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https://www.readbyqxmd.com/read/28107357/vasopressor-use-for-severe-hypotension-a-multicentre-prospective-observational-study
#1
Francois Lamontagne, Deborah J Cook, Maureen O Meade, Andrew Seely, Andrew G Day, Emmanuel Charbonney, Karim Serri, Yoanna Skrobik, Paul Hebert, Charles St-Arnaud, Hector Quiroz-Martinez, Michaël Mayette, Daren K Heyland
BACKGROUND: The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/28107266/early-fluid-overload-prolongs-mechanical-ventilation-in-children-with-viral-lower-respiratory-tract-disease
#2
Sarah A Ingelse, Hanke M G Wiegers, Job C Calis, Job B van Woensel, Reinout A Bem
OBJECTIVES: Viral-lower respiratory tract disease is common in young children worldwide and is associated with high morbidity. Acute respiratory failure due to viral-lower respiratory tract disease necessitates PICU admission for mechanical ventilation. In critically ill patients in PICU settings, early fluid overload is common and associated with adverse outcomes such as prolonged mechanical ventilation and increased mortality. It is unclear, however, if this also applies to young children with viral-lower respiratory tract disease induced acute respiratory failure...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28107265/long-term-function-after-pediatric-critical-illness-results-from-the-survivor-outcomes-study
#3
Neethi P Pinto, Elizabeth W Rhinesmith, Tae Yeon Kim, Peter H Ladner, Murray M Pollack
OBJECTIVE: Knowledge of the long-term outcomes of survivors of pediatric critical illness is sparse but important. The aim of this study was to evaluate morbidity and mortality 6 months and 3 years after hospital discharge. DESIGN: Prospective cohort study. SETTING: Urban, inner city, academic PICU. PATIENTS: Consecutive patients admitted to the PICU from June 2012 to August 2012. INTERVENTIONS: None...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28107096/implementation-of-an-aggressive-enteral-nutrition-protocol-and-the-effect-on-clinical-outcomes
#4
Daniel Dante Yeh, Catrina Cropano, Sadeq A Quraishi, Eva Fuentes, Haytham M A Kaafarani, Jarone Lee, Yuchiao Chang, George Velmahos
BACKGROUND: Macronutrient deficiency in critical illness is associated with worse outcomes. We hypothesized that an aggressive enteral nutrition (EN) protocol would result in higher macronutrient delivery and fewer late infections. METHODS: We enrolled adult surgical intensive care unit (ICU) patients receiving >72 hours of EN from July 2012 to June 2014. Our intervention consisted of increasing protein prescription (2.0-2.5 vs 1.5-2.0 g/kg/d) and compensatory feeds for EN interruption...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28106832/plaimos-a-remote-mobile-healthcare-platform-to-monitor-cardiovascular-and-respiratory-variables
#5
Ramses Miramontes, Raúl Aquino, Arturo Flores, Guillermo Rodríguez, Rafael Anguiano, Arturo Ríos, Arthur Edwards
The number of elderly and chronically ill patients has grown significantly over the past few decades as life expectancy has increased worldwide, leading to increased demands on the health care system and significantly taxing traditional health care practices. Consequently, there is an urgent need to use technology to innovate and more constantly and intensely monitor, report and analyze critical patient physiological parameters beyond conventional clinical settings in a more efficient and cost effective manner...
January 19, 2017: Sensors
https://www.readbyqxmd.com/read/28105784/what-prevents-critically-ill-patients-with-respiratory-failure-from-using-non-invasive-positive-pressure-ventilation-a-mixed-methods-study
#6
Hiroaki Murata, Tomoko Inoue, Osamu Takahashi
AIM: To identify the factors that prevent patients in respiratory failure from using noninvasive positive pressure ventilation (NPPV). The following were evaluated: (i) the patients who converted from NPPV to endotracheal intubation; and (ii) the patients who abandoned NPPV. METHODS: Patients were interviewed regarding their experience with NPPV. Next, the factors that prevented the continuation of NPPV were identified and those data were collected retrospectively from medical records...
January 20, 2017: Japan Journal of Nursing Science: JJNS
https://www.readbyqxmd.com/read/28105617/-establishment-of-prediction-model-of-acute-gastrointestinal-injury-classification-of-critically-ill-patients-based-on-digital-gastrointestinal-sounds-monitoring
#7
Yan Wang, Jianrong Wang, Weiwei Liu, Guangliang Zhang
OBJECTIVE: To develop the prediction model of acute gastrointestinal injury (AGI) classification of critically ill patients. METHODS: The binary channel gastrointestinal sounds (GIS) monitor system was used to gather and analyze the GIS of 60 consecutive critically ill patients who were admitted in Critical Care Medicine of PLA General Hospital from April 2015 to November 2015 (patients with chronic gastrointestinal disease or history of gastrointestinal surgery were excluded)...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28104387/impact-of-echinocandin-on-prognosis-of-proven-invasive-candidiasis-in-icu-a-post-hoc-causal-inference-model-using-the-amarcand2-study
#8
Sébastien Bailly, Olivier Leroy, Elie Azoulay, Philippe Montravers, Jean-Michel Constantin, Hervé Dupont, Didier Guillemot, Olivier Lortholary, Jean-Paul Mira, Pierre-François Perrigault, Jean-Pierre Gangneux, Jean-François Timsit
OBJECTIVE: guidelines recommend first-line systemic antifungal treatment (SAT) with echinocandins in invasive candidiasis (IC), especially in critically ill patients. This study aimed at assessing the impact of echinocandins compared to azoles as initial SAT on the 28-day prognosis in adult ICU patients. METHODS: From the prospective multicenter AmarCAND2 cohort (835 patients), we selected those with documented IC and treated with echinocandins (ECH) or azoles (AZO)...
January 16, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28104277/microcirculatory-monitoring-in-septic-patients-where-do-we-stand
#9
G Gruartmoner, J Mesquida, C Ince
Microcirculatory alterations play a pivotal role in sepsis-related morbidity and mortality. However, since the microcirculation has been a "black box", current hemodynamic management of septic patients is still guided by macrocirculatory parameters. In the last decades, the development of several technologies has shed some light on microcirculatory evaluation and monitoring, and the possibility of incorporating microcirculatory variables to clinical practice no longer seems to be beyond reach. The present review provides a brief summary of the current technologies for microcirculatory evaluation, and attempts to explore the potential role and benefits of their integration to the resuscitation process in critically ill septic patients...
January 16, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28103536/evidence-based-guidelines-for-the-use-of-tracheostomy-in-critically-ill-patients
#10
Néstor Raimondi, Macarena R Vial, José Calleja, Agamenón Quintero, Albán Cortés, Edgar Celis, Clara Pacheco, Sebastián Ugarte, José M Añón, Gonzalo Hernández, Erick Vidal, Guillermo Chiappero, Fernando Ríos, Fernando Castilleja, Alfredo Matos, Enith Rodriguez, Paulo Antoniazzi, José Mario Teles, Carmelo Dueñas, Jorge Sinclair, Lorenzo Martínez, Ingrid von der Osten, José Vergara, Edgar Jiménez, Max Arroyo, Camilo Rodríguez, Javier Torres, Sebastián Fernandez-Bussy, Joseph L Nates
OBJECTIVES: To provide evidence-based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. METHODS: A taskforce composed of representatives of 10 member countries of the Pan-American and Iberic Federation of Societies of Critical and Intensive Therapy Medicine and of the Latin American Critical Care Trial Investigators Network developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation system...
October 20, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28102522/present-and-future-of-interventional-treatment-of-resistant-hypertension
#11
REVIEW
Ayhan Yoruk, Sinan S Tankut, John P Gassler, John D Bisognano
The increasing prevalence of hypertension, a significant cause of disability and premature death throughout the world, is a major public health concern. This is especially true for the subset of patients who suffer from resistant hypertension, which is associated with a fourfold greater risk of cardiovascular events as compared to those hypertensive patients able to achieve target blood pressure. Though quite daunting in number and ill effect, hypertension remains the most common and the most important modifiable risk factor for coronary heart disease, congestive heart failure, peripheral vascular disease, stroke, and chronic kidney disease...
January 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28102521/clinical-assessment-and-train-of-four-measurements-in-critically-ill-patients-treated-with-recommended-doses-of-cisatracurium-or-atracurium-for-neuromuscular-blockade-a-prospective-descriptive-study
#12
Pierre Bouju, Jean-Marc Tadié, Nicolas Barbarot, Julien Letheulle, Fabrice Uhel, Pierre Fillatre, Guillaume Grillet, Angélique Goepp, Yves Le Tulzo, Arnaud Gacouin
BACKGROUND: Despite few studies, a monitoring of a neuromuscular blockade with a train of four (TOF) is recommended in intensive care unit (ICU). Our objective was to compare the results of ulnar and facial TOF measurements with an overall clinical assessment for neuromuscular blockade in ICU patients treated with recommended doses of atracurium or cisatracurium, including patients with acute respiratory disease syndrome (ARDS). METHODS: We prospectively included in two ICUs 119 patients, 94 with ARDS, who required a neuromuscular blockade for more than 24 h...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28102514/carbapenemase-producing-klebsiella-pneumoniae-bloodstream-infection-in-critically-ill-patients-risk-factors-and-predictors-of-mortality
#13
M Papadimitriou-Olivgeris, F Fligou, C Bartzavali, A Zotou, A Spyropoulou, K Koutsileou, S Vamvakopoulou, N Sioulas, V Karamouzos, E D Anastassiou, I Spiliopoulou, M Christofidou, M Marangos
A significant increase in carbapenemase-producing Klebsiella pneumoniae (CP-Kp) bacteraemias has been observed worldwide. The objective of the present work was to study the risk factors and predictors of mortality of CP-Kp bacteraemias among critically ill patients. During a 4-year period (2012-3015), a matched 1:2 case-control study was conducted. Klebsiella pneumoniae was identified by Vitek 2 technology. Antibiotic susceptibility was performed by the agar disc diffusion method and Etest. The presence of the bla KPC, bla VIM and bla NDM genes was confirmed by polymerase chain reaction (PCR)...
January 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28101803/lung-retransplantation-in-an-adult-13%C3%A2-years-after-single-lobar-transplant-in-childhood
#14
Seiichiro Sugimoto, Shinji Otani, Takashi Ohki, Takeshi Kurosaki, Kentaroh Miyoshi, Masaomi Yamane, Shinichiro Miyoshi, Takahiro Oto
Single living-donor lobar lung transplantation provides acceptable results for critically ill children; however, an additional lung transplantation may be required in the future as the recipient grows. We describe a case of successful lung retransplantation in a grown-up patient after single lobar lung transplantation in childhood. A 23-year-old man underwent bilateral cadaveric lung retransplantation for chronic lung allograft dysfunction 13 years after right single living-donor lobar transplantation for idiopathic pulmonary arterial hypertension performed at the age of 10 years...
January 18, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28101605/surviving-sepsis-campaign-international-guidelines-for-management-of-sepsis-and-septic-shock-2016
#15
Andrew Rhodes, Laura E Evans, Waleed Alhazzani, Mitchell M Levy, Massimo Antonelli, Ricard Ferrer, Anand Kumar, Jonathan E Sevransky, Charles L Sprung, Mark E Nunnally, Bram Rochwerg, Gordon D Rubenfeld, Derek C Angus, Djillali Annane, Richard J Beale, Geoffrey J Bellinghan, Gordon R Bernard, Jean-Daniel Chiche, Craig Coopersmith, Daniel P De Backer, Craig J French, Seitaro Fujishima, Herwig Gerlach, Jorge Luis Hidalgo, Steven M Hollenberg, Alan E Jones, Dilip R Karnad, Ruth M Kleinpell, Younsuk Koh, Thiago Costa Lisboa, Flavia R Machado, John J Marini, John C Marshall, John E Mazuski, Lauralyn A McIntyre, Anthony S McLean, Sangeeta Mehta, Rui P Moreno, John Myburgh, Paolo Navalesi, Osamu Nishida, Tiffany M Osborn, Anders Perner, Colleen M Plunkett, Marco Ranieri, Christa A Schorr, Maureen A Seckel, Christopher W Seymour, Lisa Shieh, Khalid A Shukri, Steven Q Simpson, Mervyn Singer, B Taylor Thompson, Sean R Townsend, Thomas Van der Poll, Jean-Louis Vincent, W Joost Wiersinga, Janice L Zimmerman, R Phillip Dellinger
OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015...
January 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28101565/use-of-neuromuscular-electrical-stimulation-to-preserve-the-thickness-of-abdominal-and-chest-muscles-of-critically-ill-patients-a-randomized-clinical-trial
#16
Ana M Dall' Acqua, Amanda Sachetti, Laura J Santos, Fernando A Lemos, Tanara Bianchi, Wagner S Naue, Alexandre S Dias, Graciele Sbruzzi, Silvia R R Vieira
OBJECTIVE: To evaluate and compare the effects of neuromuscular electrical stimulation combined with conventional physical therapy on muscle thickness in critically ill patients. DESIGN: Double-blind, randomized controlled trial. PATIENTS: Twenty-five patients participated in the study. METHODS: Patients on mechanical ventilation for 24-48 h were randomized to an intervention group (neuromuscular electrical stimulation + conventional physical therapy) or a conventional group (sham neuromuscular electrical stimulation + conventional physical therapy)...
January 19, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28101334/implementation-of-short-incubation-maldi-tof-ms-identification-from-positive-blood-cultures-in-routine-diagnostics-and-effects-on-empiric-antimicrobial-therapy
#17
Robin Köck, Jörg Wüllenweber, Dagmar Horn, Christian Lanckohr, Karsten Becker, Evgeny A Idelevich
BACKGROUND: Results of blood culture (BC) diagnostics should be swiftly available to guide treatment of critically ill patients. Conventional BC diagnostics usually performs species identification of microorganisms from mature solid medium colonies. Species identification might be speed up by using matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry (MS) of biomass from shortly incubated solid media. METHODS: This single-center analysis compared the applicability of MALDI-TOF-based species identification from shortly incubated cultures in laboratory routine vs...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28100526/comparison-of-different-techniques-of-central-venous-pressure-measurement-in-mechanically-ventilated-critically-ill-patients
#18
C Roger, L Muller, B Riou, N Molinari, B Louart, H Kerbrat, J-L Teboul, J-Y Lefrant
BACKGROUND: Several techniques exist for measuring central venous pressure (CVP) but little information is available about the accuracy of each method. The aim of this study was to compare different methods of CVP measurements in mechanically ventilated patients. METHODS: CVP was measured in mechanically ventilated patients without spontaneous breathing using four different techniques: 1) end expiratory CVP measurement at the base of the" c" wave (CVPMEASURED), chosen as the reference method; 2) CVP measurement from the monitor averaging CVP over the cardiac and respiratory cycles (CVPMONITOR); 3) CVP measurement after a transient withdrawing of mechanical ventilation (CVPNADIR); 4) CVP measurement corrected for the transmitted respiratory pressure induced by intrinsic PEEP (calculated CVP: CVPCALCULATED)...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28099643/balanced-crystalloids-for-septic-shock-resuscitation
#19
Thiago Domingos Corrêa, Alexandre Biasi Cavalcanti, Murillo Santucci Cesar de Assunção
Timely fluid administration is crucial to maintain tissue perfusion in septic shock patients. However, the question concerning which fluid should be used for septic shock resuscitation remains a matter of debate. A growing body of evidence suggests that the type, amount and timing of fluid administration during the course of sepsis may affect patient outcomes. Crystalloids have been recommended as the first-line fluids for septic shock resuscitation. Nevertheless, given the inconclusive nature of the available literature, no definitive recommendations about the most appropriate crystalloid solution can be made...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099642/sedation-protocols-versus-daily-sedation-interruption-a-systematic-review-and-meta-analysis
#20
Antonio Paulo Nassar, Marcelo Park
Objective: The aim of this study was to systematically review studies that compared a mild target sedation protocol with daily sedation interruption and to perform a meta-analysis with the data presented in these studies. Methods: We searched Medline, Scopus and Web of Science databases to identify randomized clinical trials comparing sedation protocols with daily sedation interruption in critically ill patients requiring mechanical ventilation. The primary outcome was mortality in the intensive care unit...
October 2016: Revista Brasileira de Terapia Intensiva
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