keyword
https://read.qxmd.com/read/38536545/early-sevoflurane-sedation-in-severe-covid-19-related-lung-injury-patients-a-pilot-randomized-controlled-trial
#1
JOURNAL ARTICLE
Beatrice Beck-Schimmer, Erik Schadde, Urs Pietsch, Miodrag Filipovic, Seraina Dübendorfer-Dalbert, Patricia Fodor, Tobias Hübner, Reto Schuepbach, Peter Steiger, Sascha David, Bernard D Krüger, Thomas A Neff, Martin Schläpfer
BACKGROUND: This study aimed to assess a potential organ protective effect of volatile sedation in a scenario of severe inflammation with an early cytokine storm (in particular IL-6 elevation) in patients suffering from COVID-19-related lung injury with invasive mechanical ventilation and sedation. METHODS: This is a small-scale pilot multicenter randomized controlled trial from four tertiary hospitals in Switzerland, conducted between April 2020 and May 2021. 60 patients requiring mechanical ventilation due to severe COVID-19-related lung injury were included and randomized to 48-hour sedation with sevoflurane vs...
March 27, 2024: Annals of Intensive Care
https://read.qxmd.com/read/38509149/plasma-renin-as-a-novel-prognostic-biomarker-of-sepsis-associated-acute-respiratory-distress-syndrome
#2
JOURNAL ARTICLE
Anjali Chakradhar, Rebecca M Baron, Mayra Pinilla Vera, Prasad Devarajan, Lakhmir Chawla, Peter C Hou
Sepsis-associated acute respiratory distress syndrome (ARDS) is a life-threatening condition in critical care medicine for which there is a substantial need for early prognostic biomarkers of outcome. The present study seeks to link plasma renin levels and 30-day mortality in sepsis-associated ARDS patients treated at our institution. The Registry of Critical Illness (RoCI) prospectively enrolled patients from the intensive care units (ICU) within a single academic medical center, and a convenience sample of patients with sepsis-associated ARDS was analyzed from this cohort...
March 20, 2024: Scientific Reports
https://read.qxmd.com/read/38498038/development-and-validation-of-an-interpretable-conformal-predictor-to-predict-sepsis-mortality-risk-retrospective-cohort-study
#3
MULTICENTER STUDY
Meicheng Yang, Hui Chen, Wenhan Hu, Massimo Mischi, Caifeng Shan, Jianqing Li, Xi Long, Chengyu Liu
BACKGROUND: Early and reliable identification of patients with sepsis who are at high risk of mortality is important to improve clinical outcomes. However, 3 major barriers to artificial intelligence (AI) models, including the lack of interpretability, the difficulty in generalizability, and the risk of automation bias, hinder the widespread adoption of AI models for use in clinical practice. OBJECTIVE: This study aimed to develop and validate (internally and externally) a conformal predictor of sepsis mortality risk in patients who are critically ill, leveraging AI-assisted prediction modeling...
March 18, 2024: Journal of Medical Internet Research
https://read.qxmd.com/read/38479195/the-effect-of-vasopressor-agents-on-pressure-injury-development-in-intensive-care-patients
#4
JOURNAL ARTICLE
Ayda Kebapci, Ruhat Tilki
BACKGROUND: Vasopressors are life-saving agents that increase mean arterial pressure. The pharmacodynamic features of these agents and previous studies suggest that vasopressors may be an essential risk factor in developing pressure injuries. OBJECTIVE: This study aimed to examine the effect of vasopressors in medical-surgical intensive care patients on pressure injury development. DESIGN AND SETTINGS: This retrospective and correlational study was conducted between March 2021- May 2022...
March 12, 2024: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://read.qxmd.com/read/38471766/methylene-blue-in-metformin-intoxication-not-just-rescue-but-also-initial-treatment
#5
JOURNAL ARTICLE
Banu Katlan
Metformin (MTF) is a widely used oral antidiabetic medication. Regardless the reason, high doses of MTF cause lactic acidosis as a result of its effects on mitochondrial ATP production and no-mediated vascular smooth muscle relaxation. Metformin-associated lactic acidosis can be life-threatening despite all treatments. Methylene blue (MB) has the potential to reverse the toxic effects of MTF through its effects on both the mitochondrial respiratory chain and nitric oxide production. The use of MB in MTF intoxication has only been reported in a limited number of cases...
March 13, 2024: Pediatric Emergency Care
https://read.qxmd.com/read/38454423/pediatric-sepsis-inflammatory-blood-biomarkers-that-correlate-with-clinical-variables-and-severity-of-illness-scores
#6
JOURNAL ARTICLE
Sean Leonard, Hailey Guertin, Natalya Odoardi, Michael R Miller, Maitray A Patel, Mark Daley, Gediminas Cepinskas, Douglas D Fraser
BACKGROUND: Sepsis is a dysregulated systemic inflammatory response triggered by infection, resulting in organ dysfunction. A major challenge in clinical pediatrics is to identify sepsis early and then quickly intervene to reduce morbidity and mortality. As blood biomarkers hold promise as early sepsis diagnostic tools, we aimed to measure a large number of blood inflammatory biomarkers from pediatric sepsis patients to determine their predictive ability, as well as their correlations with clinical variables and illness severity scores...
March 7, 2024: Journal of Inflammation
https://read.qxmd.com/read/38449574/digital-ischemia-in-an-extreme-preterm-infant-treated-with-nitroglycerin-patch
#7
Mansour Al Qurashi, Abdulaziz Al-Khotani, Farzeen Mohtisham, Eman AlRaddadi, Heba AlShaikh, Alqassem Y Hakami, Syed Sameer Aga
Ischemic limb lesions occasionally occur in neonates admitted to neonatal intensive care units. Known risk factors include the placement of arterial catheters, arterial punctures to obtain blood samples, and the use of vasoactive/vasopressor medications for hypotension. Prolonged peripheral tissue ischemia may result in serious complications, and successful management depends on early detection, proper assessment, and the institution of appropriate intervention. Currently, there is no standard approach for the management of peripheral tissue ischemia in extreme preterm infants...
2024: Case Reports in Pediatrics
https://read.qxmd.com/read/38449336/early-beta-blocker-utilization-in-critically-ill-patients-with-moderate-severe-traumatic-brain-injury-a-retrospective-cohort-study
#8
JOURNAL ARTICLE
Margot Kelly-Hedrick, Sunny Yang Liu, Jordan Komisarow, Jordan Hatfield, Tetsu Ohnuma, Miriam M Treggiari, Katharine Colton, Evangeline Arulraja, Monica S Vavilala, Daniel T Laskowitz, Joseph P Mathew, Adrian Hernandez, Michael L James, Karthik Raghunathan, Vijay Krishnamoorthy
BACKGROUND: There is limited evidence that beta-blockers may provide benefit for patients with moderate-severe traumatic brain injury (TBI) during the acute injury period. Larger studies on utilization patterns and impact on outcomes in clinical practice are lacking. OBJECTIVE: The present study uses a large, national hospital claims-based dataset to examine early beta-blocker utilization patterns and its association with clinical outcomes among critically ill patients with moderate-severe TBI...
March 6, 2024: Journal of Intensive Care Medicine
https://read.qxmd.com/read/38428939/associations-between-present-on-admission-do-not-resuscitate-orders-and-short-term-outcomes-in-patients-with-pneumonia
#9
JOURNAL ARTICLE
Megan M Sheehan, Marya D Zilberberg, Peter K Lindenauer, Thomas L Higgins, Peter B Imrey, Ning Guo, Abhishek Deshpande, Sarah D Haessler, Michael B Rothberg
OBJECTIVES: Do-not-resuscitate ( DNR) orders are used to express patient preferences for cardiopulmonary resuscitation. This study examined whether early DNR orders are associated with differences in treatments and outcomes among patients hospitalized with pneumonia. METHODS: This is a retrospective cohort study of 768,015 adult patients hospitalized with pneumonia from 2010 to 2015 in 646 US hospitals. The exposure was DNR orders present on admission. Secondary analyses stratified patients by predicted in-hospital mortality...
March 2024: Southern Medical Journal
https://read.qxmd.com/read/38398322/effects-of-early-initiation-of-polymyxin-b-hemoperfusion-therapy-in-patients-with-cancer-with-refractory-septic-shock
#10
JOURNAL ARTICLE
Jae Hoon Lee, Won Ho Han, Hyun-Jae Im, Jee Hee Kim
Background : We aimed to analyze the correlation between in-hospital mortality and hemodynamic changes, using polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) initiation time in patients with cancer with refractory septic shock. Methods : Forty-six patients with cancer who received PMX-DHP for refractory septic shock were retrospectively analyzed and classified into early (≤3 h between refractory septic shock and PMX-DHP; n = 17) and late (>3 h; n = 29) initiation groups. The vasopressor inotropic score ( VIS ), sequential organ failure assessment (SOFA) score, and lactate clearance before and 24 h post-PMX-DHP were compared...
February 9, 2024: Journal of Clinical Medicine
https://read.qxmd.com/read/38335145/association-of-early-dexmedetomidine-utilization-with-clinical-outcomes-after-moderate-severe-traumatic-brain-injury-a-retrospective-cohort-study
#11
JOURNAL ARTICLE
Sunny Yang Liu, Margot Kelly-Hedrick, Jordan Komisarow, Jordan Hatfield, Tetsu Ohnuma, Miriam M Treggiari, Katharine Colton, Evangeline Arulraja, Monica S Vavilala, Daniel T Laskowitz, Joseph P Mathew, Adrian Hernandez, Michael L James, Karthik Raghunathan, Vijay Krishnamoorthy
BACKGROUND: Traumatic brain injury (TBI) is an expensive and common public health problem. Management of TBI oftentimes includes sedation to facilitate mechanical ventilation (MV) for airway protection. Dexmedetomidine has emerged as a potential candidate for improved patient outcomes when used for early sedation after TBI due to its potential modulation of autonomic dysfunction. We examined early sedation patterns, as well as the association of dexmedetomidine exposure with clinical and functional outcomes among mechanically ventilated patients with moderate-severe TBI (msTBI) in the United States...
February 9, 2024: Anesthesia and Analgesia
https://read.qxmd.com/read/38325215/hypotension-prediction-index-for-the-prevention-of-hypotension-during-surgery-and-critical-care-a-narrative-review
#12
REVIEW
Siwen Dong, Qing Wang, Shuai Wang, Congcong Zhou, Hongwei Wang
Surgeons and anesthesia clinicians commonly face a hemodynamic disturbance known as intraoperative hypotension (IOH), which has been linked to more severe postoperative outcomes and increases mortality rates. Increased occurrence of IOH has been positively associated with mortality and incidence of myocardial infarction, stroke, and organ dysfunction hypertension. Hence, early detection and recognition of IOH is meaningful for perioperative management. Currently, when hypotension occurs, clinicians use vasopressor or fluid therapy to intervene as IOH develops but interventions should be taken before hypotension occurs; therefore, the Hypotension Prediction Index (HPI) method can be used to help clinicians further react to the IOH process...
January 18, 2024: Computers in Biology and Medicine
https://read.qxmd.com/read/38321417/the-first-reported-mortality-from-aluminum-phosphide-poisoning-in-lebanon-a-case-report
#13
JOURNAL ARTICLE
Pierre Edde, Anthony El Kortbawi, Zeina Halabi, Nancy Sakr, Alondra Barakat, Tharwat El Zahran
BACKGROUND: Aluminum phosphide is a commonly used pesticide, particularly in developing countries where uncontrolled insecticides and pesticides are commonly prevalent. Mortalities have been reported due to accidental and suicidal exposures to aluminum phosphide. To date, there has been no reported mortality case of aluminum phosphide in Lebanon. In addition, there is no specific antidote for aluminum phosphide toxicity and the treatment is mainly supportive. This is why awareness should be spread about this case to include it in the differential diagnoses and enhance prompt management and response in future encounters...
February 6, 2024: International Journal of Emergency Medicine
https://read.qxmd.com/read/38307529/early-sepsis-care-with-the-national-early-warning-score-2-guided-sepsis-hour-1-bundle-in-the-emergency-department-hybrid-type-1-effectiveness-implementation-pilot-stepped-wedge-randomised-controlled-trial-news-1-trips-protocol
#14
JOURNAL ARTICLE
Rex Pui Kin Lam, Kevin Kei Ching Hung, Chun Tat Lui, Wai Shing Kwok, Wendy Wing Tak Lam, Eric Ho Yin Lau, Siddharth Sridhar, Peter Yau Tak Ng, Chi Hung Cheng, Tat Chi Tsang, Matthew Sik Hon Tsui, Colin Alexander Graham, Timothy Hudson Rainer
INTRODUCTION: Early sepsis treatment in the emergency department (ED) is crucial to improve patient survival. Despite international promulgation, the uptake of the Surviving Sepsis Campaign (SSC) Hour-1 Bundle (lactate measurement, blood culture, broad-spectrum antibiotics, 30 mL/kg crystalloid for hypotension/lactate ≥4 mmol/L and vasopressors for hypotension during/after fluid resuscitation within 1 hour of sepsis recognition) is low across healthcare settings...
February 1, 2024: BMJ Open
https://read.qxmd.com/read/38304706/cefepime-daily-exposure-and-the-associated-impact-on-the-change-in-sequential-organ-failure-assessment-scores-and-vasopressors-requirement-in-critically-ill-patients-using-repeated-measures-mixed-effect-modeling
#15
JOURNAL ARTICLE
Mohammad H Alshaer, Roy Williams, Mays J Mousa, Kaitlin M Alexander, Kelly L Maguigan, Kayihura Manigaba, Nicole Maranchick, Bethany R Shoulders, Timothy W Felton, Sumith K Mathew, Charles A Peloquin
IMPORTANCE: Sepsis and septic shock are major healthcare problems that need early and appropriate management. OBJECTIVES: To evaluate the association of daily cefepime pharmacokinetic/pharmacodynamic (PK/PD) parameters with change in Sequential Organ Failure Assessment (SOFA) score and vasopressors requirement. DESIGN SETTING AND PARTICIPANTS: This is a retrospective study. Adult ICU patients who received cefepime for Gram-negative pneumonia or bloodstream infection (BSI) and had cefepime concentrations measured were included...
November 2023: Critical care explorations
https://read.qxmd.com/read/38301370/predicting-septic-shock-in-patients-with-sepsis-at-emergency-department-triage-level-using-systolic-and-diastolic-shock-index
#16
JOURNAL ARTICLE
Yumin Jeon, Sungjin Kim, Sejoong Ahn, Jong-Hak Park, Hanjin Cho, Sungwoo Moon, Sukyo Lee
INTRODUCTION: Identifying patients with at a high risk of progressing to septic shock is essential. Due to systemic vasodilation in the pathophysiology of septic shock, the use of diastolic blood pressure (DBP) has emerged. We hypothesized that the initial shock index (SI) and diastolic SI (DSI) at the emergency department (ED) triage can predict septic shock. METHOD: This observational study used the prospectively collected sepsis registry. The primary outcome was progression to septic shock...
January 28, 2024: American Journal of Emergency Medicine
https://read.qxmd.com/read/38281956/venovenous-extracorporeal-membrane-oxygenation-after-cardiac-arrest-for-acute-respiratory-distress-syndrome-caused-by-legionella-a-case-report
#17
JOURNAL ARTICLE
John C Grotberg, Linda Schulte, Erin Schumer, Mary Sullivan, Kunal Kotkar, Mohammad F Masood, Amit Pawale
BACKGROUND: Legionella remains underdiagnosed in the intensive care unit and can progress to acute respiratory distress syndrome (ARDS), multiorgan failure and death. In severe cases, venovenous extracorporeal membrane oxygenation (VV-ECMO) allows time for resolution of disease with Legionella-targeted therapy. VV-ECMO outcomes for Legionella are favorable with reported survival greater than 70%. Rapid molecular polymerase chain reaction (PCR) testing of the lower respiratory tract aids in diagnosing Legionella with high sensitivity and specificity...
January 28, 2024: Journal of Cardiothoracic Surgery
https://read.qxmd.com/read/38281375/utility-of-emergency-department-triage-tools-in-predicting-the-need-for-intensive-respiratory-or-vasopressor-support-in-adult-patients-with-covid-19
#18
JOURNAL ARTICLE
Anandhi Deva, Ronit Juthani, Ezhil Kugan, N Balamurugan, Manu Ayyan
BACKGROUND: Serum and radiological parameters used to predict prognosis in COVID patients are not feasible in the Emergency Department. Due to its damaging effect on multiple organs and lungs, scores used to assess multiorgan damage and pneumonia such as Pandemic Medical Early Warning Score (PMEWS), National Early Warning Score 2 (NEWS2), WHO score, quick Sequential Organ Failure Assessment (qSOFA), and DS-CRB 65 can be used to triage patients in the Emergency Department. They can be used to predict patients with the highest risk of seven-day mortality and need for intensive respiratory or vasopressor support (IRVS)...
January 23, 2024: American Journal of Emergency Medicine
https://read.qxmd.com/read/38276999/echocardiographic-characteristics-in-neonates-with-septic-shock
#19
JOURNAL ARTICLE
Kumari Gunjan, Manoj Modi, Anup Thakur, Arun Soni, Satish Saluja
Clinical parameters used for hemodynamic assessment and titration of vasopressor therapy in neonates with septic shock have several limitations. Functional echocardiography is an emerging tool for bedside assessment of cardiac function and may be useful for diagnosis of shock and assessing the response to therapy. Data regarding echocardiographic parameters in neonates with shock is lacking. This prospective observational study was conducted in a Level III NICU with the primary objective of comparing echocardiographic characteristics of neonates with septic shock at diagnosis, following fluid boluses, and after maximum inotropic support [A1]...
January 26, 2024: European Journal of Pediatrics
https://read.qxmd.com/read/38251615/trauma-anesthesiology-perioperative-management-update
#20
REVIEW
Ryan Perlman, Kevin Tsai, Jessie Lo
Anesthesia for patients with life-threatening injuries is an essential part of post-accident care. Unfortunately, there is variability in trauma anesthesia care and numerous nonstandardized methods of working with patients remain. Uncertainty exists as to when and how best to intubate trauma patients, the use of vasopressors, and the appropriate management of severe traumatic brain injury. Some physicians recommend prehospital rapid sequence intubation, whereas others use bag-mask ventilation at lower pressures with no cricoid pressure and early transport to a trauma center...
December 2023: Advances in Anesthesia
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