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investigations in icu

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https://www.readbyqxmd.com/read/28645964/the-predictive-value-of-serial-changes-in-diaphragm-function-during-the-spontaneous-breathing-trial-for-weaning-outcome-a-study-protocol
#1
Pengmin Zhou, Zhongheng Zhang, Yucai Hong, Huabo Cai, Hui Zhao, Peifeng Xu, Yiming Zhao, Shengping Lin, Xuchang Qin, JiaWei Guo, Yun Pan, Junru Dai
INTRODUCTION: There is a variety of tools being used in clinical practice for the prediction of weaning success from mechanical ventilation. However, their diagnostic performances are less than satisfactory. The purpose of this study is to investigate the value of serial changes in diaphragm function measured by ultrasound during the spontaneous breathing trial (SBT) as a weaning predictor. METHODS AND ANALYSIS: This is a prospective observational study conducted in a 10-bed medical emergency intensive care unit (EICU) in a university-affiliated hospital...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645517/glucose-control-diabetes-status-and-mortality-in-critically-ill-patients-the-continuum-from-intensive-care-unit-admission-to-hospital-discharge
#2
James S Krinsley, Paula Maurer, Sharon Holewinski, Roy Hayes, Douglas McComsey, Guillermo E Umpierrez, Stanley A Nasraway
OBJECTIVE: To describe the relationships among glycemic control, diabetes mellitus (DM) status, and mortality in critically ill patients from intensive care unit (ICU) admission to hospital discharge. PATIENTS AND METHODS: This is a retrospective investigation of 6387 ICU patients with 5 or more blood glucose (BG) tests and 4462 ICU survivors admitted to 2 academic medical centers from July 1, 2010, through December 31, 2014. We studied the relationships among mean BG level, hypoglycemia (BG level <70 mg/dL [to convert to mmol/L, multiply by 0...
June 7, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28645462/analgosedation-practices-and-the-impact-of-sedation-depth-on-clinical-outcomes-among-patients-requiring-mechanical-ventilation-in-the-emergency-department-a-cohort-study
#3
Robert J Stephens, Enyo Ablordeppey, Anne M Drewry, Christopher Palmer, Brian T Wessman, Nicholas M Mohr, Brian W Roberts, Stephen Y Liang, Marin H Kollef, Brian M Fuller
BACKGROUND: Analgesia and sedation are cornerstone therapies for mechanically ventilated patients. Despite data showing that early deep sedation in the intensive care unit influences outcome, this has not been investigated in the emergency department (ED). Therefore, ED-based sedation practices, and their influence on outcome, remain incompletely defined. This study's objectives were to describe ED sedation practices in mechanically ventilated patients, and to test the hypothesis that ED sedation depth is associated with worse outcomes METHODS: This was a cohort study on a prospectively compiled ED registry of adult, mechanically ventilated patients at a single academic medical center...
June 20, 2017: Chest
https://www.readbyqxmd.com/read/28644925/does-low-body-mass-index-predict-the-hospital-mortality-of-adult-western-or-asian-patients
#4
Charlene Compher, Takashi Higashiguchi, Jianchun Yu, Gordon L Jensen
BACKGROUND: Some strategies for screening and assessment of malnutrition include a low but variable body mass index (BMI) cutoff, while others do not. The purpose of this systematic review was to investigate published data for Western and Asian hospital samples to determine how the prevalence of low BMI is associated with increased hospital mortality. METHOD: A PubMed search of the past 10 years (2006-2016) was conducted with the terms "BMI," "malnutrition," "adult," "outcome," and "hospital" or "ICU" for articles published in English...
June 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28643814/-unresponsive-wakefulness-syndrome-clinical-predictors-of-late-recovery
#5
Gianfranco Lamberti, Elena Antoniono, Francesca Gozzerino, Donatella Giraudo
Patients affected by the outcomes of serious traumatic and/or non-traumatic brain injury may show progressive recovery characterized by a broad spectrum of clinical conditions, which are often not completely different, but of differing seriousness. The unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS) are syndromes that may characterize progression from the coma state and may be temporary clinical conditions, or in some cases, the final outcome of acute brain injury. The eventual recovery of consciousness is a dynamic process, in constant progress following the acute event...
May 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28641231/association-between-timing-of-intubation-and-outcome-in-critically-ill-patients-a-secondary-analysis-of-the-icon-audit
#6
Philippe R Bauer, Ognjen Gajic, Rahul Nanchal, Rahul Kashyap, Ignacio Martin-Loeches, Yasser Sakr, Stephan M Jakob, Bruno François, Xavier Wittebole, Richard G Wunderink, Jean-Louis Vincent
PURPOSE: The optimal timing of endotracheal intubation in critically ill patients requiring invasive mechanical ventilation remains undefined. MATERIAL AND METHODS: In a secondary analysis of the large, prospective ICON database, we used a piecewise proportional hazards model to compare outcomes in patients who underwent intubation early (within two days after intensive care unit [ICU] admission) or later. RESULTS: After excluding 5340 patients already intubated on admission or with therapeutic limitation, 4729 patients were analyzed, of whom 4074 never underwent intubation...
June 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28640084/effect-of-dexmedetomidine-and-midazolam-for-flexible-fiberoptic-bronchoscopy-in-intensive-care-unit-patients-a-retrospective-study
#7
Yang Gao, Kai Kang, Haitao Liu, Liu Jia, Rong Tang, Xing Zhang, Hongliang Wang, Kaijiang Yu
This study aimed to investigate the clinical effectiveness of dexmedetomidine and midazolam for sedation of intensive care unit (ICU) patients requiring flexible fiberoptic bronchoscopy (FFB).This retrospective cohort study included 148 patients from the third ICU ward of the Second Affiliated Hospital of Harbin Medical University (Harbin, China) who received simultaneous invasive mechanical ventilation and FFB between March 2012 and December 2014. Patients were divided into dexmedetomidine (n  =  72) and midazolam (n  =  76) groups according to sedative mode...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639165/molecular-characterization-of-intestinal-carriage-of-carbapenem-resistant-enterobacteriaceae-among-inpatients-at-two-iranian-university-hospitals-first-report-of-co-production-of-bla-ndm-7-and-bla-oxa-48
#8
H Solgi, F Badmasti, Z Aminzadeh, C G Giske, M Pourahmad, F Vaziri, S A Havaei, F Shahcheraghi
Gastrointestinal colonization of carbapenem-resistant Enterobacteriaceae (CRE) could serve as a reservoir for the transmission of these pathogens in the clinical setting. The aim of this study was to investigate the intestinal carriage of CRE and to analyze risk factors for CRE carriage. Rectal swabs were collected from 95 patients at two Iranian university hospitals. CRE screening was performed using selective media (CHROMagar and MacConkey agar). Polymerase chain reaction (PCR) was used to detect carbapenemase-encoding genes...
June 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28638594/high-burden-of-antimicrobial-resistance-among-gram-negative-bacteria-causing-healthcare-associated-infections-in-a-critical-care-unit-of-nepal
#9
Narayan Prasad Parajuli, Subhash Prasad Acharya, Shyam Kumar Mishra, Keshab Parajuli, Basista Prasad Rijal, Bharat Mani Pokhrel
BACKGROUND: Healthcare associated infections (HCAI) and antimicrobial resistance are principal threats to the patients of intensive care units and are the major determining factors for patient outcome. They are associated with increased morbidity, mortality, excess hospitalization and financial costs. The present study is an attempt to investigate the spectrum and antimicrobial resistance of bacterial isolates involved in healthcare associated infections (HCAI) in the patients of a critical care unit at a tertiary care university hospital in Kathmandu, Nepal...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28635201/hamman-rich-syndrome-a-forgotten-entity
#10
William Newmarch, Angelica Puopolo, Madina Weiler, Brian Casserly
The following report outlines the case of a 76-year-old gentleman who presented to the hospital with acute interstitial pneumonitis, a rare and rapidly progressive type of idiopathic interstitial pneumonia. The patient initially presented with a three-week history of progressive shortness of breath and cough which was diagnosed as community acquired pneumonia. Treatment with oral antibiotics was unsuccessful resulting in re-presentation the following week with type one respiratory failure. Investigations revealed widespread inflammatory changes consistent with an acute inflammatory process...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28634135/outcomes-and-role-of-urgent-endoscopy-in-high-risk-patients-with-acute-nonvariceal-gastrointestinal-bleeding
#11
Soo-Han Cho, Yoon-Seon Lee, Youn-Jung Kim, Chang Hwan Sohn, Shin Ahn, Dong-Woo Seo, Won Young Kim, Jae Ho Lee, Kyoung Soo Lim
BACKGROUND & AIMS: We investigated clinical outcomes in high-risk patients with acute nonvariceal upper gastrointestinal bleeding (UGIB), and determined if urgent endoscopy is effective. METHODS: Consecutive patients with Glasgow-Blatchford score >7 who underwent endoscopy for acute nonvariceal UGIB at the emergency department from January 1, 2005, to December 31, 2014, were included. Urgent (<6 h) and elective (6-48 h) endoscopies were defined according to the time to endoscopy after the initial presentation...
June 17, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28631455/the-prognostic-importance-of-chronic-end-stage-diseases-in-geriatric-patients-admitted-to-163-italian-icus
#12
Daniele Poole, Stefano Finazzi, Giovanni Nattino, Danilo Radrizzani, Giuseppe Gristina, Paolo Malacarne, Sergio Livigni, Guido Bertolini
BACKGROUND: The number of elderly patients undergoing major surgical interventions and then needing admission to intensive care unit (ICU) grows steadily. We investigated this issue in a cohort of 232,278 patients admitted in 5 years (2011-2015) to 163 Italian general ICUs. METHODS: Surgical patients older than 75 registered in the GiViTI MargheritaPROSAFE project were analysed. The impact on hospital mortality of important chronic conditions (severe COPD, NYHA class IV, dementia, end-stage renal disease, cirrhosis with portal hypertension) was investigated with two prognostic models developed yearly on patients staying in the ICU less or more than 24 hours...
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28631088/etiologies-diagnostic-work-up-and-outcomes-of-acute-respiratory-distress-syndrome-with-no-common-risk-factor-a-prospective-multicenter-study
#13
Nicolas de Prost, Tài Pham, Guillaume Carteaux, Armand Mekontso Dessap, Christian Brun-Buisson, Eddy Fan, Giacomo Bellani, John Laffey, Alain Mercat, Laurent Brochard, Bernard Maître
BACKGROUND: Patients meeting the Berlin definition for the acute respiratory distress syndrome (ARDS) might lack exposure to one or more "common" risk factors and exhibit different clinical phenotype and outcomes. We aimed to compare the clinical presentation and outcome of ARDS patients with or without risk factors, the impact on hospital mortality, and to assess the diagnostic work-up performed. The current study is an ancillary analysis of an international, multicenter, prospective cohort study (the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure, LUNG SAFE)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28630622/bowel-ischemia-in-icu-patients-diagnostic-value-of-i-fabp-depends-on-the-interval-to-the-triggering-event
#14
Stefan Ludewig, Rami Jarbouh, Michael Ardelt, Henning Mothes, Falk Rauchfuß, René Fahrner, Jürgen Zanow, Utz Settmacher
BACKGROUND: Intestinal fatty acid-binding protein (I-FABP) has been shown to be of high diagnostic value in patients with acute mesenteric ischemia. Whether these results can be reproduced in critically ill patients on the ICU was to be investigated. MATERIALS AND METHODS: I-FABP was measured in serum and urine of 43 critically ill patients in ICU when mesenteric ischemia was suspected. Bowel ischemia was confirmed in 21 patients (group 1). 22 patients who survived at least seven days without confirmation of ischemia were assigned to group 2...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28629754/improving-compliance-with-surgical-antibiotic-prophylaxis-guidelines-a-multicenter-evaluation
#15
Cristiane Schmitt, Rubia Aparecida Lacerda, Ruth Natalia Teresa Turrini, Maria Clara Padoveze
BACKGROUND: Improving surgical antibiotic prophylaxis (SAP) use is an important element in the control of antimicrobial resistance. However, compliance with SAP guidelines is unsatisfactory. This study investigated the level of compliance with SAP guidelines in neurosurgery, and institutional characteristics associated with compliance. METHODS: This study assessed surgeries in 9 Brazilian hospitals. Medical record reviews and a structured questionnaire were used to assess compliance and to describe institutional characteristics...
June 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28628675/interleukin-10-lymphocyte-ratio-predicts-mortality-in-severe-septic-patients
#16
Xi Li, Zhiheng Xu, Xiaoqing Pang, Yongbo Huang, Baoxin Yang, Yuanyuan Yang, Kangxie Chen, Xiaoqing Liu, Pu Mao, Yimin Li
BACKGROUND: Immunosuppression is common even in the early stage of severe sepsis. Interleukin-10 (IL-10) secretion and lymphocyte exhaustion are the main features of sepsis-induced immunosuppression. However, the relationship between IL-10 and the lymphocyte is still unclear. We investigated if IL-10/lymphocyte ratio (IL10LCR) were associated with mortality in severe septic patients. METHODS: Adult patients with severe sepsis admitted to ICU of the First Affiliated Hospital of Guangzhou Medical University were identified from October 2012 to August 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28627661/altered-expression-of-ppar%C3%A2-%C3%AE-and-trpc-in-neonatal-rats-with-persistent-pulmonary-hypertension
#17
Yanna Du, Jianhua Fu, Li Yao, Lin Qiao, Na Liu, Yujiao Xing, Xindong Xue
Persistent pulmonary hypertension of the newborn (PPHN) is a life‑threatening disease that is commonly observed in the neonatal intensive care unit. PPHN is pathologically characterized by pulmonary vascular remodeling and, in particular, pulmonary artery smooth muscle cell (PASMC) proliferation. Decreased expression levels of peroxisome proliferator‑activated receptor γ (PPAR‑γ), which is a member of the nuclear receptor hormone superfamily, in combination with elevated expressions of transient receptor potential cation channel, subfamily C, member 1 (TRPC1) and TRPC6 contributes to the PASMC proliferation and excessive pulmonary vascular remodeling in adult pulmonary hypertension (PH)...
June 9, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28626334/effect-of-neuro-development-treatment-on-motor-development-in-preterm-infants
#18
Eun-Ju Lee
[Purpose] To investigate the effects of Neuro-Development Treatment on development in the preterm infants. [Subjects and Methods] A total of 96 premature infants were recruited for this study; 62 low birth weight preterm infants (<2.5 kg, high risk infants for developmental delay) and 34 premature infants (>2.5 kg, low risk infants for developmental delay). High risk infants were divided into intervention group (32 infants) and control group (30 infants) at time of admission. Low risk infants were into comparative group (34 infants)...
June 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28625259/-antithrombin-iii-for-early-diagnosis-of-dic-in-sepsis-patients-a-retrospective-analysis-with-445-patients
#19
Yanjing Xu, Ran Zhu, Yini Sun, Xin Li, Xiaochun Ma
OBJECTIVE: To investigated the role of antithrombin III (AT-III) levels in the early diagnosis of disseminated intravascular coagulation (DIC) in patients with sepsis and the predictive effect of AT-III on the development of DIC. METHODS: A retrospective study was conducted. Patients admitted to intensive care unit (ICU) of the First Affiliated Hospital of China Medical University from January to December in 2015 were enrolled. The patients were divided into sepsis group and non-sepsis group according to the diagnostic criteria of sepsis...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625258/-plasma-level-of-neutrophil-extracellular-traps-in-septic-patients-and-its-clinical-significance-a-prospective-observational-study
#20
Fangxiao Zhang, Zhidan Zhang, Xiaochun Ma
OBJECTIVE: To investigate the changes of neutrophil extracellular traps (NETs) level in plasma of sepsis patients and judge its clinical value for early diagnosing of sepsis. METHODS: A prospective observational study was conducted. The patients after surgery aged > 18 years and expected to stay in the ICU > 24 hours admitted to intensive care unit (ICU) of the First Affiliated Hospital of China Medical University from November 2014 to February 2015 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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