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APACHE II score and critical illness

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https://www.readbyqxmd.com/read/28078828/biomarkers-upon-discontinuation-of-renal-replacement-therapy-predict-60-day-survival-and-renal-recovery-in-critically-ill-patients-with-acute-kidney-injury
#1
Tingting Yang, Si Sun, Yuliang Zhao, Qiang Liu, Mei Han, Liping Lin, Baihai Su, Songmin Huang, Lichuan Yang
Introduction There is no consensus on the specific indications for weaning critically ill patients with acute kidney injury (AKI) off renal replacement therapy (RRT). This study aimed to explore the prognostic value of several biomarkers measured upon discontinuation of RRT for their value in predicting 60-day survival and renal recovery in an effort to add knowledge to the decision-making process regarding RRT withdrawal. Methods We prospectively enrolled 102 patients with AKI who required RRT from the intensive care unit...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28039586/plasma-phospholipid-fatty-acid-profile-is-altered-in-both-septic-and-non-septic-critically-ill-a-correlation-with-inflammatory-markers-and-albumin
#2
František Novak, J Borovska, M Vecka, J Rychlikova, L Vavrova, H Petraskova, A Zak, O Novakova
This study analyzes fatty acid (FA) composition in plasma lipids and erythrocyte phospholipids while comparing septic and non-septic critically ill patients. The aim was to describe impacts of infection and the inflammatory process. Patients with severe sepsis (SP, n = 13); age-, sex- and APACHE II score-matched non-septic critically ill with systemic inflammatory response syndrome (NSP, n = 13); and age-/sex-matched healthy controls (HC, n = 13) were included in a prospective case-control study during the first 24 h after admission to the intensive care unit...
December 30, 2016: Lipids
https://www.readbyqxmd.com/read/28028673/outcomes-of-elderly-critically-ill-medical-and-surgical-patients-a-multicentre-cohort-study
#3
Ian M Ball, Sean M Bagshaw, Karen E A Burns, Deborah J Cook, Andrew G Day, Peter M Dodek, Demetrios J Kutsogiannis, Sangeeta Mehta, John G Muscedere, Alexis F Turgeon, Henry T Stelfox, George A Wells, Ian G Stiell
PURPOSE: Very elderly (over 80 yr of age) critically ill patients admitted to medical-surgical intensive care units (ICUs) have a high incidence of mortality, prolonged hospital length of stay, and dependent living conditions should they survive. The primary purpose of this study is to describe the outcomes and differences in outcomes between very elderly medical patients and their surgical counterparts admitted to Canadian ICUs, thereby informing decision-making for clinicians and substitute decision-makers...
December 27, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28025639/evaluation-of-bone-metabolism-in-critically-ill-patients-using-ctx-and-pinp
#4
Alexandra Gavala, Konstantinos Makris, Anna Korompeli, Pavlos Myrianthefs
Background. Prolonged immobilization, nutritional and vitamin D deficiency, and specific drug administration may lead to significant bone resorption. Methods and Patients. We prospectively evaluated critically ill patients admitted to the ICU for at least 10 days. Demographics, APACHE II, SOFA scores, length of stay (LOS), and drug administration were recorded. Blood collections were performed at baseline and on a weekly basis for five consecutive weeks. Serum levels of PINP, β-CTx, iPTH, and 25(OH)vitamin D were measured at each time-point...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27987290/effects-of-time-and-day-of-admission-on-the-outcome-of-critically-ill-patients-admitted-to-icu
#5
Jose Orsini, Salil Rajayer, Noeen Ahmad, Nanda Din, Joaquin Morante, Ryan Malik, Ahmed Shim
BACKGROUND: Studies have shown that patients admitted to hospitals on weekends and after-hours experience worse outcome than those admitted on weekdays and daytime hours. Although admissions of patients to intensive care units (ICUs) occur 24 hours a day, not all critical care units maintain the same level of staffing during nighttime, weekends, and holidays. This raises concerns in view of evidence showing that the organizational structure of an ICU influences the outcome of critically ill patients...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27957725/glutamine-fish-oil-and-antioxidants-in-critical-illness-metaplus-trial-post-hoc-safety-analysis
#6
Zandrie Hofman, Sophie Swinkels, Arthur R H van Zanten
BACKGROUND: The role of plasma glutamine, fish oil and antioxidants concentrations in the treatment effect of immune-modulating high-protein versus high-protein enteral nutrition on 6-month mortality in critically ill patients is explored, as unexpected negative outcomes of recent large randomized controlled trials on immune-modulating nutrients have raised questions about safety of these interventions. METHODS: Post hoc analysis of the MetaPlus randomized controlled trial which was performed in a total of 301 medical, surgical and trauma critically ill patients in fourteen European intensive care units...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27930821/assessment-of-asymmetrical-dimethylarginine-metabolism-in-patients-with-critical-illness
#7
Rawia A Ghashut, Scott Blackwell, Sylvia Ryan, Laura Willox, Donald C McMillan, John Kinsella, Dinesh Talwar
BACKGROUND: Critically ill patients experience metabolic disorders including hypercatabolic state and hyperglycaemia and these are associated with poor outcome. Hyperglycaemia and asymmetric dimethylarginine (ADMA) are reported to have significant influences on endothelial dysfunction. The aim of the present study was to examine the relationship between plasma asymmetric dimethylarginine (ADMA) and related arginine metabolism in patients with critical illness. MATERIALS AND METHODS: Two venous blood samples (EDTA) (104 patients), on admission and follow up sample in the last day in ICU (died or discharge sample median 7, IQR 6-8, range 5-15)...
December 8, 2016: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27903267/skeletal-muscle-quality-as-assessed-by-ct-derived-skeletal-muscle-density-is-associated-with-6-month-mortality-in-mechanically-ventilated-critically-ill-patients
#8
Wilhelmus G P M Looijaard, Ingeborg M Dekker, Sandra N Stapel, Armand R J Girbes, Jos W R Twisk, Heleen M Oudemans-van Straaten, Peter J M Weijs
BACKGROUND: Muscle quantity at intensive care unit (ICU) admission has been independently associated with mortality. In addition to quantity, muscle quality may be important for survival. Muscle quality is influenced by fatty infiltration or myosteatosis, which can be assessed on computed tomography (CT) scans by analysing skeletal muscle density (SMD) and the amount of intermuscular adipose tissue (IMAT). We investigated whether CT-derived low skeletal muscle quality at ICU admission is independently associated with 6-month mortality and other clinical outcomes...
December 1, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27902388/the-exploration-of-risk-factors-of-concurrent-bacteraemia-in-patients-critically-ill-with-severe-dengue
#9
Chin-Ming Chen, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Hui-Chun Chao, Chiu-Yin Yeh, Wen-Liang Yu
We investigated the clinical features of intensive care unit (ICU) patients with concomitant severe dengue infection and bacteraemia to identify risk factors for this comorbidity. The records of all ICU dengue patients admitted during the period of 31 July-30 November 2015 were reviewed. Patients with 'concurrent bacteremia' (positive bacterial blood culture within 72 h of ICU admission) were identified. ICU admission was required for 142 patients, of which 22 (15.5 %) had concurrent bacteraemia. Species of the genus Streptococcus was the most common pathogens, followed by Escherichia coli then species of the genus Staphylococcus...
December 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27901330/critically-ill-octogenarians-and-nonagenarians-evaluation-of-long-term-outcomes-post-hospital-trajectories-and-quality-of-life-one-year-and-seven-years-after-icu-discharge
#10
Sandra Oeyen, Joris Vermassen, Ruth Piers, Dominique Benoit, Lieven Annemans, Johan Decruyenaere
BACKGROUND: To investigate long-term outcomes, post-hospital trajectories, and quality of life (QOL) in patients ≥ 80 years admitted to the intensive care unit (ICU) of a tertiary care hospital. METHODS: A 1-year prospective observational cohort analysis was performed. All consecutive patients ≥ 80 years admitted to the ICU were screened for inclusion. Demographics, comorbidity, organ failures, and outcomes were analyzed. QOL before admission, 3 months, 1 year, and 7 years after ICU discharge was assessed using EuroQoL-5D (EQ-5D) and Medical Outcomes Study 36-item Short Form Health Survey (SF-36) questionnaires...
November 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27882011/better-prognostic-marker-in-icu-apache-ii-sofa-or-sap-ii
#11
Iftikhar Haider Naqvi, Khalid Mahmood, Syed Ziaullaha, Syed Mohammad Kashif, Asim Sharif
OBJECTIVES: This study was designed to determine the comparative efficacy of different scoring system in assessing the prognosis of critically ill patients. METHODS: This was a retrospective study conducted in medical intensive care unit (MICU) and high dependency unit (HDU) Medical Unit III, Civil Hospital, from April 2012 to August 2012. All patients over age 16 years old who have fulfilled the criteria for MICU admission were included. Predictive mortality of APACHE II, SAP II and SOFA were calculated...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27881149/antipsychotic-prescribing-patterns-during-and-after-critical-illness-a-prospective-cohort-study
#12
Jason E Tomichek, Joanna L Stollings, Pratik P Pandharipande, Rameela Chandrasekhar, E Wesley Ely, Timothy D Girard
BACKGROUND: Antipsychotics are used to treat delirium in the intensive care unit (ICU) despite unproven efficacy. We hypothesized that atypical antipsychotic treatment in the ICU is a risk factor for antipsychotic prescription at discharge, a practice that might increase risk since long-term use is associated with increased mortality. METHODS: After excluding patients on antipsychotics prior to admission, we examined antipsychotic use in a prospective cohort of ICU patients with acute respiratory failure and/or shock...
November 24, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27878350/home-return-after-surgery-in-patients-aged-over-85%C3%A2-years-is-associated-with-preoperative-albumin-levels-the-type-of-surgery-and-apache-ii-score
#13
Bora Lee, Sungwon Na, Miran Park, Sungyeon Ham, Jeongmin Kim
BACKGROUND: Owing to an aging society, both the number of operations for patients aged >85 years and the average age of patients admitted to the intensive care unit (ICU) are rapidly increasing. However, mortality is not an appropriate outcome measurement in patients aged >85 years; a more important outcome is home return (HR), because quality of life is valuable to these patients. We identified predictors for HR of patients aged >85 years admitted to the ICU after surgery...
November 22, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27873292/icu-management-based-on-picco-parameters-reduces-duration-of-mechanical-ventilation-and-icu-length-of-stay-in-patients-with-severe-thoracic-trauma-and-acute-respiratory-distress-syndrome
#14
Zhong Yuanbo, Wang Jin, Shi Fei, Long Liangong, Liu Xunfa, Xu Shihai, Shan Aijun
BACKGROUND: This study aimed to assess whether a management algorithm using data obtained with a PiCCO system can improve clinical outcomes in critically ill patients with acute respiratory distress syndrome (ARDS). RESULTS: The PaO2/FiO2 ratio increased over time in both groups, with a sharper increase in the PiCCO group. There was no difference in 28-day mortality (3.2 vs. 3.6%, P = 0.841). Days on mechanical ventilation (3 vs. 5 days, P = 0.002) and ICU length of stay (6 vs...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27834985/clinical-outcome-of-critically-ill-patients-with-thrombocytopenia-and-hypophosphatemia-in-the-early-stage-of-sepsis
#15
Evgeni Brotfain, Andrei Schwartz, Avi Boniel, Leonid Koyfman, Matthew Boyko, Ruslan Kutz, Moti Klein
BACKGROUND: Hypophosphatemia and thrombocytopenia may both be independent risk factors for the development of multiple organ failure and correlate well with the severity of sepsis. In the present study we wanted to analyze the potential clinical role and prognostic significance of both early hypophosphatemia and thrombocytopenia on clinical outcomes of critically ill ICU patients with severe sepsis. METHODS: We analyzed the clinical data, including the outcome of critically ill ICU patients with severe sepsis who presented during a 5 year period with early hypophosphatemia and thrombocytopenia...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27832565/safety-of-nicotine-replacement-therapy-in-critically-ill-smokers-a-retrospective-cohort-study
#16
A Kerr, J T McVey, A M Wood, Fmp Van Haren
Nicotine replacement therapy (NRT) is a common first-line treatment to prevent nicotine withdrawal in smokers. However, available literature reports conflicting results regarding its efficacy and safety in critically ill patients. The objective of this study was to evaluate the relationship between NRT in smokers in the intensive care unit (ICU) and outcomes. This case-control study was conducted in a university-affiliated tertiary hospital ICU. Over a period of five years, 126 active smokers who received transdermal NRT were matched to 126 active smokers who did not receive NRT...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27832556/can-femoral-venous-pressure-be-used-as-an-estimate-for-standard-vesical-intra-abdominal-pressure-measurement
#17
A E Howard, A Regli, E Litton, M M Malbrain, A-M Palermo, B L De Keulenaer
Intra-abdominal hypertension (IAH) is highly prevalent in critically ill patients admitted to the intensive care unit and is associated with an increased morbidity and mortality. The present study investigated whether femoral venous pressure (FVP) can be used as a surrogate parameter for intra-abdominal pressure (IAP) measured via the bladder in IAH grade II (IAP <20 mmHg) or grade III (IAP ≥20 mmHg). This was a single-centre prospective study carried out in a tertiary adult intensive care unit. IAP was measured via the bladder with a urinary catheter with simultaneous recording of the FVP via a femoral central line...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27801377/impact-of-colistin-initiation-delay-on-mortality-of-ventilator-associated-pneumonia-caused-by-a-baumannii
#18
Shaher Samrah, Yazan Bashtawi, Wail Hayajneh, Basima Almomani, Suleiman Momany, Yousef Khader
INTRODUCTION: There has been increased incidence and high mortality in cases with ventilator-associated pneumonia (VAP) caused by colistin-only-susceptible Acinetobacter baumannii (COS-AB). Colistin has emerged as a therapeutic option for VAP caused by multidrug-resistant Gram-negative organisms including COS-AB. A retrospective study was conducted to examine the impact of early versus late initiation of colistin on 30-day mortality of critically ill patients with VAP caused by COS-AB...
October 31, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/27797987/short-term-and-medium-term-survival-of-critically-ill-patients-with-solid-tumours-admitted-to-the-intensive-care-unit-a-retrospective-analysis
#19
Richard Fisher, Carole Dangoisse, Siobhan Crichton, Craig Whiteley, Luigi Camporota, Richard Beale, Marlies Ostermann
OBJECTIVES: Patients with cancer frequently require unplanned admission to the intensive care unit (ICU). Our objectives were to assess hospital and 180-day mortality in patients with a non-haematological malignancy and unplanned ICU admission and to identify which factors present on admission were the best predictors of mortality. DESIGN: Retrospective review of all patients with a diagnosis of solid tumours following unplanned admission to the ICU between 1 August 2008 and 31 July 2012...
October 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27789124/use-of-the-apache-ii-score-to-assess-impact-of-therapeutic-plasma-exchange-for-critically-ill-patients-with-hypertriglyceride-induced-pancreatitis
#20
Shazia Nakhoda, Ann B Zimrin, Maria R Baer, Jennie Y Law
OBJECTIVES: Hypertriglyceridemic (HTG) pancreatitis carries significant morbidity and mortality and often requires intensive care unit (ICU) admission. Therapeutic plasma exchange (TPE) rapidly lowers serum triglyceride (TG) levels. However, evidence supporting TPE for HTG pancreatitis is lacking. METHODS: Ten patients admitted to the ICU for HTG pancreatitis underwent TPE at our institution from 2005-2015. We retrospectively calculated the Acute Physiology and Chronic Health Examination II (APACHE II) score at the time of initial TPE and again after the final TPE session to assess the impact of triglyceride apheresis on morbidity and mortality associated with HTG pancreatitis...
October 17, 2016: Transfusion and Apheresis Science
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