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https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#1
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28709443/severity-of-acute-gastrointestinal-injury-grade-is-a-predictor-of-all-cause-mortality-in-critically-ill-patients-a-multicenter-prospective-observational-study
#2
Bangchuan Hu, Renhua Sun, Aiping Wu, Yin Ni, Jingquan Liu, Feng Guo, Lijun Ying, Guoping Ge, Aijun Ding, Yunchao Shi, Changwen Liu, Lei Xu, Ronglin Jiang, Jun Lu, Ronghai Lin, Yannan Zhu, Weidong Wu, Bo Xie
BACKGROUND: In 2012, the European Society of Intensive Care Medicine proposed a definition for acute gastrointestinal injury (AGI) based on current medical evidence and expert opinion. The aim of the present study was to evaluate the feasibility of using the current AGI grading system and to investigate the association between AGI severity grades with clinical outcome in critically ill patients. METHODS: Adult patients at 14 general intensive care units (ICUs) with an expected ICU stay ≥24 h were prospectively studied...
July 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28705203/serum-lactate-is-an-independent-predictor-of-hospital-mortality-in-critically-ill-patients-in-the-emergency-department-a-retrospective-study
#3
Ralphe Bou Chebl, Christopher El Khuri, Ali Shami, Eva Rajha, Nagham Faris, Rana Bachir, Gilbert Abou Dagher
BACKGROUND: Elevated lactate has been found to be associated with a higher mortality in a diverse patient population. The aim of the study is to investigate if initial serum lactate level is independently associated with hospital mortality for critically ill patients presenting to the Emergency Department. METHODS: Single-center, retrospective study at a tertiary care hospital looking at patients who presented to the Emergency Department (ED) between 2014 and 2016...
July 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28697170/critically-ill-children-with-hemophagocytic-lymphohistiocytosis-a-case-series-of-14-patients
#4
Esther Huimin Leow, Shui Yen Soh, Ah Moy Tan, Yee Hui Mok, Mei Yoke Chan, Jan Hau Lee
Children with hemophagocytic lymphohistiocytosis (HLH) are at an increased risk of critical illness. In this study, we described the clinical characteristics of critically ill children with HLH and identify factors associated with poor clinical outcomes. Children who were diagnosed with HLH with emergent admission to Children's Intensive Care Unit (CICU) between January 1, 2000 and October 31, 2015 were included. The primary outcome was CICU mortality. Over the 15-year period, there were 14 critically ill patients with HLH with 23 CICU admissions...
July 10, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28662377/a-multifactor-model-for-predicting-mortality-in-critically-ill-patients-a-multicenter-prospective-cohort-study
#5
Zhongwang Li, Baoli Cheng, Jingya Wang, Guohao Xie, Xiaobo Yu, Man Huang, Zhijun Xu, Zhongqiu Lu, Huaqin Sun, Jian Zhang, Zhiyi Wang, Haiya Wu, Xu Liu, Lihua Chu, Jialian Zhao, Xiangming Fang
PURPOSE: The objective of this study was to develop a model using a combination of routine clinical variables to predict mortality in critically ill patients. METHODS: A cohort of 500 patients recruited from eight university hospital intensive care units (ICUs) was used to develop a model via logistic regression analyses. Discrimination and calibration analyses were performed to assess the model. RESULTS: The model included the lactate level (odds ratio [OR]=1...
June 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28625262/-predictive-value-of-sofa-score-combined-agi-grading-system-in-elderly-patients-with-sepsis-a-retrospective-analysis-with-91-patients
#6
Lingling Wang, Rui Chen, Zexun Mo, Jiahui Dong, Zhaokun Sun, Fei Xiao, Shaoting Hu, Richeng Xiong, Jie Sun, Zhou Yu, Zhenhui Guo
OBJECTIVE: To explore the predictive value of sequential organ failure assessment (SOFA) score combined the acute gastrointestinal injury (AGI) grading system in critical elderly patients with sepsis. METHODS: A retrospective analysis was conducted. Elderly patients with sepsis aged > 60 years admitted to medical intensive care unit (MICU) of General Hospital of Guangzhou Military Command from March 2014 to December 2015 and experiencing critical care over 48 hours were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625256/-comparison-of-effect-of-norepinephrine-and-terlipressin-on-patients-with-ards-combined-with-septic-shock-a-prospective-single-blind-randomized-controlled-trial
#7
Zhi Chen, Ping Zhou, Yuanhua Lu, Chunli Yang
OBJECTIVE: To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock. METHODS: A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28620552/refractory-lactic-acidosis-in-small-cell-carcinoma-of-the-lung
#8
Daniel J Oh, Ellen Dinerman, Andrew H Matthews, Abraham W Aron, Katherine M Berg
BACKGROUND: Elevated lactate levels in critically ill patients are most often thought to be indicative of relative tissue hypoxia or type A lactic acidosis. Shock, severe anemia, and thromboembolic events can all cause elevated lactate due to tissue hypoperfusion, as well as the mitochondrial dysfunction thought to occur in sepsis and other critically ill states. Malignancy can also lead to elevation in lactate, a phenomenon described as type B lactic acidosis, which is much less commonly encountered in the critically ill...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28610957/effectiveness-of-heart-rate-control-on-hemodynamics-in-critically-ill-patients-with-atrial-tachyarrhythmias-managed-by-amiodarone
#9
Joe-Elie Salem, Pauline Dureau, Christian Funck-Brentano, Jean-Sébastien Hulot, Maria El-Aissaoui, Nadia Aissaoui, Saik Urien, Christophe Faisy
Atrial tachyarrhythmias (AT) are common in intensive care unit (ICU) patients and might contribute to hemodynamic instability if heart rate (HR) is persistently too rapid. We aimed to assess if HR control below 115 or 130bpm with amiodarone improves hemodynamics in ICU patients with AT. This observational study included 73 ICU patients with disabling AT receiving amiodarone for HR control. A total of 525 changes (mainly within 4-8h) in mean arterial pressure (MAP) and 167 changes in plasma lactate in response to HR variations above 115 or 130bpm were analyzed...
June 10, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28595555/microdialysis-assessed-adipose-tissue-metabolism-in-critically-ill-patients
#10
Ioannis Ilias, Nikitas Nikitas, Maria Theodorakopoulou, Ioanna Dimopoulou
BACKGROUND: Microdialysis is a minimally invasive technique that allows direct in situ and in vivo sampling, studies and manipulations of the interstitial/extracellular fluid/space. It has been shown to be of use mainly in acute brain injury/neurocritical care. METHODS: Microdialysis has been used to study obesity, diabetes mellitus, inflammation and pharmacokinetics at the adipose tissue level. In critically ill patients (and particularly in those with sepsis or septic shock), within days to weeks, adipose tissue shows profound alterations; under such conditions the implementation of microdialysis can provide researchers with interesting findings...
June 8, 2017: Recent Patents on Endocrine, Metabolic & Immune Drug Discovery
https://www.readbyqxmd.com/read/28586613/hyperlactetemia-and-its-trends-in-critically-ill-children-admitted-in-pediatric-intensive-care-unit-of-a-developing-country
#11
Qalab Abbas, Muhammad Tariq Jamil, Leena Jafri, Anwar Ul Haque, Vivek Khetpal
BACKGROUND: There is increasing evidence that in setting of critical ailments clinical signs lag biomarkers like Lactate and hyperlactetemia can be the only marker for this disorder. This study was conducted to describe the incidence of hyperlactatemia in critically ill children and its association with outcome. METHODS: Retrospective review of medical records of all children who had their lactic acid (LA) levels measured during their admission in PICU from January 2014 to December 2015 was done...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28575484/comprehensive-analysis-of-liberal-and-restrictive-transfusion-strategies-in-pediatric-intensive-care-unit
#12
Basak Akyildiz, Nazan Ulgen Tekerek, Ozge Pamukcu, Adem Dursun, Musa Karakukcu, Nazmi Narin, Mehmet Yay, Ferhan Elmali
Background: We prospectively compared restrictive and liberal transfusion strategies for critically ill children regarding hemodynamic and laboratory parameters. Methods: A total of 180 children requiring packed red blood cells (PRBCs) were randomized into two groups: the liberal transfusion strategy group (transfusion trigger < 10 g/dL, Group 1) and the restrictive transfusion strategy group (transfusion trigger ≤ 7 g/dL, Group 2). Basal variables including venous/arterial hemoglobin, hematocrit and lactate levels; stroke volume; and cardiac output were recorded at the beginning and end of the transfusion...
May 30, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28536944/fluid-responsiveness-predicted-by-transcutaneous-partial-pressure-of-oxygen-in-patients-with-circulatory-failure-a-prospective-study
#13
Jingyuan Xu, Xiao Peng, Chun Pan, Shixia Cai, Xiwen Zhang, Ming Xue, Yi Yang, Haibo Qiu
BACKGROUND: Significant effort has been devoted to defining parameters for predicting fluid responsiveness. Our goal was to study the feasibility of predicting fluid responsiveness by transcutaneous partial pressure of oxygen (PtcO2) in the critically ill patients. METHODS: This was a single-center prospective study conducted in the intensive care unit of a tertiary care teaching hospital. Shock patients who presented with at least one clinical sign of inadequate tissue perfusion, defined as systolic blood pressure <90 mmHg or a decrease >40 mmHg in previously hypertensive patients or the need for vasopressive drugs; urine output <0...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28524025/-effect-of-esmolol-on-hemodynamics-and-clinical-outcomes-in-patients-with-septic-shock
#14
Shupeng Wang, Min Li, Jun Duan, Li Yi, Xu Huang, Desheng Chen, Gang Li
OBJECTIVE: To evaluate the effect of heart rate control with esmolol on hemodynamics, inflammatory cytokines and clinical outcomes in patients with septic shock. METHODS: A prospective randomized controlled trial was conducted. The patients with septic shock admitted to Department of Critical Care Medicine of China-Japan Friendship Hospital from August 2014 to October 2016 were enrolled. After 24 hours of resuscitation and other therapy, they were randomly divided into two groups by sealed envelope...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28489032/clinical-significance-and-prognostic-effect-of-serum-25-hydroxyvitamin-d-concentrations-in-critical-and-severe-hand-foot-and-mouth-disease
#15
Hong-Xing Dang, Cheng-Jun Liu, Jing Li, Shi-Jiao Chen, Feng Xu
OBJECTIVE: To examine the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with critical and severe hand, foot and mouth disease (HFMD) and assess the clinical significance and prognostic effect of 25(OH)D concentrations in children with HFMD. METHODS: This is a prospective observational study. The 138 children with HFMD were divided into common (49 cases), severe (52 cases), and critical (37 cases) HFMD groups. Another 59 healthy children undergoing outpatient medical examinations during the same period were chosen as the control group...
May 10, 2017: Nutrients
https://www.readbyqxmd.com/read/28486864/practical-use-of-lactate-levels-in-the-intensive-care
#16
Eva E Vink, Jan Bakker
Hyperlactatemia is a strong predictor of mortality in diverse populations of critically ill patients. In this article, we will give an overview of how lactate is used in the intensive care unit. We describe the use of lactate as a predictor of outcome, as a marker to initiate therapy and to monitor adequacy of initiated treatments.
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28460210/hypoxic-hepatitis-its-biochemical-profile-causes-and-risk-factors-of-mortality-in-critically-ill-patients-a-cohort-study-of-565-patients
#17
Mohammed M Aboelsoud, Amen I Javaid, Mazen O Al-Qadi, James H Lewis
PURPOSE: A retrospective analysis of critically-ill patients with hypoxic hepatitis (HH) to characterize the biochemical profile and to identify predictors of mortality using the Medical Information Mart for Intensive Care III database. METHODS: HH was defined as a rapid increase in AST/ALT≥800IU/L after exclusion of other causes. We investigated the correlation between various clinical and laboratory parameters and mortality rates using regression models. RESULTS: Among 38,645 ICU-patients, 565 (1...
April 26, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28438182/forced-fluid-removal-versus-usual-care-in-intensive-care-patients-with-high-risk-acute-kidney-injury-and-severe-fluid-overload-ffaki-study-protocol-for-a-randomised-controlled-pilot-trial
#18
Rasmus E Berthelsen, Theis Itenov, Anders Perner, Jens-Ulrik Jensen, Michael Ibsen, Andreas Emil Kryger Jensen, Morten Bestle
BACKGROUND: Intravenous administration of fluids is an essential part of critical care. While some fluid administration is likely beneficial, there is increasing observational evidence that the development of fluid overload is associated with increased mortality. There are no randomised trials to confirm this association in patients with acute kidney injury. We aim to perform a pilot trial to test the feasibility of forced fluid removal compared to standard care in patients with acute kidney injury and severe fluid overload, the FFAKI trial...
April 24, 2017: Trials
https://www.readbyqxmd.com/read/28419061/functional-status-of-neonatal-and-pediatric-patients-after-extracorporeal-membrane-oxygenation
#19
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, Tammara Jenkins, Kathleen L Meert
OBJECTIVES: To describe functional status at hospital discharge for neonatal and pediatric patients treated with extracorporeal membrane oxygenation, and identify factors associated with functional status and mortality. DESIGN: Secondary analysis of observational data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014. SETTING: Eight hospitals affiliated with the Collaborative Pediatric Critical Care Research Network...
June 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28407811/saline-versus-balanced-crystalloids-for-intravenous-fluid-therapy-in-the-emergency-department-study-protocol-for-a-cluster-randomized-multiple-crossover-trial
#20
Wesley H Self, Matthew W Semler, Jonathan P Wanderer, Jesse M Ehrenfeld, Daniel W Byrne, Li Wang, Leanne Atchison, Matthew Felbinger, Ian D Jones, Stephan Russ, Andrew D Shaw, Gordon R Bernard, Todd W Rice
BACKGROUND: Prior studies in critically ill patients suggest the supra-physiologic chloride concentration of 0.9% ("normal") saline may be associated with higher risk of renal failure and death compared to physiologically balanced crystalloids. However, the comparative effects of 0.9% saline and balanced fluids are largely unexamined among patients outside the intensive care unit, who represent the vast majority of patients treated with intravenous fluids. METHODS/DESIGN: This study, entitled Saline Against Lactated Ringer's or Plasma-Lyte in the Emergency Department (SALT-ED), is a pragmatic, cluster, multiple-crossover trial at a single institution evaluating clinical outcomes of adults treated with 0...
April 13, 2017: Trials
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