Flora T Scheffenbichler, Bijan Teja, Karuna Wongtangman, Nicole Mazwi, Karen Waak, Stefan J Schaller, Xinling Xu, Silvia Barbieri, Nazzareno Fagoni, Jessica Cassavaugh, Manfred Blobner, Carol L Hodgson, Nicola Latronico, Matthias Eikermann
OBJECTIVES: It is unclear whether early mobilization in the surgical ICU helps improve patients' functional recovery to a level that enables independent living. We assessed dose of mobilization (level + duration). We tested the research hypotheses that dose of mobilization predicts adverse discharge and that both duration of mobilization and maximum mobilization level predict adverse discharge. DESIGN: International, prospective cohort study. SETTING: Study conducted in five surgical ICUs at four different institutions...
January 8, 2021: Critical Care Medicine
Katie M Moynihan, Shirley Ge, Lynn A Sleeper, Minmin Lu, Kristofer G Andren, Jessica Mecklosky, Reza Rahbar, Francis Fynn-Thompson, Diego Porras, John Arnold, Daniel P Kelly, Michael S D Agus, Ravi R Thiagarajan, Peta M A Alexander
OBJECTIVES: Hemoptysis is uncommon in children, even among the critically ill, with a paucity of epidemiological data to inform clinical decision-making. We describe hemoptysis-associated ICU admissions, including those who were critically ill at hemoptysis onset or who became critically ill as a result of hemoptysis, and identify predictors of mortality. DESIGN: Retrospective cohort study. Demographics, hemoptysis location, and management were collected. Pediatric Logistic Organ Dysfunction-2 score within 24 hours of hemoptysis described illness severity...
January 7, 2021: Critical Care Medicine
Sébastien Redant, David De Bels, Patrick M Honoré
OBJECTIVE: Severe acute respiratory syndrome coronavirus-2 acute kidney injury is a condition that in many ways resembles classical acute kidney injury. The pathophysiology appears to be multifactorial, and accordingly, our main objective was to review possible components of this form of acute kidney injury. DATA SOURCES: Literature review. DATA SYNTHESIS: Our principal observation was that the various components of severe acute respiratory syndrome coronavirus-2 acute kidney injury appear to be relatively similar to the classical forms...
January 7, 2021: Critical Care Medicine
Emanuele Favaron, Can Ince, Matthias P Hilty, Bülent Ergin, Philip van der Zee, Zühre Uz, Pedro D Wendel Garcia, Daniel A Hofmaenner, Claudio T Acevedo, Wim Jan van Boven, Sakir Akin, Diederik Gommers, Henrik Endeman
OBJECTIVES: In this study, we hypothesized that coronavirus disease 2019 patients exhibit sublingual microcirculatory alterations caused by inflammation, coagulopathy, and hypoxemia. DESIGN: Multicenter case-controlled study. SETTING: Two ICUs in The Netherlands and one in Switzerland. PATIENTS: Thirty-four critically ill coronavirus disease 2019 patients were compared with 33 healthy volunteers. INTERVENTIONS: None...
January 7, 2021: Critical Care Medicine
Ivor S Douglas, Diandra D Swanson, Terra Hiller, Judy Oakes, Jamie Bach, Christopher Whelchel, Jennifer Pickering, Tobias George, Mark Kearns, Michael Hanley, Kara Mould, Sarah Roark, Jason Mansoori, Anuj Mehta, Eric P Schmidt, Anna Neumeier
OBJECTIVES: Prone position ventilation is a potentially life-saving ancillary intervention but is not widely adopted for coronavirus disease 2019 or acute respiratory distress syndrome from other causes. Implementation of lung-protective ventilation including prone positioning for coronavirus disease 2019 acute respiratory distress syndrome is limited by isolation precautions and personal protective equipment scarcity. We sought to determine the safety and associated clinical outcomes for coronavirus disease 2019 acute respiratory distress syndrome treated with prolonged prone position ventilation without daily repositioning...
January 7, 2021: Critical Care Medicine
Allison Tong, Amanda Baumgart, Nicole Evangelidis, Andrea K Viecelli, Simon A Carter, Luciano Cesar Azevedo, Tess Cooper, Andrew Bersten, Lilia Cervantes, Derek P Chew, Sally Crowe, Ivor S Douglas, Ella Flemyng, Julian H Elliott, Elyssa Hannan, Peter Horby, Martin Howell, Angela Ju, Jaehee Lee, Eduardo Lorca, Deena Lynch, Karine E Manera, John C Marshall, Andrea Matus Gonzalez, Anne McKenzie, Sangeeta Mehta, Mervyn Mer, Andrew Conway Morris, Dale M Needham, Saad Nseir, Pedro Povoa, Mark Reid, Yasser Sakr, Ning Shen, Alan R Smyth, A John Simpson, Tom Snelling, Giovanni F M Strippoli, Armando Teixeira-Pinto, Antoni Torres, Tari Turner, Steve Webb, Paula R Williamson, Laila Woc-Colburn, Junhua Zhang, Jonathan C Craig
OBJECTIVES: Respiratory failure, multiple organ failure, shortness of breath, recovery, and mortality have been identified as critically important core outcomes by more than 9300 patients, health professionals, and the public from 111 countries in the global coronavirus disease 2019 core outcome set initiative. The aim of this project was to establish the core outcome measures for these domains for trials in coronavirus disease 2019. DESIGN: Three online consensus workshops were convened to establish outcome measures for the four core domains of respiratory failure, multiple organ failure, shortness of breath, and recovery...
January 5, 2021: Critical Care Medicine
Charlotte A Patterson, Duncan Wyncoll, Amita Patel, Yusupha Ceesay, William Newsholme, Meera Chand, Hannah Mitchell, Mark Tan, Jonathan D Edgeworth
OBJECTIVES: Candida auris has been implicated in ICU outbreaks worldwide and is notable for being difficult to identify and treat its resilience in the environment and significant patient mortality associated with invasive disease. Here, we describe a small C. auris outbreak and how it was terminated. DESIGN: Single-center, observational. SETTING: Two general adult ICUs at an urban U.K. teaching hospital. PATIENTS: All patients positive for C...
January 4, 2021: Critical Care Medicine
Fiona Muttalib, Sebastián González-Dambrauskas, Jan Hau Lee, Mardi Steere, Asya Agulnik, Srinivas Murthy, Neill K J Adhikari
OBJECTIVES: To describe the infrastructure and resources for pediatric emergency and critical care delivery in resource-limited settings worldwide. DESIGN: Cross-sectional survey with survey items developed through literature review and revised following piloting. SETTING: The electronic survey was disseminated internationally in November 2019 via e-mail directories of pediatric intensive care societies and networks and using social media...
December 21, 2020: Critical Care Medicine
John C Grotberg, Robert C Hyzy, Jose De Cardenas, Ivan N Co
OBJECTIVE: To describe the physiology of air leak in bronchopleural fistula in mechanically ventilated patients and how understanding of its physiology drives management of positive-pressure ventilation. To provide guidance of lung isolation, mechanical ventilator, pleural catheter, and endobronchial strategies for the management of bronchopleural fistula on mechanical ventilation. DATA SOURCES: Online search of PubMed and manual review of articles (laboratory and patient studies) was performed...
December 18, 2020: Critical Care Medicine
Michael H Lazar, Raef Fadel, Jayna Gardner-Gray, Geneva Tatem, Martina T Caldwell, Jennifer Swiderek, Jeffrey H Jennings
OBJECTIVES: To investigate the potential influence of racial differences in outcomes of patients infected by coronavirus disease 2019-positive patients who require intensive care in an urban hospital. DESIGN: Retrospective cohort study. SETTING: Henry Ford Health System Multidisciplinary ICU, a total of 156 beds spread throughout the hospital in Detroit, MI. PATIENTS: We obtained data from the electronic medical record of all adult severe acute respiratory syndrome coronavirus-2-positive patients managed in the ICU of Henry Ford Hospital in Detroit, MI, between March 13, 2020, and July 31, 2020...
December 18, 2020: Critical Care Medicine
E Vincent S Faustino, Veronika Shabanova, Leslie J Raffini, Sarah B Kandil, Simon Li, Matthew G Pinto, Jill M Cholette, Sheila J Hanson, Marianne E Nellis, Cicero T Silva, Ranjit Chima, Anjali Sharathkumar, Kimberly A Thomas, Tara McPartland, Joana A Tala, Philip C Spinella
OBJECTIVES: We obtained preliminary evidence on the efficacy of early prophylaxis on the risk of central venous catheter-associated deep venous thrombosis and its effect on thrombin generation in critically ill children. DESIGN: Bayesian phase 2b randomized clinical trial. SETTING: Seven PICUs. PATIENTS: Children less than 18 years old with a newly inserted central venous catheter and at low risk of bleeding. INTERVENTION: Enoxaparin adjusted to anti-Xa level of 0...
December 18, 2020: Critical Care Medicine
Sandeep Tripathi, Shruti Kumar, Shubhi Kaushik
OBJECTIVE: Midline catheters are considered "midway" regarding vascular access. The objective of this systematic review was to explore the current practice, dwell time, and complication rates of midline catheters. DESIGN: Systematic review. SETTING: Search on four databases, PUBMED, CINAHL, Scopus, and Embase, were conducted for English language articles published after the year 2000. MEASUREMENTS AND MAIN RESULTS: A total of 987 articles were identified, of which 31 manuscripts met the inclusion criteria and were selected for review...
December 18, 2020: Critical Care Medicine
Benjamin R Griffin, Chaorong Wu, John C O'Horo, Sarah Faubel, Diana Jalal, Kianoush Kashani
OBJECTIVES: Thrombocytopenia is common in critically ill patients treated with continuous renal replacement therapy and decreases in platelets following continuous renal replacement therapy initiation have been associated with increased mortality. Platelets play a role in innate and adaptive immunity, making it plausible that decreases in platelets following continuous renal replacement therapy initiation predispose patients to development of infection. Our objective was to determine if greater decreases in platelets following continuous renal replacement therapy correlate with increased rates of secondary infection...
December 18, 2020: Critical Care Medicine
Kelly Farrah, Lauralyn McIntyre, Christopher J Doig, Robert Talarico, Monica Taljaard, Murray Krahn, Dean Fergusson, Alan J Forster, Doug Coyle, Kednapa Thavorn
OBJECTIVES: To examine long-term mortality, resource utilization, and healthcare costs in sepsis patients compared to hospitalized nonsepsis controls. DESIGN: Propensity-matched population-based cohort study using administrative data. SETTING: Ontario, Canada. PATIENTS: We identified a cohort of adults (≥ 18) admitted to hospitals in Ontario between April 1, 2012, and March 31, 2016, with follow-up to March 31, 2017...
December 17, 2020: Critical Care Medicine
Bruno da Silva Guimarães, Leonardo Cordeiro de Souza, Hebe Faria Cordeiro, Thiago Loureiro Regis, Cristiane Almeida Leite, Fernanda Patricio Puga, Sergio Hernando Alvim, Jocemir Ronaldo Lugon
OBJECTIVES: To test if the use of an inspiratory muscle training program with an electronic resistive loading device is associated with benefits as to muscle strength, weaning, and survival in the ICU. DESIGN: Prospective randomized controlled trial. SETTINGS: Study conducted at the ICU of a Navy's hospital, Rio de Janeiro, Brazil, from January 2016 to September 2018. PATIENTS: Tracheostomized patients (18-86 yr) on prolonged weaning...
December 16, 2020: Critical Care Medicine
Ryan McGinn, Dean A Fergusson, Duncan J Stewart, Arnold S Kristof, Carly C Barron, Bernard Thebaud, Lauralyn McIntyre, Dawn Stacey, Mark Liepmann, Aurore Dodelet-Devillers, Haibo Zhang, Richard Renlund, Elliot Lilley, Gregory P Downey, Earl G Brown, Lucie Côté, Claudia C Dos Santos, Alison E Fox-Robichaud, Sabah N A Hussain, John G Laffey, Mingyao Liu, Jenna MacNeil, Holly Orlando, Salman T Qureshi, Patricia V Turner, Brent W Winston, Manoj M Lalu
OBJECTIVES: In many jurisdictions, ethical concerns require surrogate humane endpoints to replace death in small animal models of acute lung injury. Heterogenous selection and reporting of surrogate endpoints render interpretation and generalizability of findings between studies difficult. We aimed to establish expert-guided consensus among preclinical scientists and laboratory animal veterinarians on selection and reporting of surrogate endpoints, monitoring of these models, and the use of analgesia...
December 16, 2020: Critical Care Medicine
Jason T Chapman, Jeff Breeding, Stephen J Kerr, Marko Bajic, Priya Nair, Hergen Buscher
OBJECTIVES: To describe the incidence and outcomes of radiologically confirmed acute CNS complications in extracorporeal membrane oxygenation patients at an Australian extracorporeal membrane oxygenation referral center and identify associated patient characteristics. DESIGN: Retrospective cohort study. SETTING: Single-center tertiary institution. PATIENTS: Four-hundred twelve consecutive adult patients supported with extracorporeal membrane oxygenation from 2009 to 2017...
December 16, 2020: Critical Care Medicine
Oliver Hunsicker, Lukas Beck, Alexander Krannich, Tobias Finger, Vincent Prinz, Claudia Spies, Steffen Weber-Carstens, Stefan Wolf, Jan Adriaan Graw, Mario Menk
OBJECTIVES: Intracranial hemorrhage is a serious complication in patients receiving venovenous extracorporeal membrane oxygenation during treatment of the acute respiratory distress syndrome. We analyzed timing, outcome, and risk factors of intracranial hemorrhage in patients on venovenous extracorporeal membrane oxygenation. DESIGN: Retrospective cohort study. SETTING: Single acute respiratory distress syndrome referral center. PATIENTS: Patients receiving venovenous extracorporeal membrane oxygenation were identified from a cohort of 1,044 patients with acute respiratory distress syndrome...
December 15, 2020: Critical Care Medicine
Erika P Plata-Menchaca, Ricard Ferrer
No abstract text is available yet for this article.
December 8, 2020: Critical Care Medicine
Xiuyun Liu, Kei Akiyoshi, Mitsunori Nakano, Ken Brady, Brian Bush, Rohan Nadkarni, Archana Venkataraman, Raymond C Koehler, Jennifer K Lee, Charles W Hogue, Marek Czosnyka, Peter Smielewski, Charles H Brown
OBJECTIVES: Monitoring cerebral autoregulation may help identify the lower limit of autoregulation in individual patients. Mean arterial blood pressure below lower limit of autoregulation appears to be a risk factor for postoperative acute kidney injury. Cerebral autoregulation can be monitored in real time using correlation approaches. However, the precise thresholds for different cerebral autoregulation indexes that identify the lower limit of autoregulation are unknown. We identified thresholds for intact autoregulation in patients during cardiopulmonary bypass surgery and examined the relevance of these thresholds to postoperative acute kidney injury...
December 4, 2020: Critical Care Medicine
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