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Post icu syndrome

Faisal R Jahangiri, Sami Al Eissa, Samir Sayegh, Fahad Al Helal, Shomoukh A Al-Sharif, Monerah M Annaim, Sheryar Muhammad, Tanweer Aziz
A 16-year-old male patient with Ehler-Danlos syndrome (EDS) and a back deformity since birth presented with severe kyphoscoliosis. The patient was neurologically intact but had respiratory and cardiac insufficiencies. A two-stage vertebral column resection (VCR) at T9-T10 with multiple level fusion with multimodality intraoperative neurophysiological monitoring (IONM) was planned.  During the first stage, pedicle screws were placed at multiple spinal levels above and below the VCR level. Upper and lower somatosensory evoked potentials (SSEP), transcranial electrical motor evoked potentials (TCeMEP), and electromyography were monitored continuously and showed no significant changes...
August 31, 2016: Curēus
A Molina Raya, A García Navarro, C San Miguel Méndez, M Domínguez Bastante, M T Villegas Herrera, K Granero, A Becerra Massare, J M Villar Del Moral, M Expósito, Y Fundora Suárez
OBJECTIVE: The aim of this work was to determine the impact of obesity on the morbidity and mortality of liver transplantation (LT) recipients. METHODS: A single-center, observational-cohort, retrospective study was conducted in patients undergoing LT from January 2008 to December 2014 to compare complications and survival between those with body mass index (BMI) <35 kg/m(2) and those with BMI ≥35 kg/m(2). RESULTS: The study included 170 patients: 162 (95...
September 2016: Transplantation Proceedings
Jonathan A Silversides, Emmet Major, Andrew J Ferguson, Emma E Mann, Daniel F McAuley, John C Marshall, Bronagh Blackwood, Eddy Fan
BACKGROUND: It is unknown whether a conservative approach to fluid administration or deresuscitation (active removal of fluid using diuretics or renal replacement therapy) is beneficial following haemodynamic stabilisation of critically ill patients. PURPOSE: To evaluate the efficacy and safety of conservative or deresuscitative fluid strategies in adults and children with acute respiratory distress syndrome (ARDS), sepsis or systemic inflammatory response syndrome (SIRS) in the post-resuscitation phase of critical illness...
October 12, 2016: Intensive Care Medicine
Tiphaine Bourseau, Flavie Fremondière, Valérie Dubus, Bénédicte Gohier, Dewi Le Gal, Fabien Cave, Isabelle Richard, Nicolas Lerolle
OBJECTIVE: After critical illness, some survivors experience long-term physical, functional, neurocognitive and/or mental health impairments, which has been termed "Post-Intensive Care syndrome" (PICS) [1]. A specific follow-up is required and many specialized follow-up clinics have been created both abroad and in France. The aim of this study is to evaluate long-term outcomes after critical illness, through the International Classification of Functioning, Disability and Health, and to analyse rehabilitation needs after intensive care unit (ICU) discharge...
September 2016: Annals of Physical and Rehabilitation Medicine
Simone Thomas, Jane H Burridge, Marcus Pohl, Frank Oehmichen, Jan Mehrholz
OBJECTIVES: To describe the time course of recovery of sit-to-stand function in patients with intensive-care-unit-acquired muscle weakness and the impact of recovery. METHODS: A cohort study in post-acute intensive care unit and rehabilitation units. Patients with chronic critical illness and intensive-care-unit-acquired muscle weakness were included. Sit-to-stand function was measured daily, using a standardized chair height, defined as 120% of the individual's knee height...
October 12, 2016: Journal of Rehabilitation Medicine
Morteza Jabbary Moghaddam, Ali Barkhori, Alireza Mirkheshti, Morteza Hashemian, Seyed Amir Mohajerani
BACKGROUND: Post-thoracotomy pain syndrome (PTPS) is pain that recurs or persists along a thoracotomy incision for at least two months following surgery. Dexmedetomidine (dex) is an α-2 agonist that also has analgesic, sedative-hypnotic, and sympatholytic properties. OBJECTIVES: To determine the effect of pre-emptive dexmedetomidine on the incidence of PTPS in patients undergoing coronary artery bypass grafting (CABG). PATIENTS AND METHODS: This randomized clinical trial enrolled 104 candidates for elective coronary artery bypass grafting (CABG) and randomly assigned them to either a dex group or a control group...
June 2016: Anesthesiology and Pain Medicine
Kevin J Solverson, Christopher Grant, Christopher J Doig
BACKGROUND: Prior studies of physical functioning after critical illness have been mostly limited to survivors of acute respiratory distress syndrome. The purpose of this study was to objectively assess muscle strength and physical functioning in survivors of critical illness from a general ICU and the associations of these measures to health-related quality of life (HRQL), mental health and critical illness variables. METHODS: This was a prospective cohort study of 56 patients admitted to a medical ICU (length of stay ≥4 days) from April 1, 2009, and March 31, 2010...
December 2016: Annals of Intensive Care
Elizabeth R Pfoh, Amy W Wozniak, Elizabeth Colantuoni, Victor D Dinglas, Pedro A Mendez-Tellez, Carl Shanholtz, Nancy D Ciesla, Peter J Pronovost, Dale M Needham
PURPOSE: Survivors of acute respiratory distress syndrome (ARDS) are at high risk for new or ongoing physical declines after hospital discharge. The objective of our study was to evaluate the epidemiology of physical declines over 5-year follow-up and identify patients at risk for decline. METHODS: This multi-site prospective cohort study evaluated ARDS survivors who completed a physical status assessment at 3 or 6 months post-discharge. Three measures were evaluated: muscle strength (Medical Resource Council sumscore); exercise capacity [6-min walk test (6MWT)]; physical functioning [36-Item Short Form Health Survey (SF-36 survey)]...
October 2016: Intensive Care Medicine
Lori L Boland, Jonathan S Hokanson, Karl M Fernstrom, Tyler G Kinzy, Charles J Lick, Paul A Satterlee, Brian K LaCroix
INTRODUCTION: We aimed to pilot test the delivery of sepsis education to emergency medical services (EMS) providers and the feasibility of equipping them with temporal artery thermometers (TATs) and handheld lactate meters to aid in the prehospital recognition of sepsis. METHODS: This study used a convenience sample of prehospital patients meeting established criteria for sepsis. Paramedics received education on systemic inflammatory response syndrome (SIRS) criteria, were trained in the use of TATs and hand-held lactate meters, and enrolled patients who had a recent history of infection, met ≥ 2 SIRS criteria, and were being transported to a participating hospital...
September 2016: Western Journal of Emergency Medicine
Michele M Pelter, Denise Loranger, Teri M Kozik, Richard Fidler, Xiao Hu, Mary G Carey
BACKGROUND: Most patients presenting with suspected acute coronary syndrome (ACS) are admitted to telemetry units. While telemetry is an appropriate level of care, acute complications requiring a higher level of care in the intensive care unit (ICU) occur. PURPOSE: Among patients admitted to telemetry for suspected ACS, we determine the frequency of unplanned ICU transfer, and examine whether ECG changes indicative of myocardial ischemia, and/or symptoms preceded unplanned transfer...
August 26, 2016: Journal of Electrocardiology
Sandra Martins Pereira, Carla Margarida Teixeira, Ana Sofia Carvalho, Pablo Hernández-Marrero
INTRODUCTION: Professionals working in intensive and palliative care units, hence caring for patients at the end-of-life, are at risk of developing burnout. Workplace conditions are determinant factors to develop this syndrome among professionals providing end-of-life care. OBJECTIVES: To identify and compare burnout levels between professionals working in intensive and palliative care units; and to assess which workplace experiences are associated with burnout...
2016: PloS One
Kurt D Piggott, Grace George, Harun Fakioglu, Carlos Blanco, Sukumar Saguna Narasimhulu, Kamal Pourmoghadam, Hamish Munroe, William Decampli
AIM: To investigate and describe our current institutional management protocol for single-ventricle patients who must undergo a Ladd's procedure. METHODS: We retrospectively reviewed the charts of all patients from January 2005 to March 2014 who were diagnosed with heterotaxy syndrome and an associated intestinal rotation anomaly who carried a cardiac diagnosis of functional single ventricle and were status post stage I palliation. A total of 8 patients with a history of stage I single-ventricle palliation underwent Ladd's procedure during this time period...
August 8, 2016: World Journal of Clinical Pediatrics
Tamara McColl, Mathieu Gatien, Lisa Calder, Krishan Yadav, Ryan Tam, Melody Ong, Monica Taljaard, Ian Stiell
BACKGROUND: In 2008-2009, the Canadian Institute for Health Information reported over 30,000 cases of sepsis hospitalizations in Canada, an increase of almost 4,000 from 2005. Mortality rates from severe sepsis and septic shock continue to remain greater than 30% in Canada and are significantly higher than other critical conditions treated in the emergency department (ED). Our group formed a multidisciplinary sepsis committee, conducted an ED process of care analysis, and developed a quality improvement protocol...
September 9, 2016: CJEM
Maité Garrouste-Orgeas, Isabelle Vinatier, Alexis Tabah, Benoit Misset, Jean-François Timsit
BACKGROUND: The relatives of intensive care unit (ICU) patients must cope with both the severity of illness of their loved one and the unfamiliar and stressful ICU environment. This hardship may lead to post-intensive care syndrome. French guidelines provide recommendations on welcoming and informing families of ICU patients. We questioned whether and how they are applied 5 years after their publication. METHODS: We conducted a large survey among French ICUs to evaluate their visiting policies and how information was provided to patient's family...
December 2016: Annals of Intensive Care
Eog van Vliet, G H Dijkema, E Schuit, K Y Heida, C Roos, Jam van der Post, E C Parry, L McCowan, D J Lyell, Y Y El-Sayed, D B Carr, A L Clark, Z A Mahdy, M Uma, N C Sayin, G F Varol, B W Mol, M A Oudijk
BACKGROUND: Preterm birth is the leading cause of neonatal mortality and morbidity in developed countries. Whether continued tocolysis after 48 hours of rescue tocolysis improves neonatal outcome is unproven. OBJECTIVES: To evaluate the effectiveness of maintenance tocolytic therapy with oral nifedipine on the reduction of adverse neonatal outcomes and the prolongation of pregnancy by performing an individual patient data meta-analysis (IPDMA). SEARCH STRATEGY: We searched PubMed, Embase, and Cochrane databases for randomised controlled trials of maintenance tocolysis therapy with nifedipine in preterm labour...
October 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Demet Altun, Emre Çamci
We report a case of anesthetic management of a 43-year-old patient with Eagle's syndrome (ES) in whom post-extubation acute airway obstruction occurred due to bilateral hypoglossal nerve paralysis. After an accurate examination, elongated bilateral stylohyoid ligament was observed and surgical resection was planned. After completion of the surgery following extubation, significant dysfunction in swallowing, speech function, and tongue motion was observed. The clinical situation was evaluated as bilateral hypoglossal nerve paralysis related to the procedure...
August 20, 2016: Journal of Anesthesia
Joachim Marti, Peter Hall, Patrick Hamilton, Sarah Lamb, Chris McCabe, Ranjit Lall, Julie Darbyshire, Duncan Young, Claire Hulme
BACKGROUND: The long-term economic and quality-of-life outcomes of patients admitted to intensive care unit (ICU) with acute respiratory distress syndrome are not well understood. In this study, we investigate 1-year costs, survival and quality of life following ICU admission in patients who required mechanical ventilation for acute respiratory distress syndrome. METHODS: Economic analysis of data collected alongside a UK-based multi-centre randomised, controlled trial, aimed at comparing high-frequency oscillatory ventilation with conventional mechanical ventilation...
2016: Journal of Intensive Care
Oscar A Viteri, Sean C Blackwell, Suneet P Chauhan, Jerrie S Refuerzo, Claudia Pedroza, Ximena C Salazar, Baha M Sibai
OBJECTIVE: To estimate whether antenatal corticosteroids before 34 weeks of gestation are associated with reduced incidence of respiratory distress syndrome (RDS) and composite neonatal morbidity in preterm twins. METHODS: This was a secondary analysis of a multicenter randomized trial for the prevention of preterm birth in multiple gestations. All liveborn, nonanomalous twins delivered between 24 0/7 and 36 6/7 weeks of gestation were included. Neonatal outcomes were compared between women who received antenatal corticosteroids and those who did not...
September 2016: Obstetrics and Gynecology
Giuseppe Ristagno, Serge Masson, Marjaana Tiainen, Stepani Bendel, Roberto Bernasconi, Tero Varpula, Valentina Milani, Jukka Vaahersalo, Michela Magnoli, Eberhard Spanuth, Simona Barlera, Roberto Latini, Sanna Hoppu, Ville Pettilä, Markus B Skrifvars
BACKGROUND: An intense systemic inflammatory response is observed following reperfusion after cardiac arrest. Heparin-binding protein (HBP) is a granule protein released by neutrophils that intervenes in endothelial permeability regulation. In the present study, we investigated plasma levels of HBP in a large population of patients resuscitated from out-of-hospital cardiac arrest. We hypothesized that high circulating levels of HBP are associated with severity of post-cardiac arrest syndrome and poor outcome...
2016: Critical Care: the Official Journal of the Critical Care Forum
Thibaut Caruba, Delphine Hourton, Brigitte Sabatier, Dominique Rousseau, Annick Tibi, Cécile Hoffart-Jourdain, Akim Souag, Nelly Freitas, Mounia Yjjou, Carla Almeida, Nathalie Gomes, Pascaline Aucouturier, Juliette Djadi-Prat, Philippe Menasché, Gilles Chatellier, Bernard Cholley
BACKGROUND: Patients with a left ventricular ejection fraction (LVEF) of less than 40 % are at high risk of developing postoperative low cardiac output syndrome (LCOS). Despite actual treatments (inotropic agents and/or mechanical assist devices), the mortality rate of such patients remains very high (13 to 24 %). The LICORN trial aims at assessing the efficacy of a preoperative infusion of levosimendan in reducing postoperative LCOS in patients with poor LVEF undergoing coronary artery bypass grafting (CABG)...
August 5, 2016: Journal of Cardiothoracic Surgery
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