Read by QxMD icon Read

Critical care

shared collection
35 papers 0 to 25 followers
By T C
Jason Phua, Nathan C Dean, Qi Guo, Win Sen Kuan, Hui Fang Lim, Tow Keang Lim
Mortality rates for severe community-acquired pneumonia (CAP) range from 17 to 48 % in published studies.In this review, we searched PubMed for relevant papers published between 1981 and June 2016 and relevant files. We explored how early and aggressive management measures, implemented within 24 hours of recognition of severe CAP and carried out both in the emergency department and in the ICU, decrease mortality in severe CAP.These measures begin with the use of severity assessment tools and the application of care bundles via clinical decision support tools...
August 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
Kensuke Nakamura, Ryota Inokuchi, Takahiro Hiruma, Kurato Tokunaga, Kent Doi, Susumu Nakajima
Beta-blockers are important for severe-status patients with atrial fibrillation-related tachycardia. Beta 1-selective intravenous injection are routinely used, but long-term administration is difficult due to cost-performance- or management-related issues. A bisoprolol patch, a beta-blocker to be percutaneously absorbed, recently became commercially available in Japan. As it may facilitate effective absorption and a mild elevation of the blood concentration, we retrospectively analyzed 16 patients with atrial fibrillation-related tachycardia who were admitted to the Intensive Care Unit of Hitachi General Hospital Emergency and Critical Care Center, and underwent switching therapy from landiolol to a bisoprolol patch...
October 2016: Journal of Anesthesia
M Beed, P G Brindley, R Mahajan, I Juttner, J Campion-Smith, V G Wilson
BACKGROUND: Statins may have immunomodulatory effects that benefit critically ill patients. Therefore, we retrospectively examined the association between survival and the prescription of statins prior to admission to an intensive care unit (ICU), or high dependency unit (HDU), as a result of major elective surgery or as an emergency with a presumed diagnosis of sepsis. METHODS: We retrospectively studied critical care patients (ICU or HDU) from a tertiary referral UK teaching hospital...
October 2016: Journal of Critical Care
Yi Yang, Jianfeng Xie, Fengmei Guo, Federico Longhini, Zhiwei Gao, Yingzi Huang, Haibo Qiu
OBJECTIVE: To measure the ability of a new bioscore to diagnose sepsis in a general critical care population. METHODS: The study was done at an intensive care unit (ICU) from April to December 2012. Demographic and clinical patient information were recorded on admission to the ICU with blood samples taken for C-reactive protein (CRP), procalcitonin (PCT), interleukin-6, white blood cell count, as well as body temperature, age and the sepsis-related organ failure (SOFA) score...
December 2016: Annals of Intensive Care
Annemieke Oude Lansink-Hartgring, Lara Hessels, Joachim Weigel, Anne Marie G A de Smet, Diederik Gommers, Prashant V Nannan Panday, Ewout J Hoorn, Maarten W Nijsten
BACKGROUND: Dysnatremia is associated with adverse outcome in critically ill patients. Changes in patients or treatment strategies may have affected the incidence of dysnatremia over time. We investigated long-term changes in the incidence of dysnatremia and analyzed its association with mortality. METHODS: Over a 21-year period (1992-2012), all serum sodium measurements were analyzed retrospectively in two university hospital ICUs, up to day 28 of ICU admission for the presence of dysnatremia...
December 2016: Annals of Intensive Care
Sami Abdellatif, Ahlem Trifi, Foued Daly, Khaoula Mahjoub, Rochdi Nasri, Salah Ben Lakhal
BACKGROUND: Cases of ventilator-associated pneumonia (VAP) due to multidrug-resistant (MDR) gram-negative bacilli (GNB) mainly Acinetobacter baumannii, Pseudomonas aeruginosa and enterobacteria are common in hospitalised patients of Tunisian intensive care units (ICUs). Parenteral colistin has been used for the therapy of VAP caused by MDR GNB at Tunisian hospitals over the past few years with a favourable clinical response. However, its use fell out of favour because of the reported drug-related nephrotoxicity and neurotoxicity...
December 2016: Annals of Intensive Care
Marcel Levi
BACKGROUND: Recently, a new generation of direct-acting oral anticoagulants (DOACs) with a greater specificity towards activated coagulation factors was introduced based on encouraging results for efficacy and safety in clinical studies. An initial limitation of these new drugs was the absence of an adequate strategy to reverse the effect if a bleeding event occurs or an urgent invasive procedure has to be carried out. MAIN TEXT: Specific reversing agents for DOACs have become available, however, and are now evaluated in clinical studies...
August 20, 2016: Critical Care: the Official Journal of the Critical Care Forum
Airton Leonardo de Oliveira Manoel, Alberto Goffi, Fernando Godinho Zampieri, David Turkel-Parrella, Abhijit Duggal, Thomas R Marotta, R Loch Macdonald, Simon Abrahamson
Spontaneous intracerebral hemorrhage (ICH), defined as nontraumatic bleeding into the brain parenchyma, is the second most common subtype of stroke, with 5.3 million cases and over 3 million deaths reported worldwide in 2010. Case fatality is extremely high (reaching approximately 60 % at 1 year post event). Only 20 % of patients who survive are independent within 6 months. Factors such as chronic hypertension, cerebral amyloid angiopathy, and anticoagulation are commonly associated with ICH. Chronic arterial hypertension represents the major risk factor for bleeding...
September 18, 2016: Critical Care: the Official Journal of the Critical Care Forum
Xu Liu, Kai Zhang, Wei Wang, Guohao Xie, Xiangming Fang
BACKGROUND: Atrial fibrillation occurs frequently in patients following cardiac surgery and can be a cause of increased morbidity and mortality. The use of dexmedetomidine to prevent atrial fibrillation is unclear. The present study was designed to evaluate the effect of dexmedetomidine sedation on the incidence of atrial fibrillation after cardiac surgery. METHODS: Upon arrival to the intensive care unit (ICU), cardiac surgery patients without prior atrial fibrillation or flutter were randomized to receive either dexmedetomidine (0...
September 21, 2016: Critical Care: the Official Journal of the Critical Care Forum
Karen S Brown, Hamim Zahir, Michael A Grosso, Hans J Lanz, Michele F Mercuri, Jerrold H Levy
BACKGROUND: Four nonvitamin K antagonist oral anticoagulants (NOACs) are approved for the prevention of stroke in patients with nonvalvular atrial fibrillation and for the treatment of venous thromboembolism. These include the direct thrombin inhibitor dabigatran and the direct factor Xa inhibitors rivaroxaban, apixaban, and edoxaban. Bleeding is a complication for all anticoagulants and concerns regarding bleeding risk and the suitability of effective reversal strategies may be a barrier to their prescription...
September 23, 2016: Critical Care: the Official Journal of the Critical Care Forum
Shane P Selvanderan, Matthew J Summers, Mark E Finnis, Mark P Plummer, Yasmine Ali Abdelhamid, Michael B Anderson, Marianne J Chapman, Christopher K Rayner, Adam M Deane
OBJECTIVES: Pantoprazole is frequently administered to critically ill patients for prophylaxis against gastrointestinal bleeding. However, comparison to placebo has been inadequately evaluated, and pantoprazole has the potential to cause harm. Our objective was to evaluate benefit or harm associated with pantoprazole administration. DESIGN: Prospective randomized double-blind parallel-group study. SETTING: University-affiliated mixed medical-surgical ICU...
October 2016: Critical Care Medicine
Catherine L Oberg, Robert J Hiensch, Hooman D Poor
OBJECTIVE: To report a case series of three patients with hepatitis C virus infection who all presented with severe type B lactic acidosis shortly after starting treatment with ombitasvir-paritaprevir-ritonavir-dasabuvir. DESIGN: Case series. SETTING: ICU. PATIENTS: Three patients, all who had HCV cirrhosis with mild hepatic impairment (Child-Pugh A) and had started taking ombitasvir-paritaprevir-ritonavir-dasabuvir within the preceding 2 weeks, presented with similar nonspecific symptoms of lethargy, fatigue, and nausea...
September 22, 2016: Critical Care Medicine
Joshua T Swan, Carol M Ashton, Lan N Bui, Vy P Pham, Beverly A Shirkey, Jolene E Blackshear, Jimmy B Bersamin, Rubie May L Pomer, Michael L Johnson, Audrey D Magtoto, Michelle O Butler, Shirley K Tran, Leah R Sanchez, Jessica G Patel, Robert A Ochoa, Shaikh A Hai, Karen I Denison, Edward A Graviss, Nelda P Wray
OBJECTIVE: To test the hypothesis that compared with daily soap and water bathing, 2% chlorhexidine gluconate bathing every other day for up to 28 days decreases the risk of hospital-acquired catheter-associated urinary tract infection, ventilator-associated pneumonia, incisional surgical site infection, and primary bloodstream infection in surgical ICU patients. DESIGN: This was a single-center, pragmatic, randomized trial. Patients and clinicians were aware of treatment-group assignment; investigators who determined outcomes were blinded...
October 2016: Critical Care Medicine
Alexander H Flannery, Douglas R Oyler, Gerald L Weinhouse
OBJECTIVE: This study aimed to assess whether interventions targeted at improving sleep in the ICU were associated with reductions in ICU delirium. Secondary outcomes include duration of delirium and ICU length of stay. DATA SOURCES: MEDLINE, CINAHL, Web of Science, Scopus, WorldCat, and International Pharmaceutical Abstracts were searched from inception to January 2016. STUDY SELECTION: Studies investigating any type of sleep intervention (nonpharmacologic or pharmacologic) and assessing the impact on ICU delirium were included...
August 9, 2016: Critical Care Medicine
Erin Frazee, Kianoush Kashani
BACKGROUND: Intravenous fluids (IVF) are frequently utilized to restore intravascular volume in patients with distributive and hypovolemic shock. Although the benefits of the appropriate use of fluids in intensive care units (ICUs) and hospitals are well described, there is growing knowledge regarding the potential risks of volume overload and its impact on organ failure and mortality. To avoid volume overload and its associated complications, strategies to identify fluid responsiveness are developed and utilized more often among ICU patients...
June 2016: Kidney Diseases
Andre C Kalil, Mark L Metersky, Michael Klompas, John Muscedere, Daniel A Sweeney, Lucy B Palmer, Lena M Napolitano, Naomi P O'Grady, John G Bartlett, Jordi Carratalà, Ali A El Solh, Santiago Ewig, Paul D Fey, Thomas M File, Marcos I Restrepo, Jason A Roberts, Grant W Waterer, Peggy Cruse, Shandra L Knight, Jan L Brozek
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.These guidelines are intended for use by healthcare professionals who care for patients at risk for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), including specialists in infectious diseases, pulmonary diseases, critical care, and surgeons, anesthesiologists, hospitalists, and any clinicians and healthcare providers caring for hospitalized patients with nosocomial pneumonia...
September 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Matthew W Semler, Todd W Rice
Sepsis is a common and life-threatening inflammatory response to severe infection treated with antibiotics and fluid resuscitation. Despite the central role of intravenous fluid in sepsis management, fundamental questions regarding which fluid and in what amount remain unanswered. Recent advances in understanding the physiologic response to fluid administration, and large clinical studies examining resuscitation strategies, fluid balance after resuscitation, colloid versus crystalloid solutions, and high- versus low-chloride crystalloids, inform the current approach to sepsis fluid management and suggest areas for future research...
June 2016: Clinics in Chest Medicine
Yasuyuki Kakihana, Takashi Ito, Mayumi Nakahara, Keiji Yamaguchi, Tomotsugu Yasuda
Sepsis is aggravated by an inappropriate immune response to invading microorganisms, which occasionally leads to multiple organ failure. Several lines of evidence suggest that the ventricular myocardium is depressed during sepsis with features of diastolic dysfunction. Potential candidates responsible for septic cardiomyopathy include pathogen-associated molecular patterns (PAMPs), cytokines, and nitric oxide. Extracellular histones and high-mobility group box 1 that function as endogenous damage-associated molecular patterns (DAMPs) also contribute to the myocardial dysfunction associated with sepsis...
2016: Journal of Intensive Care
Jeffrey E Gotts, Michael A Matthay
Sepsis, severe sepsis, and septic shock represent increasingly severe systemic inflammatory responses to infection. Sepsis is common in the aging population, and it disproportionately affects patients with cancer and underlying immunosuppression. In its most severe form, sepsis causes multiple organ dysfunction that can produce a state of chronic critical illness characterized by severe immune dysfunction and catabolism. Much has been learnt about the pathogenesis of sepsis at the molecular, cell, and intact organ level...
2016: BMJ: British Medical Journal
Sumeet Reddy, Laurence Weinberg, Paul Young
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2016. Other selected articles can be found online at Further information about the Annual Update in Intensive Care and Emergency Medicine is available from
2016: Critical Care: the Official Journal of the Critical Care Forum
2016-07-25 01:18:45
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"