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https://read.qxmd.com/read/30772978/-predictive-value-of-white-blood-cell-procalcitonin-and-high-sensitivity-c-reactive-protein-for-the-bloodstream-infection-in-the-super-elderly-critically-ill-patients
#1
Y Xia, Y Wang, H W He, X L Hong, Q Z An, H M Zhang, Y Long
Objective: To investigate the ability of white blood cell (WBC), procalcitonin (PCT) and high-sensitivity C-reactive protein (hs-CRP) in the super-elderly patients with bloodstream infection. Methods: It was a retrospective study. A total of 77 patients (≥85 years) admitted to the ICU of Peking Union Medical College Hospital from June, 2016 to December, 2017 were enrolled. The patients included 67 males and 10 females, with an age of 85-105 years and the average age was (92±5) years. According to the results of blood culture, patients were divided into positive blood culture group ( n= 50) and negative blood culture group ( n= 27)...
January 29, 2019: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://read.qxmd.com/read/30772131/usefulness-of-rbc-distribution-width-and-c-reactive-protein-to-predict-mortality-in-pediatric-non-cardiac-critical-illness
#2
Gang Li, Peng Jia, Jian Zhao, Xingdan Wu, Yan Duan, Dong Liu, Ting Wang, Bin Liu
INTRODUCTION: We aimed to assess the performance of red blood cell distribution width (RDW), C-reactive protein (CRP) or the combination of both to predict clinical outcomes in pediatric non-cardiovascular critical illness. MATERIALS AND METHODS: We analyzed 404 pediatric non-cardiovascular critically ill patients admitted to pediatric intensive care unit (PICU). Potential predictors were identified using multivariable logistic regression. We also calculated the power of RDW and CRP additive to pediatric critical illness score (PCIS) to predict mortality with calculation of C-index value, integrated discrimination improvement (IDI) and net reclassification improvement (NRI) indices...
January 23, 2019: American Journal of Emergency Medicine
https://read.qxmd.com/read/30760225/is-interleukin-6-a-better-predictor-of-successful-antibiotic-therapy-than-procalcitonin-and-c-reactive-protein-a-single-center-study-in-critically-ill-adults
#3
Lorenz Weidhase, Daniel Wellhöfer, Gero Schulze, Thorsten Kaiser, Tim Drogies, Ulrike Wurst, Sirak Petros
BACKGROUND: The aim of this study was to evaluate whether Interleukin-6 (IL-6) could be a faster indicator of treatment success in adults with severe sepsis and septic shock compared to procalcitonin (PCT) and C-reactive protein (CRP). METHODS: Data from adult patients with severe sepsis and septic shock managed at the medical intensive care unit (ICU) of the University Hospital Leipzig between September 2009 and January 2012 were analyzed retrospectively. Values for CRP, PCT and IL-6 on admission as well as after 24 and 48-72 h were collected...
February 13, 2019: BMC Infectious Diseases
https://read.qxmd.com/read/30745185/what-predicts-the-outcome-in-patients-with-intestinal-ischemia-a-single-center-experience
#4
R Grotelüschen, W Bergmann, M N Welte, M Reeh, J R Izbicki, K Bachmann
BACKGROUND: Acute mesenteric ischemia (AMI) is associated with a mortality of 60-80%. Early diagnosis and rapid treatment have a decisive influence on therapy. The aim of this study was to evaluate the prognostic value of AMI markers on mortality, in order to better anticipate the clinical course and to initiate therapeutic steps at an early stage. STUDY DESIGN: An analysis from our prospective database of 302 consecutive patients with AMI who were treated surgically in the Department of General Surgery between February 2003 and October 2014 was performed...
February 8, 2019: Journal of Visceral Surgery
https://read.qxmd.com/read/30744430/bronchoalveolar-fluid-and-plasma-inflammatory-biomarkers-in-contemporary-ards-patients
#5
Renee D Stapleton, Benjamin T Suratt, Margaret J Neff, Mark M Wurfel, Lorraine B Ware, John T Ruzinski, Ellen Caldwell, Teal S Hallstrand, Polly E Parsons
PURPOSE: Bronchoalveolar fluid (BALF) and plasma biomarkers are often endpoints in early phase randomized trials (RCTs) in acute respiratory distress syndrome (ARDS). With ARDS mortality decreasing, we analyzed baseline biomarkers in samples from contemporary ARDS patients participating in a prior RCT and compared these to historical controls. MATERIALS AND METHODS: Ninety ARDS adult patients enrolled in the parent trial. BALF and blood were collected at baseline, day 4 ± 1, and day 8 ± 1...
February 12, 2019: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://read.qxmd.com/read/30741491/enteral-nutrition-in-the-mechanically-ventilated-patient
#6
REVIEW
Karen Allen, Leah Hoffman
Mechanically ventilated patients are unable to take food orally and therefore are dependent on enteral nutrition for provision of both energy and protein requirements. Enteral nutrition is supportive therapy and may impact patient outcomes in the intensive care unit. Early enteral nutrition has been shown to decrease complications and hospital length of stay and improve the prognosis at discharge. Nutrition support is unique for patients on mechanical ventilation and, as recently published literature shows, should be tailored to the individuals' underlying pathology...
February 11, 2019: Nutrition in Clinical Practice
https://read.qxmd.com/read/30741444/effect-of-registered-dietitian-nutritionist-order-writing-privileges-on-enteral-nutrition-administration-in-selected-intensive-care-units
#7
Bianca D Arney, Stacey A Senter, Avital C Schwartz, Taylor Meily, Stacy Pelekhaty
BACKGROUND: Adequate nutrition is linked to improved patient outcomes during critical illness. Nutrition care is further enhanced by registered dietitian nutritionist (RDN) order-writing privileges, which improve the implementation of nutrition interventions. The purpose of this performance improvement project was to evaluate the effect of RDN order-writing privileges on enteral nutrition (EN) order compliance and nutrition delivery in selected intensive care units (ICUs) at a university-affiliated teaching hospital...
February 11, 2019: Nutrition in Clinical Practice
https://read.qxmd.com/read/30741439/pep-up-enhanced-protein-energy-provision-via-the-enteral-route-feeding-protocol-in-surgical-patients-a-multicenter-pilot-randomized-controlled-trial
#8
D Dante Yeh, Luis Alfonso Ortiz, Jae Moo Lee, Jeffrey Chan, Katherine McKenzie, Brian Young, Lindsay Chetelat, Bryan Collier, Andrew Benson, Daren K Heyland
BACKGROUND: The Enhanced Protein-Energy Provision via the Enteral Route Feeding Protocol (PEP uP) has been shown to be feasible, safe, and effective in delivering significantly more energy/protein, though it has not been well studied in surgical/trauma patients. We hypothesized that PEP uP will effectively increase energy/protein delivery to critically ill surgical/trauma patients. METHODS: This multicenter, prospective, randomized pilot study included adult patients admitted to surgical service who were expected to require mechanical ventilation for >24 hours and intensive care unit (ICU) care for >72 hours...
February 11, 2019: JPEN. Journal of Parenteral and Enteral Nutrition
https://read.qxmd.com/read/30733936/emphysematous-pyelonephritis-following-ureterovesical-reimplantation-for-congenital-obstructive-megaureter-pediatric-case-report-and-review-of-the-literature
#9
Vincenza Girgenti, Gloria Pelizzo, Salvatore Amoroso, Gregorio Rosone, Marco Di Mitri, Mario Milazzo, Salvatore Giordano, Rosaria Genuardi, Valeria Calcaterra
Introduction: Emphysematous pyelonephritis (EPN) is a rare, life-threatening necrotizing infection of the kidney. To date, very few cases of EPN have been described in the pediatric age. The first case of EPN in a toddler occurring after ureterovesical reimplantation for congenital obstructive megaureter is reported with a literature review. Case Report: A 23-month-old male, with a prenatal diagnosis of obstructive megaureter and incomplete duplication of the left urinary tract, was admitted to our Unit where he underwent surgery to treat increased dilatation of the renal pelvis and appearance of an obstructive curve...
2019: Frontiers in Pediatrics
https://read.qxmd.com/read/30718172/postoperative-medical-complications-and-intermediate-care-unit-intensive-care-unit-admission-in-joint-replacement-surgery-a-prospective-risk-model
#10
Anne Klausing, Markus Martini, Matthias Dominik Wimmer, Sascha Gravius, Dieter Christian Wirtz, Thomas Martin Randau
BACKGROUND: Postoperative complications are the main consumers of technical, medical, and human resources. Especially in the field of elective joint replacement surgery, a specialized, easy-to-obtain, and cost-efficient preoperative stratification and risk-estimation model is missing. METHODS: With preoperatively surveyed patient parameters, we identified the most relevant parameters to predict postoperative medical complications. We devised a prospective risk model, measuring the individual probability for intermediate care unit (IMC) or intensive care unit (ICU) admission...
January 5, 2019: Journal of Arthroplasty
https://read.qxmd.com/read/30717340/clinical-value-of-presepsin-in-comparison-to-hscrp-as-a-monitoring-and-early-prognostic-marker-for-sepsis-in-critically-ill-patients
#11
Elham A Hassan, Abeer S Abdel Rehim, Asmaa O Ahmed, Hanan Abdullahtif, Alaa Attia
Sepsis carries a poor prognosis for critically ill patients, even withintensive management. We aimed to determined early predictors of sepsis-related in-hospital mortality and to monitor levels of presepsin and high sensitivity C reactive protein (hsCRP) during admission relative to the applied treatment and the development of complications.An observational study was conducted on 68 intensive care unit (ICU) patients with sepsis. Blood samples from each patient were collected at admission (day 0) for measuring presepsin, hsCRP, biochemical examination, complete blood picture and microbiological culture and at the third day (day 3) for measuring presepsin and hsCRP...
February 2, 2019: Medicina
https://read.qxmd.com/read/30715516/a-comparison-of-point-of-care-c-reactive-protein-test-to-standard-c-reactive-protein-laboratory-measurement-in-a-neonatal-intensive-care-unit-setting
#12
Kim Prince, Fierdoz Omar, Yaseen Joolay
Background: Biomarkers assist in diagnosing neonatal sepsis but often provide results 6 to 48 h later. Bedside C-reactive protein (CRP) test may help to expedite clinical management. We assessed the performance of point of care test (POCT) CRP against routine laboratory analysis and determined the time difference in obtaining results. Methods: A prospective observational study was conducted over 4 months. Neonates clinically indicated, had CRP simultaneously tested using the POCT and laboratory assays...
January 31, 2019: Journal of Tropical Pediatrics
https://read.qxmd.com/read/30707877/-application-value-of-resting-energy-monitoring-in-nutritional-support-therapy-for-mechanical-ventilation-patients
#13
Jun Shi, Ligang Xi, Tianhang Chi, Jiguan Song, Zifang Wang
OBJECTIVE: To investigate the value of resting energy expenditure (REE) monitoring in nutritional support therapy of critical patients on mechanical ventilation. METHODS: A prospective randomized controlled trial was conducted. Sixty critical patients [acute physiology and chronic health evaluation II score (APACHE II) > 15] on ventilation admitted to intensive care unit (ICU) of Dalian Friendship Hospital from September 2016 to October 2018 were enrolled. The enrolled patients were randomly divided into Harris-Benedict formula (HB formula) group and indirect energy measurement (metabolic vehicle) group with 30 patients in each group...
January 2019: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://read.qxmd.com/read/30707321/severe-toxicity-from-checkpoint-protein-inhibitors-what-intensive-care-physicians-need-to-know
#14
REVIEW
Virginie Lemiale, Anne-Pascale Meert, François Vincent, Michael Darmon, Philippe R Bauer, Andry Van de Louw, Elie Azoulay
Checkpoint protein inhibitor antibodies (CPI), including cytotoxic T-lymphocyte-associated antigen 4 inhibitors (ipilimumab, tremelimumab) and the programmed cell death protein 1 pathway/programmed cell death protein 1 ligand inhibitors (pembrolizumab, nivolumab, durvalumab, atezolizumab), have entered routine practice for the treatment of many cancers. They improve the outcome for many cancers, and more patients will be treated with CPI in the future. Although CPI can lead to adverse events (AE) less frequently than for chemotherapy, their use can require intensive care unit admission in case of severe immune-related adverse events (IrAE)...
February 1, 2019: Annals of Intensive Care
https://read.qxmd.com/read/30704891/influence-of-nutrition-support-therapy-on-readmission-among-patients-with-acute-heart-failure-in-the-intensive-care-unit-a-single-center-observational-study
#15
Isao Miyajima, Tomoaki Yatabe, Hajime Kuroiwa, Takahiko Tamura, Masataka Yokoyama
BACKGROUND & AIMS: The effect of nutrition support therapy on prevention of readmission among patients with acute heart failure (HF) in an intensive care unit (ICU) setting remains unclear. We hypothesized that nutrition support therapy might decrease the readmission rate among these patients. Thus, we conducted a single-center prospective observational study to verify this hypothesis. METHODS: Patients diagnosed with acute HF admitted to the ICU for more than 14 days between April 2016 and March 2017 were included in the analysis...
January 22, 2019: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://read.qxmd.com/read/30689610/aquaporin-5-1364a-c-promoter-polymorphism-is-associated-with-pulmonary-inflammation-and-survival-in-acute-respiratory-distress-syndrome
#16
Tim Rahmel, Katharina Rump, Jürgen Peters, Michael Adamzik
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: Acute respiratory distress syndrome is defined according to clinical criteria, but lack of precise characterization may contribute to negative trials and impede personalized care. Polymorphisms of aquaporin-5, a key mediator of inflammation, may impact outcome. WHAT THIS ARTICLE TELLS US THAT IS NEW: In acute respiratory distress syndrome attributable to bacterial pneumonia, the C-allele of the aquaporin-5 -1364A/C promoter polymorphism is associated with less pulmonary inflammation and greater survival...
January 3, 2019: Anesthesiology
https://read.qxmd.com/read/30686699/azithromycin-and-early-allograft-function-after-lung-transplantation-a-randomized-controlled-trial
#17
Anke Van Herck, Anna E Frick, Veronique Schaevers, Annelies Vranckx, Eric K Verbeken, Bart M Vanaudenaerde, Annelore Sacreas, Tobias Heigl, Arne P Neyrinck, Dirk Van Raemdonck, Lieven J Dupont, Jonas Yserbyt, Stijn E Verleden, Geert M Verleden, Robin Vos
BACKGROUND: Chronic lung allograft dysfunction (CLAD) is the single most important factor limiting long-term survival after lung transplantation (LTx). Azithromycin has been shown to improve CLAD-free and long-term survival, yet the possible impact on early lung allograft function is unclear. METHODS: A prospective, randomized, double-blind, placebo-controlled trial of pre-transplant and prompt post-transplant azithromycin treatment was performed at the University Hospitals Leuven...
December 14, 2018: Journal of Heart and Lung Transplantation
https://read.qxmd.com/read/30682545/low-vitamin-d-at-icu-admission-is-associated-with-cancer-infections-acute-respiratory-insufficiency-and-liver-failure
#18
Tatyanne Ln Gomes, Renata C Fernandes, Liana L Vieira, Raquel M Schincaglia, João F Mota, Marciano S Nóbrega, Claude Pichard, Gustavo D Pimentel
OBJECTIVES: Vitamin D deficiency may be associated with comorbidities and poor prognosis. However, this association in patients in the intensive care unit (ICU) has not been fully elucidated. The aim of this study was to investigate whether the serum concentrations of 25-hydroxyvitamin D (25[OH]D) within the first 48 h after ICU admission are associated with prognostic indicators (Acute Physiology and Chronic Health Evaluation [APACHE] II, Sequential Organ Failure Assessment [SOFA] score, Charlson comorbidity index [CCI]), clinical complications, serum C-reactive protein (CRP) concentrations, mechanical ventilation duration, and mortality...
October 24, 2018: Nutrition
https://read.qxmd.com/read/30680697/sevoflurane-prevents-airway-remodeling-via-downregulation-of-vegf-and-tgf-%C3%AE-1-in-mice-with-ova-induced-chronic-airway-inflammation
#19
Qi-Ying Shen, Ling Wu, Chuan-Sheng Wei, Yan-Nan Zhou, Hui-Mei Wu
Asthma is characterized by chronic airway inflammation, which is the underlying cause of airway remodeling featured by goblet cell hyperplasia, subepithelial fibrosis, and proliferation of smooth muscle. Sevoflurane has been used to treat life-threatening asthma and our previous study shows that sevoflurane inhibits acute lung inflammation in ovalbumin (OVA)-induced allergic mice. However, the effect of sevoflurane on airway remodeling in the context of chronic airway inflammation and the underlying mechanism are still unknown...
January 24, 2019: Inflammation
https://read.qxmd.com/read/30673776/colonization-with-multidrug-resistant-organisms-determines-the-clinical-course-of-patients-with-acute-myeloid-leukemia-undergoing-intensive-induction-chemotherapy
#20
Olivier Ballo, Ikram Tarazzit, Jan Stratmann, Claudia Reinheimer, Michael Hogardt, Thomas A Wichelhaus, Volkhard Kempf, Hubert Serve, Fabian Finkelmeier, Christian Brandts
INTRODUCTION: The global spread of multidrug-resistant organisms (MDRO) complicates treatment and isolation measures in hospitals and has shown to increase mortality. Patients with disease- or therapy-related immunodeficiency are especially at risk for fatal infections caused by MDRO. The impact of MDRO colonization on the clinical course of AML patients undergoing intensive induction chemotherapy-a potentially curative but highly toxic treatment option-has not been systematically studied...
2019: PloS One
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