Byunggeon Park, Jongmin Park, Jae Kwang Lim, Kyung Min Shin, Jaehee Lee, Hyewon Seo, Yong Hoon Lee, Jun Heo, Won Kee Lee, Jin Young Kim, Ki Beom Kim, Sungjun Moon, Sooyoung Choi
OBJECTIVE: Lung segmentation using volumetric quantitative computed tomography (CT) analysis may help predict outcomes of patients with coronavirus disease (COVID-19). The aim of this study was to investigate the relationship between CT volumetric quantitative analysis and prognosis in patients with COVID-19. MATERIALS AND METHODS: CT images from patients diagnosed with COVID-19 from February 18 to April 15, 2020 were retrospectively analyzed. CT with a negative finding, failure of quantitative analysis, or poor image quality was excluded...
August 4, 2020: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Jessica Barochiner, Rocío Martínez
WHAT IS KNOWN AND OBJECTIVE: Controversy has arisen in the scientific community on whether the use of renin-angiotensin system (RAS) inhibitors in the context of COVID-19 would be beneficial or harmful. A meta-analysis of eligible studies comparing the occurrence of severe and fatal COVID-19 in infected hypertensive patients who were under treatment with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) vs no treatment or other antihypertensives was conducted...
August 7, 2020: Journal of Clinical Pharmacy and Therapeutics
Mahmood S Choudhery, David T Harris
Since its eruption in China, novel coronavirus disease (Covid-19) has been reported in most of the countries and territories (>200) of the world with ~ 18 million confirmed cases (as of August 3, 2020). In most of the countries, Covid-19 upsurge is uncontrolled with a significant mortality rate. Currently no treatment effective for Covid-19 is available in the form of vaccines or antiviral drugs and patients are currently treated symptomatically. Although majority of the patients develop mild symptoms and recover without mechanical ventilation for respiratory management, severe respiratory illness develops in a significant portion of affected patients and may result in death...
August 7, 2020: Cell Biology International
Chin-Ming Chen, Ai-Chin Cheng, Willy Chou, Padhmavathi Selvam, Chih Mei Cheng
BACKGROUND: Prolonged physical immobilization has negative effects on patients on mechanical ventilation (MV). AIMS: To introduce a quality improvement programme with early mobilization on the outcomes of patients on MV in the intensive care unit (ICU). We particularly studied the impact of the ABCDE (daily Awakening, Breathing trial, drug Co-ordination, Delirium survey and treatment, and Early mobilization) bundle on the outcome of MV patients with acute respiratory failure in the ICU...
August 6, 2020: Nursing in Critical Care
How-Yang Tseng, Yi-Cheng Shen, Yen-Sung Lin, Chih-Yen Tu, Hung-Jen Chen
BACKGROUND: This study aimed to evaluate the characteristics of patients with newly diagnosed advanced lung cancer who initially presented with respiratory failure. METHODS: This was a retrospective study which analyzed patients in the intensive care unit (ICU) with newly diagnosed advanced lung cancer who were placed on mechanical ventilation (MV). We defined newly diagnosed lung cancer as pathological or molecular results for treatment decisions not yet determined when the patient was admitted to ICU...
August 6, 2020: Thoracic Cancer
Emma Louise Sierp, Rochelle Kurmis, Kylie Lange, Rosalie Yandell, Marianne Chapman, John Greenwood, Lee-Anne S Chapple
BACKGROUND: Gastrointestinal (GI) dysmotility impedes nutrient delivery in critically ill patients with major burns. We aimed to quantify the incidence, timing, and factors associated with GI dysmotility and subsequent nutrition delivery. METHODS: A 10-year retrospective observational study included mechanically ventilated adult critically ill patients with ≥15% Total Body Surface Area (TBSA) burns receiving nutrition support. Patients were categorized as having GI dysmotility if they had any gastric residual volume (GRV) ≥250ml...
August 7, 2020: JPEN. Journal of Parenteral and Enteral Nutrition
D B Hauschild, L D A Oliveira, J C Ventura, M S Farias, E Barbosa, N L Bresolin, Y M F Moreno
BACKGROUND: Persistent inflammation, immunosuppression and catabolism syndrome (PICS) has been described in critically ill adults and may contribute to unfavourable outcomes. The present study aimed to describe and characterise PICS in critically ill children (PICS-ped) and to verify its association with clinical outcomes. METHODS: A prospective longitudinal study was conducted in a paediatric intensive care unit (PICU) with children aged between 3 months and 15 years...
August 7, 2020: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
Q Ma, D Qi, X-Y Deng, G-D Yuan, W-G Tian, Y Cui, X-F Yan, D-X Wang
OBJECTIVE: To investigate the effect of corticosteroid on hospital mortality, hospital length of stay, and time of viral clearance in patients with severe and critical COVID-19. PATIENTS AND METHODS: Patients with severe and critical COVID-19 who had been discharged or expired were enrolled in this study. Patients were divided into corticosteroid group and non-corticosteroid group according to the systemic corticosteroid use or not. Clinical data were collected, and hospital mortality, hospital length of stay, time of viral clearance, time of mechanical ventilation, and duration from illness onset to symptom resolution were compared between the two groups...
August 2020: European Review for Medical and Pharmacological Sciences
Swati Mahich, Suresh Kumar Angurana, Renu Suthar, Venkataseshan Sundaram, Vimal Singh Munda, Vikas Gautam
OBJECTIVES: To study the clinical profile, complications, antibiotic resistance pattern, treatment, and outcome of out-born neonates with Acinetobacter spp. sepsis admitted in Pediatric emergency of a tertiary care hospital in North India. METHODS: In this subgroup analysis of a prospective study (conducted over 1 y, February 2018 through January 2019), neonates with Acinetobacter spp. sepsis were included. The data collection included demographic details, clinical features, pre-referral treatment, complications, antibiotic resistance pattern, treatment, and final outcome...
August 7, 2020: Indian Journal of Pediatrics
Olivia S Kates, Brandy M Haydel, Sander S Florman, Meenakshi M Rana, Zohra S Chaudhry, Mayur S Ramesh, Kassem Safa, Camille Nelson Kotton, Emily A Blumberg, Behdad D Besharatian, Sajal D Tanna, Michael G Ison, Maricar Malinis, Marwan M Azar, Robert M Rakita, Jose A Morillas, Aneela Majeed, Afrah S Sait, Mario Spaggiari, Vagish Hemmige, Sapna A Mehta, Henry Neumann, Abbasali Badami, Jason D Goldman, Anuradha Lala, Marion Hemmersbach-Miller, Margaret E McCort, Valida Bajrovic, Carlos Ortiz-Bautista, Rachel Friedman-Moraco, Sameep Sehgal, Erika D Lease, Cynthia E Fisher, Ajit P Limaye
BACKGROUND: The COVID-19 pandemic has led to significant reductions in transplantation, motivated in part by concerns of disproportionately more severe disease among solid organ transplant (SOT) recipients. However, clinical features, outcomes, and predictors of mortality in SOT recipients are not well-described. METHODS: We performed a multi-center cohort study of SOT recipients with laboratory-confirmed COVID-19. Data were collected using standardized intake and 28-day follow-up electronic case report forms...
August 7, 2020: Clinical Infectious Diseases
Stephen W Olson, James D Oliver, Jacob Collen, Jessica Bunin, Todd D Gleeson, Brian E Foster, Mark P Simmons, Hua W Chen, Jennifer B Ficke, Tara E Brown, Mark T Nau, Brennan R Cebula, Jan Kielstein, Kevin K Chung
To determine whether Seraph-100 (Exthera Medical Corporation, Martinez, CA) treatment provides clinical benefit for severe coronavirus disease 2019 cases that require mechanical ventilation and vasopressor support. Data Sources: The first two patients in the United States treated with the novel Seraph-100 device. These cases were reviewed by the Food and Drug Administration prior to granting an emergency use authorization for treatment of coronavirus disease 2019. Study Selection: Case series...
August 2020: Critical care explorations
Steve Primmaz, Christophe Le Terrier, Noémie Suh, François Ventura, Filippo Boroli, Karim Bendjelid, Sara Cereghetti, Raphaël Giraud, Claudia Heidegger, Deborah Pugin, Nils Siegenthaler, Didier Tassaux, Jean-Clément Cabrol, Nathan Dolet, Christoph Ellenberger, Gleicy Keli Barcelos, Marc-Joseph Licker, Georges Savoldelli, Eduardo Schiffer, Angèle Gayet-Ageron, Laurent Kaiser, Martin R Tramèr, Jérôme Pugin
Objectives: In many countries, large numbers of critically ill patients with coronavirus disease 2019 are admitted to the ICUs within a short period of time, overwhelming usual care capacities. Preparedness and reorganization ahead of the wave to increase ICU surge capacity may be associated with favorable outcome. The purpose of this study was to report our experience in terms of ICU organization and anticipation, as well as reporting patient characteristics, treatment, and outcomes...
August 2020: Critical care explorations
Andrea Duca, Irdi Memaj, Federico Zanardi, Carlo Preti, Andrea Alesi, Lorenzo Della Bella, Elena Ghezzi, Fabiano Di Marco, Ferdinando Luca Lorini, Serena Venturelli, Stefano Fagiuoli, Roberto Cosentini
Background: Novel Coronavirus SARS-CoV-2 pandemic is spreading around the world. At the end of February, the outburst of the pandemic has hit hard on northern Italian's hospitals. As of today, no data have been published regarding the severity of respiratory failure of patients presenting to the Emergency Departments. Moreover, the outcome the patients forced to undergo Continuous Positive Airway Pressure (CPAP) or Non-Invasive Positive Pressure Ventilation (NIPPV) due to lack of Intensive Care resources is unknown...
July 2020: EClinicalMedicine
Tariq Kewan, Fahrettin Covut, Mohammed J Al-Jaghbeer, Lori Rose, K V Gopalakrishna, Bassel Akbik
Background: Tocilizumab was approved for chimeric antigen receptor T-cell therapy induced cytokine release syndrome and it may provide clinical benefit for selected COVID-19 patients. Methods: In this retrospective cohort study, we analyzed hypoxic COVID-19 patients who were consecutively admitted between March 13, 2020 and April 19, 2020. Patients with lung infiltrates and elevated inflammatory markers received a single dose of tocilizumab if no contraindication was present...
July 2020: EClinicalMedicine
Antonio Mastroianni, Sonia Greco, Giovanni Apuzzo, Salvatore De Santis, Carmela Oriolo, Alfredo Zanolini, Luciana Chidichimo, Valeria Vangeli
Background: Patients with severe coronavirus disease 2019 (COVID-19) have elevated levels of acute phase reactants and inflammatory cytokines, including interleukin-6, indicative of cytokine release syndrome (CRS). The interleukin-6 receptor inhibitor tocilizumab is used for the treatment of chimeric antigen receptor T-cell therapy-induced CRS. Methods: Patients aged 18 years or older with laboratory-confirmed COVID-19 admitted to the Annunziata Hospital in Cosenza, Italy, through March 7, 2020, who received at least one dose of tocilizumab 162 mg subcutaneously for the treatment of COVID-19-related CRS in addition to standard care were included in this retrospective observational study...
July 2020: EClinicalMedicine
Qian Wen Sng, Chengsi Ong, Su Ling Linda Ang, Angela Hui Ping Kirk, Jan Hau Lee
Strategies to improve nutritional management are associated with better outcomes in pediatric intensive care units. We implemented a calorie-based protocol that integrated an electronic feeds calculator and stepwise feeds increment algorithm. Methods: Using a pretest-posttest design, we compared the effectiveness of the calorie-based protocol with an existing fluid-based protocol in a quality improvement project. The main outcome measure was the proportion of patients prescribed with the appropriate amount of calories (defined as 90%-110% of calculated energy requirements)...
January 2020: Pediatric Quality & Safety
Jianying Guo, Yanyan Hong, Zhiyong Wang, Yukun Li
Low plasma triiodothyronine (T3) concentration indicates nonthyroidal illness syndrome (NTIS), which might be associated with a poor outcome in patients in the intensive care unit (ICU). This study evaluated the relationship between NTIS and prognostic indicators in patients admitted to the ICU and examined the fT3 cut-off points that could be associated with 28-day mortality. This prospective observational study included patients admitted to the ICU of The Third Hospital of Hebei Medical University from February to November 2018...
2020: BioMed Research International
Agnieszka Neumann-Podczaska, Salwan R Al-Saad, Lukasz M Karbowski, Michal Chojnicki, Slawomir Tobis, Katarzyna Wieczorowska-Tobis
The SARS-CoV-2 tendency to affect the older individuals more severely, raises the need for a concise summary isolating this age population. Analysis of clinical features in light of most recently published data allows for improved understanding, and better clinical judgement. A thorough search was performed to collect all articles published from 1st of January to 1st of June 2020, using the keywords COVID-19 and SARS-CoV-2 followed by the generic terms elderly , older adults or older individuals . The quality assessment of studies and findings was performed by an adaptation of the STROBE statement and CERQual approach...
July 2020: Aging and Disease
Yue Li, Zhongyi Sun, Yuhua Hu, Bingjie Li, Xinxin Bu, Yanyan Luo, Shujun Li, Xiaoqing Chen
Background: The reasonable use of amino acids (AAs) in parenteral nutrition (PN) is very critical to the growth and development of premature infants. However, the appropriate dose of AAs has not been determined. Our study was designed to investigate the clinical effect of two different doses of AAs in PN for low birth weight premature infants. Materials and Methods: This randomized controlled study included 191 preterm infants who admitted to the neonatal intensive care unit of the First Affiliated Hospital of Nanjing Medical University from June 2015 to December 2016 and they were randomly divided into Group 1 ( n = 81) and Group 2 ( n = 110)...
2020: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
Yoshikazu Yamaguchi, Tetsuya Miyashita, Yuko Matsuda, Makoto Sasaki, Shunsuke Takaki, Stephani S Kim, Joseph D Tobias, Takahisa Goto
Background: Precise control of tidal volume is one of the keys in limiting ventilator-induced lung injury and ensuring adequate ventilation in mechanically ventilated neonates. The aim of the study was to compare the tidal volume (mVT) measured from the expiratory limb of the ventilator with the actual tidal volume (aVT) that would be delivered to the patient using a lung model to simulate a neonate. Methods: This study was conducted using the ASL5000 lung simulator...
2020: Medical Devices: Evidence and Research
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