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APACHE II score and critical illness

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https://www.readbyqxmd.com/read/28919614/use-of-acute-physiology-and-chronic-health-evaluation-apache-ii-and-red-cell-distribution-width-rdw-for-assessment-of-mortality-of-patients-with-sepsis-in-icu
#1
A Q Huda, M R Karim, M A Mahmud, M S Islam, M F Haque, M R Islam, M A Hossain
Critically ill patients of Intensive Care Unit (ICU) need highest level of monitoring, intense nursing care and integrated management which are very expensive and consume significant part of hospital resources. Prediction of outcome from disease has become an essential component of health science. So, various scoring systems have been developed to predict outcome of critically ill patients in ICU. There is no perfect model of severity score to predict ICU mortality. Search for new system is still remaining as continuous efforts to find the best model to get accurate information about the prognosis and outcome of critically ill patients...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28910303/the-influence-of-analgesic-based-sedation-protocols-on-delirium-and-outcomes-in-critically-ill-patients-a-randomized-controlled-trial
#2
Dan Liu, Jie Lyu, Huiying Zhao, Youzhong An
OBJECTIVE: To investigate the influence of analgesic-based midazolam sedation on delirium and outcomes in critically ill patients and to analyze the risk factors of delirium. DESIGN: Single center, prospective randomized controlled trial. SETTING: A surgical intensive care unit (ICU) in a tertiary care hospital in China. PATIENTS: Mechanically ventilated patients requiring sedation. MEASUREMENTS AND MAIN RESULTS: Patients admitted to the surgical intensive care unit who required sedation and were undergoing mechanical ventilation for longer than 24 hours were randomly divided into three groups: 1) the remifentanil group received remifentanil and midazolam, 2) the fentanyl group received fentanyl and midazolam, and 3) the control group received only midazolam...
2017: PloS One
https://www.readbyqxmd.com/read/28905701/outcomes-of-patients-with-severe-influenza-infection-admitted-to-intensive-care-units-a-retrospective-study-in-a-medical-centre
#3
Chien-Ming Chao, Chih-Cheng Lai, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Kuo-Shu Yuan, Chin-Ming Chen
PURPOSE: This study assessed clinical manifestations and prognostic factors of critically ill patients with severe influenza admitted to the intensive care unit (ICU) in Taiwan's recent outbreak. METHODOLOGY: Patients admitted to ICU for severe influenza between January 1, 2015, and March 31, 2016, were identified and their medical records were retrospectively reviewed. The primary endpoints were outcomes and predictors of in-hospital mortality. RESULTS: There were 125 patients with an average Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 20...
September 14, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28904478/how-useful-is-extravascular-lung-water-measurement-in-managing-lung-injury-in-intensive-care-unit
#4
Anirban Bhattacharjee, Debasis Pradhan, Prithwis Bhattacharyya, Samarjit Dey, Daniala Chhunthang, Akash Handique, Angkita Barman, Mohd Yunus
CONTEXT: The primary goal of septic shock management is optimization of organ perfusion, often at the risk of overloading the interstitium and causing pulmonary edema. The conventionally used end points of resuscitation do not generally include volumetric parameters such as extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI). AIMS: This study aimed to assess the prognostic value of EVLWI and PVPI by calculating their correlation with the severity of lung injury...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28900902/derivation-and-validation-of-a-prognostic-model-for-postoperative-risk-stratification-of-critically-ill-patients-with-faecal-peritonitis
#5
Ascanio Tridente, Julian Bion, Gary H Mills, Anthony C Gordon, Geraldine M Clarke, Andrew Walden, Paula Hutton, Paul A H Holloway, Jean-Daniel Chiche, Frank Stuber, Christopher Garrard, Charles Hinds
BACKGROUND: Prognostic scores and models of illness severity are useful both clinically and for research. The aim of this study was to develop two prognostic models for the prediction of long-term (6 months) and 28-day mortality of postoperative critically ill patients with faecal peritonitis (FP). METHODS: Patients admitted to intensive care units with faecal peritonitis and recruited to the European GenOSept study were divided into a derivation and a geographical validation subset; patients subsequently recruited to the UK GAinS study were used for temporal validation...
September 12, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28892669/development-of-a-prediction-model-for-long-term-quality-of-life-in-critically-ill-patients
#6
Sandra Oeyen, Karel Vermeulen, Dominique Benoit, Lieven Annemans, Johan Decruyenaere
PURPOSE: We developed a prediction model for quality of life (QOL) 1 year after intensive care unit (ICU) discharge based upon data available at the first ICU day to improve decision-making. METHODS: The database of a 1-year prospective study concerning long-term outcome and QOL (assessed by EuroQol-5D) in critically ill adult patients consecutively admitted to the ICU of a university hospital was used. Cases with missing data were excluded. Utility indices at baseline (UIb) and at 1 year (UI1y) were surrogates for QOL...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28871441/international-registry-on-the-use-of-the-cytosorb%C3%A2-adsorber-in-icu-patients-study-protocol-and-preliminary-results
#7
REVIEW
S Friesecke, K Träger, G A Schittek, Z Molnar, F Bach, K Kogelmann, R Bogdanski, A Weyland, A Nierhaus, F Nestler, D Olboeter, D Tomescu, D Jacob, H Haake, E Grigoryev, M Nitsch, A Baumann, M Quintel, M Schott, J T Kielstein, A Meier-Hellmann, F Born, U Schumacher, M Singer, J Kellum, F M Brunkhorst
INTRODUCTION: The aim of this clinical registry is to record the use of CytoSorb® adsorber device in critically ill patients under real-life conditions. METHODS: The registry records all relevant information in the course of product use, e. g., diagnosis, comorbidities, course of the condition, treatment, concomitant medication, clinical laboratory parameters, and outcome (ClinicalTrials.gov Identifier: NCT02312024). Primary endpoint is in-hospital mortality as compared to the mortality predicted by the APACHE II and SAPS II score, respectively...
September 4, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28868165/serum-vitamin-d-level-at-icu-admission-and-mortality
#8
Hakan Korkut Atalan, Bülent Güçyetmez
OBJECTIVE: Vitamin D is a fat-soluble vitamin that plays a major role in the regulation of bone and calcium metabolism and has effects on the immune and cardiovascular systems. Vitamin D deficiency is commonly seen in the general population as well as in critically ill patients and is reported to be associated with increased mortality and morbidity. Our aim was to determine the relationship between vitamin D level at ICU admission and mortality. METHODS: A total of 491 patients admitted to the ICU between January 2014 and January 2015 were evaluated retrospectively...
August 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28866754/opioid-associated-iatrogenic-withdrawal-in-critically-ill-adult-patients-a-multicenter-prospective-observational-study
#9
Pan Pan Wang, Elaine Huang, Xue Feng, Charles-André Bray, Marc M Perreault, Philippe Rico, Patrick Bellemare, Paul Murgoi, Céline Gélinas, Annie Lecavalier, Dev Jayaraman, Anne Julie Frenette, David Williamson
BACKGROUND: Opioids and benzodiazepines are frequently used in the intensive care unit (ICU). Regular use and prolonged exposure to opioids in ICU patients followed by abrupt tapering or cessation may lead to iatrogenic withdrawal syndrome (IWS). IWS is well described in pediatrics, but no prospective study has evaluated this syndrome in adult ICU patients. The objective of this study was to determine the incidence of IWS caused by opioids in a critically ill adult population. This multicenter prospective cohort study was conducted at two level-1 trauma ICUs between February 2015 and September 2015 and included 54 critically ill patients...
September 2, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28838261/baseline-serum-bicarbonate-levels-independently-predict-short-term-mortality-in-critically-ill-patients-with-ischaemic-cardiogenic-shock
#10
Olivier Wigger, Stefan Bloechlinger, David Berger, Jonas Häner, Thomas Zanchin, Stephan Windecker, Lorenz Räber, Joerg C Schefold
BACKGROUND: Cardiogenic shock is a feared complication of acute myocardial infarction with high mortality rates. Data on the predictive role of acid base dysregulation in this clinical setting are sparse. We therefore embarked on investigating the predictive role of serum bicarbonate in critically ill intensive care unit (ICU) patients with cardiogenic shock. METHODS: A total of 165 ischaemic cardiogenic shock patients (118 men, aged 68.4 years (interquartile range 59...
December 1, 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28814347/early-troponin-i-in-critical-illness-and-its-association-with-hospital-mortality-a-cohort-study
#11
Annemarie B Docherty, Malcolm Sim, Joao Oliveira, Michael Adlam, Marlies Ostermann, Timothy S Walsh, John Kinsella, Nazir I Lone
BACKGROUND: Troponin I (TnI) is frequently elevated in critical illness, but its interpretation is unclear. Our primary objectives in this study were to evaluate whether TnI is associated with hospital mortality and if this association persists after adjusting for potential confounders. We also aimed to ascertain whether addition of TnI to the Acute Physiological and Chronic Health Evaluation II (APACHE II) risk prediction model improves its performance in general intensive care unit (ICU) populations...
August 16, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28795669/-evaluation-of-volume-overload-in-critical-patients-by-monitoring-change-of-cardiac-output-under-bed-head-raising-combined-with-passive-leg-raising
#12
Long Zhang, Luhao Wang, Weixiong Luo, Meihua Mei, Youjuan Chen, Bin Ouyang
OBJECTIVE: To investigate whether the change of cardiac output (CO) with bed head raising (BHR) combined with passive leg raising (PLR) can be used to assess volume overload in critical patients. METHODS: A prospective observational diagnostic trial was designed. The patients who underwent fluid resuscitation 6 hours or more, and admitted to intensive care unit (ICU) of Meizhou People's Hospital in Guangdong Province from January to December in 2016 were enrolled...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28746171/the-value-of-apache-ii-in-predicting-mortality-after-paraquat-poisoning-in-chinese-and-korean-population-a-systematic-review-and-meta-analysis
#13
REVIEW
Jianshu Huang, Dandan Xuan, Xiuju Li, Li Ma, Yuanling Zhou, Hejian Zou
BACKGROUND: The Acute Physiology and Chronic Health Evaluation II (APACHE II) score is used to determine disease severity and predict outcomes in critically ill patients. However, the prognostic significance of APACHE after acute paraquat (PQ) poisoning remains unclear. The meta-analysis was aimed to study the value of APACHE II in predicting mortality in PQ-exposed Chinese and Korean patients. METHODS: Databases that included PubMed, Embase, Cochrane Library, and the Chinese National Knowledge Infrastructure were searched through August 2016...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28732314/the-effect-of-low-dose-furosemide-in-critically-ill-patients-with-early-acute-kidney-injury-a-pilot-randomized-blinded-controlled-trial-the-spark-study
#14
Sean M Bagshaw, R T Noel Gibney, Peter Kruger, Imran Hassan, Finlay A McAlister, Rinaldo Bellomo
PURPOSE: Furosemide is commonly prescribed in acute kidney injury (AKI). Prior studies have found conflicting findings on whether furosemide modifies the course and outcome of AKI. METHODS: Pilot multi-center randomized blinded placebo-controlled trial in adult patients with AKI admitted to three intensive care units. Participants were randomly allocated to furosemide bolus and infusion or 0.9% saline placebo. Primary endpoint was worsening AKI, defined by the RIFLE criteria...
July 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28723773/development-and-validation-of-risk-stratification-delirium-prediction-model-for-critically-ill-patients-a-prospective-observational-single-center-study
#15
Yu Chen, Hang Du, Bao-Hua Wei, Xue-Ni Chang, Chen-Ming Dong
The objective is to develop a model based on risk stratification to predict delirium among adult critically ill patients and whether early intervention could be provided for high-risk patients, which could reduce the incidence of delirium.We designed a prospective, observational, single-center study. We examined 11 factors, including age, APACHE-II score, coma, emergency operation, mechanical ventilation (MV), multiple trauma, metabolic acidosis, history of hypertension, delirium and dementia, and application of Dexmedetomidine Hydrochloride...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28709443/severity-of-acute-gastrointestinal-injury-grade-is-a-predictor-of-all-cause-mortality-in-critically-ill-patients-a-multicenter-prospective-observational-study
#16
Bangchuan Hu, Renhua Sun, Aiping Wu, Yin Ni, Jingquan Liu, Feng Guo, Lijun Ying, Guoping Ge, Aijun Ding, Yunchao Shi, Changwen Liu, Lei Xu, Ronglin Jiang, Jun Lu, Ronghai Lin, Yannan Zhu, Weidong Wu, Bo Xie
BACKGROUND: In 2012, the European Society of Intensive Care Medicine proposed a definition for acute gastrointestinal injury (AGI) based on current medical evidence and expert opinion. The aim of the present study was to evaluate the feasibility of using the current AGI grading system and to investigate the association between AGI severity grades with clinical outcome in critically ill patients. METHODS: Adult patients at 14 general intensive care units (ICUs) with an expected ICU stay ≥24 h were prospectively studied...
July 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28698265/risk-factors-for-noninvasive-ventilation-failure-in-critically-ill-subjects-with-confirmed-influenza-infection
#17
Alejandro Rodríguez, Cristina Ferri, Ignacio Martin-Loeches, Emili Díaz, Joan R Masclans, Federico Gordo, Jordi Sole-Violán, María Bodí, Francesc X Avilés-Jurado, Sandra Trefler, Monica Magret, Gerard Moreno, Luis F Reyes, Judith Marin-Corral, Juan C Yebenes, Andres Esteban, Antonio Anzueto, Stefano Aliberti, Marcos I Restrepo
BACKGROUND: Despite wide use of noninvasive ventilation (NIV) in several clinical settings, the beneficial effects of NIV in patients with hypoxemic acute respiratory failure (ARF) due to influenza infection remain controversial. The aim of this study was to identify the profile of patients with risk factors for NIV failure using chi-square automatic interaction detection (CHAID) analysis and to determine whether NIV failure is associated with ICU mortality. METHODS: This work was a secondary analysis from prospective and observational multi-center analysis in critically ill subjects admitted to the ICU with ARF due to influenza infection requiring mechanical ventilation...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28682944/a-simplified-mortality-score-using-delta-neutrophil-index-and-the-thrombotic-microangiopathy-score-for-prognostication-in-critically-ill-patients
#18
Eun Kyong Goag, Jong Wook Lee, Yun Ho Roh, Ah Young Leem, Song Yee Kim, Joo Han Song, Eun Young Kim, Ji Ye Jung, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Kyung Soo Chung
BACKGROUND: This study was conducted to assess the prognostic value of a simplified mortality score (SMS) using the delta neutrophil index (DNI) and thrombotic microangiopathy (TMA) score, both easily obtained from the complete blood count, to identify critically ill patients at high risk of death. METHODS: This was a retrospective study performed in the medical ICU at Yonsei University College of Medicine from June 2015 to February 2016. The primary end-point was 28-day all-cause mortality...
July 4, 2017: Shock
https://www.readbyqxmd.com/read/28673010/rhubarb-vs-glycerin-enema-for-treatment-of-critically-ill-patients-with-intra-abdominal-hypertension
#19
Bing Wan, Hao Zhang, Jiangtao Yin, Haiyan Fu, Yikun Chen, Liping Yang, Dadong Liu, Tangfeng Lv, Yong Song
Rhubarb has been used as an evacuant for thousands of years. However, recent research has indicated that rhubarb inhibits inflammation and protects organ function. In the current study, the use of rhubarb was investigated in patients with intra-abdominal hypertension (IAH). Specifically, its dual role in attenuating lung and bowel injury by catharsis and inhibiting inflammation was evaluated. Patients in the glycerin group (n=56) received 110 ml of glycerin enema by coloclysis once daily for 7 to 9 days. Patients in the rhubarb group (n=56) were treated with a mixture of 0...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28666246/the-correlation-between-cvp-derived-parameters-and-the-prognosis-of-critically-ill-patients
#20
Xiaoting Wang, Huan Chen, Dawei Liu, Qing Zhang, Longxiang Su
OBJECTIVE: To investigate the effect of central venous pressure on the organ dysfunction and prognosis of critically ill patients. METHODS: We conducted a retrospective observational cohort study of 488 ICU patients with central venous pressure and its derived parameters in a half-year period in one single ICU centre to compare the length of ICU stay, critical illness scores (SOFA and APACHE II), serum creatinine and lactate levels. RESULTS: The initial, peak and mean CVP levels of critically ill patients and length of ICU stay, peak lactate levels and SOFA scores were significantly correlated...
August 2017: Journal of Critical Care
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