Our objective was to prospectively evaluate the relationship between frailty and post-ICU disability, incident nursing home (NH) admission, and death. METHODS: The parent cohort included 754 adults aged ≥70, who were evaluated monthly for disability in 13 functional activities and every 18 months for frailty (1998-2014)...
March 17, 2018: Chest
Ekta Agarwal, Maree Ferguson, Merrilyn Banks, Angela Vivanti, Marijka Batterham, Judy Bauer, Sandra Capra, Elisabeth Isenring
BACKGROUND & AIMS: Obesity, defined as a BMI ≥ 30 kg/m2 , has demonstrated protective associations with mortality in some diseases. However, recent evidence demonstrates that poor nutritional status in critically ill obese patients confounds this relationship. The purpose of this paper is to evaluate if poor nutritional status, poor food intake and adverse health-related outcomes have a demonstrated association in non-critically ill obese acute care hospital patients. METHODS: This is a secondary analysis of the Australasian Nutrition Care Day Survey dataset (N = 3122), a prospective cohort study conducted in hospitals from Australia and New Zealand in 2010...
March 10, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Jean-Louis Trouillet, Olivier Collange, Fouad Belafia, François Blot, Gilles Capellier, Eric Cesareo, Jean-Michel Constantin, Alexandre Demoule, Jean-Luc Diehl, Pierre-Grégoire Guinot, Franck Jegoux, Erwan L'Her, Charles-Edouard Luyt, Yazine Mahjoub, Julien Mayaux, Hervé Quintard, François Ravat, Sébastien Vergez, Julien Amour, Max Guillot
Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the grading of recommendations assessment, development and evaluation (GRADE) method...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
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