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https://www.readbyqxmd.com/read/28320079/ketamine-reduces-the-need-for-intubation-in-patients-with-acute-severe-mental-illness-and-agitation-requiring-transport-to-definitive-care-an-observational-study
#1
Cathrin S Parsch, Adrianne Boonstra, David Teubner, Wade Emmerton, Brian McKenny, Daniel Y Ellis
OBJECTIVES: The aim of this study was to review mental health patients transported by a dedicated statewide critical care retrieval team before and after the implementation of a ketamine sedation guideline. METHODS: This is a a retrospective cohort study of mental health patients with acute behavioural disturbance, transported between January 2010 and December 2015. RESULTS: A total of 78 patients were transported in the study period, 50 before and 28 after implementation of the ketamine guideline in June 2013...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28319910/the-role-of-vasopressin-and-the-vasopressin-type-v1a-receptor-agonist-selepressin-in-septic-shock
#2
REVIEW
Antonio F Saad, Marc O Maybauer
Septic shock remains one of the major causes of morbidity and mortality in the critically ill. Despite early goal therapy and administration of cathecholaminergic agents, up to 30% of patients succumb to the disease. In this manuscript, we first summarize the standard of care of patients with septic shock and current guidelines. We review the physiologic role of vasopressin and its role in septic shock management. We then review the most up-to-date evidence on the potential role of V1a receptor agonists such as Selepressin, in septic shock...
March 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28319802/associations-between-home-insulin-dose-adjustments-and-glycemic-outcomes-at-hospital-admission
#3
Saira Khan, Sherita Hill Golden, Nestoras Mathioudakis
AIMS: To describe patterns of home insulin dose adjustments for non-surgical, non-critically ill patients at admission and to describe associations between these adjustments and inpatient glycemic control. METHODS: Hospital records of non-critically ill patients treated with basal insulin prior to admission were identified. After exclusion of records in which a confounding factor influencing insulin dosing was present, 258 patient-admissions over a 3-year time period were included...
March 7, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28319467/effects-of-iv-acetaminophen-on-core-body-temperature-and-hemodynamic-responses-in-febrile-critically-ill-adults-a-randomized-controlled-trial
#4
Hildy M Schell-Chaple, Kathleen D Liu, Michael A Matthay, Daniel I Sessler, Kathleen A Puntillo
OBJECTIVE: To determine the effects of IV acetaminophen on core body temperature, blood pressure, and heart rate in febrile critically ill patients. DESIGN: Randomized, double-blind, placebo-controlled clinical trial. SETTING: Three adult ICUs at a large, urban, academic medical center. PATIENTS: Forty critically ill adults with fever (core temperature, ≥ 38.3°C). INTERVENTION: An infusion of acetaminophen 1 g or saline placebo over 15 minutes...
March 17, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28319164/modeling-the-potential-impact-on-the-us-blood-supply-of-transfusing-critically-ill-patients-with-fresher-stored-red-blood-cells
#5
Arianna Simonetti, Hussein Ezzeldin, Mikhail Menis, Stephen McKean, Hector Izurieta, Steven A Anderson, Richard A Forshee
BACKGROUND: Although some studies have suggested that transfusion recipients may have better medical outcomes if transfused with red blood cell units stored for a short time, the overall body of evidence shows mixed results. It is important to understand how using fresher stored red blood cell units for certain patient groups may affect blood availability. METHODS: Based on the Stock-and-Flow simulation model of the US blood supply developed by Simonetti et al. 2014, we evaluated a newly implemented allocation method of preferentially transfusing fresher stored red blood cell units to a subset of high-risk group of critically ill patients and its potential impact on supply...
2017: PloS One
https://www.readbyqxmd.com/read/28318674/organ-donor-management-eight-common-recommendations-and-actions-that-deserve-reflection
#6
C Chamorro-Jambrina, M R Muñoz-Ramírez, J L Martínez-Melgar, M S Pérez-Cornejo
Despite major advances in our understanding of the physiopathology of brain death (BD), there are important controversies as to which protocol is the most appropriate for organ donor management. Many recent reviews on this subject offer recommendations that are sometimes contradictory and in some cases are not applied to other critically ill patients. This article offers a review of the publications (many of them recent) with an impact upon these controversial measures and which can help to confirm, refute or open new areas of research into the most appropriate measures for the management of organ donors in BD, and which should contribute to discard certain established recommendations based on preconceived ideas, that lead to actions lacking a physiopathological basis...
March 16, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28318176/fluid-overload-and-kidney-failure-in-children-with-severe-sepsis-and-septic-shock-a-cohort-study
#7
Omar E Naveda Romero, Andrea F Naveda Meléndez
INTRODUCTION: In children with sepsis, fluid overload as a result of an aggressive fluid replacement or excessive fluid administration may result in kidney impairment and increased mortality. Objective. To determine the association between fluid overload and the rate of kidney failure in a group of children with severe sepsis and septic shock. POPULATION AND METHODS: This was a prospective cohort study conducted in the intensive care unit of Hospital Universitario de Pediatría “Dr...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28317221/psychological-and-clinical-correlates-of-posttraumatic-growth-in-cancer-a-systematic-and-critical-review
#8
REVIEW
Anna Casellas-Grau, Cristian Ochoa, Chiara Ruini
OBJECTIVE: To describe major findings on posttraumatic growth (PTG) in cancer, by analyzing its various definitions, assessment tools, and examining its main psychological and clinical correlates. Methods A search in relevant databases (PsycINFO, Pubmed, ProQuest, Scopus and Web of Science) was performed using descriptors related to the positive reactions in cancer. Articles were screened by title, abstract and full-text. RESULTS: Seventy-two met the inclusion criteria...
March 20, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28317097/engagement-in-advance-care-planning-and-surrogates-knowledge-of-patients-treatment-goals
#9
Terri R Fried, Maria Zenoni, Lynne Iannone, John O'Leary, Brenda T Fenton
OBJECTIVES: A key objective of advance care planning (ACP) is improving surrogates' knowledge of patients' treatment goals. Little is known about whether ACP outside of a trial accomplishes this. The objective was to examine patient and surrogate reports of ACP engagement and associations with surrogate knowledge of goals. DESIGN: Cohort study SETTING: Primary care in a Veterans Affairs Medical Center. PARTICIPANTS: 350 community-dwelling veterans age ≥55 years and the individual they would choose to make medical decisions on their behalf, interviewed separately...
March 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28316318/synchronous-open-heart-surgery-and-laparoscopic-cholecystectomy-an-observational-case-study-with-28-patients
#10
Mustafa Bilge Erdogan, Mehmet Kaplan, Hakki Kazaz, Bulent Salman
Acute cholecystitis (AC) may be a severe problem and may increase the mortality rate and hospital stay in patients who undergo open heart surgery (OHS), due to its aggressive course; therefore, AC should be treated as soon as possible. We aimed to present data on our synchronous cardiac and laparoscopic cholecystectomy (LC) operations performed for AC complicating patients with cardiac disease and who were waiting to undergo OHS. Between January 2008 and September 2014, we performed 2773 OHSs in Medical Park Gaziantep Hospital...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28315586/sucralfate-versus-histamine-2-receptor-antagonists-for-stress-ulcer-prophylaxis-in-adult-critically-ill-patients-a-meta-analysis-and-trial-sequential-analysis-of-randomized-trials
#11
Mustafa Alquraini, Fayez Alshamsi, Morten Hylander Møller, Emilie Belley-Cote, Saleh Almenawer, Roman Jaeschke, Robert MacLaren, Waleed Alhazzani
PURPOSE: To determine the impact of using sucralfate versus H2RAs for SUP on patient important outcomes. MATERIALS AND METHODS: We searched CENTRAL, MEDLINE, EMBASE, ACPJC, clinical trials registries, and conference proceedings through June 2016 for randomized controlled trials (RCTs) comparing sucralfate to H2RAs for SUP in adult critically ill patients. RESULTS: 21 RCTs enrolling 3121 patients met inclusion criteria. There was no significant difference between sucralfate compared to H2RAs in the risk of clinically important GI bleeding (risk ratio [RR] 1...
March 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28315452/comparing-the-therapeutic-efficacies-of-third-generation-cephalosporins-and-broader-spectrum-%C3%AE-lactams-as-appropriate-empirical-therapy-in-adults-with-community-onset-monomicrobial-enterobacteriaceae-bacteraemia-a-propensity-score-matched-analysis
#12
Chung-Hsun Lee, Chih-Chia Hsieh, Ming-Yuan Hong, Yuan-Pin Hung, Wen-Chien Ko, Ching-Chi Lee
In this study, the therapeutic efficacy of third-generation cephalosporins (3GCs) was compared with that of broader-spectrum β-lactams (BSBLs) [fourth-generation cephalosporins (4GCs) and carbapenems] as empirical therapy in adults with community-onset monomicrobial Enterobacteriaceae bacteraemia. Compared with those in the 3GC group (n = 477), a significantly higher proportion of patients in the BSBL group (n = 141) had initial presentation with severe sepsis or septic shock, critical illness (Pitt bacteraemia score ≥4) at bacteraemia onset and fatal co-morbidities (McCabe classification)...
March 14, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28314625/transthyretin-concentrations-in-acute-stroke-patients-predict-convalescent-rehabilitation
#13
Naofumi Isono, Yuki Imamura, Keiko Ohmura, Norihide Ueda, Shinji Kawabata, Motomasa Furuse, Toshihiko Kuroiwa
OBJECTIVE: For stroke patients, intensive nutritional management is an important and effective component of inpatient rehabilitation. Accordingly, acute care hospitals must detect and prevent malnutrition at an early stage. Blood transthyretin levels are widely used as a nutritional monitoring index in critically ill patients. Here, we had analyzed the relationship between the transthyretin levels during the acute phase and Functional Independence Measure in stroke patients undergoing convalescent rehabilitation...
March 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28314169/increased-mortality-in-critically-ill-patients-with-mild-or-moderate-hyperbilirubinemia
#14
Charalampos Pierrakos, Dimitrios Velissaris, Peter Felleiter, Massimo Antonelli, Philippe Vanhems, Yasser Sakr, Jean-Louis Vincent
PURPOSE: Increased bilirubin concentrations may be related to outcome, but this has not been well studied. We evaluated the relationship between total serum bilirubin levels and outcome in critically ill patients. MATERIALS AND METHODS: Data were analyzed from adult critically ill patients included in a 1-day international prevalence study after excluding those with an obvious underlying cause of hyperbilirubinemia. RESULTS: Serum bilirubin concentrations were >1 mg/dL in 2803 (31%) of 8973 patients, and these patients had higher mortality rates than patients with lower bilirubin concentrations (30% vs 21%, P<...
February 13, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28303483/proliferation-and-differentiation-of-adipose-tissue-in-prolonged-lean-and-obese-critically-ill-patients
#15
Chloë Goossens, Sarah Vander Perre, Greet Van den Berghe, Lies Langouche
BACKGROUND: In prolonged non-obese critically ill patients, preservation of adipose tissue is prioritized over that of the skeletal muscle and coincides with increased adipogenesis. However, we recently demonstrated that in obese critically ill mice, this priority was switched. In the obese, the use of abundantly available adipose tissue-derived energy substrates was preferred and counteracted muscle wasting. These observations suggest that different processes are ongoing in adipose tissue of lean vs...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28303417/protective-effect-of-amygdalin-on-lps-induced-acute-lung-injury-by-inhibiting-nf-%C3%AE%C2%BAb-and-nlrp3-signaling-pathways
#16
Ao Zhang, Weiyun Pan, Juan Lv, Hui Wu
The acute lung injury (ALI) is a leading cause of morbidity and mortality in critically ill patients. Amygdalin is derived from the bitter apricot kernel, an efficacious Chinese herbal medicine. Although amygdalin is used by many cancer patients as an antitumor agent, there is no report about the effect of amygdalin on acute lung injury. Here we explored the protective effect of amygdalin on ALI using lipopolysaccharide (LPS)-induced murine model by detecting the lung wet/dry ratio, the myeloperoxidase (MPO) in lung tissues, inflammatory cells in the bronchoalveolar lavage fluid (BALF), inflammatory cytokines production, as well as NLRP3 and NF-κB signaling pathways...
March 16, 2017: Inflammation
https://www.readbyqxmd.com/read/28303301/impact-of-tapered-cuff-tracheal-tube-on-microaspiration-of-gastric-contents-in-intubated-critically-ill-patients-a-multicenter-cluster-randomized-cross-over-controlled-trial
#17
Emmanuelle Jaillette, Christophe Girault, Guillaume Brunin, Farid Zerimech, Hélène Behal, Arnaud Chiche, Céline Broucqsault-Dedrie, Cyril Fayolle, Franck Minacori, Isabelle Alves, Stéphanie Barrailler, Julien Labreuche, Laurent Robriquet, Fabienne Tamion, Emmanuel Delaporte, Damien Thellier, Claire Delcourte, Alain Duhamel, Saad Nseir
PURPOSE: Studies on the impact of tapered-cuff tracheal tubes on rates of microaspiration and ventilator-associated pneumonia (VAP) in intubated patients have reported conflicting results. The aim of this study was to determine the influence of this shape of tracheal cuff on abundant microaspiration of gastric contents in critically ill patients. METHODS: All patients intubated in the intensive care unit (ICU) and requiring mechanical ventilation for at least 48 h were eligible for this multicenter cluster-randomized controlled cross-over open-label study...
March 16, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28303236/treating-the-critically-ill-with-radiotherapy-lessons-learned-from-a-young-woman-with-cardiac-angiosarcoma
#18
Emma C Fields, Bryan Squires, Harry Lomas
BACKGROUND: Treating patients who are critically ill with radiotherapy (RT) brings a unique set of challenges as it involves treating patients who require mechanical life support, unconventional positioning, and a multidisciplinary team approach to ensure safety. However, when the benefits of such treatment outweigh the risks, the challenges can be overcome, as demonstrated in this unique case of cardiac angiosarcoma. CASE DESCRIPTION: This is a case of a 42-year-old female with a right sided cardiac angiosarcoma who quickly developed cardiac tamponade and respiratory failure related to compression of her right heart by the tumor...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28302323/new-onset-diabetes-after-acute-and-critical-illness-a-systematic-review
#19
REVIEW
Chirag J Jivanji, Varsha M Asrani, John A Windsor, Maxim S Petrov
Hyperglycemia is commonly observed during acute and critical illness. Recent studies have investigated the risk of developing diabetes after acute and critical illness, but the relationship between degree of in-hospital hyperglycemia and new-onset diabetes has not been investigated. This study examines the evidence for the relationship between in-hospital hyperglycemia and prevalence of new-onset diabetes after acute and critical illness. A literature search was performed of the MEDLINE, EMBASE, and Scopus databases for relevant studies published from January 1, 2000, through August 4, 2016...
March 13, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28302179/balanced-crystalloids-versus-saline-in-the-intensive-care-unit-study-protocol-for-a-cluster-randomized-multiple-crossover-trial
#20
Matthew W Semler, Wesley H Self, Li Wang, Daniel W Byrne, Jonathan P Wanderer, Jesse M Ehrenfeld, Joanna L Stollings, Avinash B Kumar, Antonio Hernandez, Oscar D Guillamondegui, Addison K May, Edward D Siew, Andrew D Shaw, Gordon R Bernard, Todd W Rice
BACKGROUND: Saline, the intravenous fluid most commonly administered to critically ill adults, contains a high chloride content, which may be associated with acute kidney injury and death. Whether using balanced crystalloids rather than saline decreases the risk of acute kidney injury and death among critically ill adults remains unknown. METHODS: The Isotonic Solutions and Major Adverse Renal Events Trial (SMART) is a pragmatic, cluster-level allocation, cluster-level crossover trial being conducted between 1 June 2015 and 30 April 2017 in five intensive care units at Vanderbilt University Medical Center in Nashville, TN, USA...
March 16, 2017: Trials
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