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Critical Care

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10 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27849656/the-use-of-nesiritide-in-children-with-congenital-heart-disease
#1
Ronald A Bronicki, Michele Domico, Paul A Checchia, Curtis E Kennedy, Ayse Akcan-Arikan
OBJECTIVE: We evaluated the use of nesiritide in children with critical congenital heart disease, pulmonary congestion, and inadequate urine output despite conventional diuretic therapy. DESIGN: We conducted a retrospective analysis of 26 consecutive patients, comprising 37 infusions occurring during separate hospitalizations. Hemodynamic variables, urine output, and serum creatinine levels were monitored prior to and throughout the duration of therapy with nesiritide...
November 15, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27760796/the-association-between-duration-of-resuscitation-and-favorable-outcome-after-out-of-hospital-cardiac-arrest-implications-for-prolonging-or-terminating-resuscitation
#2
Joshua C Reynolds, Brian E Grunau, Jon C Rittenberger, Kelly N Sawyer, Michael C Kurz, Clifton W Callaway
BACKGROUND: -Little evidence guides the appropriate duration of resuscitation in out-of-hospital cardiac arrest (OHCA), and case features justifying longer or shorter durations are ill-defined. We estimated the impact of resuscitation duration on the probability of favorable functional outcome in OHCA using a large, multi-center cohort. METHODS: -Secondary analysis of a North American, single blind, multi-center, cluster-randomized clinical trial (ROC-PRIMED) of consecutive adults with non-traumatic, EMS-treated, OHCA...
October 19, 2016: Circulation
https://www.readbyqxmd.com/read/27276234/intensive-blood-pressure-lowering-in-patients-with-acute-cerebral-hemorrhage
#3
RANDOMIZED CONTROLLED TRIAL
Adnan I Qureshi, Yuko Y Palesch, William G Barsan, Daniel F Hanley, Chung Y Hsu, Renee L Martin, Claudia S Moy, Robert Silbergleit, Thorsten Steiner, Jose I Suarez, Kazunori Toyoda, Yongjun Wang, Haruko Yamamoto, Byung-Woo Yoon
Background Limited data are available to guide the choice of a target for the systolic blood-pressure level when treating acute hypertensive response in patients with intracerebral hemorrhage. Methods We randomly assigned eligible participants with intracerebral hemorrhage (volume, <60 cm(3)) and a Glasgow Coma Scale (GCS) score of 5 or more (on a scale from 3 to 15, with lower scores indicating worse condition) to a systolic blood-pressure target of 110 to 139 mm Hg (intensive treatment) or a target of 140 to 179 mm Hg (standard treatment) in order to test the superiority of intensive reduction of systolic blood pressure to standard reduction; intravenous nicardipine to lower blood pressure was administered within 4...
September 15, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27043165/amiodarone-lidocaine-or-placebo-in-out-of-hospital-cardiac-arrest
#4
RANDOMIZED CONTROLLED TRIAL
Peter J Kudenchuk, Siobhan P Brown, Mohamud Daya, Thomas Rea, Graham Nichol, Laurie J Morrison, Brian Leroux, Christian Vaillancourt, Lynn Wittwer, Clifton W Callaway, James Christenson, Debra Egan, Joseph P Ornato, Myron L Weisfeldt, Ian G Stiell, Ahamed H Idris, Tom P Aufderheide, James V Dunford, M Riccardo Colella, Gary M Vilke, Ashley M Brienza, Patrice Desvigne-Nickens, Pamela C Gray, Randal Gray, Norman Seals, Ron Straight, Paul Dorian
BACKGROUND: Antiarrhythmic drugs are used commonly in out-of-hospital cardiac arrest for shock-refractory ventricular fibrillation or pulseless ventricular tachycardia, but without proven survival benefit. METHODS: In this randomized, double-blind trial, we compared parenteral amiodarone, lidocaine, and saline placebo, along with standard care, in adults who had nontraumatic out-of-hospital cardiac arrest, shock-refractory ventricular fibrillation or pulseless ventricular tachycardia after at least one shock, and vascular access...
May 5, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26969237/guidelines-for-urgent-management-of-stroke-in-children
#5
REVIEW
Michael J Rivkin, Timothy J Bernard, Michael M Dowling, Catherine Amlie-Lefond
Stroke in children carries lasting morbidity. Once recognized, it is important to evaluate and treat children with acute stroke efficiently and accurately. All children should receive neuroprotective measures. It is reasonable to consider treatment with advanced thrombolytic and endovascular agents. Delivery of such care requires purposeful institutional planning and organization in pediatric acute care centers. Primary stroke centers established for adults provide an example of the multidisciplinary approach that can be applied to the evaluation and treatment of children who present with acute stroke...
March 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/26975590/early-versus-late-parenteral-nutrition-in-critically-ill-children
#6
RANDOMIZED CONTROLLED TRIAL
Tom Fivez, Dorian Kerklaan, Dieter Mesotten, Sascha Verbruggen, Pieter J Wouters, Ilse Vanhorebeek, Yves Debaveye, Dirk Vlasselaers, Lars Desmet, Michael P Casaer, Gonzalo Garcia Guerra, Jan Hanot, Ari Joffe, Dick Tibboel, Koen Joosten, Greet Van den Berghe
BACKGROUND: Recent trials have questioned the benefit of early parenteral nutrition in adults. The effect of early parenteral nutrition on clinical outcomes in critically ill children is unclear. METHODS: We conducted a multicenter, randomized, controlled trial involving 1440 critically ill children to investigate whether withholding parenteral nutrition for 1 week (i.e., providing late parenteral nutrition) in the pediatric intensive care unit (ICU) is clinically superior to providing early parenteral nutrition...
March 24, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26945333/pediatric-cardiac-intensive-care-society-2014-consensus-statement-pharmacotherapies-in-cardiac-critical-care-pulmonary-hypertension
#7
John S Kim, Julia McSweeney, Joanne Lee, Dunbar Ivy
OBJECTIVE: To review the pharmacologic treatment options for pulmonary arterial hypertension in the cardiac intensive care setting and summarize the most-recent literature supporting these therapies. DATA SOURCES AND STUDY SELECTION: Literature search for prospective studies, retrospective analyses, and case reports evaluating the safety and efficacy of pulmonary arterial hypertension therapies. DATA EXTRACTION: Mechanisms of action and pharmacokinetics, treatment recommendations, safety considerations, and outcomes for specific medical therapies...
March 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/26920493/duration-of-prehospital-resuscitation-efforts-after-out-of-hospital-cardiac-arrest
#8
Ken Nagao, Hiroshi Nonogi, Naohiro Yonemoto, David F Gaieski, Noritoshi Ito, Morimasa Takayama, Shinichi Shirai, Singo Furuya, Sigemasa Tani, Takeshi Kimura, Keijiro Saku
BACKGROUND: During out-of-hospital cardiac arrest, it is unclear how long prehospital resuscitation efforts should be continued to maximize lives saved. METHODS AND RESULTS: Between 2005 and 2012, we enrolled 282 183 adult patients with bystander-witnessed out-of-hospital cardiac arrest from the All-Japan Utstein Registry. Prehospital resuscitation duration was calculated as the time interval from call receipt to return of spontaneous circulation in cases achieving prehospital return of spontaneous circulation or from call receipt to hospital arrival in cases not achieving prehospital return of spontaneous circulation...
April 5, 2016: Circulation
https://www.readbyqxmd.com/read/26612740/outcomes-of-dexmedetomidine-treatment-in-pediatric-patients-undergoing-congenital-heart-disease-surgery-a-meta-analysis
#9
REVIEW
Wanying Pan, Yueting Wang, Lin Lin, Ge Zhou, Xiaoxiao Hua, Liqiu Mo
BACKGROUND: Dexmedetomidine decreases cardiac complications in adults undergoing cardiovascular surgery. This systematic review assessed whether perioperative dexmedetomidine improves congenital heart disease (CHD) surgery outcomes in children. METHODS: The PubMed, Embase, and Cochrane Library databases were searched for randomized controlled trials (RCTs) or observational studies that were published until 16 April 2015 and compared dexmedetomidine with placebo or an alternative anesthetic agent during pediatric CHD surgery...
March 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/24108526/effect-of-heart-rate-control-with-esmolol-on-hemodynamic-and-clinical-outcomes-in-patients-with-septic-shock-a-randomized-clinical-trial
#10
RANDOMIZED CONTROLLED TRIAL
Andrea Morelli, Christian Ertmer, Martin Westphal, Sebastian Rehberg, Tim Kampmeier, Sandra Ligges, Alessandra Orecchioni, Annalia D'Egidio, Fiorella D'Ippoliti, Cristina Raffone, Mario Venditti, Fabio Guarracino, Massimo Girardis, Luigi Tritapepe, Paolo Pietropaoli, Alexander Mebazaa, Mervyn Singer
IMPORTANCE: β-Blocker therapy may control heart rate and attenuate the deleterious effects of β-adrenergic receptor stimulation in septic shock. However, β-Blockers are not traditionally used for this condition and may worsen cardiovascular decompensation related through negative inotropic and hypotensive effects. OBJECTIVE: To investigate the effect of the short-acting β-blocker esmolol in patients with severe septic shock. DESIGN, SETTING, AND PATIENTS: Open-label, randomized phase 2 study, conducted in a university hospital intensive care unit (ICU) between November 2010 and July 2012, involving patients in septic shock with a heart rate of 95/min or higher requiring high-dose norepinephrine to maintain a mean arterial pressure of 65 mm Hg or higher...
October 23, 2013: JAMA: the Journal of the American Medical Association
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