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https://www.readbyqxmd.com/read/29208005/recovery-after-critical-illness-putting-the-puzzle-together-a-consensus-of-29
#1
REVIEW
Elie Azoulay, Jean-Louis Vincent, Derek C Angus, Yaseen M Arabi, Laurent Brochard, Stephen J Brett, Giuseppe Citerio, Deborah J Cook, Jared Randall Curtis, Claudia C Dos Santos, E Wesley Ely, Jesse Hall, Scott D Halpern, Nicholas Hart, Ramona O Hopkins, Theodore J Iwashyna, Samir Jaber, Nicola Latronico, Sangeeta Mehta, Dale M Needham, Judith Nelson, Kathleen Puntillo, Michael Quintel, Kathy Rowan, Gordon Rubenfeld, Greet Van den Berghe, Johannes Van der Hoeven, Hannah Wunsch, Margaret Herridge
In this review, we seek to highlight how critical illness and critical care affect longer-term outcomes, to underline the contribution of ICU delirium to cognitive dysfunction several months after ICU discharge, to give new insights into ICU acquired weakness, to emphasize the importance of value-based healthcare, and to delineate the elements of family-centered care. This consensus of 29 also provides a perspective and a research agenda about post-ICU recovery.
December 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29228951/hypovitaminosis-c-and-vitamin-c-deficiency-in-critically-ill-patients-despite-recommended-enteral-and-parenteral-intakes
#2
Anitra C Carr, Patrice C Rosengrave, Simone Bayer, Steve Chambers, Jan Mehrtens, Geoff M Shaw
BACKGROUND: Vitamin C is an essential water-soluble nutrient which cannot be synthesised or stored by humans. It is a potent antioxidant with anti-inflammatory and immune-supportive roles. Previous research has indicated that vitamin C levels are depleted in critically ill patients. In this study we have assessed plasma vitamin C concentrations in critically ill patients relative to infection status (septic shock or non-septic) and level of inflammation (C-reactive protein concentrations)...
December 11, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29262831/antimicrobials-for-the-treatment-of-drug-resistant-acinetobacter-baumannii-pneumonia-in-critically-ill-patients-a-systemic-review-and-bayesian-network-meta-analysis
#3
Su Young Jung, Seung Hee Lee, Soo Young Lee, Seungwon Yang, Hayeon Noh, Eun Kyoung Chung, Jangik I Lee
BACKGROUND: An optimal therapy for the treatment of pneumonia caused by drug-resistant Acinetobacter baumannii remains unclear. This study aims to compare various antimicrobial strategies and to determine the most effective therapy for pneumonia using a network meta-analysis. METHODS: Systematic search and quality assessment were performed to select eligible studies reporting one of the following outcomes: all-cause mortality, clinical cure, and microbiological eradication...
December 20, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29284503/bronchoscopy-versus-an-endotracheal-tube-mounted-camera-for-the-peri-interventional-visualization-of-percutaneous-dilatational-tracheostomy-a-prospective-randomized-trial-vivapdt
#4
Jörn Grensemann, Lars Eichler, Sophie Kähler, Dominik Jarczak, Marcel Simon, Hans O Pinnschmidt, Stefan Kluge
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) in critically ill patients often involves bronchoscopic optical guidance. However, this procedure is not without disadvantages. Therefore, we aimed to study a recently introduced endotracheal tube-mounted camera (VivaSightTM-SL tube [VST]; ETView, Misgav, Israel) for guiding PDT. METHODS: This was a randomized controlled trial involving 46 critically ill patients who received PDT using optical guidance with a VST or with bronchoscopy...
December 29, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29297397/time-sensitive-therapeutics
#5
REVIEW
John J Marini
Much of what we now do in Critical Care carries an air of urgency, a pressing need to discover and act, with priorities biased toward a reactive response. However, efficacy often depends not simply upon what we do, but rather on whether, when, and how persistently we intervene. The practice of medicine is based upon diagnosis, integration of multiple sources of information, keen judgment, and appropriate intervention. Timing may not be everything, as the well-known adage suggests, but in the intensive care unit (ICU) timing issues clearly deserve more attention than they are currently given...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29297399/the-coming-era-of-precision-medicine-for-intensive-care
#6
REVIEW
Jean-Louis Vincent
Recent advances in technology and better understanding of mechanisms underlying disease are beginning to enable us to better characterize critically ill patients. Instead of using nonspecific syndromic groupings, such as sepsis or acute respiratory distress syndrome, we can now classify individual patients according to various specific characteristics, such as immune status. This "personalized" medicine approach will enable us to distinguish patients who have similar clinical presentations but different cellular and molecular responses that will influence their need for and responses (both negative and positive) to specific treatments...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29297400/seven-unconfirmed-ideas-to-improve-future-icu-practice
#7
REVIEW
John J Marini, Daniel De Backer, Can Ince, Mervyn Singer, Frank Van Haren, Martin Westphal, Paul Wischmeyer
With imprecise definitions, inexact measurement tools, and flawed study execution, our clinical science often lags behind bedside experience and simply documents what appear to be the apparent faults or validity of ongoing practices. These impressions are later confirmed, modified, or overturned by the results of the next trial. On the other hand, insights that stem from the intuitions of experienced clinicians, scientists and educators-while often neglected-help place current thinking into proper perspective and occasionally point the way toward formulating novel hypotheses that direct future research...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29095723/antiviral-treatment-of-severe-non-influenza-respiratory-virus-infection
#8
Nathan J Brendish, Tristan W Clark
PURPOSE OF REVIEW: Non-influenza respiratory virus infections are a frequent cause of severe acute respiratory infections, especially in infants, the elderly, and the immunocompromised. We review here the current treatment options for non-influenza respiratory viruses and promising candidate antiviral agents currently in development. RECENT FINDINGS: Small molecule antiviral agents active against respiratory syncytial virus (RSV), such as ALS-8176 and GS-5806, show considerable promise in challenge studies and are undergoing late-phase clinical trials in hospitalised adults and children...
December 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29206655/pathophysiology-clinical-presentation-and-treatment-of-coma-and-acute-kidney-injury-complicating-falciparum-malaria
#9
Katherine Plewes, Gareth D H Turner, Arjen M Dondorp
PURPOSE OF REVIEW: Cerebral impairment and acute kidney injury (AKI) are independent predictors of mortality in both adults and children with severe falciparum malaria. In this review, we present recent advances in understanding the pathophysiology, clinical features, and management of these complications of severe malaria, and discuss future areas of research. RECENT FINDINGS: Cerebral malaria and AKI are serious and well recognized complications of severe malaria...
February 2018: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28984705/the-crashing-patient-hemodynamic-collapse
#10
Hitesh Gidwani, Hernando Gómez
PURPOSE OF REVIEW: Rapid restoration of tissue perfusion and oxygenation are the main goals in the resuscitation of a patient with circulatory collapse. This review will focus on providing an evidence based framework of the technological and conceptual advances in the evaluation and management of the patient with cardiovascular collapse. RECENT FINDINGS: The initial approach to the patient in cardiovascular collapse continues to be based on the Ventilate-Infuse-Pump rule...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29016366/acute-life-threatening-hypoxemia-during-mechanical-ventilation
#11
Thomas Piraino, Eddy Fan
PURPOSE OF REVIEW: To describe current evidence-based practice in the management of acute life-threatening hypoxemia in mechanically ventilated patients and some of the methods used to individualize the care of the patient. RECENT FINDINGS: Patients with acute life-threatening hypoxemia will often meet criteria for severe ARDS, for which there are only a few treatment strategies that have been shown to improve survival outcomes. Recent findings have increased our knowledge of the physiological effects of spontaneous breathing and the application of PEEP...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29127502/piperacillin-tazobactam-as-alternative-to-carbapenems-for-icu-patients
#12
REVIEW
Benoit Pilmis, Vincent Jullien, Alexis Tabah, Jean-Ralph Zahar, Christian Brun-Buisson
Several studies suggest that alternatives to carbapenems, and particulary beta-lactam/beta-lactamase inhibitor combinations, can be used for therapy of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE)-related infections in non-ICU patients. Little is known concerning ICU patients in whom achieving the desired plasmatic pharmacokinetic/pharmacodynamic (PK/PD) target may be difficult. Also, in vitro susceptibility to beta-lactamase inhibitors might not translate into clinical efficacy. We reviewed the recent clinical studies examining the use of BL/BLI as alternatives to carbapenems for therapy of bloodstream infection, PK/PD data and discuss potential ecological benefit from avoiding the use of carbapenems...
November 10, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29073778/bronchial-artery-embolization-first-line-option-for-managing-massive-hemoptysis
#13
Yutaka Miyano, Masato Kanzaki, Takamasa Onuki
Background Today, treatment for hemoptysis is not limited to surgery, and among the various options, bronchial artery embolization is regarded as an effective approach. Methods In this retrospective study, 179 of 389 patients with massive hemoptysis were treated with bronchial artery embolization, without taking into account the underlying pathological lesions responsible (bronchiectasis in 41, aspergilloma in 29, lung cancer in 25, old tuberculosis in 23, pyothorax in 19, others in 23). Results Bronchial artery embolization failed in 12 cases...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28781176/electrical-neuromodulation-of-the-respiratory-system-after-spinal-cord-injury
#14
REVIEW
Jan T Hachmann, Peter J Grahn, Jonathan S Calvert, Dina I Drubach, Kendall H Lee, Igor A Lavrov
Spinal cord injury (SCI) is a complex and devastating condition characterized by disruption of descending, ascending, and intrinsic spinal circuitry resulting in chronic neurologic deficits. In addition to limb and trunk sensorimotor deficits, SCI can impair autonomic neurocircuitry such as the motor networks that support respiration and cough. High cervical SCI can cause complete respiratory paralysis, and even lower cervical or thoracic lesions commonly result in partial respiratory impairment. Although electrophrenic respiration can restore ventilator-independent breathing in select candidates, only a small subset of affected individuals can benefit from this technology at this moment...
September 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28870357/neurostimulation-devices-for-the-treatment-of-neurologic-disorders
#15
REVIEW
Christine A Edwards, Abbas Kouzani, Kendall H Lee, Erika K Ross
Rapid advancements in neurostimulation technologies are providing relief to an unprecedented number of patients affected by debilitating neurologic and psychiatric disorders. Neurostimulation therapies include invasive and noninvasive approaches that involve the application of electrical stimulation to drive neural function within a circuit. This review focuses on established invasive electrical stimulation systems used clinically to induce therapeutic neuromodulation of dysfunctional neural circuitry. These implantable neurostimulation systems target specific deep subcortical, cortical, spinal, cranial, and peripheral nerve structures to modulate neuronal activity, providing therapeutic effects for a myriad of neuropsychiatric disorders...
September 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28901793/intravenous-fosfomycin-for-the-treatment-of-hospitalized-patients-with-serious-infections
#16
Andrew F Shorr, Jason M Pogue, John F Mohr
With the worldwide increase in the rates of antimicrobial resistance, antimicrobials with novel mechanisms of action are needed to fill a void in the antimicrobial armamentarium. Areas covered: Intravenous fosfomycin has been studied extensively in a wide variety of infections including cUTI, lower respiratory tract infection, bone and joint infections, endocarditis, meningitis, and bacteremia outside of the United States. This paper reviews the in vitro activity, pharmacokinetic properties, and clinical experience of intravenous fosfomycin in hospitalized patients with serious infections...
October 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28922285/what-where-and-why-exploring-fluorodeoxyglucose-pet-s-ability-to-localise-and-differentiate-infection-from-cancer
#17
Abby Douglas, Eddie Lau, Karin Thursky, Monica Slavin
PURPOSE OF REVIEW: To review the utility of FDG-PET imaging in detecting the cause of fever and infection in patients with cancer. RECENT FINDINGS: FDG-PET has been shown to have high sensitivity and accuracy for causes of neutropenic fever, leading to higher diagnostic certainty in this group. Recent advances in pathogen-specific labelling in PET to identify Aspergillus spp. and Yersinia spp. infections in mice, as well as differentiating between Gram-positive, Gram-negative and mycobacterial infections are promising...
December 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28922286/nocardia-infections-in-solid-organ-and-hematopoietic-stem-cell-transplant-recipients
#18
Julien Coussement, David Lebeaux, Claire Rouzaud, Olivier Lortholary
PURPOSE OF REVIEW: Nocardia spp. is a gram-positive bacteria that may cause infections in humans. Nocardiosis has been described since the early years of transplantation. This review aims to provide an overview of present knowledge regarding posttransplant nocardiosis, with a focus on recent findings. RECENT FINDINGS: Nocardiosis is not rare among transplant recipients, especially after thoracic transplantation and/or in case of intense immunosuppressive regimen or use of tacrolimus...
December 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28938246/the-evolving-landscape-of-new-diagnostic-tests-for-invasive-aspergillosis-in-hematology-patients-strengths-and-weaknesses
#19
Dieter Buchheidt, Mark Reinwald, Martin Hoenigl, Wolf-Karsten Hofmann, Birgit Spiess, Tobias Boch
PURPOSE OF REVIEW: The diagnosis of invasive aspergillosis in hematologic patients is a complex composite of clinical preconditions and features, imaging findings, biomarker combinations from appropriate clinical samples and microbiological and/or histological findings. RECENT FINDINGS: Recent developments in the evolving landscape of diagnostic tests for invasive aspergillosis in adult hematology patients are highlighted. SUMMARY: Novel approaches and tools are currently under development...
December 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28938251/critical-illness-related-corticosteroid-insufficiency-circi-a-narrative-review-from-a-multispecialty-task-force-of-the-society-of-critical-care-medicine-sccm-and-the-european-society-of-intensive-care-medicine-esicm
#20
Djillali Annane, Stephen M Pastores, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Bram Rochwerg, Sophia C Rodgers, James A Russell, Greet Van den Berghe
OBJECTIVE: To provide a narrative review of the latest concepts and understanding of the pathophysiology of critical illness-related corticosteroid insufficiency (CIRCI). PARTICIPANTS: A multi-specialty task force of international experts in critical care medicine and endocrinology and members of the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. DATA SOURCES: Medline, Database of Abstracts of Reviews of Effects (DARE), Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews...
December 2017: Critical Care Medicine
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