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https://www.readbyqxmd.com/read/28914277/antidepressant-use-and-depressive-symptoms-in-intensive-care-unit-survivors
#1
Sophia Wang, Chris Mosher, Sujuan Gao, Kayla Kirk, Sue Lasiter, Sikander Khan, You Na Kheir, Malaz Boustani, Babar Khan
Nearly 30% of intensive care unit (ICU) survivors have depressive symptoms 2-12 months after hospital discharge. We examined the prevalence of depressive symptoms and risk factors for depressive symptoms in 204 patients at their initial evaluation in the Critical Care Recovery Center (CCRC), an ICU survivor clinic based at Eskenazi Hospital in Indianapolis, Indiana. Thirty-two percent (N = 65) of patients had depressive symptoms on initial CCRC visit. For patients who are not on an antidepressant at their initial CCRC visit (N = 135), younger age and lower education level were associated with a higher likelihood of having depressive symptoms...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28906362/are-we-ever-too-old-characteristics-and-outcome-of-octogenarians-admitted-to-a-medical-intensive-care-unit
#2
Johanna Maria Muessig, Maryna Masyuk, Amir Movahed Nia, Marcus Franz, Bjoern Kabisch, Malte Kelm, Christian Jung
The aging population increases the demand of intensive care unit (ICU) treatments. However, the availability of ICU beds is limited. Thus, ICU admission of octogenarians is considered controversial. The population above 80 years is a very heterogeneous group though, and age alone might not be the best predictor. Aim of this study was to analyze resource consumption and outcome of octogenarians admitted to a medical ICU to identify reliable survival predictors in a senescent society.This retrospective observational study analyzes 930 octogenarians and 5732 younger patients admitted to a medical ICU...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28899584/evaluating-the-past-to-improve-the-future-a-qualitative-study-of-icu-patients-experiences
#3
Kristin Dahle Olsen, Marit Nester, Britt Sætre Hansen
BACKGROUND: The recovery period for patients who have been in an intensive care unitis often prolonged and suboptimal. Anxiety, depression and post-traumatic stress disorder are common psychological problems. Intensive care staff offer various types of intensive aftercare. Intensive care follow-up aftercare services are not standard clinical practice in Norway. OBJECTIVE: The overall aim of this study is to investigate how adult patients experience theirintensive care stay their recovery period, and the usefulness of an information pamphlet...
September 9, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28898744/the-ability-of-intensive-care-unit-physicians-to-estimate-long-term-prognosis-in-survivors-of-critical-illness
#4
Ivo W Soliman, Olaf L Cremer, Dylan W de Lange, Arjen J C Slooter, Johannes Hans J M van Delden, Diederik van Dijk, Linda M Peelen
PURPOSE: To assess the reliability of physicians' prognoses for intensive care unit (ICU) survivors with respect to long-term survival and health related quality of life (HRQoL). METHODS: We performed an observational cohort-study in a single mixed tertiary ICU in The Netherlands. ICU survivors with a length of stay >48h were included. At ICU discharge, one-year prognosis was estimated by physicians using the four-option Sabadell score to record their expectations...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28892669/development-of-a-prediction-model-for-long-term-quality-of-life-in-critically-ill-patients
#5
Sandra Oeyen, Karel Vermeulen, Dominique Benoit, Lieven Annemans, Johan Decruyenaere
PURPOSE: We developed a prediction model for quality of life (QOL) 1 year after intensive care unit (ICU) discharge based upon data available at the first ICU day to improve decision-making. METHODS: The database of a 1-year prospective study concerning long-term outcome and QOL (assessed by EuroQol-5D) in critically ill adult patients consecutively admitted to the ICU of a university hospital was used. Cases with missing data were excluded. Utility indices at baseline (UIb) and at 1 year (UI1y) were surrogates for QOL...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28890524/diagnosis-and-management-of-patients-with-paroxysmal-sympathetic-hyperactivity-following-acute-brain-injuries-using-a-consensus-based-diagnostic-tool-a-single-institutional-case-series
#6
Shigeo Godo, Shigemi Irino, Atsuhiro Nakagawa, Yu Kawazoe, Motoo Fujita, Daisuke Kudo, Ryosuke Nomura, Hiroaki Shimokawa, Shigeki Kushimoto
Paroxysmal sympathetic hyperactivity (PSH) is a distinct syndrome of episodic sympathetic hyperactivities following severe acquired brain injury, characterized by paroxysmal transient fever, tachycardia, hypertension, tachypnea, excessive diaphoresis and specific posturing. PSH remains to be an under-recognized condition with a diagnostic pitfall especially in the intensive care unit (ICU) settings due to the high prevalence of concomitant diseases that mimic PSH. A consensus set of diagnostic criteria named PSH-Assessment Measure (PSH-AM) has been developed recently, which is consisted of two components: a diagnosis likelihood tool derived from clinical characteristics of PSH, and a clinical feature scale assigned to the severity of each sympathetic hyperactivity...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28888275/mean-arterial-pressure-of-65-mm-hg-versus-85-100-mm-hg-in-comatose-survivors-after-cardiac-arrest-rationale-and-study-design-of-the-neuroprotect-post-cardiac-arrest-trial
#7
Koen Ameloot, Cathy De Deyne, Bert Ferdinande, Matthias Dupont, Pieter-Jan Palmers, Thibault Petit, Ward Eertmans, Clara Moonen, Ann Belmans, Robin Lemmens, Joseph Dens, Stefan Janssens
BACKGROUND: Post-cardiac arrest (CA) patients admitted to the intensive care unit (ICU) have a poor prognosis, with estimated survival rates of around 30%-50%. On admission, these patients have a large cerebral penumbra at risk for additional damage in case of suboptimal brain oxygenation during their stay in the ICU. The aim of the Neuroprotect post-CA trial is to investigate whether forcing mean arterial blood pressure (MAP) and mixed venous oxygen saturation (SVO2) in a specific range (MAP 85-100 mm Hg, SVO2 65%-75%) with additional pharmacological support (goal-directed hemodynamic optimization) may better salvage the penumbra, reduce cerebral ischemia, and improve functional outcome when compared with current standard of care (MAP 65 mm Hg)...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28882377/lasting-impression-of-violence-retained-bullets-and-depressive-symptoms
#8
Randi N Smith, Mark J Seamon, Vinayak Kumar, Andrew Robinson, Justine Shults, Patrick M Reilly, Therese S Richmond
BACKGROUND: Over 70,000 nonfatal firearm injuries occur in the US annually, frequently leaving victims injured with retained bullets. The long-term psychological risks associated with retained bullets remains unstudied. By serving as a constant reminder of injury, we hypothesized that the presence of retained bullets after firearm injury is associated with increased PTSD and depression symptom severity. METHODS: We conducted a prospective cohort study (2013-2015) of Black male survivors of firearm injury at an urban Level I trauma center...
September 4, 2017: Injury
https://www.readbyqxmd.com/read/28870480/propofol-sedation-substantially-increases-the-caloric-and-lipid-intake-in-critically-ill-patients
#9
Mélanie Charrière, Emma Ridley, Jennifer Hastings, Oliver Bianchet, Carlos Scheinkestel, Mette M Berger
OBJECTIVE: The amount of lipid delivered to patients varies considerably depending on the non-nutritional intake from sedation, and on the feeding solution. The aim of this study was to quantify the magnitude and proportion of lipids and energy provided from propofol sedation in intensive care unit (ICU) patients. METHODS: This was a retrospective analysis of prospectively collected data in consecutive patients admitted to the ICUs of two university hospitals. Inclusion criterion included an ICU stay >5 d...
October 2017: Nutrition
https://www.readbyqxmd.com/read/28869492/the-lactate-albumin-ratio-a-valuable-tool-for-risk-stratification-in-septic-patients-admitted-to-icu
#10
Michael Lichtenauer, Bernhard Wernly, Bernhard Ohnewein, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Alexander Lauten, Paul Christian Schulze, Uta C Hoppe, Malte Kelm, Christian Jung
The lactate/albumin ratio has been reported to be associated with mortality in pediatric patients with sepsis. We aimed to evaluate the lactate/albumin ratio for its prognostic relevance in a larger collective of critically ill (adult) patients admitted to an intensive care unit (ICU). A total of 348 medical patients admitted to a German ICU for sepsis between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013. The association of the lactate/albumin ratio (cut-off 0...
September 2, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28868165/serum-vitamin-d-level-at-icu-admission-and-mortality
#11
Hakan Korkut Atalan, Bülent Güçyetmez
OBJECTIVE: Vitamin D is a fat-soluble vitamin that plays a major role in the regulation of bone and calcium metabolism and has effects on the immune and cardiovascular systems. Vitamin D deficiency is commonly seen in the general population as well as in critically ill patients and is reported to be associated with increased mortality and morbidity. Our aim was to determine the relationship between vitamin D level at ICU admission and mortality. METHODS: A total of 491 patients admitted to the ICU between January 2014 and January 2015 were evaluated retrospectively...
August 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28866969/a-scoping-review-of-use-of-wearable-devices-to-evaluate-outcomes-in-survivors-of-critical-illness
#12
Samuel Gluck, Lee-Anne S Chapple, Marianne J Chapman, Theodore J Iwashyna, Adam M Deane
OBJECTIVE: Wearable devices using new technology may be a cost-effective method to assess functional outcomes in survivors of critical illness. Our primary objective was to review the extent to which wearable devices such as smartphones, pedometers, accelerometers and global positioning systems have been used to evaluate outcomes in survivors of an intensive care unit admission. DESIGN: We included studies of patients surviving an ICU admission and which measured outcomes using wearable devices...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28863012/critical-care-organizations-business-of-critical-care-and-value-performance-building
#13
Sharon Leung, Sara R Gregg, Craig M Coopersmith, A Joseph Layon, John Oropello, Daniel R Brown, Stephen M Pastores, Vladimir Kvetan
OBJECTIVE: New, value-based regulations and reimbursement structures are creating historic care management challenges, thinning the margins and threatening the viability of hospitals and health systems. The Society of Critical Care Medicine convened a taskforce of Academic Leaders in Critical Care Medicine on February 22, 2016, during the 45th Critical Care Congress to develop a toolkit drawing on the experience of successful leaders of critical care organizations in North America for advancing critical care organizations (Appendix 1)...
August 31, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28851605/new-onset-atrial-fibrillation-and-clinical-outcome-in-non-cardiac-intensive-care-unit-patients
#14
Stamatis S Makrygiannis, Despina Rizikou, Nikolaos G Patsourakos, Manolis Lampakis, Anastasia Margariti, Olga S Ampartzidou, Konstantinos Sakellaridis, Paraskevi Tselioti, Athanasios Pipilis, Athanasios A Prekates
BACKGROUND: Data regarding new onset atrial fibrillation (nAF) in general, non-cardiac, intensive care unit (ICU) patients are limited. However, it has been suggested that nAF is associated with worse clinical outcome in these patients. OBJECTIVE: The purpose of the present work was to study the prognostic impact of nAF, in this setting. METHODS: We prospectively studied all patients admitted to a single ICU for a period of 12 months. Patients admitted for brief post-operative monitoring, patients with chronic, intermittent atrial fibrillation and atrial fibrillation present upon admission, were excluded...
August 26, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28851588/do-sedation-and-analgesia-contribute-to-long-term-cognitive-dysfunction-in-critical-care-survivors
#15
S Fernandez-Gonzalo, M Turon, C De Haro, J López-Aguilar, M Jodar, L Blanch
Deep sedation during stay in the Intensive Care Unit (ICU) may have deleterious effects upon the clinical and cognitive outcomes of critically ill patients undergoing mechanical ventilation. Over the last decade a vast body of literature has been generated regarding different sedation strategies, with the aim of reducing the levels of sedation in critically ill patients. There has also been a growing interest in acute brain dysfunction, or delirium, in the ICU. However, the effect of sedation during ICU stay upon long-term cognitive deficits in ICU survivors remains unclear...
August 26, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28842727/effect-of-vitamin-d3-on-bone-turnover-markers-in-critical-illness-post-hoc-analysis-from-the-vitdal-icu-study
#16
V Schwetz, C Schnedl, T Urbanic-Purkart, C Trummer, H P Dimai, A Fahrleitner-Pammer, C Putz-Bankuti, K B Christopher, B Obermayer-Pietsch, T R Pieber, H Dobnig, K Amrein
In this post hoc analysis of the VITdAL-ICU study, an RCT in critically ill adults with 25-hydroxyvitamin D levels ≤20 ng/ml, vitamin D3 did not have a significant effect on β-Crosslaps and osteocalcin. INTRODUCTION: Observational studies have shown accelerated bone loss in ICU survivors. A reversible contributor is vitamin D deficiency. In a post hoc analysis of the VITdAL-ICU study, we evaluated the effect of high-dose vitamin D3 on the bone turnover markers (BTM) β-Crosslaps (CTX) and osteocalcin (OC)...
August 25, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28841360/prehospital-end-tidal-carbon-dioxide-predicts-mortality-in-trauma-patients
#17
Kelsey Childress, Kelly Arnold, Christopher Hunter, George Ralls, Linda Papa, Salvatore Silvestri
BACKGROUND: End-tidal carbon dioxide (EtCO2) measurement has been shown to have prognostic value in acute trauma. OBJECTIVE: Evaluate the association of prehospital EtCO2 and in-hospital mortality in trauma patients and to assess its prognostic value when compared to traditional vital signs. METHODS: Retrospective, cross-sectional study of patients transported by a single EMS agency to a level one trauma center. We evaluated initial out-of-hospital vital signs documented by EMS personnel including EtCO2, respiratory rate (RR), systolic BP (SBP), diastolic BP (DBP), pulse (P), and oxygen saturation (O2) and hospital data...
August 25, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28838900/a-patient-cohort-on-long-term-sequelae-of-sepsis-survivors-study-protocol-of-the-mid-german-sepsis-cohort
#18
André Scherag, Christiane S Hartog, Carolin Fleischmann, Dominique Ouart, Franziska Hoffmann, Christian König, Miriam Kesselmeier, Sandra Fiedler, Monique Philipp, Anke Braune, Cornelia Eichhorn, Christin Gampe, Heike Romeike, Konrad Reinhart
INTRODUCTION: An increasing number of patients survive sepsis; however, we lack valid data on the long-term impact on morbidity from prospective observational studies. Therefore, we designed an observational cohort to quantify mid-term and long-term functional disabilities after intensive care unit (ICU)-treated sepsis. Ultimately, findings for the Mid-German Sepsis Cohort (MSC) will serve as basis for the implementation of follow-up structures for patients with sepsis and help to increase quality of care for sepsis survivors...
August 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28837430/the-epidemiology-of-chronic-critical-illness-after-severe-traumatic-injury-at-two-level-one-trauma-centers
#19
Juan C Mira, Joseph Cuschieri, Tezcan Ozrazgat-Baslanti, Zhongkai Wang, Gabriela L Ghita, Tyler J Loftus, Julie A Stortz, Steven L Raymond, Jennifer D Lanz, Laura V Hennessy, Babette Brumback, Philip A Efron, Henry V Baker, Frederick A Moore, Ronald V Maier, Lyle L Moldawer, Scott C Brakenridge
OBJECTIVE: To determine the incidence and risk factors of chronic critical illness after severe blunt trauma. DESIGN: Prospective observational cohort study (NCT01810328). SETTING: Two-level one trauma centers in the United States. PATIENTS: One hundred thirty-five adult blunt trauma patients with hemorrhagic shock who survived beyond 48 hours after injury. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Chronic critical illness was defined as an ICU stay lasting 14 days or more with evidence of persistent organ dysfunction...
August 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28821973/bilirubin-in-the-early-course-of-venovenous-extracorporeal-membrane-oxygenation-support-for-refractory-ards
#20
Chiara Lazzeri, Manuela Bonizzoli, Giovanni Cianchi, Stefano Batacchi, Marco Chiostri, Giorgio Enzo Fulceri, Laura Tadini Buoninsegni, Adriano Peris
Bilirubin is known as a marker of hepatic dysfunction and is incorporated in scoring algorithms to assess prognosis in critically ill patients. No data are so far available on the prognostic role of hepatic dysfunction in patients with severe ARDS on venovenous extracorporeal membrane oxygenation (VV-ECMO) support. In 112 consecutive patients with severe ARDS treated with VV-ECMO, we aimed at assessing whether increased bilirubin during the first 72 h could affect early death. Increased serum bilirubin (≥1...
August 18, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
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