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Critical care immunocompromised

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https://www.readbyqxmd.com/read/28425335/the-incidence-of-and-risk-factors-for-postintubation-hypotension-in-the-immunocompromised-critically-ill-adult
#1
Nathan J Smischney, Mohamed O Seisa, John Cambest, Robert A Wiegand, Kyle D Busack, Theodore O Loftsgard, Darrell R Schroeder, Daniel A Diedrich
OBJECTIVES: Our primary aim was to ascertain the frequency of postintubation hypotension in immunocompromised critically ill adults with secondary aims of arriving at potential risk factors for the development of postintubation hypotension and its impact on patient-related outcomes. METHODS: Critically ill adult patients (≥18 years) were included from January 1, 2010, to December 31, 2014. We defined immunocompromised as patients with any solid organ or nonsolid organ malignancy or transplant, whether solid organ or not, requiring current chemotherapy...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28410318/characteristics-and-outcome-of-patients-after-allogeneic-hematopoietic-stem-cell-transplantation-treated-with-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#2
Philipp Wohlfarth, Gernot Beutel, Pia Lebiedz, Hans-Joachim Stemmler, Thomas Staudinger, Matthieu Schmidt, Matthias Kochanek, Tobias Liebregts, Fabio Silvio Taccone, Elie Azoulay, Alexandre Demoule, Stefan Kluge, Morten Svalebjørg, Catherina Lueck, Johanna Tischer, Alain Combes, Boris Böll, Werner Rabitsch, Peter Schellongowski
OBJECTIVES: The acute respiratory distress syndrome is a frequent condition following allogeneic hematopoietic stem cell transplantation. Extracorporeal membrane oxygenation may serve as rescue therapy in refractory acute respiratory distress syndrome but has not been assessed in allogeneic hematopoietic stem cell transplantation recipients. DESIGN: Multicenter, retrospective, observational study. SETTING: ICUs in 12 European tertiary care centers (Austria, Germany, France, and Belgium)...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28390391/measuring-1-3-%C3%AE-d-glucan-in-tracheal-aspirate-bronchoalveolar-lavage-fluid-and-serum-for-detection-of-suspected-candida-pneumonia-in-immunocompromised-and-critically-ill-patients-a-prospective-observational-study
#3
Kang-Cheng Su, Kun-Ta Chou, Yi-Han Hsiao, Ching-Min Tseng, Vincent Yi-Fong Su, Yu-Chin Lee, Diahn-Warng Perng, Yu Ru Kou
BACKGROUND: While Candida pneumonia is life-threatening, biomarker measurements to early detect suspected Candida pneumonia are lacking. This study compared the diagnostic values of measuring levels of (1, 3)-β-D-glucan in endotracheal aspirate, bronchoalveolar lavage fluid, and serum to detect suspected Candida pneumonia in immunocompromised and critically ill patients. METHODS: This prospective, observational study enrolled immunocompromised, critically ill, and ventilated patients with suspected fungal pneumonia in mixed intensive care units from November 2010 to October 2011...
April 8, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28355466/invasive-mould-infections-in-the-icu-setting-complexities-and-solutions
#4
Matteo Bassetti, Emilio Bouza
Infections caused by filamentous fungi represent a major burden in the ICU. Invasive aspergillosis is emerging in non-neutropenic individuals with predisposing conditions, e.g. corticosteroid treatment, chronic obstructive pulmonary disease, liver cirrhosis, solid organ cancer, HIV infection and transplantation. Diagnosis is challenging because the signs and symptoms are non-specific, and initiation of additional diagnostic examinations is often delayed because clinical suspicion is low. Isolation of an Aspergillus species from the respiratory tract in critically ill patients, and tests such as serum galactomannan, bronchoalveolar lavage 1-3-β-d-glucan and specific PCR should be interpreted with caution...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28346081/pneumocystis-jiroveci-pneumonia-pjp-in-non-hiv-immunocompromised-individuals
#5
Kathleen Schoovaerts, Luc Dirix, Annemie Rutten, Jef Van Schaeren, Bruno Van Herendael, Sofie Van Grieken, Luc Heytens
OBJECTIVES: PJP is a major cause of morbidity and mortality in immunocompromised individuals. Diagnosing PJP is often difficult because respiratory signs might be minimal or absent and the sensitivity of a chest X-ray (CXR) is low. We studied the clinical risk factors in order to increase awareness and facilitate the diagnosis. METHODS: We studied a prospective case series over a one year period (from 1 January 2015 to 1 January 2016) and did a retrospective analysis (from 2013 to 2016) of all PJP positive bronchoalveolar lavage (BAL) analysis...
March 27, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28160958/opportunistic-fungal-infections-in-critical-care-units
#6
REVIEW
Deborah D Garbee, Stephanie S Pierce, Jennifer Manning
Fungal infections are rare compared with bacterial infections, but they are on the increase in critical care units. Diagnosis can be difficult, resulting in increased mortality. Immunocompromised patients are at higher risk for fungal infections, including organ transplant, oncology, and HIV/AIDS patients. Fatigue and fever are common symptoms that require critical care nurses to remain vigilant in assessment to identify at-risk patients and promote use of timely cultures and appropriate treatments for fungal infections...
March 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28152729/reducing-hospital-aquired-pneumonia-hap-with-massey-screen
#7
Robyn Dunbar, Cheryl Clements, Margaret Bonawitz, Joanne McGovern
232 Background: Hospital Acquired Pneumonia (HAP) is a leading cause of prolonged hospitalization in patients. The oncology population is especially susceptible to critical illness related to an immunocompromised state. The purpose of this study was to implement the Massey Bedside Swallowing Screen upon admission to the oncology telemetry unit to detect any deficits that could potentially lead to HAP, in conjunction with strict oral care for identified high risk patients. METHODS: The importance of the Massey Bedside Swallowing Screen upon admission and the knowledge that early detection leads to better patient outcomes was educated to the nursing staff...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/27753764/inherent-risk-factors-for-nosocomial-infection-in-the-long-stay-critically-ill-child-without-known-baseline-immunocompromise-a-post-hoc-analysis-of-the-crisis-trial
#8
Joseph A Carcillo, J Michael Dean, Richard Holubkov, John Berger, Kathleen L Meert, Kanwaljeet J S Anand, Jerry Zimmerman, Christopher J Newth, Rick Harrison, Jeri Burr, Douglas F Willson, Carol Nicholson, Michael J Bell, Robert A Berg, Thomas P Shanley, Sabrina M Heidemann, Heidi Dalton, Tammara L Jenkins, Allan Doctor, Angie Webster
BACKGROUND: Nosocomial infection remains an important health problem in long stay (>3 days) pediatric intensive care unit (PICU) patients. Admission risk factors related to the development of nosocomial infection in long stay immune competent patients in particular are not known. METHODS: Post-hoc analysis of the previously published Critical Illness Stress induced Immune Suppression (CRISIS) prevention trial database, to identify baseline risk factors for nosocomial infection...
November 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27713885/the-immunocompromised-oncohematological-critically-ill-patient-considerations-in-severe-infections
#9
REVIEW
Belén Encina, Leonel Lagunes, Marc Morales-Codina
Sepsis and septic shock remain a major cause of mortality among critically ill patient. This is particularly relevant among cancer patients as highlighted by different series showing that up to one in five patients admitted to intensive care units (ICU) with sepsis have cancer, and also, sepsis is a leading reason for ICU admission in patients with cancer. The classic predictors of mortality among these patients (such as cancer lineage, neutropenia degree, or bone marrow transplantation history) have changed during the last decades, and they should no longer be used to rule out ICU admission...
September 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27660289/interaction-between-2-nutraceutical-treatments-and-host-immune-status-in-the-pediatric-critical-illness-stress-induced-immune-suppression-comparative-effectiveness-trial
#10
Joseph A Carcillo, J Michael Dean, Richard Holubkov, John Berger, Kathleen L Meert, Kanwaljeet J S Anand, Jerry J Zimmerman, Christopher J L Newth, Rick Harrison, Jeri Burr, Douglas F Willson, Carol Nicholson, Michael J Bell, Robert A Berg, Thomas P Shanley, Sabrina M Heidemann, Heidi Dalton, Tammara L Jenkins, Allan Doctor, Angie Webster, Robert F Tamburro
BACKGROUND AND AIMS: The pediatric Critical Illness Stress-induced Immune Suppression (CRISIS) trial compared the effectiveness of 2 nutraceutical supplementation strategies and found no difference in the development of nosocomial infection and sepsis in the overall population. We performed an exploratory post hoc analysis of interaction between nutraceutical treatments and host immune status related to the development of nosocomial infection/sepsis. METHODS: Children from the CRISIS trial were analyzed according to 3 admission immune status categories marked by decreasing immune competence: immune competent without lymphopenia, immune competent with lymphopenia, and previously immunocompromised...
September 22, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27659437/a-5-year-surveillance-study-on-antimicrobial-resistance-of-acinetobacter-baumannii-clinical-isolates-from-a-tertiary-greek-hospital
#11
Sofia Maraki, Elpis Mantadakis, Viktoria Eirini Mavromanolaki, Diamantis P Kofteridis, George Samonis
BACKGROUND: Acinetobacter baumannii has emerged as a major cause of nosocomial outbreaks. It is particularly associated with nosocomial pneumonia and bloodstream infections in immunocompromised and debilitated patients with serious underlying pathologies. Over the last two decades, a remarkable rise in the rates of multidrug resistance to most antimicrobial agents that are active against A. baumannii has been noted worldwide. We evaluated the rates of antimicrobial resistance and changes in resistance over a 5-year period (2010-2014) in A...
September 2016: Infection & Chemotherapy
https://www.readbyqxmd.com/read/27612566/predicting-invasive-fungal-disease-due-to-candida-species-in-non-neutropenic-critically-ill-adult-patients-in-united-kingdom-critical-care-units
#12
Jason Shahin, Elizabeth J Allen, Krishna Patel, Hannah Muskett, Sheila E Harvey, Jonathan Edgeworth, Christopher C Kibbler, Rosemary A Barnes, Sharmistha Biswas, Neil Soni, Kathryn M Rowan, David A Harrison
BACKGROUND: Given the predominance of invasive fungal disease (IFD) amongst the non-immunocompromised adult critically ill population, the potential benefit of antifungal prophylaxis and the lack of generalisable tools to identify high risk patients, the aim of the current study was to describe the epidemiology of IFD in UK critical care units, and to develop and validate a clinical risk prediction tool to identify non-neutropenic, critically ill adult patients at high risk of IFD who would benefit from antifungal prophylaxis...
2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27517077/intramuscular-injection-abscess-due-to-vrsa-a-new-health-care-challenge
#13
Senthil Nathan Sambandam, Ganeshkumar Jayasree Rohinikumar, Arif Gul, Varatharaj Mounasamy
Abscess formation following intramuscular injections is rare and they are most commonly seen in immunocompromised individuals. In this case series we present a cohort of three patients presented to us in a critically ill condition with an abscess due to intramuscular injection. Vancomycin resistant staphylococcus aureus was isolated from all three patients. These patients posed a major challenge to the healthcare system and the treating physician because of the: severity of illness, virulence and resistance of the organism, rarity of the situation, immune state of the patient, and lack of supporting evidence to properly guide management in the use of health resources...
June 2016: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/27495046/risk-factors-for-mortality-in-patients-with-stenotrophomonas-maltophilia-bacteremia
#14
Yong Duk Jeon, Woo Yong Jeong, Moo Hyun Kim, In Young Jung, Mi Young Ahn, Hea Won Ann, Jin Young Ahn, Sang Hoon Han, Jun Yong Choi, Young Goo Song, June Myung Kim, Nam Su Ku
Stenotrophomonas maltophilia is a nosocomial pathogen associated with high morbidity and mortality, particularly in immunocompromised or critically ill patients. In this study, we investigated the risk factors for mortality in patients with S. maltophilia bacteremia.Retrospectively, medical records from all patients with S. maltophilia bacteremia between December 2005 and 2014 at Severance Hospital, a 2000-bed tertiary care hospital in Seoul, Korea, were reviewed. Analysis was performed to identify factors associated with 28-day mortality...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27475024/comparison-of-1-3-%C3%AE-d-glucan-with-galactomannan-in-serum-and-bronchoalveolar-fluid-for-the-detection-of-aspergillus-species-in-immunosuppressed-mechanical-ventilated-critically-ill-patients
#15
Tobias Lahmer, Michael Neuenhahn, Jürgen Held, Sebastian Rasch, Roland M Schmid, Wolfgang Huber
PURPOSE: Invasive pulmonary aspergillosis (IPA) is an important cause of morbidity/mortality in immunocompromised critically ill patients. New diagnostic strategies for early detection of IPA include the noninvasive biomarkers 1,3-β-d-glucan (BDG), serum, and bronchoalveolar (BAL) fluid galactomannan (GM). The aim of this study was to compare these markers for early detection of IPA in immunosuppressed critically ill patients. METHODS: Between December 2014 and December 2015, 49 immunosuppressed patients with respiratory failure were treated at our intensive care unit (ICU)...
December 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27379619/inherent-risk-factors-for-nosocomial-infection-in-the-long-stay-critically-ill-child-without-known-baseline-immunocompromise-a-post-hoc-analysis-of-the-crisis-trial
#16
Joseph A Carcillo, J Michael Dean, Richard Holubkov, John Berger, Kathleen L Meert, Kjs Anand, Jerry Zimmerman, Christopher J Newth, Rick Harrison, Jeri Burr, Douglas F Willson, Carol Nicholson, Michael J Bell, Robert A Berg, Thomas P Shanley, Sabrina M Heidemann, Heidi Dalton, Tammara L Jenkins, Allan Doctor, Angie Webster
BACKGROUND: Nosocomial infection remains an important health problem in long stay (> 3 days) pediatric intensive care unit (PICU) patients. Admission risk factors related to the development of nosocomial infection in long stay immune competent patients in particular are not known. METHODS: Post-hoc analysis of the previously published Critical Illness Stress induced Immune Suppression (CRISIS) prevention trial database, to identify baseline risk factors for nosocomial infection...
June 30, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27316915/french-intensive-care-society-international-congress-r%C3%A3-animation-2016
#17
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27134159/management-of-infections-in-critically-ill-returning-travellers-in-the-intensive-care-unit-ii-clinical-syndromes-and-special-considerations-in-immunocompromised-patients
#18
REVIEW
Jordi Rello, Oriol Manuel, Philippe Eggimann, Guy Richards, Christian Wejse, Jorgen Eskild Petersen, Kai Zacharowski, Hakan Leblebicioglu
This position paper is the second ESCMID Consensus Document on this subject and aims to provide intensivists, infectious disease specialists, and emergency physicians with a standardized approach to the management of serious travel-related infections in the intensive care unit (ICU) or the emergency department. This document is a cooperative effort between members of two European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study groups and was coordinated by Hakan Leblebicioglu and Jordi Rello for ESGITM (ESCMID Study Group for Infections in Travellers and Migrants) and ESGCIP (ESCMID Study Group for Infections in Critically Ill Patients), respectively...
July 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27081478/probiotics-in-critically-ill-children
#19
REVIEW
Sunit C Singhi, Suresh Kumar
Gut microflora contribute greatly to immune and nutritive functions and act as a physical barrier against pathogenic organisms across the gut mucosa. Critical illness disrupts the balance between host and gut microflora, facilitating colonization, overgrowth, and translocation of pathogens and microbial products across intestinal mucosal barrier and causing systemic inflammatory response syndrome and sepsis. Commonly used probiotics, which have been developed from organisms that form gut microbiota, singly or in combination, can restore gut microflora and offer the benefits similar to those offered by normal gut flora, namely immune enhancement, improved barrier function of the gastrointestinal tract (GIT), and prevention of bacterial translocation...
2016: F1000Research
https://www.readbyqxmd.com/read/27076972/non-invasive-ventilation-in-immunocompromised-patients-with-acute-hypoxemic-respiratory-failure
#20
Lorenzo Del Sorbo, Angela Jerath, Martin Dres, Matteo Parotto
The survival rate of immunocompromised patients has improved over the past decades in light of remarkable progress in diagnostic and therapeutic options. Simultaneously, there has been an increase in the number of immunocompromised patients with life threatening complications requiring intensive care unit (ICU) treatment. ICU admission is necessary in up to 15% of patients with acute leukemia and 20% of bone marrow transplantation recipients, and the main reason for ICU referral in this patient population is acute hypoxemic respiratory failure, which is associated with a high mortality rate, particularly in patients requiring endotracheal intubation...
March 2016: Journal of Thoracic Disease
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