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APACHE II score and critical illness

Jun Lu, Xing Wang, Qiuhua Chen, Mingqi Chen, Lu Cheng, Hua Jiang, Zhiguang Sun
BACKGROUND AND AIMS: Continuous renal replacement therapy (CRRT) is an important treatment in the intensive care unit (ICU). Nevertheless, the outcome of CRRT remains unclear. It is important to find a useful and easy indicator to predict the prognosis in patients on CRRT treatment. We undertook this study to observe the association between serum D-dimer level and mortality of ICU patients in the treatment of CRRT. METHODS: A total of 149 patients who received CRRT were enrolled in our study...
July 2016: Archives of Medical Research
Alladi Mohan, G Sivaram Naik, J Harikrishna, D Prabath Kumar, M H Rao, Kvs Sarma, K K Guntupalli
BACKGROUND & OBJECTIVES: Ingestion of Cleistanthus collinus causes hypokalemia and cardiac arrhythmias leading to mortality in most cases. We undertook this retrospective study to evaluate the clinical presentation and predictors of outcome in critically ill patients admitted with C. collinus poisoning. METHODS: The case records of 56 patients admitted to the medical intensive care unit (MICU) of a tertiary care teaching hospital in south India (2000-2014) with C...
June 2016: Indian Journal of Medical Research
Alice Sabatino, Giuseppe Regolisti, Laura Bozzoli, Filippo Fani, Riccardo Antoniotti, Umberto Maggiore, Enrico Fiaccadori
MAIN PROBLEM: In patients with Acute Kidney Injury there is a lack of nutritional variables that can assess nutritional status, more specifically lean body mass (LBM) and skeletal muscle mass, at the individual level. In this clinical setting, ultrasound (US)) of the quadriceps femoris could represent a widely available, non-invasive, affordable, and reliable tool to evaluate skeletal muscle. METHODS: We performed a cross-sectional observational study in adult critically ill patients with KDIGO stage 3 AKI on dialysis...
October 1, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Kay Choong See, Si Yu Peng, Jason Phua, Chew Lai Sum, Johncy Concepcion
BACKGROUND: Swallowing difficulties are common, and dysphagia occurs frequently in intensive care unit (ICU) patients after extubation. Yet, no guidelines on postextubation swallowing assessment exist. We aimed to investigate the safety and effectiveness of nurse-performed screening (NPS) for postextubation dysphagia in the medical ICU. METHODS: We conducted a retrospective cohort study of mechanically ventilated patients who were extubated in a 20-bed medical ICU...
October 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
Amit Baheti
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Anthony T Gerlach, Danielle M Blais, G Morgan Jones, Pamela K Burcham, Stanislaw P Stawicki, Charles H Cook, Claire V Murphy
BACKGROUND: Dexmedetomidine is commonly used for sedation in the Intensive Care Unit (ICU), and its use may be associated with hypotension. We sought to determine predictors of dexmedetomidine-associated hypotension. METHODS: Retrospective, single-center study of 283 ICU patients in four adults ICUs over a 12 month period. Univariate analyses were performed to determine factors associated with dexmedetomidine-related hypotension. Risk factors significant at the 0...
July 2016: International Journal of Critical Illness and Injury Science
Fernando Callejo-Torre, Jose Maria Eiros Bouza, Pedro Olaechea Astigarraga, Maria Jesus Coma Del Corral, Mercedes Palomar Martínez, Francisco Alvarez-Lerma, Maria Jesús López-Pueyo
Predicting methicillin-resistant Staphylococcus aureus (MRSA) in intensive care units (ICUs) avoids inappropriate antimicrobial empirical treatment and enhances infection control. We describe risk factors for colonisation/infection related to MRSA (MRSA-C/I) in critically ill patients once in the ICU and on ICU admission, and search for an easy-to-use predictive model for MRSA colonisation/infection on ICU admission. This multicentre cohort study included 69,894 patients admitted consecutively (stay>24h) in April-June in the five-year period 2006-2010 from 147 Spanish ICUs participating in the National Surveillance Study of Nosocomial Infections in ICUs (ENVIN-HELICS)...
September 1, 2016: Le Infezioni in Medicina
Patrick J van der Geest, Nicole G M Hunfeld, Sophie E Ladage, A B Johan Groeneveld
BACKGROUND: In critically ill patients the incidence of invasive fungal infections caused by Candida spp. has increased remarkably. Echinocandins are recommended as initial treatment for invasive fungal infections. The safety and efficacy of micafungin compared to caspofungin is similar, but no comparison is made between anidulafungin and micafungin concerning safety and efficacy. We therefore performed a retrospective study to assess these aspects in critically ill patients with invasive candidiasis...
2016: BMC Infectious Diseases
Yo-Han Lee, Seok Jeong Lee, Myoung Kyu Lee, Won-Yeon Lee, Suk Joong Yong, Sang-Ha Kim
BACKGROUND: Serum selenium levels are lower in critically ill patients as compared with healthy controls. However, there is no data about the difference in serum selenium levels depending on the severity of lung diseases. We aimed to identify the factors associated with low serum selenium levels in critically ill patients with respiratory diseases. METHODS: A prospective study was performed in 83 patients with respiratory diseases who had admitted to the intensive care unit (ICU) and general wards...
August 2016: Journal of Thoracic Disease
Tobias Lahmer, Jürgen Held, Sebastian Rasch, Christopher Schnappauf, Analena Beitz, Roland M Schmid, Wolfgang Huber
INTRODUCTION: Invasive fungal disease (IFD) remains a significant cause of morbidity and mortality in critically ill patients. METHODS: Examination of 1,3-β-D-glucan (BDG) for IFD and as outcome parameter in immunocompromised critically ill patients with septic shock. RESULTS: Thirty-two (69 %) out of 46 included patients had BDG beyond the cutoff of >80 pg/ml (mean 320 pg/ml). Twelve (37 %) had findings of Aspergillus spp. in BAL (mean BDG 413 pg/ml)...
September 12, 2016: Mycopathologia
John Victor Peter, Kurien Thomas, Lakshmanan Jeyaseelan, Bijesh Yadav, Thomas Isiah Sudarsan, Jony Christina, Anna Revathi, K R John, Thambu David Sudarsanam
OBJECTIVES: The majority of patients in India access private sector providers for curative medical services. However, there is scanty information on the cost of treatment of critically ill patients in this setting. The study evaluates the cost and extent of financial subsidy required for patients admitted to an intensive care unit (ICU) in India. METHODS: Data on direct medical, direct nonmedical, and indirect cost were prospectively collected from critically ill patients admitted to a tertiary teaching hospital in India...
September 9, 2016: International Journal of Technology Assessment in Health Care
Konstantin A Krychtiuk, Max Lenz, Lorenz Koller, Maria C Honeder, Lisa Wutzlhofer, Chao Zhang, Lijian Chi, Gerald Maurer, Alexander Niessner, Kurt Huber, Johann Wojta, Gottfried Heinz, Walter S Speidl
Although patients admitted to an intensive care unit (ICU) suffer from various pathologies, many develop a systemic inflammatory response syndrome (SIRS). As key regulators of innate immunity, monocytes may be crucially involved in SIRS development. Monocytes can be distinguished into three subsets: Classical monocytes (CD14++CD16-; CM), non-classical monocytes (CD14+CD16++CCR2-; NCM) and intermediate monocytes (CD14++CD16+CCR2+; IM). The aim of this prospective, observational study was to analyse whether monocyte subset distribution is associated with 30-day survival in critically ill patients...
September 8, 2016: Thrombosis and Haemostasis
Eric Sy, Juan J Ronco, Rowan Searle, Constantine J Karvellas
PURPOSE: We evaluated the Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) score to predict survival in a Canadian critically ill cohort with acute-on-chronic liver failure. METHODS: We retrospectively examined 274 acute-on-chronic liver failure patients admitted to a quaternary level intensive care unit (ICU) between April 1, 2000, and April 30, 2011. We evaluated severity of illness scores, including the Acute Physiology and Chronic Health Evaluation (APACHE) II, model for end-stage liver disease (MELD), Child-Turcotte-Pugh (CTP), SOFA, and CLIF-SOFA...
August 10, 2016: Journal of Critical Care
Zhiwei Lu, Yusheng Cheng, Xiongwen Tu, Liang Chen, Hu Chen, Jian Yang, Jinyan Wang, Liqin Zhang
PURPOSE: The aim of this study was to appraise the effect of community-acquired pneumonia (CAP) on inhospital mortality in critically ill acute exacerbation of COPD (AECOPD) patients admitted to a respiratory intensive care unit. PATIENTS AND METHODS: A retrospective observational study was performed. Consecutive critically ill AECOPD patients receiving treatment in a respiratory intensive care unit were reviewed from September 1, 2012, to August 31, 2015. Categorical variables were analyzed using chi-square tests, and continuous variables were analyzed by Mann-Whitney U-test...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Constantinos Tsioutis, Evangelos I Kritsotakis, Spyridon A Karageorgos, Soultana Stratakou, Charalambos Psarologakis, Sofia Kokkini, Achilleas Gikas
Limited data exist regarding prognostic factors and optimal antimicrobial treatment of infections caused by extensively drug-resistant Acinetobacter baumannii (XDR-AB). This retrospective cohort study included 93 adult patients who developed ventilator-associated pneumonia (VAP) due to XDR-AB in the ICU of the University Hospital of Heraklion, Greece, from October 2012 to April 2015. XDR-AB isolates were mainly susceptible to colistin (93.5%) and tigecycline (25.8%), whereas 6 (6.5%) were pandrug-resistant...
August 12, 2016: International Journal of Antimicrobial Agents
Anders G Kjaergaard, Anders Dige, Jeppe S Nielsen, Else Tønnesen, Jan Krog
Endothelial activation is pivotal in the development and escalation of sepsis. Central to endothelial activation is the endothelial up-regulation of cellular adhesion molecules (CAMs) including E-selectin, ICAM-1, VCAM-1, and PECAM-1. Shed CAMs are also found in circulating soluble forms (sCAMs). We investigated whether sCAMs can be used as biomarkers for the differentiation between septic and non-septic patients. Furthermore, we investigated lymphocyte and monocyte expression of LFA-1 (CD11a/CD18) and VLA-4 (CD49d/CD29) ligands for ICAM-1 and VCAM-1, respectively...
October 2016: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
Kirsten Balvers, Marjolein Van der Horst, Maarten Graumans, Christa Boer, Jan M Binnekade, J Carel Goslings, Nicole P Juffermans
AIMS: To study the impact of hypothermia upon admission to the Intensive Care Unit (ICU) on early and late mortality and to develop a prediction model for late mortality in severely injured trauma patients. MATERIALS AND METHODS: A multicenter retrospective cohort study was performed in adult trauma patients admitted to the ICU of two Level-1 trauma centers between 2007 and 2012. Hypothermia was defined as a core body temperature of ≤35° Celsius. Logistic regression analyses were performed to quantify the effect of hypothermia on 24-hour and 28-day mortality and to develop a prediction model...
July 2016: Journal of Emergencies, Trauma, and Shock
Aline C Q Leão, Paulo R Menezes, Maura S Oliveira, Anna S Levin
BACKGROUND: It has been challenging to determine the true clinical impact of Acinetobacter spp., due to the predilection of this pathogen to colonize and infect critically ill patients, who often have a poor prognosis. The aim of this study was to assess whether Acinetobacter spp. bacteremia is associated with lower survival compared with bacteremia caused by other pathogens in critically ill patients. METHODS: This study was performed at Hospital das Clínicas, University of São Paulo, Brazil...
2016: BMC Infectious Diseases
Nawal Salahuddin, Lama Amer, Mini Joseph, Alya El Hazmi, Hassan Hawa, Khalid Maghrabi
Introduction. Deescalation refers to either discontinuation or a step-down of antimicrobials. Despite strong recommendations in the Surviving Sepsis Guidelines (2012) to deescalate, actual practices can vary. Our objective was to identify variables that are associated with deescalation failure. Methods. In this prospective study of patients with sepsis/septic shock, patients were categorized into 4 groups based on antibiotic administration: no change in antibiotics, deescalation, escalation (where antibiotics were changed to those with a broader spectrum of antimicrobial coverage), or mixed changes (where both escalation to a broader spectrum of coverage and discontinuation of antibiotics were carried out)...
2016: Critical Care Research and Practice
Marianne J Chapman, Adam M Deane, Stephanie L O'Connor, Nam Q Nguyen, Robert J L Fraser, Duncan B Richards, Kimberley E Hacquoil, Lakshmi S Vasist Johnson, Matthew E Barton, George E Dukes
BACKGROUND: The promotility agents currently available to treat gastroparesis and feed intolerance in the critically ill are limited by adverse effects. The aim of this study was to assess the pharmacodynamic effects and pharmacokinetics of single doses of the novel gastric promotility agent motilin agonist camicinal (GSK962040) in critically ill feed-intolerant patients. METHODS: A prospective, randomized, double-blind, parallel-group, placebo-controlled, study was performed in mechanically ventilated feed-intolerant patients [median age 55 (19-84), 73 % male, APACHE II score 18 (5-37) with a gastric residual volume ≥200 mL]...
2016: Critical Care: the Official Journal of the Critical Care Forum
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