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https://www.readbyqxmd.com/read/29028707/icu-acquired-weakness-chronic-critical-illness-and-the-persistent-inflammation-immunosuppression-and-catabolism-syndrome
#1
Tyler John Loftus, Frederick Allen Moore, Lyle L Moldawer
No abstract text is available yet for this article.
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28991776/serum-and-alveolar-procalcitonin-had-a-weak-diagnostic-value-for-ventilator-associated-pneumonia-in-patients-with-pulmonary-infection-score-%C3%A2-6
#2
Mehran Shokri, Roya Ghasemian, Masomeh Bayani, Valiollah Amri Maleh, Masoumeh Kamrani, Mahmoud Sadeghi-Haddad-Zavareh, Soheil Ebrahimpour
BACKGROUND: Measuring the serum and alveolar procalcitonin level as inflammatory marker in the diagnosis of ventilator-associated pneumonia (VAP) has been taken into account. In this study, serum and alveolar procalcitonin levels in patients with suspected VAP and patients with confirmed VAP were compared. METHODS: This cross-sectional study was conducted using 50 intubated intensive care unit (ICU) patients, connected to ventilator, from October 2014 to April 2015...
October 7, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28984049/mir-422a-suppresses-smad4-protein-expression-and-promotes-resistance-to-muscle-loss
#3
Richard Paul, Jen Lee, Anna V Donaldson, Martin Connolly, Mohammad Sharif, Samantha Amanda Natanek, Ulrich Rosendahl, Michael I Polkey, Mark Griffiths, Paul R Kemp
BACKGROUND: Loss of muscle mass and strength are important sequelae of chronic disease, but the response of individuals is remarkably variable, suggesting important genetic and epigenetic modulators of muscle homeostasis. Such factors are likely to modify the activity of pathways that regulate wasting, but to date, few such factors have been identified. METHODS: The effect of miR-422a on SMAD4 expression and transforming growth factor (TGF)-β signalling were determined by western blotting and luciferase assay...
October 6, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28938290/body-composition-changes-in-severely-burned-children-during-icu-hospitalization
#4
Janos Cambiaso-Daniel, Ioannis Malagaris, Eric Rivas, Gabriel Hundeshagen, Charles D Voigt, Elizabeth Blears, Ron P Mlcak, David N Herndon, Celeste C Finnerty, Oscar E Suman
OBJECTIVES: Prolonged hospitalization due to burn injury results in physical inactivity and muscle weakness. However, how these changes are distributed among body parts is unknown. The aim of this study was to evaluate the degree of body composition changes in different anatomical regions during ICU hospitalization. DESIGN: Retrospective chart review. SETTING: Children's burn hospital. PATIENTS: Twenty-four severely burned children admitted to our institution between 2000 and 2015...
September 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28919067/impact-of-iron-deficiency-diagnosis-using-hepcidin-mass-spectrometry-dosage-methods-on-hospital-stay-and-costs-after-a-prolonged-icu-stay-study-protocol-for-a-multicentre-randomised-single-blinded-medico-economic-trial
#5
Sigismond Lasocki, Hervé Puy, Grégoire Mercier, Sylvain Lehmann
BACKGROUND: Iron deficiency (ID) is frequent but difficult to diagnose in critically ill patients. ID may be responsible for prolonged post-ICU hospital stays, since it results in fatigue, muscle weakness and anaemia. Hepcidin, the key iron metabolism hormone, may be a good marker of ID in these patients. The aim of this study is to determine whether using mass spectrometry hepcidin determination to diagnose (and treat) ID after prolonged ICU stays may reduce patients' subsequent hospital stays and costs in comparison with conventional (ferritin) methods...
September 14, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28917004/critical-illness-associated-diaphragm-weakness
#6
REVIEW
Martin Dres, Ewan C Goligher, Leo M A Heunks, Laurent J Brochard
Diaphragm weakness is highly prevalent in critically ill patients. It may exist prior to ICU admission and may precipitate the need for mechanical ventilation but it also frequently develops during the ICU stay. Several risk factors for diaphragm weakness have been identified; among them sepsis and mechanical ventilation play central roles. We employ the term critical illness-associated diaphragm weakness to refer to the collective effects of all mechanisms of diaphragm injury and weakness occurring in critically ill patients...
September 15, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28877145/european-society-of-anaesthesiology-and-european-board-of-anaesthesiology-guidelines-for-procedural-sedation-and-analgesia-in-adults
#7
Jochen Hinkelbein, Massimo Lamperti, Jonas Akeson, Joao Santos, Joao Costa, Edoardo De Robertis, Dan Longrois, Vesna Novak-Jankovic, Flavia Petrini, Michel M R F Struys, Francis Veyckemans, Thomas Fuchs-Buder, Robert Fitzgerald
: Procedural sedation and analgesia (PSA) has become a widespread practice given the increasing demand to relieve anxiety, discomfort and pain during invasive diagnostic and therapeutic procedures. The role of, and credentialing required by, anaesthesiologists and practitioners performing PSA has been debated for years in different guidelines. For this reason, the European Society of Anaesthesiology (ESA) and the European Board of Anaesthesiology have created a taskforce of experts that has been assigned to create an evidence-based guideline and, whenever the evidence was weak, a consensus amongst experts on: the evaluation of adult patients undergoing PSA, the role and competences required for the clinicians to safely perform PSA, the commonly used drugs for PSA, the adverse events that PSA can lead to, the minimum monitoring requirements and post-procedure discharge criteria...
September 5, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28875277/-critical-illness-myopathy-and-polyneuropathy
#8
REVIEW
D Senger, F Erbguth
An average of 50-80% of patients treated in the intensive care unit is affected by disturbances of neuromuscular functions due to damage to the nerves and muscles, which has led to the terms critical illness polyneuropathy and myopathy. Both components occur in 30-50% of patients, while the others predominantly show a pure myopathy, while pure neuropathy is rare. Meanwhile, the descriptive term of the concept as intensive care unit-acquired weakness (ICUAW) is preferred. The most significant risk factors for the development of ICUAW are sepsis, multiorgan dysfunction and acute respiratory distress syndrome (ARDS)...
October 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28828366/sedation-and-neuromuscular-blocking-agents-in-acute-respiratory-distress-syndrome
#9
REVIEW
Jeremy Bourenne, Sami Hraiech, Antoine Roch, Marc Gainnier, Laurent Papazian, Jean-Marie Forel
Mechanical ventilation (MV) is the cornerstone of acute respiratory distress syndrome (ARDS) management. The use of protective ventilation is a priority in this acute phase of lung inflammation. Neuromuscular blocking agents (NMBAs) induce reversible muscle paralysis. Their use in patients with ARDS remains controversial but occurs frequently. NMBAs are used in 25-45% of ARDS patients for a mean period of 1±2 days. The main indications of NMBAs are hypoxemia and facilitation of MV. For ethical reasons, NMBA use is inseparable from sedation in the management of early ARDS...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28821360/development-and-implementation-of-an-early-mobility-program-for-mechanically-ventilated-pediatric-patients
#10
Kristina A Betters, Kiran B Hebbar, David Farthing, Brittany Griego, Tricia Easley, Hartley Turman, Lauren Perrino, Stephanie Sparacino, Mary L deAlmeida
PURPOSE: Early mobility (EM) is being used in adult ICUs in an effort to treat and prevent intensive care unit acquired weakness (ICU-AW) and Post-Intensive Care Syndrome (PICS). Data supports children suffer from ICU-AW and PICS as well. Our objective was to create and implement an EM protocol for pediatric patients receiving invasive mechanical ventilation. METHODS: A multidisciplinary EM committee was formed to create and implement an EM protocol in a quarternary care PICU...
October 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28809518/mir-542-promotes-mitochondrial-dysfunction-and-smad-activity-and-is-raised-in-icu-acquired-weakness
#11
Roser Farre Garros, Richard Paul, Martin Connolly, Amy Lewis, Benjamin E Garfield, S Amanda Natanek, Susannah Bloch, Vincent Mouly, Mark J Griffiths, Michael I Polkey, Paul R Kemp
RATIONALE: Loss of skeletal muscle mass and function is a common consequence of critical illness and a range of chronic diseases but the mechanisms by which this occurs are unclear. OBJECTIVES: We aimed to identify miRNAs that were increased in the quadriceps of patients with muscle wasting and to determine the molecular pathways by which they contributed to muscle dysfunction. METHODS: miR-542-3p/-5p were quantified in the quadriceps of patients with COPD and intensive care unit acquired weakness (ICUAW)...
August 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28780488/development-of-a-risk-score-to-predict-extubation-failure-in-patients-with-traumatic-brain-injury
#12
Helena França Correia Dos Reis, Mansueto Gomes-Neto, Mônica Lajana Oliveira Almeida, Mário Ferreira da Silva, Lorena Barreto Arruda Guedes, Bruno Prata Martinez, Mário de Seixas Rocha
PURPOSE: To identify predictors and develop a risk score for the prediction of extubation failure in TBI patients. MATERIALS AND METHODS: We prospectively evaluated 311 TBI adults receiving mechanical ventilation for >48h in the intensive care unit. Epidemiological, ventilatory, airway protective, laboratory, and hemodynamic predictors were evaluated. A multiple logistic regression model was developed to predict the extubation failure risk. A score was developed using the arithmetic sum of the points for each independent predictor, whose scores were proportional to the regression coefficient...
July 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#13
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gérard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigué, Laure de Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28685324/phenotypic-characteristics-and-outcome-of-juvenile-dermatomyositis-in-arab-children
#14
Sulaiman M Al-Mayouf, Nora AlMutiari, Mohammed Muzaffer, Rawiah Shehata, Adel Al-Wahadneh, Reem Abdwani, Safia Al-Abrawi, Mohammed Abu-Shukair, Zeyad El-Habahbeh, Abdullah Alsonbul
This study describes the disease characteristics and outcome of Arab children with juvenile dermatomyositis (JDM) and compares the findings with other ethnicities. We retrospectively reviewed the hospital registries of the participating hospitals for children with JDM seen between 1990 and 2016 in three Arab countries. All patients fulfilled Bohan and Peter criteria for JDM, diagnosed before 14 years of age and were of Arab ethnicity. Clinical and laboratory features as well as the long-term outcomes including accrual disease damage were collected at the last follow-up visit...
July 6, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28674380/exceptionally-high-creatine-kinase-ck-levels-in-multicausal-and-complicated-rhabdomyolysis-a-case-report
#15
Pavan Luckoor, Mashal Salehi, Afua Kunadu
BACKGROUND Rhabdomyolysis is a syndrome caused by muscle breakdown. It can be caused by traumatic as well as non-traumatic factors such as drugs, toxins, and infections. Although it has been initially associated with only traumatic causes, non-traumatic causes now appear to be at least 5 times more frequent. In rhabdomyolysis, the CK levels can range anywhere from 10 000 to 200 000 or even higher. The higher the CK levels, the greater will be the renal damage and associated complications. We present the case of a patient with exceptionally massive rhabdomyolysis with unusually high CK levels (nearly 1 million) caused by combined etiologic factors and complicated with acute renal failure...
July 4, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28651475/high-frequency-ventilation-modalities-as-salvage-therapy-for-smoke-inhalation-associated-acute-lung-injury-a-systematic-review
#16
Andrew C Miller, Paula A Ferrada, Sameer S Kadri, Krupa Nataraj-Bhandari, Amir Vahedian-Azimi, Sadeq A Quraishi
BACKGROUND: Smoke inhalation-associated acute lung injury (SI-ALI) is a major cause of morbidity and mortality in victims of fire tragedies. To date, there are no evidence-based guidelines on ventilation strategies in acute respiratory distress syndrome (ARDS) after smoke inhalation. We reviewed the existing literature for clinical studies of salvage mechanical ventilation (MV) strategies in patients with SI-ALI, focusing on mortality and pneumonia as outcomes. METHODS: A systematic search was designed in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#17
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28627353/-ultrasonographic-evaluation-of-diaphragm-structure-and-function
#18
Feifei Wang, Xiaoping Zhu, Shaolin Ma
Diaphragm is the principal respiratory muscle. Diaphragm dysfunction resulting from mechanical ventilation, chronic cardiopulmonary disease, medicine, cardio-thoracic surgery, septic shock and chronic malnutrition predisposes to weaning failure from mechanical ventilation and prolongs intensive care unit (ICU) stay. Traditionally, the method of assessment of diaphragm structure and function was invasive, lacking specific, and was difficult to be used bedside. A number of recent studies have been suggested that ultrasonographic evaluation has been proposed as an accurate, safe and noninvasive method of quantification of diaphragm structure and function...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28614196/superiority-of-serum-cystatin-c-over-creatinine-in-prediction-of-long-term-prognosis-at-discharge-from-icu
#19
Bo Ravn, John R Prowle, Johan Mårtensson, Claes-Roland Martling, Max Bell
OBJECTIVES: Renal outcomes after critical illness are seldom assessed despite strong correlation between chronic kidney disease and survival. Outside hospital, renal dysfunction is more strongly associated with mortality when assessed by serum cystatin C than by creatinine. The relationship between creatinine and longer term mortality might be particularly weak in survivors of critical illness. DESIGN: Retrospective observational cohort study. PATIENTS: In 3,077 adult ICU survivors, we compared ICU discharge cystatin C and creatinine and their association with 1-year mortality...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28614140/a-comparison-of-clinical-characteristics-and-outcomes-of-ventilator-associated-pneumonias-among-burn-patients-by-diagnostic-criteria-set
#20
Duraid Younan, Russell Griffin, Thomas Swain, Eric Schinnerer, Jean-Francois Pittet, Bernard Camins
OBJECTIVES: The National Healthcare Safety Network (NHSN) replaced its old definition for ventilator associated pneumonia (VAP) with ventilator associated events (VAEs) in 2013. Little data is available comparing the two definitions in burn patients. METHODS: Data from 2011-2014 were collected on burn patients mechanically ventilated for at least two days. VAP was determined using two methods: (1) pneumonia as defined by the previous more clinical CDC (NHSN) definition captured in the burn registry; (2) pneumonia as defined by the recent CDC (NHSN) standard of Ventilator-Associated Events where patients meeting the criteria for possible VAP (PVAP) were considered having a pneumonia...
June 13, 2017: Shock
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