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https://www.readbyqxmd.com/read/28528561/angiotensin-ii-for-the-treatment-of-vasodilatory-shock
#1
Ashish Khanna, Shane W English, Xueyuan S Wang, Kealy Ham, James Tumlin, Harold Szerlip, Laurence W Busse, Laith Altaweel, Timothy E Albertson, Caleb Mackey, Michael T McCurdy, David W Boldt, Stefan Chock, Paul J Young, Kenneth Krell, Richard G Wunderink, Marlies Ostermann, Raghavan Murugan, Michelle N Gong, Rakshit Panwar, Johanna Hästbacka, Raphael Favory, Balasubramanian Venkatesh, B Taylor Thompson, Rinaldo Bellomo, Jeffrey Jensen, Stew Kroll, Lakhmir S Chawla, George F Tidmarsh, Adam M Deane
Background Vasodilatory shock that does not respond to high-dose vasopressors is associated with high mortality. We investigated the effectiveness of angiotensin II for the treatment of patients with this condition. Methods We randomly assigned patients with vasodilatory shock who were receiving more than 0.2 μg of norepinephrine per kilogram of body weight per minute or the equivalent dose of another vasopressor to receive infusions of either angiotensin II or placebo. The primary end point was a response with respect to mean arterial pressure at hour 3 after the start of infusion, with response defined as an increase from baseline of at least 10 mm Hg or an increase to at least 75 mm Hg, without an increase in the dose of background vasopressors...
May 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28526675/iterative-user-interface-design-for-automated-sequential-organ-failure-assessment-score-calculator-in-sepsis-detection
#2
Christopher Ansel Aakre, Jaben E Kitson, Man Li, Vitaly Herasevich
BACKGROUND: The new sepsis definition has increased the need for frequent sequential organ failure assessment (SOFA) score recalculation and the clerical burden of information retrieval makes this score ideal for automated calculation. OBJECTIVE: The aim of this study was to (1) estimate the clerical workload of manual SOFA score calculation through a time-motion analysis and (2) describe a user-centered design process for an electronic medical record (EMR) integrated, automated SOFA score calculator with subsequent usability evaluation study...
May 18, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28525777/prevalence-and-clinical-significance-of-early-high-endotoxin-activity-in-septic-shock-an-observational-study
#3
Maurizio Bottiroli, Gianpaola Monti, Riccardo Pinciroli, Irene Vecchi, Valeria Terzi, Giuseppe Ortisi, Giampaolo Casella, Roberto Fumagalli
PURPOSE: To measure the prevalence of elevated Endotoxin Activity (EA) in a large cohort of patients with Septic Shock (SS), and to assess its value as an early indicator of Gram-Negative (GN) infection, disease severity, and patient risk. MATERIALS AND METHODS: Adult patients were enrolled in this observational study if an EA determination was obtained within 24-h from SS onset. Demographic, clinical, and microbiological data were collected. In-hospital follow-up was also conducted...
April 26, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28521523/sepsis-in-internal-medicine-wards-current-knowledge-uncertainties-and-new-approaches-for-management-optimization
#4
Vincenzo Zaccone, Alberto Tosoni, Giovanna Passaro, Carla Vallone, Michele Impagnatiello, Domenica Donatella Li Puma, Salvatore De Cosmo, Raffaele Landolfi, Antonio Mirijello
Sepsis represents a global health problem in terms of morbidity, mortality, social and economic costs. Although usually managed in Intensive Care Units, sepsis showed an increased prevalence among Internal Medicine wards in the last decade. This is substantially due to the ageing of population and to multi-morbidity. These characteristics represent both a risk factor for sepsis and a relative contra-indication for the admission to Intensive Care Units. Although there is a lack of literature on the management of sepsis in Internal Medicine, the outcome of these patients seems to be gradually improving...
May 18, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28511481/relationship-of-on-admission-hypocalcaemia-and-illness-severity-as-measured-by-apache-ii-and-sofa-score-in-intensive-care-patients
#5
Samarjit Dey, Habib Md Reazaul Karim, Mohd Yunus, Angkita Barman, Prithwis Bhattacharyya, Manas Pratim Borthakur
INTRODUCTION: Hypocalcaemia is very much prevalent in critically ill patients yet very less is known about its association with severity of illness. Acute Physiology and Chronic Health Evaluation (APACHE) and Sequential Organ Failure Assessment (SOFA) are two commonly used and validated scoring tool used to assess the severity of illness in critically ill patients. AIM: To analyze the relation of on admission hypocalcaemia with severity of illness as measured by APACHE-II and SOFA scores...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28510786/the-impact-of-frailty-on-noninvasive-mechanical-ventilation-in-elderly-medical-intensive-care-unit-patients
#6
Iskender Kara, F Yildirim, A Zerman, Z Gullu, N Boyaci, B B Aydogan, U Gaygisiz, K Gonderen, G Arik, M Turkoglu, M Aydogdu, G Aygencel, Z Ulger, G Gursel
AIM: Many factors affecting noninvasive ventilation (NIV) in critically ill patients have been reported in the literature, but there is no study about the effect of frailty. With this study, the frailty prevalence was evaluated with two different frailty scores among the NIV population of a medical intensive care unit (ICU). Besides, the impact of frailty on NIV success and mortality and its association with NIV application problems were evaluated. METHOD: A prospective observational cohort study was performed on patients who were over 50 years of age and assigned to NIV due to hypercapnic respiratory failure...
May 16, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28509709/utility-of-sofa-and-%C3%AE-sofa-scores-for-predicting-outcome-in-critically-ill-patients-from-the-emergency-department
#7
Renata García-Gigorro, Ignacio Sáez-de la Fuente, Helena Marín Mateos, Eva M Andrés-Esteban, Jose A Sanchez-Izquierdo, Juan C Montejo-González
OBJECTIVE: The condition of critically ill patients in the emergency department (ED) varies from moment to moment. The aims of this study are to quantify sequential organ failure assessment (SOFA) and changes in SOFA scores over time and determine its prognostic impact. PATIENTS AND METHODS: This is a prospective observational cohort study. We included 269 patients consecutively admitted to the ICU from the ED over 18 months. The SOFA scores at ED admission (ED-SOFA) and ICU admission (ICU-SOFA) were obtained...
May 15, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28506672/comparison-of-the-nosocomial-pneumonia-mortality-prediction-npmp-model-with-standard-mortality-prediction-tools
#8
M Srinivasan, N Shetty, S Gadekari, G Thunga, K Rao, V Kunhikatta
BACKGROUND: Severity or mortality prediction of nosocomial pneumonia could aid in the effective triage of patients and assisting physicians. AIM: To compare various severity assessment scoring systems for predicting intensive care unit (ICU) mortality in nosocomial pneumonia patients. METHODS: A prospective cohort study was conducted in a tertiary care university-affiliated hospital in Manipal, India. One hundred patients with nosocomial pneumonia, admitted in the ICUs who developed pneumonia after >48h of admission, were included...
April 15, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28503281/effect-of-septimeb-tm-as-a-new-natural-extract-on-severe-sepsis-a-randomized-clinical-trial
#9
Alieh Pourdast, Maryam Sanaei, Sirous Jafari, Mostafa Mohammadi, Hossein Khalili, Gita Shafiee, Zeinab Ahadi, Mahsa Rostami, Saba Alizad, Ramin Heshmat, Minoo Mohraz
BACKGROUND: Septimeb as a herbal medicine has regulatory effects on inflammation. This study set to evaluate the effects of Septimeb among patients with sepsis on inflammatory biomarkers and survival rate. METHODS: In this randomized clinical trial, 51 patients with sepsis from the ICU and medical ward of Imam Khomeini Hospital were divided into two groups: Septimeb (n=25) and control group (n=26). In the control group, the patients received a standard treatment only for 7 days, while Septimeb group received Septimeb (6cc vial with 500cc serum glucose infusion 5% daily for one to two hours) plus standard treatment of sepsis for 7 days...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28502744/effect-of-high-dose-sodium-selenite-in-cardiac-surgery-patients-a%C3%A2-randomized-controlled-bi-center-trial
#10
Tanja Schmidt, Hans Pargger, Esther Seeberger, Friedemann Eckhart, Stefanie von Felten, Christoph Haberthür
BACKGROUND & AIMS: Cardiac surgery is accompanied by oxidative stress and systemic inflammatory response, which may be associated with organ dysfunction and increased mortality. Selenium and selenoenzymes are important constituents of anti-oxidative defense. We hypothesized that high-dose sodium selenite supplementation can attenuate the postoperative inflammation and might, therefore, improve clinical outcome. METHODS: Randomized, placebo-controlled, double-blinded, bi-center study on 411 adult patients undergoing elective cardiac surgery...
May 2, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28500507/impact-of-severe-hematological-abnormalities-in-the-outcome-of-hospitalized-patients-with-influenza-virus-infection
#11
A Lalueza, H Trujillo, J Laureiro, B Ayuso, P Hernández-Jiménez, C Castillo, M Torres, D Folgueira, O Madrid, C Díaz-Pedroche, E Arrieta, C Arévalo, C Lumbreras
Although hematological abnormalities have been described among patients with influenza virus infection, little is known about their impact on the outcome of the patients. The aim of this study was to assess the frequency and clinical impact of severe hematological abnormalities in patients with confirmed influenza virus infection. This was an observational retrospective study including all adult patients with diagnosis of influenza virus infection hospitalized from January to May 2016 in our institution. Influenza virus infection was diagnosed by means of rRT-PCR assay performed on respiratory samples...
May 13, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28497591/hypophosphatemia-after-nontraumatic-intracranial-hemorrhage
#12
E Junttila, J Koskenkari, T Ala-Kokko
BACKGROUND: The aim of this study was to assess the incidence and contributing factors of hypophosphatemia and the association with poor long-term outcome after nontraumatic intracranial hemorrhage. METHODS: This was a prospective, observational study of patients with nontraumatic intracranial hemorrhage (i.e., aneurysmal or perimesencephalic subarachnoid hemorrhage, or spontaneous intracerebral or intraventricular hemorrhage) treated in the intensive care unit (ICU) at our university hospital...
May 11, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28494887/preoperative-risk-stratification-of-critically-ill-patients
#13
Curtis C Copeland, Andrew Young, Tristan Grogan, Eilon Gabel, Anahat Dhillon, Vadim Gudzenko
STUDY OBJECTIVE: Risk assessment historically emphasized cardiac morbidity and mortality in elective, outpatient, non-cardiac surgery. However, critically ill patients increasingly present for therapeutic interventions. Our study investigated the relationship of American Society of Anesthesiologists (ASA) class, revised cardiac risk index (RCRI), and sequential organ failure assessment (SOFA) score with survival to discharge in critically ill patients with respiratory failure. DESIGN: Retrospective cohort analysis over a 21-month period...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28486893/relationship-between-functional-status-prior-to-onset-of-critical-illness-and-mortality-a-prospective-multicentre-cohort-study
#14
R Rivera-Lopez, R Gutierrez-Rodriguez, C Lopez-Caler, E Aguilar-Alonso, E Castillo-Lorente, M Garcia-Delgado, M D Arias-Verdu, D Iglesias-Posadilla, J E Barrueco-Francioni, G Quesada-Garcia, R Rivera-Fernandez
This prospective study aimed to assess the association between prior functional status and hospital mortality for patients admitted to four intensive care units in Spain between 2006 and 2012. Prior functional status was classified into three groups, using a modification of the Glasgow Outcome Scale (GOS), including group 1 with no limitations on activities of daily living; group 2 with some limitations but self-sufficient; and group 3 who were dependent on others for their activities of daily living. Of the 1,757 patients considered (mean Simplified Acute Physiology Score [SAPS] predicted mortality 14...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28485319/dynamic-change-of-red-cell-distribution-width-levels-in-prediction-of-hospital-mortality-in-chinese-elderly-patients-with-septic-shock
#15
Xue-Feng Ju, Fei Wang, Li Wang, Xiao Wu, Ting-Ting Jiang, Da-Li You, Bing-Hua Yang, Jian-Jun Xia, Shan-You Hu
BACKGROUND: The normal range of red cell distribution width (RDW) level is <15%. Several studies have indicated that a high RDW level was associated with mortality in critically ill patients, and the patients with a high RDW level need increased focus in clinical practice. In view of the difficulty in defining the specific value of high RDW level, the key is to focus on the patient with the level beyond the normal upper limit. This study aimed to determine whether dynamic change of RDW levels, rather than the level itself, is predictive of death in elderly patients with septic shock when RDW level is beyond 15%...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28473224/the-n-terminal-pro-brain-natriuretic-peptide-is-the-best-predictor-of-mortality-during-hospitalization-in-patients-with-low-sepsis-related-organ-failure-assessment
#16
Eva García Villalba, Enrique Bernal Morell, Mari Paz Egea, Irene Marín, Antonia Alcaraz Garcia, Angeles Muñoz, MariCarmen Vera, Salvador Valero, Monica Martinez, Victoria Callejo Hurtado, Jose Miguel Gomez Verdu, Angela Santo, Alfredo Cano Sanchez
INTRODUCTION: The purpose of this study was to investigate the value of N-terminal pro brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP) and procalcitonin (PCT) in predicting mortality in septic patients during hospitalization with mortality risk<10% evaluated by Sepsis-related Organ Failure Assessment (SOFA). MATERIAL AND METHODS: Prospective, observational study performed in sepsis patients with SOFA risk<10%. We obtained levels of biomarkers in the first 72h after admission in hospital...
May 1, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28467150/impact-of-zinc-supplementation-on-the-clinical-outcomes-of-patients-with-severe-head-trauma-a-double-blind-randomized-clinical-trial
#17
Maryam Khazdouz, Mohsen Mazidi, Mohammad-Reza Ehsaei, Gordon Ferns, Andre Pascal Kengne, Abdol-Reza Norouzy
To determine the effects of zinc supplementation on clinical outcomes of patients with severe head trauma, this double-blind clinical trial randomly allocated 100 patients with severe head trauma, aged between 18 to 65 years, to receive placebo or 120 mg zinc via a nasogastric tube for 15 days. Plasma zinc and copper, 24-hour urinary zinc excretion, Sequential Organ Failure Assessment (SOFA) were assessed on days 1, 7, and 16. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cell (WBC) count were measured on days 1 and 16...
May 3, 2017: Journal of Dietary Supplements
https://www.readbyqxmd.com/read/28466149/potentially-modifiable-factors-contributing-to-sepsis-associated-encephalopathy
#18
Romain Sonneville, Etienne de Montmollin, Julien Poujade, Maïté Garrouste-Orgeas, Bertrand Souweine, Michael Darmon, Eric Mariotte, Laurent Argaud, François Barbier, Dany Goldgran-Toledano, Guillaume Marcotte, Anne-Sylvie Dumenil, Samir Jamali, Guillaume Lacave, Stéphane Ruckly, Bruno Mourvillier, Jean-François Timsit
PURPOSE: Identifying modifiable factors for sepsis-associated encephalopathy may help improve patient care and outcomes. METHODS: We conducted a retrospective analysis of a prospective multicenter database. Sepsis-associated encephalopathy (SAE) was defined by a score on the Glasgow coma scale (GCS) <15 or when features of delirium were noted. Potentially modifiable risk factors for SAE at ICU admission and its impact on mortality were investigated using multivariate logistic regression analysis and Cox proportional hazard modeling, respectively...
May 2, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28463183/personalized-risk-scoring-for-critical-care-prognosis-using-mixtures-of-gaussian-processes
#19
Ahmed M Alaa, Jinsung Yoon, Scott Hu, Mihaela van der Schaar
In this paper, we develop a personalized real-time risk scoring algorithm that provides timely and granular assessments for the clinical acuity of ward patients based on their (temporal) lab tests and vital signs; the proposed risk scoring system ensures timely intensive care unit (ICU) admissions for clinically deteriorating patients. METHODS: The risk scoring system is based on the idea of sequential hypothesis testing under an uncertain time horizon. The system learns a set of latent patient subtypes from the offline electronic health record data, and trains a mixture of Gaussian Process (GP) experts, where each expert models the physiological data streams associated with a specific patient subtype...
April 27, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28459403/-evaluation-value-of-oxygenation-index-of-mechanical-ventilation-on-the-prognosis-of-patients-with-ards-a-retrospective-analysis-with-228-patients
#20
Ziyi Jia, Xiaowei Liu, Zhi Liu
OBJECTIVE: To investigate the evaluation value of oxygenation index at different times of mechanical ventilation (MV) on the prognosis of patients with acute respiratory distress syndrome (ARDS). METHODS: A retrospectively analysis was conducted. A total of 228 patients with ARDS admitted to Department of Emergency of China Medical University Affiliated First Hospital from February 2014 to June 2016 were enrolled. All patients underwent MV treatment, and recruitment maneuver (RM) was performed by pressure-controlled ventilation (PCV) 30 minutes after the implementation of the protective ventilation strategy...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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