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ICU survivors

Weiwei Wang, Ting Jiang, Weihong Zhang, Chunyu Li, Jun Chen, Dandan Xiang, Kejiang Cao, Lian-Wen Qi, Ping Li, Wei Zhu, Wensen Chen, Yan Chen
The study was undertaken to describe the profile of patients and the characteristics of all multidrug-resistant gram-negative bacteria (MDR-GNB) and to assess mortality. We examined 138 patients with bloodstream infections (BSIs) caused by MDR-GNB. Clinical characteristics, antibiotic therapy, and in-hospital mortality were analyzed. Survivor and nonsurvivor subgroups were compared to identify predictors of mortality. The in-hospital mortality rate was 25.4%. Univariate analysis revealed that comorbidities and inadequate initial antimicrobial treatment could increase risk of death...
October 17, 2016: American Journal of Infection Control
Carol L Hodgson, Alison E Turnbull, Theodore J Iwashyna, Ann Parker, Wesley Davis, Clifton O Bingham, Nicola R Watts, Simon Finfer, Dale M Needham
BACKGROUND: There is increasing interest in measuring the quality of survivorship for patients admitted to the intensive care (ICU) for acute respiratory failure (ARF). However, there is substantial variability in the patient outcomes reported in studies evaluating these patients, with few data on which outcomes are essential to inform clinical practice. PURPOSE: To determine clinicians' perspectives on the outcome domains that should always be reported in studies evaluating ARF survivors after hospital discharge, and to compare findings between the US and Australian perspectives...
October 6, 2016: Physical Therapy
Savino Spadaro, Maurizia Capuzzo, Giorgia Valpiani, Sara Bertacchini, Riccardo Ragazzi, Francesca Dalla Corte, Simona Terranova, Elisabetta Marangoni, Carlo Alberto Volta
BACKGROUND: Fatigue has not been investigated in long-term Intensive Care Unit (ICU) survivors. This study aimed to assess fatigue through a specific instrument, namely the Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) scale, in ICU survivors one year after hospital discharge. A secondary aim was to compare the findings of FACIT-F with those of the Vitality domain (VT) of the 36-item Short-Form Health Survey (SF-36). METHODS: This prospective cohort study was performed on 56 adult patients with a Length Of Stay (LOS) in ICU longer than 72 h...
October 18, 2016: Health and Quality of Life Outcomes
Elina Varis, Ville Pettilä, Meri Poukkanen, Stephan M Jakob, Sari Karlsson, Anders Perner, Jukka Takala, Erika Wilkman
Hyperlactatemia predicts mortality in patients with sepsis and septic shock, and its normalization is a potential treatment goal. We investigated the association of blood lactate and its changes over time with 90-day mortality in septic shock. We performed a post hoc analysis of 513 septic shock patients with admission blood lactate measurements in the prospective, observational, multicenter FINNAKI study. Repetitive lactate measurements were available in 496 patients for analyses of change in lactate values during ICU stay...
October 17, 2016: Shock
Tellen D Bennett, Rebecca R Dixon, Cory Kartchner, Peter E DeWitt, Yamila Sierra, Diane Ladell, Allison Kempe, Desmond K Runyan, J Michael Dean, Heather T Keenan
OBJECTIVES: In children with traumatic brain injury, 1) to describe the hospital discharge functional outcome and change from baseline function using the Functional Status Scale and 2) to determine any associations between discharge Functional Status Scale and age, injury mechanism, neurologic examination, imaging, and other predictors of outcome. DESIGN: Prospective observational cohort study, May 2013 to November 2015. SETTING: Two U.S. children's hospitals designated as American College of Surgeons level 1 pediatric trauma centers...
October 6, 2016: Pediatric Critical Care Medicine
Angel Paternina-Caicedo, Jezid Miranda, Ghada Bourjeily, Andrew Levinson, Carmelo Dueñas, Camilo Bello Muñoz, José A Rojas-Suarez
BACKGROUND: Every day, about 830 women die worldwide from preventable causes related to pregnancy and childbirth. Obstetric early-warning scores have been proposed as a potential tool to reduce maternal morbidity and mortality, based upon the identification of predetermined abnormal values in the vital signs or laboratory parameters, to generate a rapid and effective medical response. Several early-warning scores have been developed for obstetrical patients, but the majority are the result of a clinical consensus rather than statistical analyses of clinical outcome measures (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
Mohammad Shaban, Nawal Salahuddin, Mohammad Raed Kolko, Moh'd Sharshir, Mohannad AbuRageila, Ahmed AlHussain
INTRODUCTION: Compromised tissue oxygenation leads to anaerobiosis, leading to organ failure and death. This study attempts to demonstrate the predictive abilities of the Pv-aCO2 gap and Pv-aCO2/Ca-vO2 ratio in shock patients undergoing resuscitation. METHODS: In a prospective study, consecutive patients with shock were included. Timed measurements of Pv-aCO2 gap, ScvO2, lactate and Pv-aCO2/ Ca-vO2 ratio were obtained. The association between the mortality and each variable at all intervals were analyzed...
September 29, 2016: Shock
Chun-Chieh Yang, Khee-Siang Chan, Kuei-Ling Tseng, Shih-Feng Weng
Lactic acidosis is common in critical care; by contrast, a subtype called alcohol-associated lactic acidosis (AALA) is rarely encountered. The primary purpose of this study was to determine the prognosis of AALA in critically ill patients and the second aim was to determine whether the survival was associated to the peak blood lactate concentration. An 8-year retrospective analysis of adult patients admitted to the intensive care unit (ICU) with AALA between January 2007 and December 2014 was considered in a tertiary care hospital...
October 17, 2016: Scientific Reports
Sami Ridwan, Horst Urbach, Susanne Greschus, Johanna von Hagen, Jonas Esche, Azize Boström
BACKGROUND: Given the young age of onset and the high probability of long-term disability after SAH, the financial impact is expected to be substantial. Primary objective was to highlight subsequent treatment costs after the acute in-hospital stay including rehabilitation and home care in comparison to ischemic stroke. METHODS: The study included 101 patients with aneurysmal SAH treated July 2007 through April 2009. In-hospital expenses were calculated using the German Diagnose Related Groups DRG...
October 12, 2016: World Neurosurgery
Yik-Kei Chan, Rity Yk Wong, Margaret Ip, Nelson Ls Lee, Joyce Hs You
BACKGROUND: To describe direct medical costs of influenza in hospitalized elderly, with and without intensive care unit (ICU) admission, during the 2014-2015 season in Hong Kong. METHODS: A retrospective study was conducted in 110 inpatients aged ≥65 years with laboratory-confirmed influenza treated by antiviral therapy during season 2014-2015 in a tertiary hospital. Resource utilization of influenza-related diagnostic and laboratory tests, medications for influenza treatment, usage of general medical ward and ICU during the influenza-related length of hospital stay (IR-LOS) were collected...
October 14, 2016: Antiviral Therapy
Suvi T Vaara, Maija Hollmén, Anna-Maija Korhonen, Mikael Maksimow, Tero Ala-Kokko, Marko Salmi, Sirpa Jalkanen, Ville Pettilä
BACKGROUND: CD73 dephosphorylates adenosine monophosphate to adenosine that is an anti-inflammatory molecule inhibiting immune activation and vascular leakage. Therefore, CD73 could be an interesting mediator both in sepsis and acute kidney injury (AKI). We aimed to explore the soluble CD73 (sCD73) levels and their evolution in critically ill patients with severe sepsis and, second, to scrutinize the potential association of sCD73 levels with AKI and 90-day mortality. METHODS: This was a post-hoc laboratory analysis of the prospective, observational FINNAKI study conducted in 17 Finnish ICU during 5 months in 2011-2012...
2016: PloS One
P E Charles, R Noel, F Massin, J Guy, P E Bollaert, J P Quenot, S Gibot
BACKGROUND: Among septic patients admitted to the intensive care unit (ICU), early recognition of those with the highest risk of death is of paramount importance. Since clinical judgment is sometimes uncertain biomarkers could provide additional information likely to guide critical illness management. We evaluated the prognostic value of soluble Triggering Receptor Expressed by Myeloid cells 1 (sTREM-1), procalcitonin (PCT) and leucocyte surface expression of CD64. METHODS: This was a prospective cohort study, which included 190 septic patient admitted to the ICU in two hospitals...
October 12, 2016: BMC Infectious Diseases
Abele Donati, Elisa Damiani, Roberta Domizi, Claudia Scorcella, Andrea Carsetti, Stefania Tondi, Valentina Monaldi, Erica Adrario, Rocco Romano, Paolo Pelaia, Mervyn Singer
BACKGROUND: Impaired microcirculatory perfusion and tissue oxygenation during critical illness are associated with adverse outcome. The aim of this study was to detect alterations in tissue oxygenation or microvascular reactivity and their ability to predict outcome in critically ill patients using thenar near-infrared spectroscopy (NIRS) with a vascular occlusion test (VOT). METHODS: Prospective observational study in critically ill adults admitted to a 12-bed intensive care unit (ICU) of a University Hospital...
October 1, 2016: Critical Care: the Official Journal of the Critical Care Forum
Alicia I Fayad, Daniel G Buamscha, Agustín Ciapponi
BACKGROUND: Acute kidney injury (AKI) is a common condition among patients in intensive care units (ICU), and is associated with substantial morbidity and mortality. Continuous renal replacement therapy (CRRT) is a blood purification technique used to treat the most severe forms of AKI but its effectiveness remains unclear. OBJECTIVES: To assess the effects of different intensities (intensive and less intensive) of CRRT on mortality and recovery of kidney function in critically ill AKI patients...
October 4, 2016: Cochrane Database of Systematic Reviews
Ramona O Hopkins, Dorothy Wade, James C Jackson
No abstract text is available yet for this article.
September 30, 2016: Intensive Care Medicine
Janet F Jensen, Ingrid Egerod, Morten H Bestle, Doris F Christensen, Ask Elklit, Randi L Hansen, Heidi Knudsen, Louise B Grode, Dorthe Overgaard
PURPOSE: The aim of this randomized controlled trial (RCT) was to test the effectiveness of a post-ICU recovery program compared to standard care during the first year after ICU discharge. METHODS: A pragmatic, non-blinded, multicenter, parallel-group RCT was conducted between December 2012 and December 2015, at ten intensive care units (ICUs) in Denmark. We randomly assigned 386 adult patients (≥18 years) after receiving mechanical ventilation (≥48 h) to standard care (SC) plus a nurse-led intensive care recovery program or standard care alone after ICU discharge (190 intervention, 196 SC)...
September 30, 2016: Intensive Care Medicine
Li Weng, Xu Huang, Lie Chen, Li-Qin Feng, Wei Jiang, Xiao-Yun Hu, Jin-Min Peng, Chun-Yao Wang, Qing-Yuan Zhan, Bin Du
BACKGROUND: Pneumocystis jiroveci pneumonia (PJP) in non-HIV patients is still a challenge for intensivists. The aim of our study was to evaluate mortality predictors of PJP patients requiring Intensive care unit (ICU) admission. METHODS: Retrospectively review medical records of patients with diagnosis of PJP admitted to four ICUs of two academic medical centers from October 2012 to October 2015. RESULTS: Eighty-two patients were enrolled in the study...
September 29, 2016: BMC Infectious Diseases
Yasmine Ali Abdelhamid, Palash Kar, Mark E Finnis, Liza K Phillips, Mark P Plummer, Jonathan E Shaw, Michael Horowitz, Adam M Deane
BACKGROUND: Hyperglycaemia occurs frequently in critically ill patients without diabetes. We conducted a systematic review and meta-analysis to evaluate whether this 'stress hyperglycaemia' identifies survivors of critical illness at increased risk of subsequently developing diabetes. METHODS: We searched the MEDLINE and Embase databases from their inception to February 2016. We included observational studies evaluating adults admitted to the intensive care unit (ICU) who developed stress hyperglycaemia if the researchers reported incident diabetes or prediabetes diagnosed ≥3 months after hospital discharge...
September 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
P Depuydt, S Oeyen, S De Smet, S De Raedt, D Benoit, J Decruyenaere, E Derom
BACKGROUND: Long-term outcome and quality of life (QOL) in patients requiring prolonged mechanical ventilation after failure to wean in the ICU is scarcely documented. We aimed to evaluate long-term survival and QOL in patients discharged from the ICU with a tracheostomy for difficult weaning, and with or without ventilator dependency at ICU discharge. METHODS: We retrospectively investigated post-ICU trajectories and survival in patients requiring tracheostomy for difficult weaning admitted to the medical ICU of a tertiary center between 1999 and 2013, discriminating between patients who were ventilator dependent or were weaned at ICU discharge...
September 27, 2016: BMC Pulmonary 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
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