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https://www.readbyqxmd.com/read/29683405/longitudinal-evaluation-of-plasma-concentrations-of-presepsin-in-patients-after-severe-trauma-a-prospective-observational-study
#1
Christian Koch, Sophie Ruhrmann, Michael Pöhlmann, Emmanuel Schneck, Borros Arneth, Thomas Zajonz, Michael Sander, Markus A Weigand, Florian Uhle
BACKGROUND: The high mortality rate of patients suffering from severe trauma is based not only on the mechanism of injury, but also on the higher risk for development of subsequent infections. Therefore, the early recognition of infection after severe trauma is of particular importance for patient outcome. However, early diagnosis is often masked by the consequences of the sterile, damage-triggered immune response. Our study sought to analyze the course of soluble CD14-subtype (sCD14-ST, presepsin) compared with clinically established inflammatory and infectious biomarkers in a cohort of patients with severe trauma...
April 23, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29670613/innate-immunity-in-the-persistent-inflammation-immunosuppression-and-catabolism-syndrome-and-its-implications-for-therapy
#2
REVIEW
Hiroyuki Horiguchi, Tyler J Loftus, Russell B Hawkins, Steven L Raymond, Julie A Stortz, McKenzie K Hollen, Brett P Weiss, Elizabeth S Miller, Azra Bihorac, Shawn D Larson, Alicia M Mohr, Scott C Brakenridge, Hironori Tsujimoto, Hideki Ueno, Frederick A Moore, Lyle L Moldawer, Philip A Efron
Clinical and technological advances promoting early hemorrhage control and physiologic resuscitation as well as early diagnosis and optimal treatment of sepsis have significantly decreased in-hospital mortality for many critically ill patient populations. However, a substantial proportion of severe trauma and sepsis survivors will develop protracted organ dysfunction termed chronic critical illness (CCI), defined as ≥14 days requiring intensive care unit (ICU) resources with ongoing organ dysfunction...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29657374/methylene-blue-for-vasoplegic-syndrome-postcardiac-surgery
#3
Aly Makram Habib, Ahmed Galal Elsherbeny, Rayd Abdelaziz Almehizia
Objectives: cardiopulmonary bypass (CPB) can be complicated by vasoplegia that is refractory to vasopressors. Methylene blue (MB) represents an alternative in such cases. Patients and Methods: Retrospective observational historical control-matched study. From 2010 to 2015, all patients who received MB for vasoplegia post-CPB were included in this study. Historical controls from the period of 2004 to 2009 were matched. End-points were the time till improvement of vasoplegia (Ti), 30-day mortality, cardiac surgical Intensive Care Unit (CSICU) morbidity, and length of stay (LOS)...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29652271/prophylactic-preoperative-levosimendan-for-off-pump-coronary-artery-bypass-grafting-in-patients-with-left-ventricular-dysfunction-single-centered-randomized-prospective-study
#4
Pushkar Mahendra Desai, Manjula S Sarkar, Sanjeeta R Umbarkar
Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients. Aim and Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29644153/acute-fatty-liver-of-pregnancy-a-thorough-examination-of-a-harmful-obstetrical-syndrome-and-its-counterparts
#5
Joshua Ronen, Shahzeb Shaheen, David Steinberg, Kevin R Justus
Diagnosed in one of every 20,000 deliveries, acute fatty liver of pregnancy (AFLP) was considered to be a deadly disease for many years. However, advancements in the clinical and surgical management of pregnant mothers have lead to a drastic decrease in maternal morbidity and mortality. The corresponding case recounts a 23-year-old gravida 2 para 1 (G2P1) at 38 weeks gestational age (GA) with no relevant past medical or family medical history that presented to the emergency department (ED) with a five-day history of nausea, protracted vomiting, hypertension, and new-onset headache...
February 6, 2018: Curēus
https://www.readbyqxmd.com/read/29609489/long-term-sequelae-of-acute-respiratory-distress-syndrome-caused-by-severe-community-acquired-pneumonia-delirium-associated-cognitive-impairment-and-post-traumatic-stress-disorder
#6
Claudia Denke, Felix Balzer, Mario Menk, Sebastian Szur, Georg Brosinsky, Sascha Tafelski, Klaus-Dieter Wernecke, Maria Deja
Objective Delirium in critically ill patients is considered a risk factor for various long-term consequences. We evaluated delirium and associated long-term outcomes in patients with acute respiratory distress syndrome with non-H1N1 and H1N1- associated severe community-acquired pneumonia (sCAP) who had been recommended to take antiviral drugs associated with delirious symptoms as adverse effects. Methods Of 64 patients, 42 survivors (H1N1, 15; non-H1N1, 27) were analyzed regarding the relationship between medication and the duration of delirium in the intensive care unit...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29599422/fatal-acute-respiratory-distress-syndrome-due-to-influenza-a-h1n1-infection-in-patients-after-kidney-transplantation-a-report-of-five-cases
#7
Paweł Zatorski, Agata Adamczyk, Maciej Kosieradzki, Teresa Baczkowska, Dariusz Kosson, Janusz Trzebicki
BACKGROUND In the general population, swine influenza is a self-limited infection. Patients after kidney transplantation, however, are at increased risk for complications and mortality from influenza A (H1N1). Acute respiratory distress syndrome (ARDS) complicates up to 55% of influenza-related pneumonia in hospitalized patients and carries a mortality of 40-46%. We describe our experience in intensive care of kidney transplant patients with ARDS complicating influenza A (H1N1) pneumonia during a flu outbreak...
March 30, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29595550/changing-neonatal-nurses-perceptions-of-caring-for-infants-experiencing-neonatal-abstinence-syndrome-and-their-mothers-an-evidenced-based-practice-opportunity
#8
Kobi Brooke Tobin
BACKGROUND: Neonatal intensive care units (NICUs) are caring for an increasing number of infants born with neonatal abstinence syndrome (NAS). The literature identifies the need for education for NICU nurses on NAS including skills for interacting with the mother with substance use disorder. PURPOSE: An evidence-based practice project was developed to offer an educational presentation targeting these topics to 206 NICU participants (93% registered nurses, 1% licensed vocational nurses, and 6% nursing assistants) at a level IV NICU...
April 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29566803/conscious-sedation-versus-general-anesthesia-in-transcatheter-aortic-valve-replacement-the-german-aortic-valve-registry
#9
Oliver Husser, Buntaro Fujita, Christian Hengstenberg, Christian Frerker, Andreas Beckmann, Helge Möllmann, Thomas Walther, Raffi Bekeredjian, Michael Böhm, Costanza Pellegrini, Sabine Bleiziffer, Rüdiger Lange, Friedrich Mohr, Christian W Hamm, Timm Bauer, Stephan Ensminger
OBJECTIVES: The aims of this study were to report on the use of local anesthesia or conscious sedation (LACS) and general anesthesia in transcatheter aortic valve replacement and to analyze the impact on outcome. BACKGROUND: Transcatheter aortic valve replacement can be performed in LACS or general anesthesia. Potential benefits of LACS, such as faster procedures and shorter hospital stays, need to be balanced with safety. METHODS: A total of 16,543 patients from the German Aortic Valve Registry from 2011 to 2014 were analyzed, and propensity-matched analyses were performed to correct for potential selection bias...
March 26, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29554066/an-algorithm-for-airway-management-in-patients-with-pierre-robin-sequence
#10
Katherine E Hicks, Kathleen R Billings, Chad A Purnell, John M Carter, Bharat Bhushan, Arun K Gosain, Dana M Thompson, Jeffrey C Rastatter
PURPOSE: Airway management in neonates with Pierre Robin sequence (PRS) can be challenging. The goal was to describe the algorithm developed by the authors over the past 8 years. METHODS: A retrospective case series analyzing airway management in neonates with PRS admitted to the neonatal intensive care unit at a tertiary care pediatric hospital was performed. The utility of the proposed algorithm for airway management incorporating more consistent use of polysomnography (PSG), and airway assessment was assessed...
March 16, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29549119/the-case-for-early-use-of-rapid-whole-genome-sequencing-in-management-of-critically-ill-infants-late-diagnosis-of-coffin-siris-syndrome-in-an-infant-with-left-congenital-diaphragmatic-hernia-congenital-heart-disease-and-recurrent-infections
#11
Nathaly M Sweeney, Shareef A Nahas, Shimul Chowdhury, Miguel Del Campo, Marilyn C Jones, David P Dimmock, Stephen F Kingsmore, Rcigm Investigators
Congenital diaphragmatic hernia (CDH) results from incomplete formation of the diaphragm leading to herniation of abdominal organs into the thoracic cavity. CDH is associated with pulmonary hypoplasia, congenital heart disease and pulmonary hypertension. Genetically, it is associated with aneuploidies, chromosomal copy number variants, and single gene mutations. CDH is the most expensive non-cardiac congenital defect: Management frequently requires implementation of Extracorporeal Membrane Oxygenation (ECMO), which increases management expenditures 2...
March 16, 2018: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/29493837/delirium-in-icu-patients-following-cardiac-surgery-an-observational-study
#12
Silvio Simeone, Gianluca Pucciarelli, Marco Perrone, Teresa Rea, Gianpaolo Gargiulo, Assunta Guillari, Gaetano Castellano, Luigi Di Tommaso, Massimo Niola, Gabriele Iannelli
AIMS AND OBJECTIVES: To observe the clinical and structural factors that can be associated with the post-operative onset of delirium in patients who have undergone heart surgery. BACKGROUND: Several risk factors could contribute to the development of delirium, such as the use of some sedative drugs and a patient's history with certain types of acute chronic disease. However, in the literature, there is little knowledge about the association between delirium in patients who have undergone cardio-surgical intervention and their clinical and environmental predictors...
March 1, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29493551/staff-and-family-response-to-end-of-life-care-in-the-icu
#13
Christiane S Hartog, Konrad Reinhart
PURPOSE OF REVIEW: End-of-life (EOL) care can be stressful for clinicians as well as patients and their relatives. Decisions to withhold or withdraw life-sustaining therapy vary widely depending on culture, beliefs and organizational norms. The following review will describe the current understanding of the problem and give an overview over interventional studies. RECENT FINDINGS: EOL care is a risk factor for clinician burnout; poor work conditions contribute to emotional exhaustion and intent to leave...
April 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29475450/neonatal-central-venous-line-observational-study-on-thrombosis-neoclot-evaluation-of-a-national-guideline-on-management-of-neonatal-catheter-related-thrombosis
#14
Jeanine J Sol, Moniek van de Loo, Marit Boerma, Klasien A Bergman, Albertine E Donker, Mark A H B M van der Hoeven, Christiaan V Hulzebos, Ronny Knol, K Djien Liem, Richard A van Lingen, Enrico Lopriore, Monique H Suijker, Daniel C Vijlbrief, Remco Visser, Margreet A Veening, Mirjam M van Weissenbruch, C Heleen van Ommen
BACKGROUND: In critically ill (preterm) neonates, central venous catheters (CVCs) are increasingly used for administration of medication or parenteral nutrition. A serious complication, however, is the development of catheter-related thrombosis (CVC-thrombosis), which may resolve by itself or cause severe complications. Due to lack of evidence, management of neonatal CVC-thrombosis varies among neonatal intensive care units (NICUs). In the Netherlands an expert-based national management guideline has been developed which is implemented in all 10 NICUs in 2014...
February 23, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29461465/septic-shock-alters-mitochondrial-respiration-of-lymphoid-cell-lines-and-human-peripheral-blood-mononuclear-cells-the-role-of-plasma
#15
Raphael Clere-Jehl, Julie Helms, Mohamad Kassem, Pierrick Le Borgne, Xavier Delabranche, Anne-Laure Charles, Bernard Geny, Ferhat Meziani, Pascal Bilbault
INTRODUCTION: In septic shock patients, post-septic immunosuppression state following the systemic inflammatory response syndrome is responsible for nosocomial infections, with subsequent increased mortality. The aim of the present study was to assess the underlying cellular mechanisms of the post-septic immunosuppression state, by investigating mitochondrial functions of peripheral blood mononuclear cells (PBMCs) from septic shock patients over 7 days. MATERIALS AND METHODS: Eighteen patients admitted to a French intensive care unit for septic shock were included...
February 14, 2018: Shock
https://www.readbyqxmd.com/read/29457491/critical-care-pharmacists-and-medication-management-in-an-icu-recovery-center
#16
Joanna L Stollings, Sarah L Bloom, Li Wang, E Wesley Ely, James C Jackson, Carla M Sevin
BACKGROUND: Many patients experience complications following critical illness; these are now widely referred to as post-intensive care syndrome (PICS). An interprofessional intensive care unit (ICU) recovery center (ICU-RC), also known as a PICS clinic, is one potential approach to promoting patient and family recovery following critical illness. OBJECTIVES: To describe the role of an ICU-RC critical care pharmacist in identifying and treating medication-related problems among ICU survivors...
February 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29432350/an-exploratory-reanalysis-of-the-randomized-trial-on-efficacy-of-corticosteroids-as-rescue-therapy-for-the-late-phase-of-acute-respiratory-distress-syndrome
#17
G Umberto Meduri, Lisa Bridges, Reed A C Siemieniuk, Mehmet Kocak
OBJECTIVES: In the Acute Respiratory Distress Syndrome Network randomized controlled trial, methylprednisolone treatment was associated with increased return to mechanical ventilation with partial loss of early improvements. We hypothesize a causal relationship between protocol-driven rapid discontinuation of methylprednisolone post extubation and return to mechanical ventilation. To explore this possibility, we investigated the timing that events occurred in each treatment arm during active treatment intervention (efficacy) and after stopping therapy...
February 9, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29429201/-survey-on-the-prevalence-of-continuous-blood-purification-in-chinese-pediatric-critical-care
#18
X Yang, S Y Qian, Y M Zhu, X Xu, C F Liu, F Xu, X X Ren, Y Wang, Y C Zhang, G P Lu
Objective: To investigate the current application status of continuous blood purification (CBP) technology and equipment in pediatric intensive care unit (PICU) in China. Methods: A cross-sectional survey was conducted to understand the current popularization of CBP technology and equipment, the management of CBP equipment and consumables, and the application of CBP in different diseases. A questionnaire named Application Status of Continuous Blood Purification Technology was applied. Children's hospitals and polyclinic hospitals with the pediatric qualification (pediatric emergency or critical care unit members of Chinese Medical Association and Chinese Medical Doctor Association) were selected...
February 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29416466/exacerbation-of-chronic-pain-after-dental-extractions-in-a-patient-with-post-treatment-lyme-disease-syndrome
#19
Stephanie Lim, Sakura Kinjo
A subset of patients who had Lyme disease experience postinfectious signs or symptoms called post-treatment Lyme disease syndrome (PTLDS). PTLDS is a chronic condition including pain in joints and muscles, neurological symptoms including demyelinating diseases, peripheral neuropathy, headaches, sleep disturbances, fatigue, and cardiac conditions. We report a case of difficult acute pain management in a patient with PTLDS who underwent dental extractions and required admission to an intensive care unit for pain control...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29407008/cardiac-intensive-care-unit-management-of-patients-after-cardiac-arrest-now-the-real-work-begins
#20
REVIEW
Varinder K Randhawa, Brian E Grunau, Derek B Debicki, Jian Zhou, Ahmed F Hegazy, Terry McPherson, A Dave Nagpal
Survival with a good quality of life after cardiac arrest continues to be abysmal. Coordinated resuscitative care does not end with the effective return of spontaneous circulation (ROSC)-in fact, quite the contrary is true. Along with identifying and appropriately treating the precipitating cause, various components of the post-cardiac arrest syndrome also require diligent observation and management, including post-cardiac arrest neurologic injury and myocardial dysfunction, systemic ischemia-reperfusion phenomenon with potential consequent multiorgan failure, and the various sequelae of critical illness...
February 2018: Canadian Journal of Cardiology
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