Critical Care Medicine | Page 2

Raoul Sutter, Barbara Meyer-Zehnder, Sira M Baumann, Stephan Marsch, Hans Pargger
OBJECTIVES: To determine the frequency of advance directives or directives disclosed by healthcare agents and their influence on decisions to withdraw/withhold life-sustaining care in neurocritically ill adults. DATA SOURCES: PubMed, Embase, and Cochrane databases. STUDY SELECTION: Screening was performed using predefined search terms to identify studies describing directives of neurocritically ill patients from 2000 to 2019. The review was registered prior to the screening process (International Prospective Register of Systematic Reviews [PROSPERO]-Identification number 149185)...
May 1, 2020: Critical Care Medicine
Jun Hyun Kim, Ádám Nagy, Alessandro Putzu, Alessandro Belletti, Giuseppe Biondi-Zoccai, Valery V Likhvantsev, Andrey G Yavorovskiy, Giovanni Landoni
OBJECTIVES: To investigate the effect of the application of therapeutic hypothermia (32-35°C) on survival and major clinical endpoints in critically ill patients. DATA SOURCES: We searched online database and clinical trial registries dated up to April 30, 2019, and references of relevant studies. STUDY SELECTION: Low risk of bias randomized trials which compared hypothermia applied for at least 24 hours and conventional therapy in critically ill patients were included...
April 30, 2020: Critical Care Medicine
Max J Martin, Teng Moua
OBJECTIVES: Prior studies report significant mortality in fibrotic interstitial lung disease patients undergoing mechanical ventilation. Little is known about baseline characteristics or ventilator strategies that might improve outcomes. We analyzed the ventilator characteristics of a large cohort of fibrotic interstitial lung disease patients from the perspective of an acute respiratory distress syndrome paradigm to see if any specific mechanical ventilation strategies might improve in-hospital mortality...
April 30, 2020: Critical Care Medicine
Petr Waldauf, Kateřina Jiroutková, Adéla Krajčová, Zudin Puthucheary, František Duška
OBJECTIVES: To assess the impact of rehabilitation in ICU on clinical outcomes. DATA SOURCES: Secondary data analysis of randomized controlled trials published between 1998 and October 2019 was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. STUDY SELECTION: We have selected trials investigating neuromuscular electrical stimulation or cycling exercises or protocolized physical rehabilitation as compared to standard of care in critically ill adults...
April 28, 2020: Critical Care Medicine
Barret Rush, John Danziger, Keith R Walley, Anand Kumar, Leo Anthony Celi
OBJECTIVES: Treatment in a disproportionately minority-serving hospital has been associated with worse outcomes in a variety of illnesses. We examined the association of treatment in disproportionately minority hospitals on outcomes in patients with sepsis across the United States. DESIGN: Retrospective cohort analysis. Disproportionately minority hospitals were defined as hospitals having twice the relative minority patient population than the surrounding geographical mean...
April 28, 2020: Critical Care Medicine
Christos Lazaridis, Fernando D Goldenberg
No abstract text is available yet for this article.
April 28, 2020: Critical Care Medicine
Ibrahim Migdady, Cory Rice, Abhishek Deshpande, Adrian V Hernandez, Carrie Price, Glenn J Whitman, Romergryko G Geocadin, Sung-Min Cho
OBJECTIVES: Extracorporeal cardiopulmonary resuscitation has shown survival benefit in select patients with refractory cardiac arrest but there is insufficient data on the frequency of different types of brain injury. We aimed to systematically review the prevalence, predictors of and survival from neurologic complications in patients who have undergone extracorporeal cardiopulmonary resuscitation. DATA SOURCES: MEDLINE (PubMed) and six other databases (EMBASE, Cochrane Library, CINAHL Plus, Web of Science, and Scopus) from inception to August 2019...
April 24, 2020: Critical Care Medicine
Irene Cortés-Puch, Willard N Applefeld, Jeffrey Wang, Robert L Danner, Peter Q Eichacker, Charles Natanson
No abstract text is available yet for this article.
April 23, 2020: Critical Care Medicine
Kirsten M Fiest, Karla D Krewulak, E Wesley Ely, Judy E Davidson, Zahinoor Ismail, Bonnie G Sept, Henry T Stelfox
OBJECTIVES: To evaluate the diagnostic accuracy of family-administered tools to detect delirium in critically ill patients. DESIGN: Diagnostic accuracy study. SETTING: Large, tertiary care academic hospital in a single-payer health system. PATIENTS: Consecutive, eligible patients with at least one family member present (dyads) and a Richmond Agitation-Sedation Scale greater than or equal to -3, no primary direct brain injury, the ability to provide informed consent (both patient and family member), the ability to communicate with research staff, and anticipated to remain admitted in the ICU for at least a further 24 hours to complete all assessments at least once...
April 23, 2020: Critical Care Medicine
Alexander H Flannery, Brittany D Bissell, Melissa Thompson Bastin, Peter E Morris, Javier A Neyra
OBJECTIVES: Critically ill patients routinely receive vancomycin as empiric antibiotic therapy. A continuous infusion administration strategy may be superior to intermittent infusion by minimizing peak concentrations and variability thereby optimizing safety. We performed a systematic review and meta-analysis to investigate the impact of vancomycin infusion strategy on acute kidney injury in critically ill adults. DATA SOURCES: A systematic search of MEDLINE, CINAHL, Web of Science, International Pharmaceutical Abstracts, and Google Scholar was undertaken...
April 20, 2020: Critical Care Medicine
Christina J Hayhurst, Annachiara Marra, Jin H Han, Mayur B Patel, Nathan E Brummel, Jennifer L Thompson, James C Jackson, Rameela Chandrasekhar, E Wesley Ely, Pratik P Pandharipande, Christopher G Hughes
OBJECTIVES: Delirium, a heterogenous syndrome, is associated with worse long-term cognition after critical illness. We sought to determine if duration of motoric subtypes of delirium are associated with worse cognition. DESIGN: Secondary analysis of prospective multicenter cohort study. SETTING: Academic, community, and Veteran Affairs hospitals. PATIENTS: Five-hundred eighty-two survivors of respiratory failure or shock...
April 20, 2020: Critical Care Medicine
Tiffany M Osborn
No abstract text is available yet for this article.
April 17, 2020: Critical Care Medicine
J Arden Conway, Priyanka Kharayat, Ronald C Sanders, Sholeen Nett, Scott L Weiss, Lauren R Edwards, Ryan Breuer, Aileen Kirby, Conrad Krawiec, Christopher Page-Goertz, Lee Polikoff, David A Turner, Justine Shults, John S Giuliano, Alberto Orioles, Sylvain Balkandier, Guillaume Emeriaud, Kyle J Rehder, Joel Lim Kian Boon, Asha Shenoi, Paula Vanderford, Gabrielle Nuthall, Anthony Lee, Jonida Zeqo, Simon J Parsons, Jamie Furlong-Dillard, Keith Meyer, Ilana Harwayne-Gidansky, Philipp Jung, Michelle Adu-Darko, G Kris Bysani, Melissa A McCarthy, Mark Shlomovich, Iris Toedt-Pingel, Aline Branca, Maria Christina Esperanza, Awni M Al-Subu, Matthew Pinto, Sarah Tallent, Rakshay Shetty, Sujatha Thyagarajan, Takanari Ikeyama, Keiko M Tarquinio, Peter Skippen, Mioko Kasagi, Joy D Howell, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVES: Tracheal intubation in critically ill children with shock poses a risk of hemodynamic compromise. Ketamine has been considered the drug of choice for induction in these patients, but limited data exist. We investigated whether the administration of ketamine for tracheal intubation in critically ill children with or without shock was associated with fewer adverse hemodynamic events compared with other induction agents. We also investigated if there was a dose dependence for any association between ketamine use and adverse hemodynamic events...
April 17, 2020: Critical Care Medicine
Jiangmei Wang, Ruoqiong Huang, Qi Xu, Guoping Zheng, Guanguan Qiu, Menghua Ge, Qiang Shu, Jianguo Xu
OBJECTIVES: The goal of this study was to determine the role of microRNA transfer in mediating the effects of mesenchymal stem cell-derived extracellular vesicles in acute lung injury. DESIGN: Experimental cell and animal studies. SETTING: University-based research laboratory. SUBJECTS: THP-1 monocytes, bone marrow-derived macrophages, and C57BL/6 mice. INTERVENTIONS: To determine the microRNA transfer in vitro, mesenchymal stem cells and mesenchymal stem cell-derived extracellular vesicles were cultured with THP-1 cells and bone marrow-derived macrophages and then assayed for microRNA expression in the target cells...
April 17, 2020: Critical Care Medicine
Joseph G Kohne, Mary K Dahmer, Heidi M Weeks, Niko Kaciroti, Michael W Quasney, Anil Sapru, Martha A Q Curley, Michael Matthay, Heidi Flori
OBJECTIVES: The 2015 definition for pediatric acute respiratory distress syndrome did not require the presence of bilateral infiltrates. We tested the hypothesis that pediatric patients meeting oxygenation criteria for pediatric acute respiratory distress syndrome but without bilateral infiltrates would have different inflammatory biomarker levels and clinical outcomes than those with bilateral infiltrates. DESIGN: Secondary analysis of a prospective cohort study...
April 17, 2020: Critical Care Medicine
Kavita K Trivedi, Rachel Bartash, Alyssa R Letourneau, Lilian Abbo, Jorge Fleisher, Christina Gagliardo, Shannon Kelley, Priya Nori, Gunter K Rieg, Phyllis Silver, Arjun Srinivasan, Jaclyn Vargas, Belinda Ostrowsky
OBJECTIVES: To use a standardized tool for a multicenter assessment of antibiotic appropriateness in ICUs and identify local antibiotic stewardship improvement opportunities. DESIGN: Pilot point prevalence conducted on October 5, 2016; point prevalence survey conducted on March 1, 2017. SETTING: ICUs in 12 U.S. acute care hospitals with median bed size 563. PATIENTS: Receiving antibiotics on participating units on March 1, 2017...
April 17, 2020: Critical Care Medicine
Matthew B Maas, Bryan D Lizza, Sabra M Abbott, Eric M Liotta, Maged Gendy, John Eed, Andrew M Naidech, Kathryn J Reid, Phyllis C Zee
OBJECTIVES: The circadian system modulates many important physiologic processes, synchronizing tissue-specific functions throughout the body. We sought to characterize acute alterations of circadian rhythms in critically ill patients and to evaluate associations between brain dysfunction, systemic multiple organ dysfunction, environmental stimuli that entrain the circadian rhythm (zeitgebers), rest-activity rhythms, and the central circadian rhythm-controlled melatonin secretion profile...
April 17, 2020: Critical Care Medicine
Matthew Schwede, Robert Y Lee, Hanjing Zhuo, Kirsten N Kangelaris, Alejandra Jauregui, Kathryn Vessel, Annika Belzer, Thomas Deiss, Michael A Matthay, Kathleen D Liu, Carolyn S Calfee
OBJECTIVES: The acute respiratory distress syndrome is common in critically ill patients. Recognition is crucial because acute respiratory distress syndrome is associated with a high mortality rate, and low tidal volume ventilation improves mortality. However, acute respiratory distress syndrome often goes unrecognized. Risk factors for under-recognition and trends over time have not been fully described. DESIGN: Retrospective chart review of patients with acute respiratory distress syndrome from a prospective cohort study of critically ill patients...
April 17, 2020: Critical Care Medicine
Zhaolin Meng, Yanan Ma, Suhang Song, Ye Li, Dan Wang, Yafei Si, Ruochen Sun, Ruochen Zhang, Hao Xue, Limei Jing, Huazhang Wu
OBJECTIVES: To evaluate the economic implications of payments based on Chinese diagnosis-related groups for critically ill patients in ICUs in terms of total hospital expenditure, out-of-pocket payments, and length of stay. DESIGN: A pre-post comparison of patient cohorts admitted to ICUs 1 year before and 1 year after Chinese diagnosis-related group reform was undertaken. Demographic characteristics, clinical data, and medical expenditures were collated from a health insurance database...
April 17, 2020: Critical Care Medicine
Virginie Lemiale, Stéphanie Pons, Adrien Mirouse, Jean-Jacques Tudesq, Yannick Hourmant, Djamel Mokart, Frédéric Pène, Achille Kouatchet, Julien Mayaux, Martine Nyunga, Fabrice Bruneel, Anne-Pascale Meert, Edith Borcoman, Magali Bisbal, Matthieu Legrand, Dominique Benoit, Elie Azoulay, Michaël Darmon, Lara Zafrani
OBJECTIVES: Cancer affects up to 20% of critically ill patients, and sepsis is one of the leading reasons for ICU admission in this setting. Early signals suggested that survival might be increasing in this population. However, confirmation studies have been lacking. The goal of this study was to assess trends in survival rates over time in cancer patients admitted to the ICU for sepsis or septic shock over the last 2 decades. DATA SOURCE: Seven European ICUs. STUDY SELECTION: A hierarchical model taking into account the year of admission and the source dataset as random variables was used to identify risk factors for day 30 mortality...
April 17, 2020: Critical Care Medicine
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