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https://www.readbyqxmd.com/read/29161713/clinical-benefits-of-high-volume-hemofiltration-in-critically-ill-pediatric-patients-with-severe-sepsis-a-retrospective-cohort-study
#1
Huijie Miao, Fei Wang, Xi Xiong, Chunxia Wang, Yucai Zhang
AIMS: The study aimed to assess the clinical benefits of high-volume hemofiltration (HVHF) in pediatric patients with severe sepsis compared with standard-volume continuous veno-venous hemofiltration (CVVH). METHODS: We retrospectively analyzed the medical records of 155 pediatric patients with severe sepsis admitted to the pediatric intensive care unit of Shanghai Children's Hospital from January 2010 to June 2016. A total of 93 patients were treated with HVHF and 62 patients were treated with CVVH...
November 22, 2017: Blood Purification
https://www.readbyqxmd.com/read/29161706/endotoxin-effects-on-cardiac-and-renal-functions-and-cardiorenal-syndromes
#2
Grazia Maria Virzì, Anna Clementi, Alessandra Brocca, Claudio Ronco
Gram-negative sepsis is a major cause of morbidity and mortality in critical ill patients. Recent findings in molecular biology and in signaling pathways have enhanced our understanding of its pathogenesis and opened up opportunities of innovative therapeutic approaches. Endotoxin plays a pivotal role in the pathogenesis of multi-organ dysfunction in the setting of gram-negative sepsis. Indeed, heart and kidney impairments seem to be induced by the release of circulating pro-inflammatory and pro-apoptotic mediators triggered by endotoxin interaction with immune cells...
November 22, 2017: Blood Purification
https://www.readbyqxmd.com/read/29161684/higher-versus-lower-continuous-renal-replacement-therapy-intensity-in-critically-ill-patients-with-liver-dysfunction
#3
Zachary O'Brien, Alan Cass, Louise Cole, Simon Finfer, Martin Gallagher, Colin McArthur, Shay McGuiness, John Myburgh, Rinaldo Bellomo, Johan Mårtensson
AIMS: To study the association between higher versus lower continuous renal replacement therapy (CRRT) intensity and mortality in critically ill patients with combined acute kidney injury and liver dysfunction. METHODS: Post-hoc analysis of patients with liver dysfunction (Sequential Organ Failure Assessment liver score ≥2 or diagnosis of liver failure/transplant) included in the Randomized Evaluation of Normal versus Augmented Level renal replacement therapy (RENAL) trial...
November 22, 2017: Blood Purification
https://www.readbyqxmd.com/read/29161207/composite-intravenous-fat-emulsion-in-a-postsurgical-critically-ill-patient-a-case-study
#4
Gregory J Roberti, Cameron G Cangelose, Robert G Martindale
Parenteral nutrition (PN), including lipids, in high-risk or poorly nourished critically ill patients is indicated when enteral nutrition is contraindicated; however, soybean oil-based PN can stimulate proinflammatory processes. Fish oil (FO) is generally less inflammatory and has recently been shown to be active in the resolution of inflammatory processes. In this study, we look at whether the use of a blended intravenous fat emulsion that includes soybean, medium-chain triglycerides, olive oil, and FO confers clinical benefits in critically ill patients...
November 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29161116/corticosteroid-therapy-for-critically-ill-patients-with-the-middle-east-respiratory-syndrome
#5
Yaseen M Arabi, Yasser Mandourah, Fahad Al-Hameed, Anees A Sindi, Ghaleb A Al Mekhlafi, Mohamed A Hussein, Jesna Jose, Ruxandra Pinto, Awad Al-Omari, Ayman Kharaba, Abdullah Almotairi, Kasim Al Khatib, Basem Alraddadi, Sarah Shalhoub, Ahmed Abdulmomen, Ismael Qushmaq, Ahmed Mady, Othman Solaiman, Abdulsalam M Al-Aithan, Rajaa Al-Raddadi, Ahmed Ragab, Hanan H Balkhy, Abdulrahman Al Harthy, Ahmad M Deeb, Hanan Al Mutairi, Abdulaziz Al-Dawood, Laura Merson, Frederick G Hayden, Robert A Fowler
RATIONALE: Corticosteroid therapy is commonly used among critically ill patients with the Middle East Respiratory Syndrome (MERS), but its impact on outcomes is uncertain. Analyses of observational studies often do not account for patients' clinical condition at the time of corticosteroid therapy initiation. OBJECTIVES: To investigate the association of corticosteroid therapy on mortality and on MERS coronavirus RNA clearance in critically ill patients with MERS...
November 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29160945/lacosamide-pharmacokinetics-in-a-critically-ill-patient-receiving-continuous-venovenous-hemofiltration
#6
Miguel J Franquiz, Shamir N Kalaria, Michael J Armahizer, Mathangi Gopalakrishnan, Paul J McCarthy, Neeraj Badjatia
OBJECTIVE: Lacosamide is a new generation antiepileptic drug (AED) that is eliminated by both hepatic and renal mechanisms. Lacosamide elimination by Continuous Renal Replacement Therapy (CRRT) has never been studied. The objective of this case report was to describe lacosamide pharmacokinetics in the setting of CRRT. METHODS: Case report of a single patient admitted to the study center with status epilepticus and multi-organ failure. The patient required both continuous venovenous hemofiltration (CVVH) and several AEDs...
November 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29159487/management-of-cardiopulmonary-assist-devices-in-critically-ill-patients-using-point-of-care-transthoracic-echocardiography-a-case-series
#7
Babar Fiza, Michael Tang, Michael Maile
Point-of-care transthoracic echocardiography is increasingly being utilized by the intensive care physicians in the management of hemodynamically unstable patients. However, its use in the management of critically ill patients requiring cardiopulmonary mechanical device support remains to be well described. In this case series, we present two case reports where point-of-care echocardiography was successfully used by the intensive care team in diagnosing and managing problems related to cardiopulmonary assist device malposition...
November 21, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29157264/identifying-at-risk-patients-for-sub-optimal-beta-lactam-exposure-in-critically-ill-patients-with-severe-infections
#8
EDITORIAL
Mohd H Abdul-Aziz, Jeffrey Lipman, Jason A Roberts
No abstract text is available yet for this article.
November 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29157258/impact-of-earplugs-and-eye-mask-on-sleep-in-critically-ill-patients-a-prospective-randomized-study
#9
Alexandre Demoule, Serge Carreira, Sophie Lavault, Olivier Pallanca, Elise Morawiec, Julien Mayaux, Isabelle Arnulf, Thomas Similowski
BACKGROUND: Poor sleep is common in intensive care unit (ICU) patients, where environmental factors contribute to reduce and fragment sleep. The objective of this study was to evaluate the impact of earplugs and eye mask on sleep architecture in ICU patients. METHODS: A single-center randomized controlled trial of 64 ICU patients was conducted from July 2012 to December 2013. Patients were randomly assigned to sleep with or without earplugs and an eye mask from inclusion until ICU discharge...
November 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29156858/risk-factors-for-colistin-associated-nephrotoxicity-and-mortality-in-critically-ill-patients
#10
Hüseyin Özkarakaş, Işıl Köse, Çiler Zincircioğlu, Sibel Ersan, Gürsel Ersan, Nimet Şenoğlu, Şükran Köse, Rıza Hakan Erbay
Background/aim: Colistin is gaining popularity against multidrug-resistant bacteria. The primary concern with colistin is its nephrotoxicity (NT). The aim of this study was to evaluate the incidence and risk factors for NT and to evaluate the risk factors for mortality in the toxicity group. Materials and methods: NT was defined according to the RIFLE criteria. Data of patients who did or did not develop NT were compared. Positive and negative predictive values, risk ratio, and correlation coefficients were calculated...
August 23, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29156619/standard-vs-calorie-dense-immune-nutrition-in-haemodynamically-compromised-cardiac-patients-a-prospective-randomized-controlled-pilot-study
#11
Sergey Efremov, Vladimir Lomivorotov, Christian Stoppe, Anna Shilova, Vladimir Shmyrev, Michail Deryagin, Alexander Karaskov
BACKGROUND: The aim of study was to test the hypothesis that early enteral nutrition (EN) with calorie-dense and protein rich enteral formula improves enteral energy and protein delivery in critically ill cardiac patients. METHODS: Prospective randomized pilot study of 40 ventilated adult patients undergoing elective cardiac surgery with use of cardiopulmonary bypass receiving inotropic support postoperatively. Patients were to receive either standard isocaloric (1000 Kcal/L and 38 g/L protein) early EN (n = 20) or calorie-dense and protein-rich (1300 Kcal/L and 66...
November 20, 2017: Nutrients
https://www.readbyqxmd.com/read/29156253/exploring-the-impact-of-using-measured-or-estimated-values-for-height-and-weight-on-the-relationship-between-bmi-and-acute-hospital-mortality
#12
Anne P Toft-Petersen, Jerome Wulff, David A Harrison, Marlies Ostermann, Mike Margarson, Kathryn M Rowan, Deborah Dawson
PURPOSE: Studies have demonstrated an association between height and weight and mortality among patients in the Intensive Care Unit (ICU) and the optimal body mass index (BMI) might be well above the optimal values in the general population. Most of these studies have relied on estimated values, the validity of which is not known. MATERIAL AND METHODS: Admissions to adult general ICUs from 1 April 2009 to 31 March 2016 in the Case Mix Programme (CMP) Database were described by height and weight assessment methods (measured or estimated)...
November 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29155302/repeated-exposure-to-sevoflurane-impairs-the-learning-and-memory-of-older-male-rats
#13
Shanbin Guo, Lidan Liu, Cong Wang, Qian Jiang, Yunxia Dong, Yue Tian
AIMS: Critically ill old patients sometimes require repeated surgical interventions, and thus it is important to determine the influence of repeated exposure to anesthetics on learning and memory. Sevoflurane, a widely used inhalation anesthetic, has few neurological adverse effects and offers a rapid return to consciousness. But the long-term influence of sevoflurane exposure and the effect of repeated sevoflurane exposure on cognition have rarely been reported, and available studies are contradictory...
November 16, 2017: Life Sciences
https://www.readbyqxmd.com/read/29154945/veno-arterial-ecmo-in-critically-ill-patients-the-age-of-maturity
#14
EDITORIAL
Nicolas Mongardon, Quentin De Roux, Simon Clariot
No abstract text is available yet for this article.
November 14, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29154111/pten-expression-and-its-association-with-glucose-control-and-calorie-supplementation-in-critically-ill-patients
#15
Alessio Molfino, Francesco Alessandri, Paola Mosillo, Donatella Dell'Utri, Alessio Farcomeni, Maria Ida Amabile, Alessandro Laviano
BACKGROUND & AIM: Phosphatase and tensin homologue (PTEN) reduces insulin sensitivity. Since critically ill patients present insulin resistance, we aimed at assessing the role of PTEN expression on glucose homeostasis and clinical outcome in patients admitted to an intensive care unit (ICU) and receiving artificial nutrition. METHODS: Observational, single-center study conducted in one ICU in Rome, Italy on adult patients hospitalized for trauma. Plasma glucose levels and its variability were recorded in patients receiving artificial nutrition...
November 4, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29153934/family-centered-care-from-the-perspective-of-parents-of-children-cared-for-in-a-pediatric-intensive-care-unit-an-integrative-review
#16
REVIEW
Carrie Hill, Kathleen A Knafl, Sheila Judge Santacroce
PROBLEM: The Institute for Patient- and Family-Centered Care's (IPFCC) definition of family-centered care (FCC) includes the following four core concepts: respect and dignity, information sharing, participation, and collaboration. To date, research has focused on the provider experience of FCC in the PICU; little is known about how parents of children hospitalized in the pediatric intensive care unit (PICU) experience FCC. ELIGIBILITY CRITERIA: Articles were included if they were published between 2006 and 2016, included qualitative, quantitative, or mixed methods results, related to care received in a PICU, and included results that were from a parent perspective...
November 16, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29153825/clinician-and-manager-perceptions-of-factors-leading-to-ward-patient-clinical-deterioration
#17
Joshua Allen, Daryl Jones, Judy Currey
BACKGROUND: Improving the timely recognition and response to clinical deterioration is a critical challenge for clinicians, educators, administrators and researchers. Clinical deterioration leading to Rapid Response Team review is associated with poor patient outcomes. A range of factors associated with clinical deterioration and its outcomes have been identified, and may help with early identification of deteriorating patients. However, the relative importance of each factor on the development of clinical deterioration is unknown...
November 16, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29152931/can-red-blood-cell-distribution-width-predict-outcome-after-cardiac-arrest
#18
Vito Fontana, Savino Spadaro, Paola Villois, Claudia Righy Shinotsuka, Alberto Fogagnolo, Leda Nobile, Jean-Louis Vincent, Jacques Creteur, Fabio S Taccone
BACKGROUND: In critically ill patients, high red blood cell distribution width (RDW) values have been associated with increased hospital mortality, but there are no data on the impact of RDW on outcomes of patients resuscitated from cardiac arrest (CA). The aim of this study was to investigate the relationship between RDW and long-term neurologic outcome in CA survivors. METHODS: We performed a retrospective analysis of an institutional database including all unconscious adult patients admitted to the intensive care unit (ICU) after non-traumatic CA between January 2007 and January 2015...
November 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29152759/retrieval-of-adult-patients-on-extracorporeal-membrane-oxygenation-by-an-intensive-care-physician-model
#19
Aidan J C Burrell, David V Pilcher, Vincent A Pellegrino, Stephen A Bernard
The optimal staffing model during the inter-hospital transfer of patients on extracorporeal membrane oxygenation (ECMO) is not known. We report the complications and outcomes of patients who were commenced on ECMO at a referring hospital by intensive care physicians and compare these findings with patients who had ECMO established at an ECMO center in Australia. This was a single center, retrospective observational study based on a prospectively collected ECMO database from Melbourne, Australia. Patients with severe cardiac and/or respiratory failure failing conventional supportive treatment between 2007-2013 were placed on ECMO via a physician-led model of ECMO retrieval, including two intensivists in a four person team, using percutaneous ECMO cannulation...
November 19, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29152207/endotracheal-intubation-in-patients-with-difficult-airway-using-laryngeal-mask-airway-with-bougie-versus-video-laryngoscopy
#20
Hesameddin Modir, Esmail Moshiri, Bita Malekianzadeh, Gholamreza Noori, Abolfazl Mohammadbeigi
Airway management is essential for safe anesthesia and endotracheal intubation is the most important procedure by which critically ill patients can be better managed, especially if done quickly and successfully. This study aimed to compare the techniques of intubation through laryngeal mask airway (LMA) using a bougie versus video laryngoscopy (VL) regarding to intubation success and the quality of intubation indices in patients with difficult airways. This randomized clinical trial was performed on 96 patients aged 16-76 years with Mallampati class 3 or 4 who underwent elective surgery...
July 2017: Medical Gas Research
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