Journal of Intensive Care Medicine

Samuel M Brown, Sarah J Beesley, Chris Stubben, Emily L Wilson, Angela P Presson, Colin Grissom, Colin Maguire, Matthew T Rondina, Ramona O Hopkins
BACKGROUND: Cognitive impairment after sepsis is an important clinical problem. Determinants of postseptic cognitive impairment are not well understood. We thus undertook a systems biology approach to exploring a possible role for apolipoprotein E (APOE) in postseptic cognitive impairment. DESIGN: Prospective, observational cohort. SETTING: Intermountain Medical Center, a tertiary referral center in Utah. PATIENTS/PARTICIPANTS: Patients with sepsis admitted to study intensive care units...
January 9, 2020: Journal of Intensive Care Medicine
Madison Morgan, Tawnya Vernon, Eric H Bradburn, Jo Ann Miller, Shreya Jammula, Frederick B Rogers
In recent years, there has been an emphasis on evaluating the outcomes of patients who have experienced an intensive care unit (ICU) readmission. This may in part be due to the Patient Protection and Affordable Care Act's Hospital Readmission Reduction Program which imposes financial sanctions on hospitals who have excessive readmission rates, informally known as bounceback rates. The financial cost associated with avoidable bounceback combined with the potentially preventable expenses can result in unnecessary financial strain...
January 9, 2020: Journal of Intensive Care Medicine
Manuela Haiduc, Sara Radparvar, Samuel L Aitken, Jerry Altshuler
BACKGROUND: Atrial fibrillation (AF) frequently develops during critical illness. In septic shock complicated by rapid AF, the use of phenylephrine may be advantageous secondary to its β-1 sparing properties. However, evidence supporting this strategy is lacking. OBJECTIVE: The purpose of this study is to determine the clinical effect on rate control of transitioning norepinephrine to phenylephrine in septic shock patients who develop AF with a rapid ventricular response (RVR)...
January 2, 2020: Journal of Intensive Care Medicine
Neveux Nathan, Jean-Paul Sculier, Lieveke Ameye, Marianne Paesmans, Grigoriu Bogdan-Dragos, Anne-Pascale Meert
INTRODUCTION: In 2016, a new definition of sepsis and septic shock was adopted. Some studies based on the general population demonstrated that the Sequential Organ Failure Assessment (SOFA) score is more accurate than the systemic inflammatory response syndrome (SIRS) criteria to predict hospital mortality of infected patients requiring intensive care. PATIENTS AND METHOD: We have analyzed all the records of patients with cancer admitted for a suspected infection between January 1, 2013, and December 31, 2016, in our oncological intensive care unit (ICU)...
December 23, 2019: Journal of Intensive Care Medicine
Chih-Ying Chien, Jiun-Lin Yan, Shih Tsung Han, Jin-Tang Chen, Ting-Shuo Huang, Yu-Hsien Chen, Chih-Yuan Wang, Yueh-Lin Lee, Kuan-Fu Chen
OBJECTIVES: Early adequate resuscitation of patients with trauma is crucial in preventing shock and early mortality. Thus, we aimed to determine the performance of the inferior vena cava (IVC) volume and other risk factors and scores in predicting massive transfusion and mortality. METHODS: We included all patients with trauma who underwent computed tomography (CT) scan of the torso, which included the abdominal area, in our emergency department (ED) from January 2014 to January 2017...
December 13, 2019: Journal of Intensive Care Medicine
Aniket S Rali, Jonathan Chandler, Andrew Sauer, Michael A Solomon, Zubair Shah
Cardiogenic shock (CS) portends an extremely high mortality of nearly 50% during index hospitalization. Prompt diagnoses of CS, its underlying etiology, and efficient implementation of treatment modalities, including mechanical circulatory support (MCS), are critical especially in light of such high predicted mortality. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides the most comprehensive cardiopulmonary support in critically ill patients and hence has seen a steady increase in its utilization over the past decade...
December 13, 2019: Journal of Intensive Care Medicine
John J Y Zhang, Jamie Ann-Hui Ong, Nicholas L Syn, Roberto Lorusso, Chuen Seng Tan, Graeme MacLaren, Kollengode Ramanathan
BACKGROUND: Although extracorporeal membrane oxygenation (ECMO) is frequently utilized as a salvage therapy for patients with cardiopulmonary failure, outcomes of its use in peripartum patients have not been clearly established. We aimed to review peer-reviewed publications on the use of ECMO in pregnant and postpartum patients, with analyses of maternal and fetal outcomes. METHODS: Data were retrieved from MEDLINE, EMBASE, and Scopus databases from 1972 up to November 2017 for publications on ECMO in peripartum patients...
December 12, 2019: Journal of Intensive Care Medicine
Leonardo Jönck Staub, Roberta Rodolfo Mazzali Biscaro, Rosemeri Maurici
BACKGROUND: Lung ultrasound (LUS) has been reported as a promising diagnostic tool for ventilator-associated pneumonia (VAP), but patients with previous lung parenchyma commitment have been not studied. PURPOSE: To evaluate whether the emergence of sonographic consolidations, rather than their presence, can improve the VAP diagnosis in a sample including patients with previous lung parenchyma diseases. METHODS: Patients who completed 48 hours of mechanical ventilation were prospectively studied with daily LUS examinations...
December 9, 2019: Journal of Intensive Care Medicine
Zaid Khot, Patrick B Murphy, Nathalie Sela, Neil G Parry, Kelly Vogt, Ian M Ball
OBJECTIVE: To determine the contemporary prevalence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome in critically ill patients. DATA SOURCES: Medline, Embase, and Central databases. STUDY SELECTION: Studies reporting on the prevalence of IAH in consecutively admitted critically ill patients using the World Society of Abdominal Compartment Syndrome (WSACS) consensus guidelines for intra-abdominal pressure (IAP) measurement...
December 6, 2019: Journal of Intensive Care Medicine
Ryota Sato, Nobuhiro Ariyoshi, Daisuke Hasegawa, Erin Crossey, Natsumi Hamahata, Takuma Ishihara, Michitaka Nasu, Gehan Devendra
BACKGROUND: Although surviving sepsis campaign guidelines recommend the use of inotropes in the presence of myocardial dysfunction, the effects of inotropes, including epinephrine, dobutamine, and milrinone, on in-hospital mortality in patients with septic shock remains unclear. MATERIALS AND METHODS: We conducted an international,2-center, retrospective cohort study. The Cox proportional hazards regression model with time-varying covariates was used to investigate whether epinephrine, milrinone, or dobutamine reduces in-hospital mortality in patients with septic shock...
December 3, 2019: Journal of Intensive Care Medicine
Michael Bender, Marco Stein, Seong Woong Kim, Eberhard Uhl, Karsten Schöller
OBJECTIVE: Intrahospital transports (IHTs) of neurosurgical intensive care unit (NICU) patients can be hazardous. Increasing intracranial pressure (ICP) and/or decreasing cerebral perfusion pressure (CPP) as well as cardiopulmonary alterations are common complications of an IHTs, which can lead to secondary brain injury. This study was performed to assess several serum biomarkers concerning their potential to improve safety of IHTs in mechanically ventilated NICU patients. METHODS: All IHTs of mechanically ventilated and sedated NICU patients from 03/2017 to 01/2018 were retrospectively analyzed...
November 28, 2019: Journal of Intensive Care Medicine
Michael Elias, Antoine Elias, John Oropello, John Doucette, Jebakaran Jebakumar, Roopa Kohli-Seth
BACKGROUND: Indications for inferior vena cava filter (IVCF) placement are controversial. This study assesses the proportion of different indications for IVCF placement and the associated 30-day event rates and predictors for all-cause mortality, deep vein thrombosis (DVT), pulmonary embolism, and bleeding after IVCF placement. METHOD: In this 5-year retrospective cohort observational study in a quaternary care center, consecutive patients with IVCF placement were identified through cross-matching of 3 database sets and classified into 3 indication groups defined as "standard" in patients with venous thromboembolism (VTE) and contraindication to anticoagulants, "extended" in patients with VTE but no contraindication to anticoagulants, and "prophylactic" in patients without VTE...
November 27, 2019: Journal of Intensive Care Medicine
Gary D Rothberger, Paul K Valestra, Khalilah Knight, Anish K Desai, Rose Calixte, Lawrence E Shapiro
OBJECTIVE: Critical illness causes a decrease in serum free triiodothyronine (T3 ) levels. This condition, known as nonthyroidal illness syndrome (NTIS), is associated with poor outcomes. The association of NTIS and outcomes in patients in the intensive care unit (ICU) requiring mechanical ventilation has not been well studied. This study aimed to determine the impact of NTIS on the outcomes of these patients. METHODS: This prospective study included 162 patients in the ICU who underwent mechanical ventilation...
November 27, 2019: Journal of Intensive Care Medicine
Yusuf Ziya Şener, Seher Şener
No abstract text is available yet for this article.
November 26, 2019: Journal of Intensive Care Medicine
Marjan Islam, David Nesheim, Samuel Acquah, Pierre Kory, Ismini Kourouni, Navitha Ramesh, Madeline Ehrlich, Gargi Bajpayee, David Steiger, Jason Filopei
No abstract text is available yet for this article.
November 26, 2019: Journal of Intensive Care Medicine
Paul Ballieu, Yasaman Besharatian, Safdar Ansari
BACKGROUND/OBJECTIVE: Blood pressure optimization and maintenance of cerebral and spinal perfusion pressure are mainstays in the treatment of a neurocritically ill patient. Traditionally, central venous access has been required for vasopressor administration, with risk of inherent complications. The authors have previously reported pilot data on the safety of peripheral administration of phenylephrine in a neurocritical care unit. In this follow-up, we report the safety, feasibility, and potential efficacy of peripheral administration of low-concentration phenylephrine in a more robust cohort...
November 22, 2019: Journal of Intensive Care Medicine
Ilanit Zada, Shan Wang, Meredith Akerman, Adel Hanna
BACKGROUND: The prevalence of direct oral anticoagulants (DOACs) has increased with continued evidence of their efficacy and ease of use. However, the rise in their utilization also surfaced a concern regarding their reversal in patients actively bleeding and/or those requiring invasive procedures. Up until 2018, there were several reversal options available including 4-factor prothrombin complex concentrate (4-factor PCC), activated charcoal, desmopressin, and tranexamic acid. Then, in 2018, andexanet alpha, a recombinant factor Xa, was approved for the reversal of apixaban and rivaroxaban in patients with life-threatening or uncontrolled bleeding...
November 20, 2019: Journal of Intensive Care Medicine
Wen Wang, Wenwen Chen, Yanmei Liu, Ling Li, Sheyu Li, Jing Tan, Xin Sun
BACKGROUND: We undertook a systematic review and meta-analysis to investigate the relationship between blood glucose levels and mortality in patients with sepsis. METHODS: Medline and EMBASE were searched from inception to April 8, 2018. Cohort studies or case-control studies reported the association between blood glucose and mortality in patients with sepsis were selected. Study characteristics, baseline characteristics, definition of hyperglycemia, and outcomes of interest were extracted...
November 20, 2019: Journal of Intensive Care Medicine
Trenton C Wray, Kristin Schmid, Darren Braude, Keith Azevedo, Todd Dettmer, Isaac Tawil, Michel Boivin, Jonathan Marinaro
INTRODUCTION: The use of transesophageal echocardiography (TEE) by intensivist physicians (IPs) and emergency physicians (EPs) in critically ill patients is increasing in the intensive care unit, emergency department, and prehospital environments. Coagulopathy and thrombocytopenia are common in critically ill patients. The risk of performing TEE in these patients is unknown. The goal of this study was to assess whether TEE is safe when performed by IPs or EPs in critically ill patients with high bleeding risk (HBR)...
November 19, 2019: Journal of Intensive Care Medicine
Shannon M Fernando, Garrick Mok, Bram Rochwerg, Shane W English, Kednapa Thavorn, Victoria A McCredie, Dar Dowlatshahi, Jeffrey J Perry, Eelco F M Wijdicks, Peter M Reardon, Peter Tanuseputro, Kwadwo Kyeremanteng
INTRODUCTION: Patients with intracranial hemorrhage (including intracerebral hemorrhage, subarachnoid hemorrhage, and traumatic hemorrhage) are commonly admitted to the intensive care unit (ICU). Although indications for oral antiplatelet agents are increasing, the impact of preadmission use on outcomes in patients with intracranial hemorrhage admitted to the ICU is unknown. We sought to evaluate the association between preadmission oral antiplatelet use, in-hospital mortality, resource utilization, and costs among ICU patients with intracranial hemorrhage...
November 19, 2019: Journal of Intensive Care Medicine
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