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Lactate critical care

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https://www.readbyqxmd.com/read/29462086/emergency-sternal-intraosseous-access-for-warm-fresh-whole-blood-transfusion-in-damage-control-resuscitation-sternal-intraosseous-access-in-dcr
#1
Christopher Kalhagen Bjerkvig, Theodor Fosse, Torunn Oveland Apelseth, Joar Sivertsen, Hanne Braathen, Håkon Skogrand Eliassen, Anne Berit Guttormsen, Andrew P Cap, Geir Strandenes
BACKGROUND: Intraosseous (IO) vascular access is increasingly used as an emergency tool for achieving access to the systemic circulation in critically ill patients. The role of IO transfusion of blood in Damage Control Resuscitation is however questionable due to possible inadequate flow rate and hemolysis. Some experts claim that IO transfusion is contraindicated. In this study we have challenged this statement by looking at flow rates of autologous fresh whole blood reinfusion and hemolysis using two of the commonly used FDA-approved and CE-marked sternal needles...
February 17, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29441175/perioperative-factors-associated-with-pressure-ulcer-development-after-major-surgery
#2
Jeong Min Kim, Hyunjeong Lee, Taehoon Ha, Sungwon Na
Background: Postoperative pressure ulcers are important indicators of perioperative care quality, and are serious and expensive complications during critical care. This study aimed to identify perioperative risk factors for postoperative pressure ulcers. Methods: This retrospective case-control study evaluated 2,498 patients who underwent major surgery. Forty-three patients developed postoperative pressure ulcers and were matched to 86 control patients based on age, sex, surgery, and comorbidities...
February 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29438568/haemodynamic-assessment-and-support-in-sepsis-and-septic-shock-in-resource-limited-settings
#3
David Misango, Rajyabardhan Pattnaik, Tim Baker, Martin W Dünser, Arjen M Dondorp, Marcus J Schultz
Background: Recommendations for haemodynamic assessment and support in sepsis and septic shock in resource-limited settings are largely lacking. Methods: A task force of six international experts in critical care medicine, all of them members of the Global Intensive Care Working Group of the European Society of Intensive Care Medicine and with extensive bedside experience in resource-limited intensive care units, reviewed the literature and provided recommendations regarding haemodynamic assessment and support, keeping aspects of efficacy and effectiveness, availability and feasibility and affordability and safety in mind...
February 9, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29416200/hyperlactatemia-and-the-importance-of-repeated-lactate-measurements-in-critically-ill-patients
#4
Amina Godinjak, Selma Jusufovic, Admir Rama, Amer Iglica, Faris Zvizdic, Adis Kukuljac, Ira Tancica, Sejla Rozajac
Objective: The aim of the study was to describe the prevalence of hyperlactatemia and emphasis on repeated lactate measurements in critically ill patients, and the associated mortality. Materials and methods: The study included 70 patients admitted in the Medical Intensive Care Unit at the Clinical Center, University of Sarajevo, in a 6-month period (July - December 2015). The following data were obtained: age, gender, reason for admission, Simplified Acute Physiology Score II, Acute Physiology and Chronic Health Evaluation, lactate concentrations upon admission, after 24 and 48 hours, and outcome (discharge from hospital or death)...
December 2017: Medical Archives
https://www.readbyqxmd.com/read/29402360/-effect-of-lactic-acid-levels-on-the-prognosis-of-critically-ill-patients-after-cardiac-and-non-cardiac-surgery-an-analysis-of-549-cases
#5
Rongqing Sun, Ke Chao, Hongfu Yang
OBJECTIVE: To compare the impact of mean lactate concentration and lactate variability on postoperative outcome after cardiac surgery and non-cardiac surgery in critical patients, and to explore the prognostic value of the first lactate and the highest lactate during the first 24 hours in intensive care unit (ICU). METHODS: A retrospective study was conducted. The postoperative patients of cardiac surgery and non-cardiac surgery who were transferred to ICU immediately, and who were at least 18 years old and whose ICU lengths of stay were at least 1 day, and who were admitted to ICU of the First Affiliated Hospital of Zhengzhou University from September 2014 to September 2016 were enrolled...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29377728/milk-volume-at-2-weeks-predicts-mother-s-own-milk-feeding-at-neonatal-intensive-care-unit-discharge-for-very-low-birthweight-infants
#6
Rebecca Hoban, Harold Bigger, Michael Schoeny, Janet Engstrom, Paula Meier, Aloka L Patel
OBJECTIVE: This study sought to determine the maternal prepregnancy, pregnancy, and delivery risk factors that predicted coming to volume (CTV; achieving pumped mother's own milk [MOM] volume ≥500 mLs/day) and the continuation of MOM provision through to discharge from the neonatal intensive care unit (NICU) in mothers and their very low birthweight (VLBW; <1,500 g at birth) infants. STUDY DESIGN: Secondary analysis of prospectively collected data from 402 mothers of VLBW infants admitted to an urban NICU, including detailed MOM pumping records for a subset (51%) of the cohort...
January 29, 2018: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/29368635/cerebral-metabolic-effects-of-strict-versus-conventional-glycaemic-targets-following-severe-traumatic-brain-injury
#7
Mark P Plummer, Natalia Notkina, Ivan Timofeev, Peter J Hutchinson, Mark E Finnis, Arun K Gupta
BACKGROUND: Optimal glycaemic targets for patients with severe traumatic brain injury remain unclear. The primary objective of this microdialysis study was to compare cerebral metabolism with strict versus conventional glycaemic control. METHODS: We performed a prospective single-centre randomised controlled within-subject crossover study of 20 adult patients admitted to an academic neurointensive care unit with severe traumatic brain injury. Patients underwent randomised, consecutive 24-h periods of strict (4-7 mmol/L; 72-126 mg/dl) and conventional (<10 mmol/L; 180 mg/dl) glycaemic control with microdialysis measurements performed hourly...
January 25, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29319634/hyperoxia-and-hypocapnia-during-pediatric-extracorporeal-membrane-oxygenation-associations-with-complications-mortality-and-functional-status-among-survivors
#8
Katherine Cashen, Ron Reeder, Heidi J Dalton, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, J Michael Dean, Robert Tamburro, Kathleen L Meert
OBJECTIVES: To determine the frequency of hyperoxia and hypocapnia during pediatric extracorporeal membrane oxygenation and their relationships to complications, mortality, and functional status among survivors. DESIGN: Secondary analysis of data collected prospectively by the Collaborative Pediatric Critical Care Research Network. SETTING: Eight Collaborative Pediatric Critical Care Research Network-affiliated hospitals. PATIENTS: Age less than 19 years and treated with extracorporeal membrane oxygenation...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29310566/analysis-of-oxidative-stress-related-markers-in-critically-ill-polytrauma-patients-an-observational-prospective-single-center-study
#9
Mihai Sandesc, Alexandru Florin Rogobete, Ovidiu Horea Bedreag, Anca Dinu, Marius Papurica, Carmen Alina Cradigati, Mirela Sarandan, Sonia Elena Popovici, Lavinia Melania Bratu, Tiberiu Bratu, Adrian Tudor Stan, Dorel Sandesc
Critically ill polytrauma patients have increased production of free radicals (FRs) and consequent alterations in biochemical pathways, as well as disruption of cellular integrity, due to increased lipid peroxidation. The aim of this study was to investigate several biomarkers associated with increased oxidative stress in critically ill polytrauma patients, and to evaluate the effect of antioxidant treatment on the clinical outcome in these patients. A total of 67 polytrauma patients from an intensive care unit met the selection criteria...
January 9, 2018: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29306908/systematic-comparison-of-routine-laboratory-measurements-with-in-hospital-mortality-icu-labome-a-large-cohort-study-of-critically-ill-patients
#10
Edris M Alkozai, Bakhtawar K Mahmoodi, Johan Decruyenaere, Robert J Porte, Annemieke Oude Lansink-Hartgring, Ton Lisman, Maarten W Nijsten
BACKGROUND: In intensive care unit (ICU) patients, many laboratory measurements can be deranged when compared with the standard reference interval (RI). The assumption that larger derangements are associated with worse outcome may not always be correct. The ICU-Labome study systematically evaluated the univariate association of routine laboratory measurements with outcome. METHODS: We studied the 35 most frequent blood-based measurements in adults admitted ≥6 h to our ICU between 1992 and 2013...
January 8, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29209776/hyperoxia-induced-cardiotoxicity-and-ventricular-remodeling-in-type-ii-diabetes-mice
#11
Jennifer Leigh Rodgers, Eva Samal, Subhra Mohapatra, Siva Kumar Panguluri
Hyperoxia, or supplemental oxygen, is regularly used in the clinical setting for critically ill patients in ICU. However, several recent studies have demonstrated the negative impact of this treatment in patients in critical care, including increased rates of lung and cardiac injury, as well as increased mortality. The purpose of this study was to determine the predisposition for arrhythmias and electrical remodeling in a type 2 diabetic mouse model (db/db), as a result of hyperoxia treatment. For this, db/db and their heterozygous controls were treated with hyperoxia (> 90% oxygen) or normoxia (normal air) for 72-h...
December 5, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29194916/the-impact-of-obesity-in-cirrhotic-patients-with-septic-shock-a-retrospective-cohort-study
#12
Beverley Kok, Constantine J Karvellas, Juan G Abraldes, Rajiv Jalan, Vinay Sundaram, David Gurka, Sean Keenan, Aseem Kumar, Greg Martinka, Brian Bookatz, Gordon Wood, Anand Kumar
BACKGROUND & AIMS: The prevalence of obesity in cirrhosis is rising. The impact of obesity in the critically-ill cirrhotic patient with sepsis/septic shock has not been evaluated. This study aimed to examine the relationship between obesity and mortality in cirrhotic patients admitted to the intensive care unit with septic shock. METHODS: A retrospective cohort study of all cirrhotic patients with septic shock (n=362) and a recorded body mass index (BMI) from an international, multicenter (CATTS) database (1996-2015) was performed...
December 1, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29190735/subgroup-analysis-of-continuous-renal-replacement-therapy-in-severely-burned-patients
#13
Jaechul Yoon, Youngmin Kim, Dohern Kym, Jun Hur, Haejun Yim, Yong-Suk Cho, Wook Chun
Continuous renal replacement therapy (CRRT) is administered to critically ill patients with renal injuries as renal replacement or renal support. We aimed to identify predictors of mortality among burn patients receiving CRRT, and to investigate clinical differences according to acute kidney injury (AKI) status. This retrospective observational study evaluated 216 Korean burn patients who received CRRT at a burn intensive care unit. Patients were categorized by AKI status. Data were collected regarding arterial pH, laboratory results, ratio of arterial oxygen partial pressure to fractional inspired oxygen (PF ratio), and urine production...
2017: PloS One
https://www.readbyqxmd.com/read/29180833/growth-differentiation-factor-15-is-a-predictor-of-mortality-in-critically-ill-patients-with-sepsis
#14
Lukas Buendgens, Eray Yagmur, Jan Bruensing, Ulf Herbers, Christer Baeck, Christian Trautwein, Alexander Koch, Frank Tacke
Growth differentiation factor-15 (GDF-15) is a member of the transforming growth factor-β superfamily related to inflammation and macrophage activation. Serum concentrations of GDF-15 can predict poor survival in chronic diseases, but its role in sepsis is obscure. Therefore, we investigated GDF-15 as a prognostic biomarker in critically ill patients. We measured GDF-15 levels in 219 critically ill patients (146 with sepsis, 73 without sepsis) upon admission to the intensive care unit (ICU), in comparison to 66 healthy controls...
2017: Disease Markers
https://www.readbyqxmd.com/read/29165898/thrombocytopenia-associated-multi-organ-failure-secondary-to-hyperglycemic-hyperosmolar-non-ketotic-syndrome-a-case-report
#15
Naile Tufan-Pekkucuksen, Maria Carolina Gazzaneo, Natasha Susana Afonso, Sarah J Swartz, Joseph R Angelo, Poyyapakkam Srivaths
Thrombocytopenia associated multi-organ failure (TAMOF) is a clinical syndrome with features of new onset thrombocytopenia, increased lactate dehydrogenase, and multi-organ failure in critically ill patients. TAMOF can be the initial presentation of an underlying disease process or can develop during the course of illness either during the hospital stay. TAMOF has a high mortality rate if not treated; therefore, early detection is critical. TAMOF has been rarely reported in diabetic ketoacidosis. We are describing the first case of a patient diagnosed with hyperglycemic, hyperosmolar non-ketotic syndrome who developed TAMOF on the third day of his hospital course...
November 22, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/29163332/clinical-use-of-cerebral-microdialysis-in-patients-with-aneurysmal-subarachnoid-hemorrhage-state-of-the-art
#16
REVIEW
Raimund Helbok, Mario Kofler, Alois Josef Schiefecker, Maxime Gaasch, Verena Rass, Bettina Pfausler, Ronny Beer, Erich Schmutzhard
Objective: To review the published literature on the clinical application of cerebral microdialysis (CMD) in aneurysmal subarachnoid hemorrhage (SAH) patients and to summarize the evidence relating cerebral metabolism to pathophysiology, secondary brain injury, and outcome. Methods: Study selection: Two reviewers identified all manuscripts reporting on the clinical use of CMD in aneurysmal SAH patients from MEDLINE. All identified studies were grouped according to their focus on brain metabolic changes during the early and subacute phase after SAH, their association with mechanisms of secondary brain injury and outcome...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29129343/prognostic-value-of-hyperlactatemia-and-lactate-clearance-after-mitral-valve-surgery
#17
Adam S Evans, Matthew A Levin, Hung-Mo Lin, Ken Lee, Menachem M Weiner, Anelechi Anyanwu, David H Adams, Alexander J C Mittnacht
OBJECTIVES: Blood lactate is frequently used to guide management in critically ill patients. In patients undergoing mitral valve surgery, an elevated lactate level is frequently observed; however, overall mortality is low. The authors hypothesized that hyperlactemia is not a useful predictor of poor outcomes in this patient population. The main aim of this study was to explore how blood lactate level and lactate clearance are associated with 30-day mortality and major adverse events in patients undergoing mitral valve surgery...
August 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29128300/enteral-versus-parenteral-early-nutrition-in-ventilated-adults-with-shock-a-randomised-controlled-multicentre-open-label-parallel-group-study-nutrirea-2
#18
Jean Reignier, Julie Boisramé-Helms, Laurent Brisard, Jean-Baptiste Lascarrou, Ali Ait Hssain, Nadia Anguel, Laurent Argaud, Karim Asehnoune, Pierre Asfar, Frédéric Bellec, Vlad Botoc, Anne Bretagnol, Hoang-Nam Bui, Emmanuel Canet, Daniel Da Silva, Michael Darmon, Vincent Das, Jérôme Devaquet, Michel Djibre, Frédérique Ganster, Maité Garrouste-Orgeas, Stéphane Gaudry, Olivier Gontier, Claude Guérin, Bertrand Guidet, Christophe Guitton, Jean-Etienne Herbrecht, Jean-Claude Lacherade, Philippe Letocart, Frédéric Martino, Virginie Maxime, Emmanuelle Mercier, Jean-Paul Mira, Saad Nseir, Gael Piton, Jean-Pierre Quenot, Jack Richecoeur, Jean-Philippe Rigaud, René Robert, Nathalie Rolin, Carole Schwebel, Michel Sirodot, François Tinturier, Didier Thévenin, Bruno Giraudeau, Amélie Le Gouge
BACKGROUND: Whether the route of early feeding affects outcomes of patients with severe critical illnesses is controversial. We hypothesised that outcomes were better with early first-line enteral nutrition than with early first-line parenteral nutrition. METHODS: In this randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2 trial) done at 44 French intensive-care units (ICUs), adults (18 years or older) receiving invasive mechanical ventilation and vasopressor support for shock were randomly assigned (1:1) to either parenteral nutrition or enteral nutrition, both targeting normocaloric goals (20-25 kcal/kg per day), within 24 h after intubation...
January 13, 2018: Lancet
https://www.readbyqxmd.com/read/29115861/postnatal-overnutrition-affects-metabolic-and-vascular-function-reflected-by-physiological-and-histological-changes-in-the-aorta-of-adult-wistar-rats
#19
Gerardo Sánchez-García, Laura Del Bosque-Plata, Enrique Hong
Rigorous nutritional care during early life leads to healthy adulthood. Cardiovascular and metabolic disorders, the most prevalent clinical challenges worldwide, are epidemiologically linked to poor nutritional habits throughout life. We aimed to understand whether postnatal overnutrition (PO) initiated during lactation affects metabolic markers and vascular function later in life. To test this hypothetical effect, we studied a PO Wistar rat model based on adjusting litter size at the third day of age to three pups and eight for the control group (C)...
November 8, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29107581/developmental-estrogen-exposures-and-disruptions-to-maternal-behavior-and-brain-effects-of-ethinyl-estradiol-a-common-positive-control
#20
Mary C Catanese, Laura N Vandenberg
Due of its structural similarity to the endogenous estrogen 17β-estradiol (E2), the synthetic estrogen 17α-ethinyl estradiol (EE2) is widely used to study the effects of estrogenic substances on sensitive organs at multiple stages of development. Here, we investigated the effects of EE2 on maternal behavior and the maternal brain in females exposed during gestation and the perinatal period. We assessed several components of maternal behavior including nesting behavior and pup retrieval; characterized the expression of estrogen receptor (ER)α in the medial preoptic area (MPOA), a brain region critical for the display of maternal behavior; and measured expression of tyrosine hydroxylase, a marker for dopaminergic cells, in the ventral tegmental area (VTA), a brain region important in maternal motivation...
November 7, 2017: Hormones and Behavior
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