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https://www.readbyqxmd.com/read/28320917/predictors-of-massive-blood-transfusion-a-delphi-study-to-examine-the-views-of-experts
#1
Jacqueline V Mclennan, K C Mackway-Jones, S T Horne, R Body
BACKGROUND: Trauma patients requiring massive blood transfusion (MBT) have high morbidity and mortality: early and aggressive use of blood products during immediate resuscitation may improve survival. There is currently a lack of evidence to guide initial identification of these patients which is especially important in areas where plasma may need to be thawed. In the absence of this evidence, this study aimed to robustly evaluate expert opinion by using a Delphi process to identify predictors of massive transfusion...
March 20, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28302179/balanced-crystalloids-versus-saline-in-the-intensive-care-unit-study-protocol-for-a-cluster-randomized-multiple-crossover-trial
#2
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
https://www.readbyqxmd.com/read/28298202/evaluation-of-sublingual-microcirculation-in-a-paediatric-intensive-care-unit-prospective-observational-study-about-its-feasibility-and-utility
#3
Rafael González, Jorge López, Javier Urbano, María José Solana, Sarah Nicole Fernández, María José Santiago, Jesús López-Herce
BACKGROUND: Evaluation of the microcirculation in critically ill patients is usually done by means of indirect parameters. The aim of our study was to evaluate the functional state of the microcirculation by direct visualization of sublingual microcirculation using Sidestream Dark Field Imaging, to determine the correlation between these findings and other parameters that are commonly used in the clinical practice and to assess the applicability of the systematic use of this technique in critically ill children...
March 15, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28268170/cytoreductive-nephrectomy-renal-cell-carcinoma-patients-with-venous-tumor-thrombus
#4
E Jason Abel, Philippe E Spiess, Vitaly Margulis, Viraj A Master, Michael Mann, Kamran Zargar, Leonardo D Borregales, Wade J Sexton, Datta Patil, Surena F Matin, Christopher G Wood, Jose A Karam
PURPOSE: Careful selection is critical to identify metastatic renal cell carcinoma (mRCC) patients who are most likely to benefit from cytoreductive nephrectomy (CN). Surgery for mRCC patients with tumor thrombus is complex and may not benefit some patients with very poor overall survival (OS). The objective of this study was to evaluate whether preoperative variables or risk stratification systems could predict OS following CN. METHODS: Prognostic factors for overall OS following surgery were evaluated in mRCC patients with venous tumor thrombus at 5 institutions from 2000-2014...
March 4, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28265453/automated-closed-loop-resuscitation-of-multiple-hemorrhages-a-comparison-between-fuzzy-logic-and-decision-table-controllers-in-a-sheep-model
#5
Nicole Ribeiro Marques, Brent J Ford, Muzna N Khan, Michael Kinsky, Donald J Deyo, William J Mileski, Hao Ying, George C Kramer
BACKGROUND: Hemorrhagic shock is the leading cause of trauma-related death in the military setting. Definitive surgical treatment of a combat casualty can be delayed and life-saving fluid resuscitation might be necessary in the field. Therefore, improved resuscitation strategies are critically needed for prolonged field and en route care. We developed an automated closed-loop control system capable of titrating fluid infusion to a target endpoint. We used the system to compare the performance of a decision table algorithm (DT) and a fuzzy logic controller (FL) to rescue and maintain the mean arterial pressure (MAP) at a target level during hemorrhages...
2017: Disaster Mil Med
https://www.readbyqxmd.com/read/28244940/elevated-mean-airway-pressure-and-central-venous-pressure-in-the-first-day-of-mechanical-ventilation-indicated-poor-outcome
#6
Yun Long, Longxiang Su, Qing Zhang, Xiang Zhou, Hao Wang, Na Cui, Wenzhao Chai, Xiaoting Wang, Xi Rui, Dawei Liu
OBJECTIVES: The relationship between respiratory mechanical parameters and hemodynamic variables remains unclear. This study was performed to determine whether mean airway pressure and central venous pressure in the first day of mechanical ventilation are associated with patient outcomes. DESIGN: Retrospective first 24-hour comparison during ICU stay. SETTING: The Department of Critical Care Medicine of Peking Union Medical College Hospital...
February 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28167245/effects-of-paraoxonase-arylesterase-ceruloplasmin-catalase-and-myeloperoxidase-activities-on-prognosis-in-pediatric-patients-with-sepsis
#7
Ganime Ayar, Yasemin Men Atmaca, Murat Alışık, Özcan Erel
BACKGROUND: The present study aimed to investigate the levels of paraoxonase (PON), stimulated paraoxonase (SPON), arylesterase (ARE), ceruloplasmin (CLP), myeloperoxidase (MPO), and catalase (CAT) in pediatric sepsis and to explore their effects on the prognosis of sepsis. METHODS: Patients diagnosed with sepsis (n=33) and healthy controls (n=30) were included. PON, SPON, ARE, CLP, MPO, and CAT activities were measured in the sepsis and control groups. Additionally, the parameters were compared between survivors and non-survivors in the sepsis group...
February 3, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28166165/automated-variable-aortic-control-versus-complete-aortic-occlusion-in-a-swine-model-of-hemorrhage
#8
Timothy K Williams, Lucas P Neff, Michael Austin Johnson, Rachel M Russo, Sarah-Ashley Ferencz, Anders J Davidson, Nathan F Clement, John Kevin Grayson, Todd E Rasmussen
BACKGROUND: Future endovascular hemorrhage control devices will require features that mitigate the adverse effects of vessel occlusion. Permissive regional hypoperfusion (PRH) with variable aortic control (VAC) is a novel strategy to minimize hemorrhage and reduce the ischemic burden of complete aortic occlusion (AO). The objective of this study was to compare PRH with VAC to AO in a lethal model of hemorrhage. METHODS: Twenty-five swine underwent cannulation of the supraceliac aorta, with diversion of aortic flow through an automated extracorporeal circuit...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28163920/risk-factors-for-the-delayed-onset-of-neuropsychologic-sequelae-following-carbon-monoxide-poisoning
#9
Takeshi Kitamoto, Masanobu Tsuda, Masaki Kato, Fukuki Saito, Yoshito Kamijo, Toshihiko Kinoshita
AIM: Carbon monoxide (CO) poisoning often manifests delayed neuropsychological sequelae. The risks and preventive factors for the development of delayed neuropsychological sequelae are controversial at present. The purpose of this retrospective study was to assess the risk factors for this condition. METHOD: We studied 81 patients with CO poisoning admitted to the Critical Care and Emergency Medicine Center at the Kansai Medical University from 2006 to 2012. All patients (64 males and 17 females; average age, 45...
October 2016: Acute Med Surg
https://www.readbyqxmd.com/read/28161178/invited-review-large-scale-indirect-measurements-for-enteric-methane-emissions-in-dairy-cattle-a-review-of-proxies-and-their-potential-for-use-in-management-and-breeding-decisions
#10
E Negussie, Y de Haas, F Dehareng, R J Dewhurst, J Dijkstra, N Gengler, D P Morgavi, H Soyeurt, S van Gastelen, T Yan, F Biscarini
Efforts to reduce the carbon footprint of milk production through selection and management of low-emitting cows require accurate and large-scale measurements of methane (CH4) emissions from individual cows. Several techniques have been developed to measure CH4 in a research setting but most are not suitable for large-scale recording on farm. Several groups have explored proxies (i.e., indicators or indirect traits) for CH4; ideally these should be accurate, inexpensive, and amenable to being recorded individually on a large scale...
February 1, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28151948/model-for-end-stage-liver-disease-excluding-inr-meld-xi-score-in-critically-ill-patients-easily-available-and-of-prognostic-relevance
#11
Bernhard Wernly, Michael Lichtenauer, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Uta C Hoppe, Malte Kelm, Christian Jung
PURPOSE: MELD-XI, an adapted version of Model for End-stage Liver Disease (MELD) score excluding INR, was reported to predict outcomes e.g. in patients with acute heart failure. We aimed to evaluate MELD-XI in critically ill patients admitted to an intensive care unit (ICU) for prognostic relevance. METHODS: A total of 4381 medical patients (66±14 years, 2862 male) admitted to a German ICU between 2004 and 2009 were included and retrospectively investigated. Admission diagnoses were e...
2017: PloS One
https://www.readbyqxmd.com/read/28144779/focused-cardiac-ultrasound-in-the-early-resuscitation-of-severe-sepsis-and-septic-shock-a-prospective-pilot-study
#12
Hiroshi Sekiguchi, Yohei Harada, Hector R Villarraga, Sunil V Mankad, Ognjen Gajic
PURPOSE: Point-of-care ultrasonography has been increasingly used in the care of critically ill patients; however, reports on its use during active resuscitation are limited. The aim of this study was to investigate the true impact of focused cardiac ultrasound (FCU) during the management of sepsis with early (6-h) resuscitation. METHODS: A prospective pilot observational study was conducted at an academic medical center from March 2011 through July 2012. Patients undergoing resuscitation for severe sepsis or septic shock were prospectively enrolled at medical and combined medical-surgical intensive care units...
January 31, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28144728/-acute-pancreatitis-in-intensive-care-medicine-which-risk-score-is-useful
#13
A J Fischer, F Andreottola, P Lenz, P Lebiedz
INTRODUCTION: Acute pancreatitis is a disease with an increasing incidence in the Western countries associated with a high mortality depending on severity of disease. Etiology is often biliary or due to alcoholism. Incidence of etiology varies between regions depending on risk-factor prevalence. Several risk scores are available to estimate mortality. The aim of the study is to identify the risk factors most relevant for patients being treated for severe acute pancreatitis in an ICU of a tertiary medical center...
January 31, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28121217/qsofa-has-poor-sensitivity-for-prehospital-identification-of-severe-sepsis-and-septic-shock
#14
Maia Dorsett, Melissa Kroll, Clark S Smith, Phillip Asaro, Stephen Y Liang, Hawnwan P Moy
OBJECTIVES: Sepsis is a common and deadly disease process for which early recognition and intervention can significantly improve clinical outcomes. Despite this, sepsis remains underrecognized and therefore undertreated in the prehospital setting. Recent recommendations by the Society of Critical Care and European Society of Intensive Care Medicine advocate use of the qSOFA (quick Sequential [Sepsis-related] Organ Failure Assessment) score in non-ICU settings to screen for septic patients at greater risk for poor outcomes...
January 25, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28110842/biomarkers-in-patients-admitted-to-the-emergency-department-after-exposure-to-acrylonitrile-in-a-major-railway-incident-involving-bulk-chemical-material
#15
Sebastiaan Colenbie, Walter Buylaert, Christophe Stove, Ellen Deschepper, Koenraad Vandewoude, Tom De Smedt, Michael Bader, Thomas Göen, An Van Nieuwenhuyse, Peter De Paepe
BACKGROUND: A railway incident with victims of exposure to the cyanogenic substance acrylonitrile (ACN). AIMS: We retrospectively (i)built an inventory of the clinical characteristics of individuals admitted to surrounding emergency departments (ED's) and (ii)studied the correlation between N-2-cyanoethylvaline (CEV), a biomarker used in a population study for evaluating exposure to ACN, with lactate and thiocyanate (SCN), biomarkers determined during emergency care...
January 3, 2017: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/28105603/resuscitation-fluid-composition-affects-hepatic-inflammation-in-a-murine-model-of-early-sepsis
#16
Amanda L Patrick, Peter M Grin, Nicole Kraus, Michelle Gold, Matthew Berardocco, Patricia C Liaw, Alison E Fox-Robichaud
BACKGROUND: Fluid resuscitation is a crucial therapy for sepsis, and the use of balanced fluids and/or isotonic albumin may improve patient survival. We have previously demonstrated that resuscitation with normal saline results in increased hepatic leukocyte recruitment in a murine model of sepsis. Given that clinical formulations of albumin are in saline, our objectives were to develop a novel balanced electrolyte solution specifically for sepsis and to determine if supplementing this solution with albumin would improve the inflammatory response in sepsis...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28074799/basic-arterial-blood-gas-biomarkers-as-a-predictor-of-mortality-in-tetralogy-of-fallot-patients
#17
Vandana Bhardwaj, Poonam Malhotra Kapoor, Kalpana Irpachi, Suruchi Ladha, Ujjwal Kumar Chowdhury
BACKGROUND: Serum lactate and base deficit have been shown to be a predictor of morbidity and mortality in critically ill patients. Poor preoperative oxygenation appears to be one of the significant factors that affects early mortality in tetralogy of Fallot (TOF). There is little published literature evaluating the utility of serum lactate, base excess (BE), and oxygen partial pressure (PO 2 ) as simple, widely available, prognostic markers in patients undergoing surgical repair of TOF...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28062337/using-laboratory-test-results-at-hospital-admission-to-predict-short-term-survival-in-critically-ill-patients-with-metastatic-or-advanced-cancer
#18
Lee Cheng, Alma Y DeJesus, Maria A Rodriguez
CONTEXT: Accurately estimating the life expectancy of critically ill patients with metastatic or advanced cancer is a crucial step in planning appropriate palliative or supportive care. OBJECTIVES: We evaluated the results of laboratory tests performed within two days of hospital admission to predict the likelihood of death within 14 days. METHODS: We retrospectively selected patients 18 years or older with metastatic or advanced cancer who were admitted to intensive care units or palliative and supportive care services in our hospital...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28056690/2017-guidelines-of-the-american-thyroid-association-for-the-diagnosis-and-management-of-thyroid-disease-during-pregnancy-and-the-postpartum
#19
Erik K Alexander, Elizabeth N Pearce, Gregory A Brent, Rosalind S Brown, Herbert Chen, Chrysoula Dosiou, William A Grobman, Peter Laurberg, John H Lazarus, Susan J Mandel, Robin P Peeters, Scott Sullivan
BACKGROUND: Thyroid disease in pregnancy is a common clinical problem. Since the guidelines for the management of these disorders by the American Thyroid Association (ATA) were first published in 2011, significant clinical and scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid disease in women during pregnancy, preconception, and the postpartum period...
March 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28030513/acute-circulatory-failure-chronic-liver-failure-sequential-organ-failure-assessment-score-a-novel-scoring-model-for-mortality-risk-prediction-in-critically-ill-cirrhotic-patients-with-acute-circulatory-failure
#20
Xiao-Dong Zhou, Qin-Fen Chen, Zheng-Xian Wang, Wen-Yue Liu, Sven Van Poucke, Zhi Mao, Sheng-Jie Wu, Wei-Jian Huang, Ming-Hua Zheng
BACKGROUND AND AIM: Acute circulatory failure (ACF) is associated with high mortality rates in critically ill cirrhotic patients. Only a few accurate scoring models exist specific to critically ill cirrhotic patients with acute circulatory failure (CICCF) for mortality risk assessment. The aim was to develop and evaluate a novel model specific to CICCF. PATIENTS AND METHODS: This study collected and analyzed the data on CICCF from the Multiparameter Intelligent Monitoring in Intensive Care-III database...
April 2017: European Journal of Gastroenterology & Hepatology
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