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JB General Surgical ICU

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K G Kreymann, M M Berger, N E P Deutz, M Hiesmayr, P Jolliet, G Kazandjiev, G Nitenberg, G van den Berghe, J Wernerman, C Ebner, W Hartl, C Heymann, C Spies
Enteral nutrition (EN) via tube feeding is, today, the preferred way of feeding the critically ill patient and an important means of counteracting for the catabolic state induced by severe diseases. These guidelines are intended to give evidence-based recommendations for the use of EN in patients who have a complicated course during their ICU stay, focusing particularly on those who develop a severe inflammatory response, i.e. patients who have failure of at least one organ during their ICU stay. These guidelines were developed by an interdisciplinary expert group in accordance with officially accepted standards and are based on all relevant publications since 1985...
April 2006: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Marinos Pericleous, Alexander Sarnowski, Alice Moore, Rik Fijten, Murtaza Zaman
Several pathogenic processes have been implicated in the development of abdominal ascites. Portal hypertension, most usually in the context of liver cirrhosis, can explain about 75% of the cases, whereas infective, inflammatory and infiltrative aetiologies can account for the rest. In this article, we discuss the consensus best practice as published by three professional bodies for the management of ascites, spontaneous bacterial peritonitis (SBP) and hepatorenal syndrome (HRS). The aim of this study was to compare available clinical guidelines and identify areas of agreement and conflict...
March 2016: European Journal of Gastroenterology & Hepatology
Eric L Scholten, Jeremy R Beitler, G Kim Prisk, Atul Malhotra
Prone positioning was first proposed in the 1970s as a method to improve gas exchange in the acute respiratory distress syndrome (ARDS). Subsequent observations of dramatic improvement in oxygenation with simple patient rotation motivated the next several decades of research. This work elucidated the physiology mechanisms underlying changes in gas exchange and respiratory mechanics with prone ventilation. However, translating physiological improvements into a clinical benefit has proven challenging; several contemporary trials showed no major clinical benefits with proning...
July 8, 2016: Chest
Andre Coetzee, Pieter Fourie
No abstract text is available yet for this article.
December 2015: Journal of Cardiothoracic and Vascular Anesthesia
Daniel Bolliger, Manfred D Seeberger, Kenichi A Tanaka
In the recent years, thromboelastography has become a popular monitoring device for hemostasis and transfusion management in major surgery, trauma, and hemophilia. Thromboelastography is performed in whole blood and assesses the viscoelastic property of clot formation under low shear condition. Thromboelastography can be performed with a variety of activator and inhibitors at different concentrations representing the most important factors for different intervals and clot formation variables reported in multiple studies and algorithms...
January 2012: Transfusion Medicine Reviews
Christopher B Overgaard, Vladimír Dzavík
No abstract text is available yet for this article.
September 2, 2008: Circulation
Paul E Marik, Rodrigo Cavallazzi, Tajender Vasu, Amyn Hirani
OBJECTIVES: : A systematic review of the literature to determine the ability of dynamic changes in arterial waveform-derived variables to predict fluid responsiveness and compare these with static indices of fluid responsiveness. The assessment of a patient's intravascular volume is one of the most difficult tasks in critical care medicine. Conventional static hemodynamic variables have proven unreliable as predictors of volume responsiveness. Dynamic changes in systolic pressure, pulse pressure, and stroke volume in patients undergoing mechanical ventilation have emerged as useful techniques to assess volume responsiveness...
September 2009: Critical Care Medicine
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
William R Vincent, Kevin W Hatton
No abstract text is available yet for this article.
July 2009: Critical Care Medicine
Jean-Louis Vincent
OBJECTIVE: To introduce the Fast Hug mnemonic (Feeding, Analgesia, Sedation, Thromboembolic prophylaxis, Head-of-bed elevation, stress Ulcer prevention, and Glucose control) as a means of identifying and checking some of the key aspects in the general care of all critically ill patients. DESIGN: Not applicable. SETTING: Any intensive care unit at any time. PATIENTS: All intensive care unit patients. INTERVENTIONS: Dependent on the results of applying the Fast Hug...
June 2005: Critical Care Medicine
V Marco Ranieri, Gordon D Rubenfeld, B Taylor Thompson, Niall D Ferguson, Ellen Caldwell, Eddy Fan, Luigi Camporota, Arthur S Slutsky
The acute respiratory distress syndrome (ARDS) was defined in 1994 by the American-European Consensus Conference (AECC); since then, issues regarding the reliability and validity of this definition have emerged. Using a consensus process, a panel of experts convened in 2011 (an initiative of the European Society of Intensive Care Medicine endorsed by the American Thoracic Society and the Society of Critical Care Medicine) developed the Berlin Definition, focusing on feasibility, reliability, validity, and objective evaluation of its performance...
June 20, 2012: JAMA: the Journal of the American Medical Association
Laurent Papazian, Carolyn S Calfee, Davide Chiumello, Charles-Edouard Luyt, Nuala J Meyer, Hiroshi Sekiguchi, Michael A Matthay, Gianfranco Umberto Meduri
Acute respiratory distress syndrome (ARDS) is defined by the association of bilateral infiltrates and hypoxaemia following an initial insult. Although a new definition has been recently proposed (Berlin definition), there are various forms of ARDS with potential differences regarding their management (ventilator settings, prone positioning use, corticosteroids). ARDS can be caused by various aetiologies, and the adequate treatment of the responsible cause is crucial to improve the outcome. It is of paramount importance to characterize the mechanisms causing lung injury to optimize both the aetiological treatment and the symptomatic treatment...
May 2016: Intensive Care Medicine
Lee-Yee Chong, Elisabetta Fenu, Gerard Stansby, Sarah Hodgkinson
No abstract text is available yet for this article.
2012: BMJ: British Medical Journal
Marie Scully, Beverley J Hunt, Sylvia Benjamin, Ri Liesner, Peter Rose, Flora Peyvandi, Betty Cheung, Samuel J Machin
No abstract text is available yet for this article.
August 2012: British Journal of Haematology
Stavros V Konstantinides, Adam Torbicki, Giancarlo Agnelli, Nicolas Danchin, David Fitzmaurice, Nazzareno Galiè, J Simon R Gibbs, Menno V Huisman, Marc Humbert, Nils Kucher, Irene Lang, Mareike Lankeit, John Lekakis, Christoph Maack, Eckhard Mayer, Nicolas Meneveau, Arnaud Perrier, Piotr Pruszczyk, Lars H Rasmussen, Thomas H Schindler, Pavel Svitil, Anton Vonk Noordegraaf, Jose Luis Zamorano, Maurizio Zompatori
No abstract text is available yet for this article.
November 14, 2014: European Heart Journal
Patrizia Tosi, Giovanni Barosi, Carlo Lazzaro, Vincenzo Liso, Monia Marchetti, Enrica Morra, Andrea Pession, Giovanni Rosti, Antonio Santoro, Pier Luigi Zinzani, Sante Tura
Tumor lysis syndrome is a potentially life threatening complication of massive cellular lysis in cancers. Identification of high-risk patients and early recognition of the syndrome is crucial in the institution of appropriate treatments. Drugs that act on the metabolic pathway of uric acid to allantoin, like allopurinol or rasburicase, are effective for prophylaxis and treatment of tumor lysis syndrome. Sound recommendations should regulate diagnosis and drug application in the clinical setting. The current article reports the recommendations on the management of tumor lysis syndrome that were issued during a Consensus Conference project, and which were endorsed by the Italian Society of Hematology (SIE), the Italian Association of Pediatric Oncologists (AIEOP) and the Italian Society of Medical Oncology (AIOM)...
December 2008: Haematologica
Claude Guérin, Jean Reignier, Jean-Christophe Richard, Pascal Beuret, Arnaud Gacouin, Thierry Boulain, Emmanuelle Mercier, Michel Badet, Alain Mercat, Olivier Baudin, Marc Clavel, Delphine Chatellier, Samir Jaber, Sylvène Rosselli, Jordi Mancebo, Michel Sirodot, Gilles Hilbert, Christian Bengler, Jack Richecoeur, Marc Gainnier, Frédérique Bayle, Gael Bourdin, Véronique Leray, Raphaele Girard, Loredana Baboi, Louis Ayzac
BACKGROUND: Previous trials involving patients with the acute respiratory distress syndrome (ARDS) have failed to show a beneficial effect of prone positioning during mechanical ventilatory support on outcomes. We evaluated the effect of early application of prone positioning on outcomes in patients with severe ARDS. METHODS: In this multicenter, prospective, randomized, controlled trial, we randomly assigned 466 patients with severe ARDS to undergo prone-positioning sessions of at least 16 hours or to be left in the supine position...
June 6, 2013: New England Journal of Medicine
Jean-Louis Vincent, Rui Moreno
General illness severity scores are widely used in the ICU to predict outcome, characterize disease severity and degree of organ dysfunction, and assess resource use. In this article we review the most commonly used scoring systems in each of these three groups. We examine the history of the development of the initial major systems in each group, discuss the construction of subsequent versions, and, when available, provide recent comparative data regarding their performance. Importantly, the different types of scores should be seen as complementary, rather than competitive and mutually exclusive...
2010: Critical Care: the Official Journal of the Critical Care Forum
Jean-Louis Vincent, Matteo Bassetti, Bruno François, George Karam, Jean Chastre, Antoni Torres, Jason A Roberts, Fabio S Taccone, Jordi Rello, Thierry Calandra, Daniel De Backer, Tobias Welte, Massimo Antonelli
Infections occur frequently in critically ill patients and their management can be challenging for various reasons, including delayed diagnosis, difficulties identifying causative microorganisms, and the high prevalence of antibiotic-resistant strains. In this review, we briefly discuss the importance of early infection diagnosis, before considering in more detail some of the key issues related to antibiotic management in these patients, including controversies surrounding use of combination or monotherapy, duration of therapy, and de-escalation...
May 17, 2016: Critical Care: the Official Journal of the Critical Care Forum
Anders Winther Voldby, Birgitte Brandstrup
BACKGROUND: Perioperative hypovolemia and fluid overload have effects on both complications following surgery and on patient survival. Therefore, the administration of intravenous fluids before, during, and after surgery at the right time and in the right amounts is of great importance. This review aims to analyze the literature concerning perioperative fluid therapy in abdominal surgery and to provide evidence-based recommendations for clinical practice. RESULTS: Preoperative oral or intravenous administration of carbohydrate containing fluids has been shown to improve postoperative well-being and muscular strength and to reduce insulin resistance...
2016: Journal of Intensive Care
2016-06-20 11:20:54
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