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https://www.readbyqxmd.com/read/28719839/the-prognostic-value-of-brain-natriuretic-peptide-bnp-in-non-cardiac-patients-with-sepsis-ultra-long-follow-up
#1
Johad Khoury, Majd Arow, Adi Elias, Badira F Makhoul, Gidon Berger, Marielle Kaplan, Tanya Mashiach, Reem Ismael-Badarneh, Doron Aronson, Zaher S Azzam
OBJECTIVES: Sepsis is a multifactorial syndrome with increasing incidence of morbidity and mortality. Identification of outcome predictors is therefore essential. Recently, elevated brain natriuretic peptide (BNP) levels have been observed in patients with septic shock. Little information is available concerning BNP levels in patients with critical illness, especially with sepsis. Therefore, this study aims to evaluate the role of BNP as a biomarker for long-term mortality in patients with sepsis...
July 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28719531/nocturnal-dexmedetomidine-in-nonintubated-critically-ill-patients-sleep-or-sedation
#2
Haley Goucher Miranda, Andrew D Krystal, Michael A Fierro
No abstract text is available yet for this article.
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28718877/takotsubo-syndrome-in-hemodynamically-unstable-patients-admitted-to-the-intensive-care-unit-a-retrospective-study
#3
J Oras, J Lundgren, B Redfors, D Brandin, E Omerovic, H Seeman-Lodding, S-E Ricksten
INTRODUCTION: Takotsubo syndrome (TS) is an acute cardiac condition that is often triggered by critical illness but that has rarely been studied in the intensive care unit (ICU) setting. The aim of this study was to (i) estimate the incidence of TS in a hemodynamically unstable ICU-population; (ii) identify predictors of TS in this population; (iii) study the impact of TS on prognosis and course of hospitalization. METHODS: Medical records from all patients admitted to our general ICU from 2012 to 2015 were analyzed...
July 18, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28718341/diagnostic-yield-and-outcomes-of-computed-tomography-of-the-head-in-critically-ill-nontrauma-patients
#4
Fabian Finkelmeier, Sophie Walter, Kai-Henrik Peiffer, Anjali Cremer, Andrea Tal, Thomas Vogl, Stefan Zeuzem, Stephan Fichtlscherer, Mireen Friedrich-Rust, Jörg Bojunga, Harald Farnik
BACKGROUND: Computed tomography of the head (HCT) is a widely used diagnostic tool, especially for emergency and trauma patients. However, the diagnostic yield and outcomes of HCT for patients on medical intensive care units (MICUs) are largely unknown. METHODS: We retrospectively evaluated all head CTs from patients admitted to a single-center MICU during a 5-year period for CT indications, diagnostic yield, and therapeutic consequences. Uni- and multivariate analyses for the evaluation of risk factors for positive head CT were conducted...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28717983/evaluation-of-acute-kidney-injury-aki-with-rifle-akin-ck-and-kdigo-in-critically-ill-trauma-patients
#5
F Ülger, M Pehlivanlar Küçük, A O Küçük, N K İlkaya, N Murat, B Bilgiç, H Abanoz
PURPOSE: The aim of our study was to evaluate the effects of AKI development on mortality with four different classification systems (RIFLE, AKIN, CK, KDIGO) in critically ill trauma patients followed in the intensive care unit. METHODS: A retrospective review of 2034 patients in our intensive care unit was conducted between July 2010 and August 2013. A total of 198 patients with primary trauma were included in the study to evaluate the development of AKI. RESULTS: When the presence of AKI was investigated according to the four criteria (RIFLE, AKIN, CK, and KDIGO), the highest incidence of AKI was found according to the KDIGO classification (74...
July 17, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28717966/association-between-aspirin-use-and-deep-venous-thrombosis-in-mechanically-ventilated-icu-patients
#6
Ena Gupta, Furqan S Siddiqi, Ryan Kunjal, Muhammad Faisal, Farah Al-Saffar, Abubakr A Bajwa, Lisa M Jones, Vandana Seeram, James D Cury, Adil Shujaat
Deep venous thrombosis (DVT) is common in intensive care unit (ICU) patients. It is often silent and may be complicated by pulmonary embolism and death. Thromboprophylaxis with heparin does not always prevent venous thromboembolism (VTE). Aspirin (ASA) reduces the risk of VTE in surgical and high-risk medical patients but it is unknown if ASA may prevent DVT in mechanically ventilated ICU patients. We performed a retrospective chart review of critically ill patients who received mechanical ventilation for >72 h and underwent venous ultrasonography for suspected DVT between Jan 2012 and Dec 2013...
July 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28717035/neurotoxic-concentration-of-piperacillin-during-continuous-infusion-in-critically-ill-patients
#7
Marie-Charlotte Quinton, Sandra Bodeau, Loay Kontar, Yoann Zerbib, Julien Maizel, Michel Slama, Kamel Masmoudi, Anne-Sophie Lemaire-Hurtel, Youssef Bennis
This retrospective cohort study included 53 patients admitted in ICU, of average age 69 years, without neurologic disorder before initiation of piperacillin continuous infusion at standard dose and who underwent piperacillin serum concentration monitoring. Among them, 23 developed neurologic disorder for which the piperacillin causality was chronologically and semiologically suggestive. A concentration threshold of 157.2 mg/L independently predicted neurotoxicity with 96.7% specificity and 52.2% sensitivity and may constitute a limitation when targeting less susceptible pathogens...
July 17, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28716593/the-critical-care-literature-2016
#8
REVIEW
Michael E Winters, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200%! (Herring et al., 2013). This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6h (Herring et al...
July 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28716451/multidrug-resistant-pseudomonas-aeruginosa-lower-respiratory-tract-infections-in-the-intensive-care-unit-prevalence-and-risk-factors
#9
Trang D Trinh, Evan J Zasowski, Kimberly C Claeys, Abdalhamid M Lagnf, Shravya Kidambi, Susan L Davis, Michael J Rybak
Intensive care unit (ICU) admission is a risk for multidrug-resistant (MDR) Pseudomonas aeruginosa, but factors specific to critically ill pneumonia patients are not fully characterized. Objective was to determine risk factors associated with MDR P. aeruginosa pneumonia among ICU patients. This was a retrospective case-control study of P. aeruginosa pneumonia in the ICU; cystic fibrosis and colonizers were excluded. Risk factors included comorbid conditions and prior healthcare exposure (anti-pseudomonal antibiotics, hospitalizations, nursing home, P...
June 19, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28716359/predictors-of-polymyxin-b-treatment-failure-in-gram-negative-healthcare-associated-infections-among-critically-ill-patients
#10
Bahiah Ismail, Mohd Nazri Shafei, Azian Harun, Saedah Ali, Mahamarowi Omar, Zakuan Zainy Deris
BACKGROUND: With increasing prevalence and spread of multidrug resistant Gram-negative infections, parenteral polymyxins resurged in clinical practice. The primary aim of the study was to determine the predictors of treatment failure and in-hospital mortality among critically ill patients treated with polymyxin B. METHODS: Demographic data, underlying diseases, procedures and details on polymyxin B therapy were retrospectively analyzed in a cohort of 84 patients who received intravenous polymyxin B in an intensive care unit from 2010 to 2014...
June 29, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28716301/discrete-%C3%AE-adrenergic-mechanisms-regulate-early-and-late-erythropoiesis-in-erythropoietin-resistant-anemia
#11
Shirin Hasan, Michael J Mosier, Andrea Szilagyi, Richard L Gamelli, Kuzhali Muthumalaiappan
BACKGROUND: Anemia of critical illness is resistant to exogenous erythropoietin. Packed red blood cells transfusions is the only treatment option, and despite related cost and morbidity, there is a need for alternate strategies. Erythrocyte development can be divided into erythropoietin-dependent and erythropoietin-independent stages. We have shown previously that erythropoietin-dependent development is intact in burn patients and the erythropoietin-independent early commitment stage, which is regulated by β1/β2-adrenergic mechanisms, is compromised...
July 14, 2017: Surgery
https://www.readbyqxmd.com/read/28714582/altered-levels-of-soluble-cd18-may-associate-immune-mechanisms-with-outcome-in-sepsis
#12
Tue Wenzel Kragstrup, Kristian Juul-Madsen, Stig Hill Christiansen, Xianwei Zhang, Jan Krog, Thomas Vorup-Jensen, Anders Gade Kjaergaard
The pathogenesis of sepsis involves a dual inflammatory response, with a hyper-inflammatory phase followed by, or in combination with, a hypo-inflammatory phase. The adhesion molecules LFA-1 (CD11a/CD18) and Mac-1 (CD11b/CD18) support leukocyte adhesion to intercellular adhesion molecules and phagocytosis through complement opsonisation, both processes relevant to the immune response during sepsis. Here, we investigate the role of soluble (s)CD18 in sepsis with emphasis on sCD18 as a mechanistic biomarker of immune reactions and outcome of sepsis...
July 17, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28714002/identification-of-key-genes-in-gram%C3%A2-positive-and-gram%C3%A2-negative-sepsis-using-stochastic-perturbation
#13
Zhenliang Li, Ying Zhang, Yaling Liu, Yanchun Liu, Youyi Li
Sepsis is an inflammatory response to pathogens (such as Gram‑positive and Gram‑negative bacteria), which has high morbidity and mortality in critically ill patients. The present study aimed to identify the key genes in Gram‑positive and Gram‑negative sepsis. GSE6535 was downloaded from Gene Expression Omnibus, containing 17 control samples, 18 Gram‑positive samples and 25 Gram‑negative samples. Subsequently, the limma package in R was used to screen the differentially expressed genes (DEGs). Hierarchical clustering was conducted for the specific DEGs in Gram‑negative and Gram‑negative samples using cluster software and the TreeView software...
July 15, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28713659/a-descriptive-report-of-early-mobilization-for-critically-ill-ventilated-patients-with-cancer
#14
Amanda Weeks, Claudine Campbell, Prabalini Rajendram, Weiji Shi, Louis Voigt
BACKGROUND: Early mobilization protocols have been successfully implemented to improve function in critically ill patients; however, no study has focused on the oncology population. OBJECTIVES: To investigate the feasibility of early mobilization and describe the rehabilitation interventions and discharge outcomes in a cohort of critically ill patients with cancer. DESIGN: Retrospective review. METHODS: A retrospective analysis of patients with cancer who participated in occupational and physical therapy while on mechanical ventilation utilizing an institutional early mobilization protocol from June 2010 - July 2011, was completed...
July 2017: Rehabilitation Oncology
https://www.readbyqxmd.com/read/28713149/reframing-medical-appropriateness-a-case-study-concerning-the-use-of-life-sustaining-technologies-for-a-patient-with-profoundly-diminished-quality-of-life
#15
Colleen M Gallagher, Elijah Weber, Nisha Rathi
This case study considers the clinical ethics issues of medical appropriateness and quality of life for patients who are critically ill. The case involves a terminally ill cancer patient with a profoundly diminished quality of life and an extremely poor prognosis; his spouse desires to bring him home, where she will arrange to keep him alive for as long as possible via life-sustaining interventions. The analysis engages with the complicated notion of medical appropriateness, both in general and as it pertains to life-sustaining interventions in a critical care setting, and considers the ethical implications of the various ways in which one might understand this concept...
2017: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/28712106/sensitivity-and-specificity-of-urinalysis-samples-in-critically-ill-patients
#16
Sean P Lee, Terrie Vasilopoulos, Thomas James Gallagher
BACKGROUND: Preemptive screening of urine for patients admitted to an intensive care unit can result in misinterpretation of data and over- or under-treatment of urinary tract infection. METHODS: Data were studied from 169 consecutive patients admitted to the neurologic or burn intensive care unit at Shands Hospital at the University of Florida. All patients had a urinary catheter in place at the time of admission. Urinalysis and urine culture were sent for analysis...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28711979/acute-kidney-injury-and-critical-limb-ischaemia-associated-with-the-use-of-the-so-called-legal-high-3-fluorophenmetrazine
#17
Michael Fawzy, Wei San Wong-Morrow, Anthony Beaumont, Chris K T Farmer
Until the law in the United Kingdom (UK) changed in May 2016 so called "legal highs" or "new psychoactive substances" were freely available in high street shops across the UK. Following prohibition these drugs are still easily purchased illegally via the internet. We report a case of a patient who self-administered 3-fluorophenmetrazine intravenously with catastrophic consequences. Adverse effects were almost immediate with symptoms of malaise and tachycardia. Two days post administration he was transferred to the intensive therapy unit with acute kidney injury and irreversible four limb ischaemia...
July 15, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28711676/should-we-consider-fecal-colonization-with-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-in-empiric-therapy-of-community-onset-sepsis
#18
Daša Stupica, Lara Lusa, Mirijam Nahtigal Klevišar, Sara Terzić, Mateja Pirš, Manica Mueller Premru, Franc Strle
In patients colonized with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E), the preference for carbapenems (CRB) over non-CRB antibiotics for empiric therapy of sepsis is questionable from an ecologic perspective and also how well colonization actually predicts an ESBL-E etiology of infection has been poorly investigated. The purpose of this retrospective observational study was to determine the positive predictive value (PPV) of ESBL-E fecal colonization for ESBL-E etiology of sepsis and the impact of empiric therapy on treatment outcome...
July 12, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28711371/extubation-to-high-flow-nasal-cannula-in-critically-ill-surgical-patients
#19
Navpreet K Dhillon, Eric J T Smith, Ara Ko, Megan Y Harada, Danielle Polevoi, Richard Liang, Galinos Barmparas, Eric J Ley
BACKGROUND: High-flow nasal cannula (HFNC) is increasingly used to reduce reintubations in patients with respiratory failure. Benefits include providing positive end expiratory pressure, reducing anatomical dead space, and decreasing work of breathing. We sought to compare outcomes of critically ill surgical patients extubated to HFNC versus conventional therapy. METHODS: A retrospective review was conducted in the surgical intensive care unit of an academic center during August 2015 to February 2016...
July 12, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28710725/clinicopathologic-parameters-associated-with-postoperative-complications-and-risk-factors-for-tumor-recurrence-and-mortality-after-tumor-resection-of-patients-with-colorectal-cancer
#20
Z Bai, J Wang, T Wang, Y Li, X Zhao, G Wu, Y Yang, W Deng, Z Zhang
OBJECTIVE: To delineate the association of postoperative complications with clinicopathologic factors and to identify risk factors for tumor recurrence and mortality after tumor resection in patients with colorectal cancer (CRC). METHODS: The clinical data of 1144 patients with CRC who underwent surgical intervention between 2003 and 2013 were retrieved. Correlations of postoperative complications with clinicopathologic factors were examined using univariate analysis...
July 14, 2017: Clinical & Translational Oncology
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