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https://www.readbyqxmd.com/read/28100110/mortality-in-patients-with-septic-shock-by-multidrug-resistant-bacteria
#1
Stefano Busani, Giulia Serafini, Elena Mantovani, Claudia Venturelli, Maddalena Giannella, Pierluigi Viale, Cristina Mussini, Andrea Cossarizza, Massimo Girardis
BACKGROUND: Patients with septic shock by multidrug resistant (MDR) microorganism maybe considered a specific population of critical patients at very high risk of death in whom the effects of standard sepsis treatment has never been assessed. The objective of this retrospective analysis was to evaluate the risk factors for 30-day mortality and the impact of sepsis management in patients with septic shock caused by MDR bacteria. METHODS: Patients with septic shock by MDR bacteria admitted to the mixed intensive care unit (ICU) of Modena University Hospital during a 6-year period were studied...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28098631/after-the-fall-the-tapestry-of-disturbance-and-recovery
#2
Nalini M Nadkarni
On July 3, 2015, Nalini Nadkarni, a world-renowned ecologist who had been studying the biologic processes of ecosystem disturbance and recovery, sustained a catastrophic 50-foot free-fall from the top of the rainforest canopy to the forest floor at her remote field research site. She lost consciousness in shock and sustained life-threatening injuries. Her accompanying students hiked out, radio-called 911, and the Harborview Medical Center (Seattle) Medivac team arrived 4 hours later to rescue her. Her prognosis was extremely grim; her family gathered in anticipation of her death as she underwent four operations during her 10 days in the ICU...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098628/the-abcdef-bundle-science-and-philosophy-of-how-icu-liberation-serves-patients-and-families
#3
E Wesley Ely
Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the postintensive care syndrome." Patients with postintensive care syndrome are robbed of their normal cognitive, emotional, and physical capacity and cannot resume their previous life. The ICU Liberation Collaborative is a real-world quality improvement initiative being implemented across 76 ICUs designed to engage strategically the ABCDEF bundle through team- and evidence-based care...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28091737/impact-of-pelvic-fractures-on-the-early-clinical-outcomes-of-severely-injured-trauma-patients
#4
K Almahmoud, R Pfeifer, K Al-Kofahi, A Hmedat, W Hyderabad, F Hildebrand, A B Peitzman, H-C Pape
BACKGROUND: Pelvic fractures contribute to morbidity and mortality following injury. We sought to study the impact of pelvic fractures on the clinical course and outcomes of trauma patients with a pelvic fracture in comparison to patients with similar injury severity without pelvic fracture to identify potential parameters to track patients' clinical course post-injury. METHODS: A cohort of 206 consecutive blunt trauma survivors, studied over a 5-year period in a level I trauma center of which 75 patients (36...
January 13, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28087409/thioredoxin-a-novel-biomarker-of-post-injury-sepsis
#5
Jesper Eriksson, Andreas Gidlöf, Mikael Eriksson, Emma Larsson, Olof Brattström, Anders Oldner
BACKGROUND: Thioredoxin (TRX), an endogenous anti-oxidant protein induced in inflammatory conditions, has been shown to increase in plasma and to be associated with outcome in septic patients. This biomarker has never been studied in a trauma setting. We hypothesized that TRX would be increased after trauma and associated with post-injury sepsis. METHODS: Single-centre prospective observational study conducted at the intensive care unit (ICU) at the Karolinska University Hospital, Stockholm, Sweden, a level-1 trauma centre...
January 10, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28078833/clinical-profile-and-outcome-of-patients-with-severe-sepsis-treated-in-an-intensive-care-unit-in-india
#6
T T Paary, M S Kalaiselvan, M K Renuka, A S Arunkumar
Introduction: Sepsis is the leading cause of intensive care unit (ICU) admissions and is associated with high mortality. Objectives: To identify the incidence, risk factors and outcome of patients with severe sepsis and septic shock. Methods: A prospective observational study was done in a multidisciplinary ICU over a period of 18 months. We included all adult patients admitted to ICU with features of severe sepsis and septic shock as per SCCM/ACCP guidelines...
30, 2016: Ceylon Medical Journal
https://www.readbyqxmd.com/read/28074799/basic-arterial-blood-gas-biomarkers-as-a-predictor-of-mortality-in-tetralogy-of-fallot-patients
#7
Vandana Bhardwaj, Poonam Malhotra Kapoor, Kalpana Irpachi, Suruchi Ladha, Ujjwal Kumar Chowdhury
BACKGROUND: Serum lactate and base deficit have been shown to be a predictor of morbidity and mortality in critically ill patients. Poor preoperative oxygenation appears to be one of the significant factors that affects early mortality in tetralogy of Fallot (TOF). There is little published literature evaluating the utility of serum lactate, base excess (BE), and oxygen partial pressure (PO 2 ) as simple, widely available, prognostic markers in patients undergoing surgical repair of TOF...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28073594/analysis-of-readmission-rates-to-the-intensive-care-unit-after-implementation-of-a-rapid-response-team-in-a-university-hospital
#8
R Bergamasco E Paula, M T Tanita, J Festti, L T Queiroz Cardoso, C M Carvalho Grion
OBJECTIVES: To compare readmission rates to the intensive care unit (ICU) before and after the implementation of a rapid response team (RRT), and to identify risk factors for readmission. DESIGN: A quasi-experimental before-after study was carried out. SETTING: A University Hospital. PATIENTS: All patients discharged from the ICU from January to December 2008 (control group) and from January 2010 to December 2012 (intervention group)...
January 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28067712/muscle-weakness-and-5-year-survival-in-acute-respiratory-distress-syndrome-survivors
#9
Victor D Dinglas, Lisa Aronson Friedman, Elizabeth Colantuoni, Pedro A Mendez-Tellez, Carl B Shanholtz, Nancy D Ciesla, Peter J Pronovost, Dale M Needham
OBJECTIVES: To longitudinally evaluate the association of post-ICU muscle weakness and associated trajectories of weakness over time with 5-year survival. DESIGN: Longitudinal prospective cohort study over 5 years of follow-up. SETTING: Thirteen ICUs in four hospitals in Baltimore, MD. PATIENTS: One hundred fifty-six acute respiratory distress syndrome survivors. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Strength was evaluated with standardized manual muscle testing using the Medical Research Council sum score (range, 0-60; higher is better), with post-ICU weakness defined as sum score less than 48...
January 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28058720/an-observational-study-of-community-acquired-severe-sepsis-comparing-intensive-care-and-non-intensive-care-patients
#10
S T Nygård, S Skrede, N Langeland, H K Flaatten
BACKGROUND: Most studies of sepsis are from intensive care units (ICUs). We aimed to investigate community-acquired severe sepsis in a broader population, in order to compare patients treated in or outside an ICU . METHODS: We performed a 1-year prospective observational study with enrollment of patients from three units; a general ICU, a combined ICU/non-ICU and a medical ward with limited surveillance facilities. Hospital survivors were followed up for 5 years...
January 6, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28058140/predictive-value-of-brain-arrest-neurological-outcome-scale-branos-on-mortality-and-morbidity-after-cardiac-arrest
#11
Cengiz Şahutoğlu, Mehmet Uyar, Kubilay Demirağ, Hasan İsayev, Ali Reşat Moral
OBJECTIVE: There are several prediction scales and parameters for prognosis after a cardiac arrest. One of these scales is the brain arrest neurological outcome scale (BrANOS), which consists of duration of cardiac arrest, Glasgow Coma Scale score and Hounsfield unit measured on cranial computed tomography (CT) scan. The objective of this study is to investigate the effectiveness of BrANOS on predicting the mortality and disability after a cardiac arrest. METHODS: We retrospectively investigated cardiac arrest patients who were hospitalized in our intensive care unit (ICU) within a 3-year period...
December 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28056053/soluble-b-and-t-lymphocyte-attenuator-correlates-to-disease-severity-in-sepsis-and-high-levels-are-associated-with-an-increased-risk-of-mortality
#12
Anna Lange, Jonas Sundén-Cullberg, Anders Magnuson, Olof Hultgren
INTRODUCTION AND AIMS: B- and T-lymphocyte Attenuator (BTLA), Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and Programmed Death 1 (PD-1) are co-inhibitory receptors that regulate T cell activation. In the present study of ICU-treated patients we measured plasma concentrations of their soluble isoforms, with the aim to evaluate their potential as sepsis biomarkers and utility as prognostic indicators. METHODS: 101 patients with sepsis, 28 patients with non-infectious critical illness (ICU controls) and 31 blood donors (healthy controls, HC) were included in the study...
2017: PloS One
https://www.readbyqxmd.com/read/28049363/circulating-chromogranin-b-levels-in-patients-with-acute-respiratory-failure-data-from-the-finnali-study
#13
Peder Langeland Myhre, Mats Stridsberg, Rita Linko, Marjatta Okkonen, Ståle Nygård, Geir Christensen, Ville Pettilä, Torbjørn Omland, Helge Røsjø
PURPOSE: Circulating chromogranin B (CgB) levels are increased in situations characterized by systemic and myocardial stress, but whether CgB provides prognostic information in patients with acute respiratory failure (ARF) is unknown. METHODS: We included 584 patients with ARF, defined as ventilatory support >6 h, and with blood samples available on Intensive Care Unit (ICU) admission and day 3 (n = 479). CgB levels were measured by radioimmunoassay and follow-up was 90 days...
January 3, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/28033033/long-term-outcomes-and-health-care-utilization-following-prolonged-mechanical-ventilation
#14
Andrea D Hill, Robert A Fowler, Karen E A Burns, Louise Rose, Ruxandra L Pinto, Damon C Scales
RATIONALE: Limited data are available to characterize the long-term outcomes and associated costs for patients who require prolonged mechanical ventilation (PMV) (defined here as mechanical ventilation for longer than 21 days). OBJECTIVES: To examine the association between prolonged mechanical ventilation and mortality, health care utilization, and costs after critical illness. METHODS: Population-based cohort study of adults who received mechanical ventilation in an intensive care unit (ICU) in Ontario, Canada between 2002 and 2013...
December 29, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28031096/impact-of-intraoperative-blood-pressure-control-and-temporary-parent-artery-blocking-on-prognosis-in-cerebral-aneurysms-surgery
#15
Min Xu, Zheng-Song Gu, Cun-Zu Wang, Xiao-Feng Lu, Ding-Chao Xiang, Zhi-Cheng Yuan, Qiao-Yu Li, Min Wu
Objective In cerebral aneurysm clipping and embolization, blood pressure control and temporary parent artery blocking are common methods to prevent aneurysm rupture. Their influence on the prognosis is uncertain. In this study, we try to find out the association between methods above and prognostic indicators.Methods We held a retrospective analysis on patients' medical records of cerebral aneurysms surgical clipping and endovascular coiling , and recorded gender, age, diagnosis, Hunt-Hess grade, Glasgow coma scale score, treatment methods, a history of hypertension, preoperative systolic blood pressure, with or without controlled hypotension, systolic blood pressure difference before and after controlled hypotension, with or without temporary artery blocking, with or without hypertension after treated aneurysm, prognostic indicators including mortality after 1 month, intensive care unit (ICU) stay time of survivors, discharged Glasgow outcome scale (GOS) score...
June 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28007503/low-spontaneous-variability-in-cerebral-blood-flow-velocity-in-non-survivors-after-cardiac-arrest
#16
J M D van den Brule, E J Vinke, L M van Loon, J G van der Hoeven, C W E Hoedemaekers
OBJECTIVE: To investigate spontaneous variability in the time and frequency domain in mean flow velocity (MFV) and mean arterial pressure (MAP) in comatose patients after cardiac arrest, and determine possible differences between survivors and non-survivors. METHODS: A prospective observational study was performed at the ICU of a tertiary care university hospital in the Netherlands. We studied 11 comatose patients and 10 controls. MFV in the middle cerebral artery was measured with simultaneously recording of MAP...
December 19, 2016: Resuscitation
https://www.readbyqxmd.com/read/27999481/comparison-of-patients-admission-mean-and-highest-sofa-scores-in-prediction-of-icu-mortality-a-prospective-observational-study
#17
Afshin Gholipour Baradari, Abolfazl Firouzian, Ali Davanlou, Mohsen Aarabi, Maryam Daneshiyan, Yaser Talebiyan Kiakolaye
BACKGROUND: Use of valid criteria for evaluation of patients admitted to intensive care unit (ICU) is essential to assess the quality of services provided. This study was conducted to evaluate admission, mean and the highest Sequential Organ Failure Assessment (SOFA) scores in predicting mortality and outcome of patients admitted to the ICU. METHODS: This prospective observational study was conducted on 300 patients admitted to the ICU of Imam Khomeini Hospital, Sari, Iran, in 2015...
October 2016: Materia Socio-medica
https://www.readbyqxmd.com/read/27987397/prophylactic-versus-clinically-driven-antibiotics-in-comatose-survivors-of-out-of-hospital-cardiac-arrest-a-randomized-pilot-study
#18
Suada Filekovic Ribaric, Matjaz Turel, Rihard Knafelj, Vojka Gorjup, Rade Stanic, Primoz Gradisek, Ognjen Cerovic, Tomislav Mirkovic, Marko Noc
AIM: To investigate benefits of prophylactic antibiotics in comatose survivors of out-of-hospital cardiac arrest (OHCA). METHODS: Patients without evidence of tracheobronchial aspiration on admission bronchoscopy were randomized to prophylactic Amoxicillin-Clavulanic acid 1.2g every 8h (P) or clinically-driven antibiotics (C) administered if signs of infection developed during initial 7days of intensive care unit (ICU) stay. RESULTS: Among 83 patients enrolled between September 2013 and February 2015, tracheobronchial aspiration was documented in 23 (28%)...
February 2017: Resuscitation
https://www.readbyqxmd.com/read/27983872/recovery-of-dysphagia-symptoms-after-oral-endotracheal-intubation-in-ards-survivors-a-5-year-longitudinal-study
#19
Martin B Brodsky, Minxuan Huang, Carl Shanholtz, Pedro A Mendez-Tellez, Jeffrey B Palmer, Elizabeth Colantuoni, Dale M Needham
RATIONALE: Nearly 60% of patients who are intubated in intensive care units (ICUs) experience dysphagia after extubation, and approximately 50% of them aspirate. Little is known about dysphagia recovery time after patients are discharged from the hospital. OBJECTIVE: To determine factors associated with recovery from dysphagia symptoms after hospital discharge for acute respiratory distress syndrome (ARDS) survivors who received oral intubation with mechanical ventilation...
December 16, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27981919/mortality-prediction-in-patients-admitted-in-surgical-intensive-care-unit-by-using-apache-iv
#20
Wetwet Wetw Wetr, Hassan Shoukat, Yar Muhammad, Khalid Masood Gondal, Imran Aslam
OBJECTIVE: To predict the mortality by the mean Acute Physiology and Chronic Health Evaluation (APACHE) IV score of all the patients admitted in a Surgical Intensive Care Unit (ICU) and comparing the score of the survivors and non-survivors. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Surgical Intensive Care Unit, Mayo Hospital, Lahore, from June 2013 to November 2014. METHODOLOGY: All adult patients admitted in the Surgical ICU were included in this study...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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