collection
https://read.qxmd.com/read/25853331/ischemic-brain-injury-in-hemodialysis-patients-which-is-more-dangerous-hypertension-or-intradialytic-hypotension
#21
REVIEW
Christopher W McIntyre, David J Goldsmith
Abnormalities of cognitive function and high levels of depression incidence are characteristic of hemodialysis patients. Although previously attributed to the humoral effects of uremia, it is becoming increasingly appreciated that many elements of the overall disease state in CKD patients contribute to functional disturbances and physical brain injury. These factors range from those associated with the underlying primary diseases (cardiovascular, diabetes etc.) to those specifically associated with the requirement for dialysis (including consequences of the hemodialysis process itself)...
June 2015: Kidney International
https://read.qxmd.com/read/25270275/lower-versus-higher-hemoglobin-threshold-for-transfusion-in-septic-shock
#22
RANDOMIZED CONTROLLED TRIAL
Lars B Holst, Nicolai Haase, Jørn Wetterslev, Jan Wernerman, Anne B Guttormsen, Sari Karlsson, Pär I Johansson, Anders Aneman, Marianne L Vang, Robert Winding, Lars Nebrich, Helle L Nibro, Bodil S Rasmussen, Johnny R M Lauridsen, Jane S Nielsen, Anders Oldner, Ville Pettilä, Maria B Cronhjort, Lasse H Andersen, Ulf G Pedersen, Nanna Reiter, Jørgen Wiis, Jonathan O White, Lene Russell, Klaus J Thornberg, Peter B Hjortrup, Rasmus G Müller, Morten H Møller, Morten Steensen, Inga Tjäder, Kristina Kilsand, Suzanne Odeberg-Wernerman, Brit Sjøbø, Helle Bundgaard, Maria A Thyø, David Lodahl, Rikke Mærkedahl, Carsten Albeck, Dorte Illum, Mary Kruse, Per Winkel, Anders Perner
BACKGROUND: Blood transfusions are frequently given to patients with septic shock. However, the benefits and harms of different hemoglobin thresholds for transfusion have not been established. METHODS: In this multicenter, parallel-group trial, we randomly assigned patients in the intensive care unit (ICU) who had septic shock and a hemoglobin concentration of 9 g per deciliter or less to receive 1 unit of leukoreduced red cells when the hemoglobin level was 7 g per deciliter or less (lower threshold) or when the level was 9 g per deciliter or less (higher threshold) during the ICU stay...
October 9, 2014: New England Journal of Medicine
https://read.qxmd.com/read/25096691/high-protein-enteral-nutrition-enriched-with-immune-modulating-nutrients-vs-standard-high-protein-enteral-nutrition-and-nosocomial-infections-in-the-icu-a-randomized-clinical-trial
#23
RANDOMIZED CONTROLLED TRIAL
Arthur R H van Zanten, François Sztark, Udo X Kaisers, Siegfried Zielmann, Thomas W Felbinger, Armin R Sablotzki, Jan J De Waele, Jean-François Timsit, Marina L H Honing, Didier Keh, Jean-Louis Vincent, Jean-Fabien Zazzo, Harvey B M Fijn, Laurent Petit, Jean-Charles Preiser, Peter J van Horssen, Zandrie Hofman
IMPORTANCE: Enteral administration of immune-modulating nutrients (eg, glutamine, omega-3 fatty acids, selenium, and antioxidants) has been suggested to reduce infections and improve recovery from critical illness. However, controversy exists on the use of immune-modulating enteral nutrition, reflected by lack of consensus in guidelines. OBJECTIVE: To determine whether high-protein enteral nutrition enriched with immune-modulating nutrients (IMHP) reduces the incidence of infections compared with standard high-protein enteral nutrition (HP) in mechanically ventilated critically ill patients...
August 6, 2014: JAMA
https://read.qxmd.com/read/25639554/classification-of-cardiopulmonary-resuscitation-chest-compression-patterns-manual-versus-automated-approaches
#24
MULTICENTER STUDY
Henry E Wang, Robert H Schmicker, Heather Herren, Siobhan Brown, John P Donnelly, Randal Gray, Sally Ragsdale, Andrew Gleeson, Adam Byers, Jamie Jasti, Christina Aguirre, Pam Owens, Joe Condle, Brian Leroux
OBJECTIVES: New chest compression detection technology allows for the recording and graphical depiction of clinical cardiopulmonary resuscitation (CPR) chest compressions. The authors sought to determine the inter-rater reliability of chest compression pattern classifications by human raters. Agreement with automated chest compression classification was also evaluated by computer analysis. METHODS: This was an analysis of chest compression patterns from cardiac arrest patients enrolled in the ongoing Resuscitation Outcomes Consortium (ROC) Continuous Chest Compressions Trial...
February 2015: Academic Emergency Medicine
https://read.qxmd.com/read/25369558/the-preventability-of-ventilator-associated-events-the-cdc-prevention-epicenters-wake-up-and-breathe-collaborative
#25
MULTICENTER STUDY
Michael Klompas, Deverick Anderson, William Trick, Hilary Babcock, Meeta Prasad Kerlin, Lingling Li, Ronda Sinkowitz-Cochran, E Wesley Ely, John Jernigan, Shelley Magill, Rosie Lyles, Caroline O'Neil, Barrett T Kitch, Ellen Arrington, Michele C Balas, Ken Kleinman, Christina Bruce, Julie Lankiewicz, Michael V Murphy, Christopher E Cox, Ebbing Lautenbach, Daniel Sexton, Victoria Fraser, Robert A Weinstein, Richard Platt
RATIONALE: The CDC introduced ventilator-associated event (VAE) definitions in January 2013. Little is known about VAE prevention. We hypothesized that daily, coordinated spontaneous awakening trials (SATs) and spontaneous breathing trials (SBTs) might prevent VAEs. OBJECTIVES: To assess the preventability of VAEs. METHODS: We nested a multicenter quality improvement collaborative within a prospective study of VAE surveillance among 20 intensive care units between November 2011 and May 2013...
February 1, 2015: American Journal of Respiratory and Critical Care Medicine
https://read.qxmd.com/read/25486574/neurally-adjusted-ventilatory-assist
#26
REVIEW
Paolo Navalesi, Federico Longhini
PURPOSE OF REVIEW: Compared with the conventional forms of partial support, neurally adjusted ventilatory assist was repeatedly shown to improve patient-ventilator synchrony and reduce the risk of overassistance, while guaranteeing adequate inspiratory effort and gas exchange. A few animal studies also suggested the potential of neurally adjusted ventilatory assist in averting the risk of ventilator-induced lung injury. Recent work adds new information on the physiological effects of neurally adjusted ventilatory assist...
February 2015: Current Opinion in Critical Care
https://read.qxmd.com/read/20843245/neuromuscular-blockers-in-early-acute-respiratory-distress-syndrome
#27
RANDOMIZED CONTROLLED TRIAL
Laurent Papazian, Jean-Marie Forel, Arnaud Gacouin, Christine Penot-Ragon, Gilles Perrin, Anderson Loundou, Samir Jaber, Jean-Michel Arnal, Didier Perez, Jean-Marie Seghboyan, Jean-Michel Constantin, Pierre Courant, Jean-Yves Lefrant, Claude Guérin, Gwenaël Prat, Sophie Morange, Antoine Roch
BACKGROUND: In patients undergoing mechanical ventilation for the acute respiratory distress syndrome (ARDS), neuromuscular blocking agents may improve oxygenation and decrease ventilator-induced lung injury but may also cause muscle weakness. We evaluated clinical outcomes after 2 days of therapy with neuromuscular blocking agents in patients with early, severe ARDS. METHODS: In this multicenter, double-blind trial, 340 patients presenting to the intensive care unit (ICU) with an onset of severe ARDS within the previous 48 hours were randomly assigned to receive, for 48 hours, either cisatracurium besylate (178 patients) or placebo (162 patients)...
September 16, 2010: New England Journal of Medicine
https://read.qxmd.com/read/21714640/early-versus-late-parenteral-nutrition-in-critically-ill-adults
#28
RANDOMIZED CONTROLLED TRIAL
Michael P Casaer, Dieter Mesotten, Greet Hermans, Pieter J Wouters, Miet Schetz, Geert Meyfroidt, Sophie Van Cromphaut, Catherine Ingels, Philippe Meersseman, Jan Muller, Dirk Vlasselaers, Yves Debaveye, Lars Desmet, Jasperina Dubois, Aime Van Assche, Simon Vanderheyden, Alexander Wilmer, Greet Van den Berghe
BACKGROUND: Controversy exists about the timing of the initiation of parenteral nutrition in critically ill adults in whom caloric targets cannot be met by enteral nutrition alone. METHODS: In this randomized, multicenter trial, we compared early initiation of parenteral nutrition (European guidelines) with late initiation (American and Canadian guidelines) in adults in the intensive care unit (ICU) to supplement insufficient enteral nutrition. In 2312 patients, parenteral nutrition was initiated within 48 hours after ICU admission (early-initiation group), whereas in 2328 patients, parenteral nutrition was not initiated before day 8 (late-initiation group)...
August 11, 2011: New England Journal of Medicine
https://read.qxmd.com/read/18492867/intensity-of-renal-support-in-critically-ill-patients-with-acute-kidney-injury
#29
RANDOMIZED CONTROLLED TRIAL
Paul M Palevsky, Jane Hongyuan Zhang, Theresa Z O'Connor, Glenn M Chertow, Susan T Crowley, Devasmita Choudhury, Kevin Finkel, John A Kellum, Emil Paganini, Roland M H Schein, Mark W Smith, Kathleen M Swanson, B Taylor Thompson, Anitha Vijayan, Suzanne Watnick, Robert A Star, Peter Peduzzi
BACKGROUND: The optimal intensity of renal-replacement therapy in critically ill patients with acute kidney injury is controversial. METHODS: We randomly assigned critically ill patients with acute kidney injury and failure of at least one nonrenal organ or sepsis to receive intensive or less intensive renal-replacement therapy. The primary end point was death from any cause by day 60. In both study groups, hemodynamically stable patients underwent intermittent hemodialysis, and hemodynamically unstable patients underwent continuous venovenous hemodiafiltration or sustained low-efficiency dialysis...
July 3, 2008: New England Journal of Medicine
https://read.qxmd.com/read/25251757/a-qualitative-investigation-of-patients-and-caregivers-experiences-of-severe-sepsis
#30
JOURNAL ARTICLE
Katy H Gallop, Cicely E P Kerr, Annabel Nixon, Lara Verdian, Joseph B Barney, Richard J Beale
OBJECTIVES: To explore and describe the subjective experiences and long-term impact of severe sepsis on survivors of severe sepsis and their informal caregivers (e.g., spouse or family member) through qualitative research methods. DESIGN: A qualitative exploratory study using semi-structured interviews with survivors of severe sepsis and their informal caregivers in the United Kingdom and United States. Participants also completed a demographic background form and sites provided medical history details...
February 2015: Critical Care Medicine
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