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ICU associated weakness

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https://www.readbyqxmd.com/read/29462714/alterations-of-conjunctival-glycocalyx-and-microcirculation-in-non-septic-critically-ill-patients
#1
Andrius Pranskunas, Tomas Tamosuitis, Neringa Balciuniene, Diana Damanskyte, Edvin Sneider, Astra Vitkauskiene, Edmundas Sirvinskas, Vidas Pilvinis, E Christiaan Boerma
As of now the relationship between glycocalyx degradation and microcirculatory perfusion abnormalities in non-septic critical ill patients is unclear. In addition, conjunctival sidestream dark field-imaging for the purpose of glycocalyx thickness estimation has never been performed. We aimed to investigate whether changes in glycocalyx thickness in non-septic patients are associated with microcirculatory alterations in conjunctival and sublingual mucosa. In this single-centre prospective observational study, using techniques for direct in-vivo observation of the microcirculation, we performed a single measurement of microcirculatory perfusion parameters and visualized glycocalyx thickness in both ocular conjunctiva and sublingual mucosa in mixed cardio surgical (n = 18) and neurocritical patients (n = 27) and compared these data with age-matched healthy controls (n = 20)...
February 17, 2018: Microvascular Research
https://www.readbyqxmd.com/read/29462165/thromboelastometry-profile-in-critically-ill-patients-a-single-center-retrospective-observational-study
#2
Tomaz Crochemore, Thiago Domingos Corrêa, Marcus D Lance, Cristina Solomon, Ary Serpa Neto, João Carlos de Campos Guerra, Priscila Scolmeister Lellis, Livia Muller Bernz, Natalia Nunes, Cassio Massashi Mancio, Ana Paula Hitomi Yokoyama, Eliézer Silva
BACKGROUND: Transfusion therapy is associated with increased morbidity, mortality and costs. Conventional coagulation tests (CCT) are weak bleeding predictors, poorly reflecting coagulation in vivo. Thromboelastometry (ROTEM) provides early identification of coagulation disorders and can guide transfusion therapy by goals, reducing blood components transfusion. OBJECTIVE: The aim of this study is to describe coagulation profile of critically ill patients using ROTEM and evaluate the association between CCT and thromboelastometry...
2018: PloS One
https://www.readbyqxmd.com/read/29354572/association-of-post-extubation-dysphagia-with-tongue-weakness-and-somatosensory-disturbance-in-non-neurologic-critically-ill-patients
#3
Hee Seon Park, Jung Hoi Koo, Sun Hong Song
Objective: To prospectively assess the association between impoverished sensorimotor integration of the tongue and lips and post-extubation dysphagia (PED). Methods: This cross-sectional study included non-neurologic critically ill adult patients who required endotracheal intubation and underwent videofluoroscopic swallowing study (VFSS) between October and December 2016. Participants underwent evaluation for tongue and lip performance, and oral somatosensory function...
December 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29241382/causes-of-mortality-in-icu-acquired-weakness
#4
Linda van Wagenberg, Esther Witteveen, Luuk Wieske, Janneke Horn
BACKGROUND: Intensive care unit-acquired weakness (ICU-AW) is a common complication of critical illness and is associated with increased mortality, longer mechanical ventilation and longer hospital stay. Little is known about the causes of mortality in patients with ICU-AW. In this study, we aimed to give an overview of the causes of death in a population diagnosed with ICU-AW during hospital admission. METHODS: Data from a prospective cohort study in the mixed medical-surgical ICU of the Academic Medical Center in Amsterdam were used...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29217407/can-we-predict-intermediate-syndrome-a-review
#5
REVIEW
Chanika Alahakoon, Tharaka Lagath Dassanayake, Indika Bandara Gawarammana, Vajira Senaka Weerasinghe
INTRODUCTION: Ingestion of organophosphorus insecticides (OPI) is a common method of deliberate self harm in the developing world. Deaths mainly follow as a result of the respiratory failure associated with both cholinergic crisis and the intermediate syndrome. Even though death can be prevented by early mechanical ventilation of these patients, limited studies are available regarding the prediction of intermediate syndrome and subsequent respiratory failure. OBJECTIVE: To systematically review articles that are published with regard to possible prediction of intermediate syndrome using clinical, biochemical and electrophysiological parameters...
December 5, 2017: Neurotoxicology
https://www.readbyqxmd.com/read/29215200/mir-424-5p-reduces-ribosomal-rna-and-protein-synthesis-in-muscle-wasting
#6
Martin Connolly, Richard Paul, Roser Farre-Garros, Samantha A Natanek, Susannah Bloch, Jen Lee, Jose P Lorenzo, Harnish Patel, Cyrus Cooper, Avan A Sayer, Stephen J Wort, Mark Griffiths, Michael I Polkey, Paul R Kemp
BACKGROUND: A loss of muscle mass occurs as a consequence of a range of chronic and acute diseases as well as in older age. This wasting results from an imbalance of protein synthesis and degradation with a reduction in synthesis and resistance to anabolic stimulation often reported features. Ribosomes are required for protein synthesis, so changes in the control of ribosome synthesis are potential contributors to muscle wasting. MicroRNAs (miRNAs) are known regulators of muscle phenotype and have been shown to modulate components of the protein synthetic pathway...
December 7, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/29061618/critical-care-cycling-study-cyclist-trial-protocol-a-randomised-controlled-trial-of-usual-care-plus-additional-in-bed-cycling-sessions-versus-usual-care-in-the-critically-ill
#7
Marc R Nickels, Leanne M Aitken, James Walsham, Adrian G Barnett, Steven M McPhail
INTRODUCTION: In-bed cycling with patients with critical illness has been shown to be safe and feasible, and improves physical function outcomes at hospital discharge. The effects of early in-bed cycling on reducing the rate of skeletal muscle atrophy, and associations with physical and cognitive function are unknown. METHODS AND ANALYSIS: A single-centre randomised controlled trial in a mixed medical-surgical intensive care unit (ICU) will be conducted. Adult patients (n=68) who are expected to be mechanically ventilated for more than 48 hours and remain in ICU for a further 48 hours from recruitment will be randomly allocated into either (1) a usual care group or (2) a group that receives usual care and additional in-bed cycling sessions...
October 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28991776/serum-and-alveolar-procalcitonin-had-a-weak-diagnostic-value-for-ventilator-associated-pneumonia-in-patients-with-pulmonary-infection-score-%C3%A2-6
#8
Mehran Shokri, Roya Ghasemian, Masomeh Bayani, Valiollah Amri Maleh, Masoumeh Kamrani, Mahmoud Sadeghi-Haddad-Zavareh, Soheil Ebrahimpour
BACKGROUND: Measuring the serum and alveolar procalcitonin level as inflammatory marker in the diagnosis of ventilator-associated pneumonia (VAP) has been taken into account. In this study, serum and alveolar procalcitonin levels in patients with suspected VAP and patients with confirmed VAP were compared. METHODS: This cross-sectional study was conducted using 50 intubated intensive care unit (ICU) patients, connected to ventilator, from October 2014 to April 2015...
October 7, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28984049/mir-422a-suppresses-smad4-protein-expression-and-promotes-resistance-to-muscle-loss
#9
Richard Paul, Jen Lee, Anna V Donaldson, Martin Connolly, Mohammad Sharif, Samantha Amanda Natanek, Ulrich Rosendahl, Michael I Polkey, Mark Griffiths, Paul R Kemp
BACKGROUND: Loss of muscle mass and strength are important sequelae of chronic disease, but the response of individuals is remarkably variable, suggesting important genetic and epigenetic modulators of muscle homeostasis. Such factors are likely to modify the activity of pathways that regulate wasting, but to date, few such factors have been identified. METHODS: The effect of miR-422a on SMAD4 expression and transforming growth factor (TGF)-β signalling were determined by western blotting and luciferase assay...
October 6, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28938290/body-composition-changes-in-severely-burned-children-during-icu-hospitalization
#10
Janos Cambiaso-Daniel, Ioannis Malagaris, Eric Rivas, Gabriel Hundeshagen, Charles D Voigt, Elizabeth Blears, Ron P Mlcak, David N Herndon, Celeste C Finnerty, Oscar E Suman
OBJECTIVES: Prolonged hospitalization due to burn injury results in physical inactivity and muscle weakness. However, how these changes are distributed among body parts is unknown. The aim of this study was to evaluate the degree of body composition changes in different anatomical regions during ICU hospitalization. DESIGN: Retrospective chart review. SETTING: Children's burn hospital. PATIENTS: Twenty-four severely burned children admitted to our institution between 2000 and 2015...
September 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28917004/critical-illness-associated-diaphragm-weakness
#11
REVIEW
Martin Dres, Ewan C Goligher, Leo M A Heunks, Laurent J Brochard
Diaphragm weakness is highly prevalent in critically ill patients. It may exist prior to ICU admission and may precipitate the need for mechanical ventilation but it also frequently develops during the ICU stay. Several risk factors for diaphragm weakness have been identified; among them sepsis and mechanical ventilation play central roles. We employ the term critical illness-associated diaphragm weakness to refer to the collective effects of all mechanisms of diaphragm injury and weakness occurring in critically ill patients...
October 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#12
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gérard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigué, Laure de Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28674380/exceptionally-high-creatine-kinase-ck-levels-in-multicausal-and-complicated-rhabdomyolysis-a-case-report
#13
Pavan Luckoor, Mashal Salehi, Afua Kunadu
BACKGROUND Rhabdomyolysis is a syndrome caused by muscle breakdown. It can be caused by traumatic as well as non-traumatic factors such as drugs, toxins, and infections. Although it has been initially associated with only traumatic causes, non-traumatic causes now appear to be at least 5 times more frequent. In rhabdomyolysis, the CK levels can range anywhere from 10 000 to 200 000 or even higher. The higher the CK levels, the greater will be the renal damage and associated complications. We present the case of a patient with exceptionally massive rhabdomyolysis with unusually high CK levels (nearly 1 million) caused by combined etiologic factors and complicated with acute renal failure...
July 4, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28651475/high-frequency-ventilation-modalities-as-salvage-therapy-for-smoke-inhalation-associated-acute-lung-injury-a-systematic-review
#14
Andrew C Miller, Paula A Ferrada, Sameer S Kadri, Krupa Nataraj-Bhandari, Amir Vahedian-Azimi, Sadeq A Quraishi
BACKGROUND: Smoke inhalation-associated acute lung injury (SI-ALI) is a major cause of morbidity and mortality in victims of fire tragedies. To date, there are no evidence-based guidelines on ventilation strategies in acute respiratory distress syndrome (ARDS) after smoke inhalation. We reviewed the existing literature for clinical studies of salvage mechanical ventilation (MV) strategies in patients with SI-ALI, focusing on mortality and pneumonia as outcomes. METHODS: A systematic search was designed in accordance with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#15
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28614196/superiority-of-serum-cystatin-c-over-creatinine-in-prediction-of-long-term-prognosis-at-discharge-from-icu
#16
Bo Ravn, John R Prowle, Johan Mårtensson, Claes-Roland Martling, Max Bell
OBJECTIVES: Renal outcomes after critical illness are seldom assessed despite strong correlation between chronic kidney disease and survival. Outside hospital, renal dysfunction is more strongly associated with mortality when assessed by serum cystatin C than by creatinine. The relationship between creatinine and longer term mortality might be particularly weak in survivors of critical illness. DESIGN: Retrospective observational cohort study. PATIENTS: In 3,077 adult ICU survivors, we compared ICU discharge cystatin C and creatinine and their association with 1-year mortality...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28614140/a-comparison-of-clinical-characteristics-and-outcomes-of-ventilator-associated-pneumonias-among-burn-patients-by-diagnostic-criteria-set
#17
Duraid Younan, Russell Griffin, Thomas Swain, Eric Schinnerer, Jean-Francois Pittet, Bernard Camins
OBJECTIVES: The National Healthcare Safety Network (NHSN) replaced its old definition for ventilator-associated pneumonia (VAP) with ventilator-associated events (VAEs) in 2013. Little data is available comparing the two definitions in burn patients. METHODS: Data from 2011 to 2014 were collected on burn patients mechanically ventilated for at least 2 days. VAP was determined using two methods: (1) pneumonia as defined by the previous more clinical CDC (NHSN) definition captured in the burn registry; (2) pneumonia as defined by the recent CDC (NHSN) standard of VAEs where patients meeting the criteria for possible VAP were considered having a pneumonia...
December 2017: Shock
https://www.readbyqxmd.com/read/28598990/neurological-failure-in-icu-patients-with-hematological-malignancies-a-prospective-cohort-study
#18
MULTICENTER STUDY
Chiara Marzorati, Djamel Mokart, Frederic Pène, Virginie Lemiale, Achille Kouatchet, Julien Mayaux, François Vincent, Martine Nyunga, Fabrice Bruneel, Antoine Rabbat, Christine Lebert, Pierre Perez, Dominique Benoit, Giuseppe Citerio, Elie Azoulay, Stephane Legriel
BACKGROUND: Epidemiological studies of neurological complications in patients with hematological malignancies are scant. The objective of the study was to identify determinants of survival in patients with hematological malignancy and neurological failure. METHODS: Post hoc analysis of a prospective study of adults with hematological malignancies admitted for any reason to one of 17 university or university-affiliated participating ICUs in France and Belgium (2010-2012)...
2017: PloS One
https://www.readbyqxmd.com/read/28589148/skeletal-muscle-and-lymphocyte-mitochondrial-dysfunctions-in-septic-shock-trigger-icu-acquired-weakness-and-sepsis-induced-immunoparalysis
#19
REVIEW
Quentin Maestraggi, Benjamin Lebas, Raphaël Clere-Jehl, Pierre-Olivier Ludes, Thiên-Nga Chamaraux-Tran, Francis Schneider, Pierre Diemunsch, Bernard Geny, Julien Pottecher
Fundamental events driving the pathological processes of septic shock-induced multiorgan failure (MOF) at the cellular and subcellular levels remain debated. Emerging data implicate mitochondrial dysfunction as a critical factor in the pathogenesis of sepsis-associated MOF. If macrocirculatory and microcirculatory dysfunctions undoubtedly participate in organ dysfunction at the early stage of septic shock, an intrinsic bioenergetic failure, sometimes called "cytopathic hypoxia," perpetuates cellular dysfunction...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28588895/evaluation-of-cough-peak-expiratory-flow-as-a-predictor-of-successful-mechanical-ventilation-discontinuation-a-narrative-review-of-the-literature
#20
REVIEW
Chuan Jiang, Antonio Esquinas, Bushra Mina
A crucial step in the transition from mechanical ventilation to extubation is the successful performance of a spontaneous breathing trial (SBT). The American College of Chest Physicians (ACCP) Guidelines recommend removal of the endotracheal tube upon successful completion of a SBT. However, this does not guarantee successful extubation as there remains a risk of re-intubation. Guidelines have outlined ventilator liberation protocols, selected use of non-invasive ventilation on extubation, early mobilization, and dynamic ventilator metrics to prevent and better predict extubation failure...
2017: Journal of Intensive Care
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