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Journal of Intensive Care Medicine

Juan Qian, Tao Zhou, Bi-Jun Qiu, Long Xiang, Jian Zhang, Bo-Tao Ning, Hong Ren, Bi-Ru Li, Qiang Xia, Ying Wang
INTRODUCTION: The aim of this study was to present our 10-year experience of pediatric intensive care unit (PICU) management with pediatric liver recipients and to understand the importance of close interdisciplinary cooperation in 2 hospitals. METHODS: A retrospective chart review study was performed according to our hospital's medical records and the pediatric liver transplant database of Renji hospital. RESULTS: A total of 767 patients received liver transplantation (LT) performed in Renji hospital between October 2006 and December 2016, of which 97 of them were admitted to PICU in our center for various complications developed after transplantation...
May 15, 2019: Journal of Intensive Care Medicine
Lauren Koffman, Fred Rincon, Joao Gomes, Sarabdeep Singh, Yitian He, Eva Ritzl, Thomas P Bleck, Peter W Kaplan, Paul Nyquist
OBJECTIVE: Research on continuous electro-encephalographic monitoring (cEEG) in the intensive care unit (ICU) has previously focused on neuroscience ICUs. This study determines cEEG utilization within a sample of specialty ICUs world-wide. METHODS: A cross-sectional electronic survey of attending level physicians across various intensive care settings. Twenty-five questions developed from consensus statements on the use of cEEG in the critically ill sent as an electronic survey...
May 13, 2019: Journal of Intensive Care Medicine
Yueh-Che Hsieh, Po-Yang Tsou, Yu-Hsun Wang, Christin Chih-Ting Chao, Wan-Chien Lee, Meng-Tse Gabriel Lee, Jiunn-Yih Wu, Shy-Shin Chang, Po-Yen Chen, Chien-Chang Lee
OBJECTIVES: Predictors for post-sepsis myocardial infarction (MI) and stroke are yet to be identified due to the competing risk of death. METHODS: This study included all hospitalized patients with sepsis from National Health Insurance Research Database of Taiwan between 2000 and 2011. The primary outcome was the first occurrence of MI and stroke requiring hospitalization within 180 days following hospital discharge from the index sepsis episode. The association between predictors and post-sepsis MI and stroke were analyzed using cumulative incidence competing risk model that controlled for the competing risk of death...
May 12, 2019: Journal of Intensive Care Medicine
Daniel Reynolds, Rahul Kashyap, Lindsey Wallace, Ognjen Gajic, Hemang Yadav
INTRODUCTION: Older adult individuals often have acute illnesses predisposing them to developing acute respiratory distress syndrome (ARDS). We aimed to identify the relationship between age and the development of ARDS in a cohort of hospitalized patients. METHODS: This was a secondary analysis of a prospective multicenter observational cohort study of hospitalized patients at risk of developing ARDS admitted to 22 hospitals from March 2009 to August 2009. Patients were classified as older adults if their age was 80 or greater...
May 8, 2019: Journal of Intensive Care Medicine
Tanuwong Viarasilpa, Nicha Panyavachiraporn, Jack Jordan, Seyed Mani Marashi, Meredith van Harn, Noel O Akioyamen, Robert G Kowalski, Stephan A Mayer
BACKGROUND: Venous thromboembolism (VTE) is a potentially life-threatening complication among critically ill patients. Neurocritical care patients are presumed to be at high risk for VTE; however, data regarding risk factors in this population are limited. We designed this study to evaluate the frequency, risk factors, and clinical impact of VTE in neurocritical care patients. METHODS: We obtained data from the electronic medical record of all adult patients admitted to neurological intensive care unit (NICU) at Henry Ford Hospital between January 2015 and March 2018...
May 7, 2019: Journal of Intensive Care Medicine
Yazan Zayed, Momen Banifadel, Mahmoud Barbarawi, Babikir Kheiri, Adam Chahine, Laith Rashdan, Tarek Haykal, Varun Samji, Emily Armstrong, Ghassan Bachuwa, Ibrahim Al-Sanouri, Elfateh Seedahmed, Dawn-Alita Hernandez
INTRODUCTION: Acute hypoxemic respiratory failure (AHRF) is a leading cause of intensive care unit (ICU) admission among immunocompromised patients. Invasive mechanical ventilation is associated with increased morbidity and mortality. OBJECTIVE: To evaluate the efficacy of various oxygenation strategies including noninvasive ventilation (NIV), high-flow nasal cannula (HFNC), and conventional oxygen therapy in immunocompromised patients with AHRF. METHODS: Electronic databases including PubMed, Embase, and the Cochrane Library were reviewed from inception to December 2018...
May 2, 2019: Journal of Intensive Care Medicine
Drayton A Hammond, Melanie N Smith, Gary D Peksa, Abhaya P Trivedi, Robert A Balk, Bryan E Menich
PURPOSE: To evaluate the effects of midodrine in addition to intravenous vasopressor therapy on outcomes in adults recovering from shock. MATERIALS AND METHODS: PubMed, Scopus, , and published abstracts were searched from inception to November 2018 for studies comparing outcomes in shock after midodrine initiation versus no midodrine. RESULTS: Three studies with 2533 patients were included. Patients in whom midodrine was added to intravenous vasopressor therapy compared to intravenous vasopressor therapy alone experienced similar intensive care unit (ICU; mean difference [MD]: 1...
April 28, 2019: Journal of Intensive Care Medicine
Angel Joel Cadena, Sara Habib, Fred Rincon, Stephanie Dobak
Malnutrition is frequently seen among patients in the intensive care unit. Evidence shows that optimal nutritional support can lead to better clinical outcomes. Recent clinical trials debate over the efficacy of enteral nutrition (EN) over parenteral nutrition (PN). Multiple trials have studied the impact of EN versus PN in terms of health-care cost and clinical outcomes (including functional status, cost, infectious complications, mortality risk, length of hospital and intensive care unit stay, and mechanical ventilation duration)...
April 28, 2019: Journal of Intensive Care Medicine
Barry Kelly, Edmund Carton
BACKGROUND: The use of extracorporeal life support (ECLS) for cardiorespiratory support is increasing. Traditional absolute contraindications are currently deemed relative contraindications. Extracorporeal life support is now considered for a wider cohort of patients on a case-by-case basis. METHOD: We performed a review of the literature and examined current Extracorporeal Life Support Organization guidelines that support the use of ECLS in the operating room, based on the underlying pathology and surgical procedure proposed...
April 23, 2019: Journal of Intensive Care Medicine
Karen Berger, Melissa Santibañez, Lina Lin, Christine A Lesch
PURPOSE: Current guidelines favor 4F-PCC over plasma for reversal of warfarin. Uncertainty remains on the hemostatic effectiveness and thrombotic risk of 4F-PCC for direct-acting oral anticoagulants (DOACs), particularly in patients with intracranial hemorrhage (ICH). This study sought to evaluate the effectiveness and safety of a lower dose protocol of 25 units/kg 4F-PCC for the management of DOAC-associated ICH in a real-world setting. MATERIALS AND METHODS: This was a retrospective study of adult patients who received at least one dose of 4F-PCC from March 2014 to December 2015 for DOAC-associated ICH...
April 14, 2019: Journal of Intensive Care Medicine
Megan E Barra, Saef Izzy, Aliyah Sarro-Schwartz, Ronald E Hirschberg, Nicole Mazwi, Brian L Edlow
BACKGROUND/OBJECTIVE: Pharmacological stimulant therapies are routinely administered to promote recovery in patients with subacute and chronic disorders of consciousness (DoC). However, utilization rates and adverse drug event (ADE) rates of stimulant therapies in patients with acute DoC are unknown. We aimed to determine the frequency of stimulant use and associated ADEs in intensive care unit (ICU) patients with acute DoC caused by traumatic brain injury (TBI). METHODS: We retrospectively identified patients with TBI admitted to the ICU at 2 level 1 trauma centers between 2015 and 2018...
April 9, 2019: Journal of Intensive Care Medicine
Cristina Sánchez Carabias, Ana María Castaño-León, Blanca Navarro B, Irene Panero, Carla Eiriz, Pedro A Gómez, Javier Egea, Alfonso Lagares
Extracranial injury is frequently present in patients with traumatic brain injury (TBI). However, no reliable biomarker exists nowadays to evaluate the magnitude and extension of extracranial injury as well as the identification of patients who are at risk of developing secondary injuries. The purpose of this study was to identify new possible peptide biomarkers by mass spectrometry analysis in patients with TBI and ascertain whether the novel biomarker discovered by peptide mass fingerprinting, serum amyloid A1 (SAA1), is capable of reflecting the condition of the patient and both intracranial and extracranial injury extension...
April 8, 2019: Journal of Intensive Care Medicine
Michael Bender, M Stein, E Uhl, M H T Reinges
OBJECTIVE: Cardiopulmonary complications/stress are well-known phenomena in patients after aneurysmal subarachnoid hemorrhage (aSAH) and might be associated with an elevated serum troponin I (TNI) level. Since the glucocorticoid hormone cortisol is released during stress situations, the present study was conducted to investigate the influence of serum cortisol (SC) on cardiac and pulmonary parameters in patients after aSAH within the first 24 hours of intensive care unit (ICU) treatment...
March 26, 2019: Journal of Intensive Care Medicine
Klaus Stahl, Markus Busch, Sabine K Maschke, Andrea Schneider, Michael P Manns, Jan Fuge, Olaf Wiesner, Bernhard C Meyer, Marius M Hoeper, Jan B Hinrichs, Sascha David
BACKGROUND: To analyze demography, clinical signs, and survival of intensive care patients diagnosed with nonocclusive mesenteric ischemia (NOMI) and to evaluate the effect of a local intra-arterial prostaglandin therapy. METHODS: Retrospective observational study screening 455 intensive care patients with acute arterial mesenteric perfusion disorder in a tertiary care hospital within the past 8 years. Lastly, 32 patients with NOMI were enrolled, of which 11 received local intra-arterial prostaglandin therapy...
March 25, 2019: Journal of Intensive Care Medicine
Jatinder Grewal, Anna-Liisa Sutt, George Cornmell, Kiran Shekar, John Fraser
PURPOSE: Patients supported with extracorporeal membrane oxygenation (ECMO) have been reported to have increased sedation requirements. Tracheostomies are performed in intensive care to facilitate longer term mechanical ventilation, reduce sedation, improve patient comfort, secretion clearance, and ability to speak and swallow. We aimed to investigate the safety of tracheostomy (TT) placement on ECMO, its impact on fluid intake, and the use of sedative, analgesic, and vasoactive drugs...
March 21, 2019: Journal of Intensive Care Medicine
Marcos Silva Restrepo, Michel A Boivin, Pierre Kory, Pralay K Sarkar, Gisela I Banauch, Stephen Halpern, Paul H Mayo
BACKGROUND: Transesophageal echocardiography has important applications for the management of the critically ill patient. There is a need to develop effective training programs for the critical care community in acquiring skill at critical care transesophageal echocardiography. OBJECTIVE: We studied the effectiveness of a 1-day simulation-based course that focused on the acquisition of skill in the performance of critical care transesophageal echocardiography. METHODS: Learners received training in image acquisition with a transesophageal simulator and training in image interpretation in small group sessions...
March 13, 2019: Journal of Intensive Care Medicine
Nikhil K Meena, Odai Sinokrot, Abhijit Duggal, Daisy Alpat, Zeba N Singh, Jean M Coviello, Manshi Li, Xiaofeng Wang, Eduardo Mireles-Cabodevila
OBJECTIVE: The diagnostic criteria for secondary hemophagocytic lymphohistiocytosis (HLH) have not been validated in the critically ill adult population. We set out to evaluate the performance of diagnostic criteria and determine the ferritin cutoff in critically ill adults. DESIGN: A retrospective single-center study. SETTING AND PATIENTS: Patients admitted to intensive care unit between 2008 and March 2010. Data were collected on consecutive patients who had ferritin measured...
March 12, 2019: Journal of Intensive Care Medicine
Matheni Sathananthan, Airani Sathananthan, Niranjan Jeganathan
PURPOSE: To date, studies have provided conflicting results regarding the impact of type 2 diabetes mellitus (DM) on sepsis-related outcomes. Our objective is to understand the impact of type 2 DM in bacterial pneumonia and sepsis-related intensive care unit (ICU) outcomes. METHODS: Retrospective study using Multiparameter Intelligent Monitoring in Intensive Care III database. We included 1698 unique patients admitted with sepsis secondary to bacterial pneumonia to the ICU within the time period of 2001 to 2012...
March 6, 2019: Journal of Intensive Care Medicine
Michael H Lazar, Eric Espinoza Moscoso, Jeffrey H Jennings
OBJECTIVE: The purpose of this study is to determine whether in patients admitted to a medical intensive care unit (ICU) service there are outcome differences between those in a medical ICU bed ("home") and a geographically distant subspecialty ICU bed ("overflow"). METHODS: We performed a retrospective cohort study of 4091 patients admitted to a medical ICU of a large tertiary-care urban teaching hospital. Depending on bed availability, some patients were housed in surgical or cardiac subspecialty ICUs while still being cared for by the primary medical ICU service...
March 5, 2019: Journal of Intensive Care Medicine
Patrick M Wieruszewski, Erin F Barreto, Jason N Barreto, Hemang Yadav, Pritish K Tosh, Kristin C Mara, Andrew H Limper
BACKGROUND: Corticosteroid therapy is a well-recognized risk factor for Pneumocystis pneumonia (PCP); however, it has also been proposed as an adjunct to decrease inflammation and respiratory failure. OBJECTIVE: To determine the association between preadmission corticosteroid use and risk of moderate-to-severe respiratory failure at the time of PCP presentation. METHODS: This retrospective cohort study evaluated HIV-negative immunosuppressed adults diagnosed with PCP at Mayo Clinic from 2006 to 2016...
February 27, 2019: Journal of Intensive Care Medicine
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