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Lactate critical care

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https://www.readbyqxmd.com/read/29679531/the-association-of-early-postoperative-lactate-levels-with-morbidity-after-elective-major-abdominal-surgery
#1
Jelena Veličković, Ivan Palibrk, Biljana Miličić, Dejan Veličković, Bojan Jovanović, Goran Rakić, Milorad Petrović, Vesna Bumbaširević
Lactate levels are widely used as an indicator of outcome in critically ill patients. We investigated the prognostic value of postoperative lactate levels for postoperative complications (POC), mortality and length of hospital stay after elective major abdominal surgery. A total of 195 patients were prospectively evaluated. Lactate levels were assessed on admission to the intensive care unit (ICU) [L0], 4 hours (L4), 12 hours (L12), and 24 hours (L24) after the operation. Demographic and perioperative clinical data were collected...
April 21, 2018: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29675709/acid-base-status-and-its-clinical-implications-in-critically-ill-patients-with-cirrhosis-acute-on-chronic-liver-failure-and-without-liver-disease
#2
Andreas Drolz, Thomas Horvatits, Kevin Roedl, Karoline Rutter, Richard Brunner, Christian Zauner, Peter Schellongowski, Gottfried Heinz, Georg-Christian Funk, Michael Trauner, Bruno Schneeweiss, Valentin Fuhrmann
BACKGROUND: Acid-base disturbances are frequently observed in critically ill patients at the intensive care unit. To our knowledge, the acid-base profile of patients with acute-on-chronic liver failure (ACLF) has not been evaluated and compared to critically ill patients without acute or chronic liver disease. RESULTS: One hundred and seventy-eight critically ill patients with liver cirrhosis were compared to 178 matched controls in this post hoc analysis of prospectively collected data...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29577222/-establishment-of-comprehensive-prediction-model-of-acute-gastrointestinal-injury-classification-of-critically-ill-patients
#3
Yan Wang, Jianrong Wang, Weiwei Liu, Guangliang Zhang
OBJECTIVE: To develop the comprehensive prediction model of acute gastrointestinal injury (AGI) grades of critically ill patients. METHODS: From April 2015 to November 2015, the binary channel gastrointestinal sounds (GIS) monitor system which has been developed and verified by the research group was used to gather and analyze the GIS of 60 consecutive critically ill patients who were admitted in Critical Care Medicine of Chinese PLA General Hospital. Also, the AGI grades (Grande I(-IIII(, the higher the level, the heavier the gastrointestinal dysfunction) were evaluated...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29576361/can-energy-intake-alter-clinical-and-hospital-outcomes-in-picu
#4
Bodil M K Larsen, Megan R Beggs, Amanda Y Leong, Sung Hyun Kang, Rabin Persad, Gonzalo Garcia Guerra
BACKGROUND & AIMS: Energy is essential for the treatment and recovery of children admitted to Pediatric Intensive Care Units (PICU). There are significant immediate and long-term health consequences of both under- and over-feeding in this population. Energy requirements of critically ill children vary depending on age, nutritional status, sepsis, fever, pharmacotherapy, and duration and stage of critical illness. This study aimed to determine the incidence of over- and under-feeding and to compare hospital outcomes between these feeding categories...
April 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29562917/the-use-of-mid-regional-proadrenomedullin-to-identify-disease-severity-and-treatment-response-to-sepsis-a-secondary-analysis-of-a-large-randomised-controlled-trial
#5
Gunnar Elke, Frank Bloos, Darius Cameron Wilson, Frank Martin Brunkhorst, Josef Briegel, Konrad Reinhart, Markus Loeffler, Stefan Kluge, Axel Nierhaus, Ulrich Jaschinski, Onnen Moerer, Andreas Weyland, Patrick Meybohm
BACKGROUND: This study assessed the ability of mid-regional proadrenomedullin (MR-proADM) in comparison to conventional biomarkers (procalcitonin (PCT), lactate, C-reactive protein) and clinical scores to identify disease severity in patients with sepsis. METHODS: This is a secondary analysis of a randomised controlled trial in patients with severe sepsis or septic shock across 33 German intensive care units. The association between biomarkers and clinical scores with mortality was assessed by Cox regression analysis, area under the receiver operating characteristic and Kaplan-Meier curves...
March 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29549960/analytical-considerations-and-general-diagnostic-and-therapeutic-ramifications-of-milk-hormones-during-lactation
#6
REVIEW
Carol L Wagner, John E Baatz, Danforth Newton, Bruce W Hollis
In this review, we will discuss the changes that occur in the mammary gland from pregnancy to lactation and the issues surrounding the analysis of circulating and milk hormones during the stages of lactogenesis. There is a cascade of events that must occur to achieve milk synthesis, milk ejection, and successful transfer to the breastfeeding infant. The adequacy and success of this process is no small measure and the assessment of milk production, the hormones involved in this process and the ability to properly diagnose conditions and causes of low milk supply are critical for the health and well-being of the mother-infant breastfeeding dyad...
January 2018: Best Practice & Research. Clinical Endocrinology & Metabolism
https://www.readbyqxmd.com/read/29549653/the-h3-haplotype-of-the-epcr-gene-determines-high-sepcr-levels-in-critically-ill-septic-patients
#7
Alice G Vassiliou, Anastasia Kotanidou, Zafeiria Mastora, Carlo Tascini, Gianluigi Cardinali, Stylianos E Orfanos
INTRODUCTION: A soluble (s) form of the endothelial protein C receptor (EPCR) circulates in plasma and inhibits activated protein C (APC) activities. The clinical impact of sEPCR and its involvement in the septic process is under investigation. This study determined the frequencies of EPCR haplotypes H1 and H3 to investigate possible associations with plasma admission levels of sEPCR in an intensive care unit (ICU) cohort of septic patients. METHODS: Three polymorphisms in the EPCR gene were genotyped in 239 Caucasian critically ill patients, and their plasma sEPCR levels were also measured at the time of admission to the ICU...
March 2018: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29548723/helpful-only-when-elevated-initial-serum-lactate-in-stable-emergency-department-patients-with-sepsis-is-specific-but-not-sensitive-for-future-deterioration
#8
Shannon M Fernando, Douglas P Barnaby, Christophe L Herry, E John Gallagher, Nathan I Shapiro, Andrew J E Seely
BACKGROUND: Early emergency department (ED) identification of septic patients at risk of deterioration is critical. Lactate is associated with 28-day mortality in admitted patients, but little evidence exists on its use in predicting short-term deterioration. OBJECTIVE: Our aim was to determine the role of initial serum lactate for prediction of short-term deterioration in stable ED patients with suspected sepsis. METHODS: We conducted a prospective cohort study of adult ED sepsis patients...
March 13, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29520370/nitric-oxide-release-for-improving-performance-of-implantable-chemical-sensors-a-review
#9
Kyoung Ha Cha, Xuewei Wang, Mark E Meyerhoff
Over the last three decades, there has been extensive interest in developing in vivo chemical sensors that can provide real-time measurements of blood gases (oxygen, carbon dioxide, and pH), glucose/lactate, and potentially other critical care analytes in the blood of hospitalized patients. However, clot formation with intravascular sensors and foreign body response toward sensors implanted subcutaneously can cause inaccurate analytical results. Further, the risk of bacterial infection from any sensor implanted in the human body is another major concern...
December 2017: Applied Materials Today
https://www.readbyqxmd.com/read/29519141/guide-for-drug-selection-during-pregnancy-and-lactation-what-pharmacists-need-to-know-for-current-practice
#10
Brooke L Griffin, Rebecca H Stone, Shareen Y El-Ibiary, Sarah Westberg, Kayce Shealy, Alicia Forinash, Abigail Yancey, Kathleen Vest, Lamis R Karaoui, Sally Rafie, Cheryl Horlen, Nicole Lodise, Nicole Cieri-Hutcherson, Sarah McBane, Anahit Simonyan
OBJECTIVE: To provide guidance for clinicians on risk assessment of medication use during pregnancy and lactation. DATA SOURCES: Authors completed PubMed searches to identify articles focused on the use of medications in pregnancy, including fetal development, drug transfer across the placenta, trimester exposure, chronic conditions in pregnancy, medications in lactation, and lactation and chronic disease. STUDY SELECTION AND DATA EXTRACTION: Articles were reviewed to provide overall guidance to medication selection during pregnancy...
March 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29495219/-central-venous-arterial-carbon-dioxide-tension-to-arterial-central-venous-oxygen-content-ratio-combined-with-lactate-clearance-rate-as-early-resuscitation-goals-of-septic-shock
#11
X H Gao, P J Li, W Cao
Objective: To investigate the prognostic significance of central venous-arterial carbon dioxide tension to arterial-venous oxygen content ratio (Pcv-aCO(2)/Ca-cvO(2)) combined with lactate clearance rate (LCR) as early resuscitation goals of septic shock. Methods: One hundred and forty-five septic shock patients admitted to Second Department of Critical Care Medicine of Lanzhou University Second Hospital from March 2013 to May 2017 were enrolled in this study.All septic shock patients received an initial resuscitation therapy according to early goal-directed therapy...
February 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29485925/balanced-crystalloids-versus-saline-in-critically-ill-adults
#12
RANDOMIZED CONTROLLED TRIAL
Matthew W Semler, Wesley H Self, Jonathan P Wanderer, Jesse M Ehrenfeld, Li Wang, Daniel W Byrne, Joanna L Stollings, Avinash B Kumar, Christopher G Hughes, Antonio Hernandez, Oscar D Guillamondegui, Addison K May, Liza Weavind, Jonathan D Casey, Edward D Siew, Andrew D Shaw, Gordon R Bernard, Todd W Rice
BACKGROUND: Both balanced crystalloids and saline are used for intravenous fluid administration in critically ill adults, but it is not known which results in better clinical outcomes. METHODS: In a pragmatic, cluster-randomized, multiple-crossover trial conducted in five intensive care units at an academic center, we assigned 15,802 adults to receive saline (0.9% sodium chloride) or balanced crystalloids (lactated Ringer's solution or Plasma-Lyte A) according to the randomization of the unit to which they were admitted...
March 1, 2018: New England Journal of Medicine
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
March 2018: Pediatric Critical Care Medicine
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