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https://read.qxmd.com/read/30872586/acute-respiratory-distress-syndrome
#1
REVIEW
Michael A Matthay, Rachel L Zemans, Guy A Zimmerman, Yaseen M Arabi, Jeremy R Beitler, Alain Mercat, Margaret Herridge, Adrienne G Randolph, Carolyn S Calfee
The acute respiratory distress syndrome (ARDS) is a common cause of respiratory failure in critically ill patients and is defined by the acute onset of noncardiogenic pulmonary oedema, hypoxaemia and the need for mechanical ventilation. ARDS occurs most often in the setting of pneumonia, sepsis, aspiration of gastric contents or severe trauma and is present in ~10% of all patients in intensive care units worldwide. Despite some improvements, mortality remains high at 30-40% in most studies. Pathological specimens from patients with ARDS frequently reveal diffuse alveolar damage, and laboratory studies have demonstrated both alveolar epithelial and lung endothelial injury, resulting in accumulation of protein-rich inflammatory oedematous fluid in the alveolar space...
March 14, 2019: Nature Reviews. Disease Primers
https://read.qxmd.com/read/30725273/-modern-breath-analysis
#2
REVIEW
L M Wirtz, S Kreuer, T Volk, T Hüppe
BACKGROUND: Analysis of exhaled air is a risk-free option for bedside diagnostics. Modern breath analysis can detect very low concentrations of volatile components. Current research focuses on drug monitoring and diagnosis of various diseases. OBJECTIVES: Presentation and discussion of current breath research relevant to intensive care medicine. MATERIALS AND METHODS: The literature in PubMed was searched using the following terms: "breath analysis", "volatile organic compounds", "critically ill" combined with "drug monitoring", "propofol", "heart failure", "pneumonia", "ARDS", "renal failure", "liver failure", "sepsis" or "hemorrhage"...
February 6, 2019: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://read.qxmd.com/read/30707863/-review-and-forecast-of-critical-care-medicine-in-2018
#3
Wei Huang, Yongxin Qin
In 2018, a bunch of considerable positive progresses have been presented, including a revised "hour-1 bundle" introduced by international guideline for management of sepsis and septic shock, trans-pulmonary pressure monitoring via esophageal manometry in acute respiratory distress syndrome (ARDS) models, successful trials for new antibiotics, angiotensin II in patients with vasodilatory shock and renal replacement therapy, advanced airway management in out-of-hospital cardiac arrest (OHCA) patients as well cellular immunotherapy for septic shock...
January 2019: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://read.qxmd.com/read/30675131/biomarkers-for-acute-respiratory-distress-syndrome-and-prospects-for-personalised-medicine
#4
REVIEW
Savino Spadaro, Mirae Park, Cecilia Turrini, Tanushree Tunstall, Ryan Thwaites, Tommaso Mauri, Riccardo Ragazzi, Paolo Ruggeri, Trevor T Hansel, Gaetano Caramori, Carlo Alberto Volta
Acute lung injury (ALI) affects over 10% of patients hospitalised in critical care, with acute respiratory distress syndrome (ARDS) being the most severe form of ALI and having a mortality rate in the region of 40%. There has been slow but incremental progress in identification of biomarkers that contribute to the pathophysiology of ARDS, have utility in diagnosis and monitoring, and that are potential therapeutic targets (Calfee CS, Delucchi K, Parsons PE, Thompson BT, Ware LB, Matthay MA, Thompson T, Ware LB, Matthay MA, Lancet Respir Med 2014, 2:611--620)...
2019: Journal of Inflammation
https://read.qxmd.com/read/30627186/elastic-band-exercises-for-patients-with-intensive-care-unit-acquired-weakness-a-case-report
#5
Massimiliano Polastri, Stefano Oldani, Lara Pisani, Stefano Nava
Intensive care unit-acquired weakness is characterised by severe impairment of muscle function that often arises after prolonged mechanical ventilation, difficult weaning, and severe sepsis. Elastic band exercises constitute an inexpensive and simple technique that is quite appealing for implementation in a "protected environment" such as the intensive care unit; however, elastic band application in the intensive care unit and in critical patients has not yet been described. A 72-year-old male was referred to the respiratory intensive care unit for hypoxemic respiratory failure due to acute respiratory distress syndrome...
February 2018: Tanaffos
https://read.qxmd.com/read/30592949/-application-value-of-continuous-blood-purification-in-pediatric-intensive-care-unit-analysis-of-203-cases
#6
Shaodong Zhao, Xuhua Ge, Penghong Xu, Yong Liu, Jun Shi, Hongjun Miao
OBJECTIVE: To explore the clinical application value of the continuous blood purification (CBP) technology in pediatric intensive care unit (ICU). METHODS: A retrospective study was conducted. All CBP patients admitted to pediatric ICU of Children's Hospital of Nanjing Medical University from 2015 to 2017 were enrolled. The disease diagnosis, CBP treatment mode, catheter placement, anticoagulation way, treatment time and adverse reactions were summarized and analyzed...
December 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://read.qxmd.com/read/30579331/choice-of-fluids-in-critically-ill-patients
#7
REVIEW
Claude Martin, Andrea Cortegiani, Cesare Gregoretti, Ignacio Martin-Loeches, Carole Ichai, Marc Leone, Gernot Marx, Sharon Einav
BACKGROUND: Fluids are by far the most commonly administered intravenous treatment in patient care. During critical illness, fluids are widely administered to maintain or increase cardiac output, thereby relieving overt tissue hypoperfusion and hypoxia. MAIN TEXT: Until recently, because of their excellent safety profile, fluids were not considered "medications". However, it is now understood that intravenous fluid should be viewed as drugs. They affect the cardiovascular, renal, gastrointestinal and immune systems...
December 22, 2018: BMC Anesthesiology
https://read.qxmd.com/read/30405282/clinical-and-laboratory-features-associated-with-acute-kidney-injury-in-severe-malaria
#8
Hiren Anghan, Prayas Sethi, Manish Soneja, Sandeep Mahajan, Naveet Wig
Introduction: Critically ill severe malaria constitutes one of the major hospital admissions in Indian setting. Clinical studies identifying the factors associated with acute kidney injury (AKI) in malaria are lacking. This study aimed to identify these factors. Methods: This prospective observational study was conducted in a tertiary care center of North India. All adult patients with severe malaria were studied during 2012-2014. Results: The study included 79 patients and AKI was observed in 36 patients...
October 2018: Indian Journal of Critical Care Medicine
https://read.qxmd.com/read/30367649/endocan-sepsis-pneumonia-and-acute-respiratory-distress-syndrome
#9
REVIEW
Nathalie De Freitas Caires, Alexandre Gaudet, Lucie Portier, Anne Tsicopoulos, Daniel Mathieu, Philippe Lassalle
Acute respiratory distress syndrome (ARDS) and hospital-acquired pneumonia (HAP) are major problems of public health in intensive care units (ICUs), occurring in 15% of critically ill patients. Among the factors explaining ARDS development, sepsis is known as a frequent cause. Sepsis, ARDS, and HAP increase morbidity, mortality, length of stay in the ICU, and the overall costs of healthcare. The major challenge remains to identify accurately among critically ill patients those at risk of poor outcomes who could benefit from novel therapies...
October 26, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/30361119/paediatric-acute-respiratory-distress-syndrome-incidence-and-epidemiology-pardie-an-international-observational-study
#10
Robinder G Khemani, Lincoln Smith, Yolanda M Lopez-Fernandez, Jeni Kwok, Rica Morzov, Margaret J Klein, Nadir Yehya, Douglas Willson, Martin C J Kneyber, Jon Lillie, Analia Fernandez, Christopher J L Newth, Philippe Jouvet, Neal J Thomas
BACKGROUND: Paediatric acute respiratory distress syndrome (PARDS) is associated with high mortality in children, but until recently no paediatric-specific diagnostic criteria existed. The Pediatric Acute Lung Injury Consensus Conference (PALICC) definition was developed to overcome limitations of the Berlin definition, which was designed and validated for adults. We aimed to determine the incidence and outcomes of children who meet the PALICC definition of PARDS. METHODS: In this international, prospective, cross-sectional, observational study, 145 paediatric intensive care units (PICUs) from 27 countries were recruited, and over a continuous 5 day period across 10 weeks all patients were screened for enrolment...
February 2019: Lancet Respiratory Medicine
https://read.qxmd.com/read/30274009/the-association-between-serum-uric-acid-level-and-prognosis-in-critically-ill-patients-uric-acid-as-a-prognosis-predictor
#11
Mehtap Pehlivanlar-Kucuk, Ahmet O Kucuk, Cagatay E Ozturk, Mehmet C Er, Fatma Ulger
BACKGROUND: Uric acid is synthesized from xanthine via xanthine oxidase as an end-product of purine metabolism. Uric acid is a major non-enzymatic antioxidant in the blood, and it exerts a protective action on vitamin C. There are a limited number of ICU studies related to uric acid, which is a valuable prognostic biomarker. This study aimed to evaluate the utility of uric acid as a biomarker in predicting the outcomes of critically ill patients. METHODS: This prospective, multi-centered cohort study included 128 patients from two different intensive care units who met the study inclusion criteria between May 2017 and October 2017...
September 1, 2018: Clinical Laboratory
https://read.qxmd.com/read/30183115/driving-pressure-and-acute-respiratory-distress-syndrome-in-critically-ill-patients
#12
Raiko Blondonnet, Elodie Joubert, Thomas Godet, Pauline Berthelin, Thibaut Pranal, Laurence Roszyk, Russell Chabanne, Nathanael Eisenmann, Alexandre Lautrette, Corinne Belville, Sophie Cayot, Thierry Gillart, Bertrand Souweine, Damien Bouvier, Loic Blanchon, Vincent Sapin, Bruno Pereira, Jean-Michel Constantin, Matthieu Jabaudon
BACKGROUND AND OBJECTIVE: Elevated driving pressure (ΔP) may be associated with increased risk of acute respiratory distress syndrome (ARDS) in patients admitted via the emergency department and with post-operative pulmonary complications in surgical patients. This study investigated the association of higher ΔP with the onset of ARDS in a high-risk, intensive care unit (ICU) population. METHODS: This is a secondary analysis of a prospective multicentre observational study...
September 5, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://read.qxmd.com/read/30084205/risk-factors-and-outcomes-of-acute-respiratory-distress-syndrome-in-critically-ill-patients-with-cirrhosis
#13
Philip Yang, Perry Formanek, Steven Scaglione, Majid Afshar
AIM: Prior randomized controlled trials of acute respiratory distress syndrome (ARDS) excluded critically ill patients with cirrhosis. Data regarding risk factors for ARDS development and outcomes from ARDS in patients with cirrhosis are scarce. We sought to characterize outcomes from ARDS in patients with cirrhosis. METHODS: An observational cohort of patients with cirrhosis admitted to an intensive care unit at a high-volume liver transplant center between 1 January 2012 and 31 December 2014 were reviewed...
August 7, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://read.qxmd.com/read/30036234/differences-between-pulmonary-and-extrapulmonary-pediatric-acute-respiratory-distress-syndrome-a-multicenter-analysis
#14
Chin Seng Gan, Judith Ju-Ming Wong, Rujipat Samransamruajkit, Soo Lin Chuah, Yek Kee Chor, Suyun Qian, Nattachai Anantasit, Xu Feng, Jacqueline Soo May Ong, Phan Huu Phuc, Suwannee Phumeetham, Rehena Sultana, Tsee Foong Loh, Lucy Chai See Lum, Jan Hau Lee
OBJECTIVES: Extrapulmonary pediatric acute respiratory distress syndrome and pulmonary pediatric acute respiratory distress syndrome are poorly described in the literature. We aimed to describe and compare the epidemiology, risk factors for mortality, and outcomes in extrapulmonary pediatric acute respiratory distress syndrome and pulmonary pediatric acute respiratory distress syndrome. DESIGN: This is a secondary analysis of a multicenter, retrospective, cohort study...
October 2018: Pediatric Critical Care Medicine
https://read.qxmd.com/read/29727522/development-of-a-short-course-on-management-of-critically-ill-patients-with-acute-respiratory-infection-and-impact-on-clinician-knowledge-in-resource-limited-intensive-care-units
#15
Janet V Diaz, Justin R Ortiz, Paula Lister, Nahoko Shindo, Neill K J Adhikari
BACKGROUND: The 2009 influenza A (H1N1) pandemic caused surges of patients in intensive care units (ICUs) in resource-limited settings. Several Ministries of Health requested clinical management guidance from the World Health Organization (WHO), which had not previously developed guidance regarding critically ill patients. OBJECTIVE: To assess the acceptability and impact on knowledge of a short course about the management of critically ill patients with acute respiratory infections complicated by sepsis or acute respiratory distress syndrome delivered to clinicians in resource-limited ICUs...
May 4, 2018: Influenza and Other Respiratory Viruses
https://read.qxmd.com/read/29324628/ulinastatin-protects-against-lps-induced-acute-lung-injury-by-attenuating-tlr4-nf-%C3%AE%C2%BAb-pathway-activation-and-reducing-inflammatory-mediators
#16
Chao Cao, Chengfen Yin, Songtao Shou, Jun Wang, Lechang Yu, Xuening Li, Yanfen Chai
Acute lung injury (ALI) and its severe form, acute respiratory distress syndrome (ARDS), remain the leading causes of morbidity and mortality in intensive care units. Ulinastatin (UTI), a serine protease inhibitor, possesses anti-inflammatory properties and has been suggested to modulate lipopolysaccharide (LPS)-induced sepsis; thus, it is now widely used in the treatment of pancreatitis, sepsis, and septic shock. Toll-like receptor 4 (TLR4), an essential LPS signaling receptor, plays a critical role in the activation of innate immunity...
January 10, 2018: Shock
https://read.qxmd.com/read/29308749/-2017-clinical-breakthroughs-in-critical-care-medicine
#17
Wei Huang
New achievements in critical care medicine 2017 may include updating of "Surviving Sepsis Campaign" international guideline. Comparing evaluation of sequential (sepsis-related) organ failure assessment (SOFA) and quick sequential organ failure assessment (qSOFA), combination therapies with steroid, vitamin B1 and vitamin C in patients with sepsis, identification of endophenotype of sepsis, as well phenotype of acute respiratory distress syndrome (ARDS). However, it is also need to mention some of negative trials, such as levosimendan in patients undergoing cardiac surgery, low-dose immunoglobulin G and polymyxin B hemoperfusion for patient with septic shock, and enteral versus parenteral early nutrition in ventilated adults with shock...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://read.qxmd.com/read/29297399/the-coming-era-of-precision-medicine-for-intensive-care
#18
REVIEW
Jean-Louis Vincent
Recent advances in technology and better understanding of mechanisms underlying disease are beginning to enable us to better characterize critically ill patients. Instead of using nonspecific syndromic groupings, such as sepsis or acute respiratory distress syndrome, we can now classify individual patients according to various specific characteristics, such as immune status. This "personalized" medicine approach will enable us to distinguish patients who have similar clinical presentations but different cellular and molecular responses that will influence their need for and responses (both negative and positive) to specific treatments...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/29264363/cell-therapy-for-the-treatment-of-sepsis-and-acute-respiratory-distress-syndrome
#19
REVIEW
Raquel Guillamat-Prats, Marta Camprubí-Rimblas, Josep Bringué, Neus Tantinyà, Antonio Artigas
Sepsis and acute respiratory distress syndrome (ARDS) are life threating diseases with high mortality and morbidity in all the critical care units around the world. After decades of research, and numerous pre-clinical and clinical trials, sepsis and ARDS remain without a specific and effective pharmacotherapy and essentially the management remains supportive. In the last years cell therapies gained potential as a therapeutic treatment for ARDS and sepsis. Based on numerous pre-clinical studies, there is a growing evidence of the potential benefits of cell based therapies for the treatment of sepsis and ARDS...
November 2017: Annals of Translational Medicine
https://read.qxmd.com/read/28875277/-critical-illness-myopathy-and-polyneuropathy
#20
REVIEW
D Senger, F Erbguth
An average of 50-80% of patients treated in the intensive care unit is affected by disturbances of neuromuscular functions due to damage to the nerves and muscles, which has led to the terms critical illness polyneuropathy and myopathy. Both components occur in 30-50% of patients, while the others predominantly show a pure myopathy, while pure neuropathy is rare. Meanwhile, the descriptive term of the concept as intensive care unit-acquired weakness (ICUAW) is preferred. The most significant risk factors for the development of ICUAW are sepsis, multiorgan dysfunction and acute respiratory distress syndrome (ARDS)...
October 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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