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Fluid critical care

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https://www.readbyqxmd.com/read/29657606/early-biliary-drainage-is-associated-with-favourable-outcomes-in-critically-ill-patients-with-acute-cholangitis
#1
Mohammed Aboelsoud, Osama Siddique, Alexander Morales, Young Seol, Mazen Al-Qadi
Introduction: Acute cholangitis (AC) is a clinical condition that requires prompt medical management with IV fluids, antibiotics, and biliary drainage (BD). The optimal timing for BD remains unclear. Aim: To investigate the effect of biliary drainage timing on clinical outcomes in AC. Material and methods: We conducted a retrospective study of patients with AC admitted to the ICU using the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database...
2018: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/29657376/smoke-inhalation-injury-etiopathogenesis-diagnosis-and-management
#2
REVIEW
Kapil Gupta, Mayank Mehrotra, Parul Kumar, Anoop Raj Gogia, Arun Prasad, Joseph Arnold Fisher
Smoke inhalation injury is a major determinant of morbidity and mortality in fire victims. It is a complex multifaceted injury affecting initially the airway; however, in short time, it can become a complex life-threatening systemic disease affecting every organ in the body. In this review, we provide a summary of the underlying pathophysiology of organ dysfunction and provide an up-to-date survey of the various critical care modalities that have been found beneficial in caring for these patients. Major pathophysiological change is development of edema in the respiratory tract...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29657372/targeted-interventions-in-critically-ill-children-with-severe-dengue
#3
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29651952/special-traumatized-populations-burns-and-hypothermia
#4
Shruti Mehrotra, Amita Misir
It is important for physicians treating children to be aware of unique presentation that require expertise and knowledge. Two areas of importance when caring for traumatized children are Thermal Burn Injuries, and Hypothermia. Burns commonly result in morbidity in children; as such, the appropriate identification of the severity of the burn and appropriate management are integral to minimize the complications of burns during the acute phase. Attention to proper fluid management is paramount. Knowledge of types of solutions to use during Burn treatment is important...
April 11, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29651625/clinical-characteristics-and-prognosis-of-severe-anti-n-methyl-d-aspartate-receptor-encephalitis-patients
#5
Yan Zhang, Gang Liu, Mengdi Jiang, Weibi Chen, Yanbo He, Yingying Su
BACKGROUND AND PURPOSE: Data concerning the characteristics and duration of the critical manifestations, treatment response, and long-term outcomes of severe anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis patients compared to those of non-severe patients are limited. This observational study was performed to explore the clinical characteristics and long-term outcomes of severe anti-NMDAR encephalitis patients. METHODS: According to their characteristics on admission to the neurology intensive care unit, patients with anti-NMDAR encephalitis were divided into a severe group and a non-severe group...
April 12, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29629201/anesthesia-and-fast-track-in-video-assisted-thoracic-surgery-vats-from-evidence-to-practice
#6
REVIEW
Marzia Umari, Stefano Falini, Matteo Segat, Michele Zuliani, Marco Crisman, Lucia Comuzzi, Francesco Pagos, Stefano Lovadina, Umberto Lucangelo
In thoracic surgery, the introduction of video-assisted thoracoscopic techniques has allowed the development of fast-track protocols, with shorter hospital lengths of stay and improved outcomes. The perioperative management needs to be optimized accordingly, with the goal of reducing postoperative complications and speeding recovery times. Premedication performed in the operative room should be wisely administered because often linked to late discharge from the post-anesthesia care unit (PACU). Inhalatory anesthesia, when possible, should be preferred based on protective effects on postoperative lung inflammation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29626019/diagnosis-and-management-of-sepsis
#7
Tom Evans
Sepsis is a common condition with high morbidity and mortality. Although many patients may require critical care, this article considers the features of sepsis that are of most relevance to acute general physicians. Recently updated definitions of sepsis and septic shock have been proposed which better identify patients who are likely to have a poor outcome, and therefore give an opportunity to escalate care. Despite these advances, there is still no molecular signature able to diagnose sepsis. Pathogenesis is complex, with many immune and non-immune mediators involved...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29621027/cardiac-output-monitoring-how-to-choose-the-optimal-method-for-the-individual-patient
#8
Bernd Saugel, Jean-Louis Vincent
PURPOSE OF REVIEW: To review the different methods available for the assessment of cardiac output (CO) and describe their specific indications in intensive care and perioperative medicine. RECENT FINDINGS: In critically ill patients, persistent circulatory shock after initial resuscitation is an indication for the assessment of CO to monitor the response to fluids and vasoactive agents. In patients with circulatory shock associated with right ventricular dysfunction, pulmonary artery hypertension, or acute respiratory distress syndrome, invasive CO monitoring using indicator dilution methods is indicated...
April 4, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29616498/quality-of-care-in-rheumatoid-disease-from-the-clinician-perspective-a-modified-delphi-panel-approach
#9
Finbar O'Shea, Peter C Taylor, Gavin Dickie, Andrew Yaworsky, Benjamin Banderas, Sumesh Kachroo
INTRODUCTION: To establish clinical consensus on important and relevant quality-of-care (QoC) attributes in rheumatic disease (RD) treatment that may improve treatment outcomes and guide best practices. METHODS: Twenty-three QoC attributes were identified in a literature review. Fifteen European-based clinicians were selected based on their contributions to RD guidelines, publications, and patient care. A three-round (an interview round and two web-based rounds) modified Delphi panel was conducted to reach consensus and finalize a QoC attribute list...
April 3, 2018: Rheumatology and Therapy
https://www.readbyqxmd.com/read/29614588/-the-effect-of-continuous-veno-venous-hemofiltration-on-neutrophil-gelatinase-associated-lipocalin-plasma-levels-in-critically-ill-patients-with-acute-kidney-injury
#10
H Wang, N Cui, Y K Zhou, W Cheng, L Li, Y Long, D W Liu
Objective: To evaluate the effect of continuous veno venous hemofiltration (CVVH) on neutrophil gelatinase associated lipocalin (NGAL) in critically ill patients with acute kidney injury (AKI). Methods: Critically ill patients with AKI who needed CVVH and admitted to Department of Critical Care Medicine of Peking Union Medical College Hospital were enrolled prospectively from January 2015 to June 2015. AN69 membrane filters were used for CVVH. Prefilter, postfilter,and plasma NGAL measurements were taken at 10 mins, 4 hours and 8 hours (T 10 min, T 4 h, T 8 h) after CVVH...
April 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29611254/oxytocin-levels-in-saliva-correlate-better-than-plasma-levels-with-concentrations-in-the-cerebrospinal-fluid-of-patients-in-neurocritical-care
#11
Jan Martin, Simone M Kagerbauer, Jens Gempt, Armin Podtschaske, Alexander Hapfelmeier, Gerhard Schneider
In the converging fields of neuroendocrinology and behavioural neuroscience, the interaction between peripheral secretion and central release of oxytocin in humans has not yet been comprehensively assessed. As the human brain is not directly accessible and as the collection of human cerebrospinal fluid (CSF) usually requires invasive procedures, easier accessible compartments such as blood or saliva attract increasing attention. In this study, we prospectively determined oxytocin concentrations in the three compartments plasma, CSF and saliva of fifty critically ill patients with neurological and neurosurgical diseases...
April 3, 2018: Journal of Neuroendocrinology
https://www.readbyqxmd.com/read/29600241/a-standardized-needs-assessment-tool-to-inform-the-curriculum-development-process-for-pediatric-resuscitation-simulation-based-education-in-resource-limited-settings
#12
Nicole Shilkofski, Amanda Crichlow, Julie Rice, Leslie Cope, Ye Myint Kyaw, Thazin Mon, Sarah Kiguli, Julianna Jung
Introduction: Under five mortality rates (UFMR) remain high for children in low- and middle-income countries (LMICs) in the developing world. Education for practitioners in these environments is a key factor to improve outcomes that will address United Nations Sustainable Development Goals 3 and 10 (good health and well being and reduced inequalities). In order to appropriately contextualize a curriculum using simulation, it is necessary to first conduct a needs assessment of the target learner population...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29597227/from-continuous-renal-replacement-therapies-to-multiple-organ-support-therapy
#13
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco, Gaetano La Manna
The incidence of the multiple organ dysfunction syndrome (MODS) is rapidly increasing in intensive care units (ICU). It usually combines with sepsis and is the most frequent cause of death in the ICU patients. The nature of the ICU patients has changed in the last years. It includes a variety of patients with severe cases due to major surgical interventions, trauma, hemodynamic instability, sepsis, and so on but also older people than previous times. All these situations can easily lead to MODS. In the prior years, the only available and efficient therapy was renal replacement therapy (RRT) for treating acute renal failure, but the development of technology also gives us devices to support the other systems...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597223/discontinuation-of-continuous-renal-replacement-therapy-and-dialysis-dependence
#14
Gregorio Romero-González, Anna Lorenzin, Mauro Neri, Fiorenza Ferrari, Alejandra Molano-Triviño, Alessandra Brendolan, Claudio Ronco
Renal replacement therapy (RRT) is a form of extracorporeal support for critical patients, especially for those with acute kidney injury. This therapy enables to gain adequate control over the great metabolic and fluids demand when kidneys are not able to do so; this condition is habitually present in patients who are admitted to intensive care units. However, it is also clear that these patients present a higher mortality rate and, in some cases, complications associated with the therapy. Therefore, it is fundamental to optimize and customize different aspects of RRT that range from the ideal timing including the modality and the dose until its suspension or ending...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29596431/measuring-the-preparedness-of-health-facilities-to-deliver-emergency-obstetric-care-in-a-south-african-district
#15
Siphiwe Bridget Pearl Thwala, Duane Blaauw, Freddie Ssengooba
BACKGROUND: Improving the delivery of emergency obstetric care (EmNOC) remains critical in addressing direct causes of maternal mortality. United Nations (UN) agencies have promoted standard methods for evaluating the availability of EmNOC facilities although modifications have been proposed by others. This study presents an assessment of the preparedness of public health facilities to provide EmNOC using these methods in one South African district with a persistently high maternal mortality ratio...
2018: PloS One
https://www.readbyqxmd.com/read/29582860/covariate-determinants-of-effective-dosing-regimens-for-time-dependent-beta-lactam-antibiotics-for-critically-ill-patients
#16
Milan Kaska, Eduard Havel, Iva Selke-Krulichova, Petr Safranek, Jan Bezouska, Jirina Martinkova
AIMS: Critically ill patients undergoing aggressive fluid resuscitation and treated empirically with hydrosoluble time-dependent beta-lactam antibiotics are at risk for sub-therapeutic plasma concentrations. The aim of this study was to assess the impact of two covariates - creatinine clearance (Clcr ) and cumulative fluid balance (CFB) on pharmacokinetics/pharmacodynamics (PK/PD) target attainment within a week of treatment with meropenem (ME) or piperacillin/tazobactam (PIP/TZB). METHODS: In this prospective observational pharmacokinetic (PK) study, 18 critically ill patients admitted to a surgical Intensive Care Unit (ICU) were enrolled...
March 27, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29578878/intra-abdominal-hypertension-is-more-common-than-previously-thought-a-prospective-study-in-a-mixed-medical-surgical-icu
#17
Patrick B Murphy, Neil G Parry, Nathalie Sela, Ken Leslie, Kelly Vogt, Ian Ball
OBJECTIVES: To determine the prevalence of intra-abdominal hypertension in mixed medical-surgical critically ill patients using modern definitions and measurement techniques. Secondarily to determine variables associated with intra-abdominal hypertension and ICU mortality. DESIGN: A prospective observational study. SETTING: Single institution trauma, medical and surgical ICU in Canada. PATIENTS: Consecutive adult patients admitted to the ICU (n = 285)...
March 23, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29575788/acute-kidney-injury-in-critically-ill-patients-a-prospective-randomized-study-of-tidal-peritoneal-dialysis-versus-continuous-renal-replacement-therapy
#18
Abdullah Al-Hwiesh, Ibrahiem Abdul-Rahman, Fredric Finkelstein, Jose Divino-Filho, Hatem Qutub, Nadia Al-Audah, Abdalla Abdelrahman, Nazeeh El-Fakhrany, Mohammed Nasr El-Din, Tamer El-Salamony, Abdulsalam Noor, Mohammed Al-Shahrani, Khalid Al-Otaibi
Few studies have discussed the role of peritoneal dialysis (PD) in managing acute kidney injury (AKI) in critically ill patients. The present study compares the outcome of AKI in intensive care unit (ICU) patients randomized to treatment with tidal PD (TPD) or continuous venovenous hemodiafiltration (CVVHDF). One hundred and twenty-five ICU patients with AKI were randomly allotted to CVVHDF, (Group A, N = 62) or TPD, (group B, N = 63). Cause and severity of renal injury were assessed at the time of initiating dialysis...
March 25, 2018: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29574777/doppler-renal-resistance-index-for-the-prediction-of-response-to-passive-leg-raising-following-cardiac-surgery
#19
William Beaubien-Souligny, Gabriel Huard, Josée Bouchard, Yoan Lamarche, André Denault, Martin Albert
PURPOSE: Doppler-based renal resistance index (RI) can be measured at the bedside of critically ill patients. This study was designed to assess if the RI predicted an increase in cardiac output (CO) following passive leg-raising (PLR) in patients admitted to the intensive care unit after cardiac surgery. METHODS: During this single center prospective study, Doppler assessment of RI and measurements of CO using the thermodilution method were performed, after surgery, in the intensive care unit before and after PLR...
March 25, 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29562530/cerebrospinal-fluid-biomarkers-for-early-and-differential-alzheimer-s-disease-diagnosis
#20
Maria Bjerke, Sebastiaan Engelborghs
An accurate and early diagnosis of Alzheimer's disease (AD) is important to select optimal patient care and is critical in current clinical trials targeting core AD neuropathological features. The past decades, much progress has been made in the development and validation of cerebrospinal fluid (CSF) biomarkers for the biochemical diagnosis of AD, including standardization and harmonization of (pre-) analytical procedures. This has resulted in three core CSF biomarkers for AD diagnostics, namely the 42 amino acid long amyloid-beta peptide (Aβ1-42), total tau protein (T-tau), and tau phosphorylated at threonine 181 (P-tau181)...
2018: Journal of Alzheimer's Disease: JAD
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