Chunfang Qiu, Luhao Wang, Chuanxi Chen, Xiangdong Guan, Bin Ouyang
OBJECTIVE: To analyze the relationship between D-lactate, intestinal fatty acid binding protein (I-FABP) and the severity as well as the prognosis of patients in intensive care unit (ICU). METHODS: Using a retrospective approach, the data derived from a prospective, randomized, single-blind, multicenter clinical study published earlier by our group were further analyzed to evaluate the effect of fat-modified enteral nutrition (EN) suspension on the intestinal barrier in ICU patients...
November 2020: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Jiali Duan, Yuejie Yang, Shuya Hou, Xia Xing, Mengfei Sun, Yang Liu, Lihua Xing
OBJECTIVE: To investigate the clinical characteristics and prognostic predictors of adult patients with acute respiratory failure due to influenza infection. METHODS: A retrospective analysis was performed on adult patients with acute respiratory failure due to confirmed influenza infection admitted to intensive care units (ICU) of the First Affiliated Hospital of Zhengzhou University and the Sixth People's Hospital of Zhengzhou between January 2018 and January 2020...
November 2020: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Yimin Zhu, Hua Xiang, Jitong Liu, Fang Chen
With the development of society and economy, people's requirements for emergency rescue technology and emergency services are gradually increasing. Building and improving the emergency of critical care system is an important issue currently facing. Controlling medical injuries is the goal of medical development. At present, people's requirements for first aid measures have shown a trend from invasive to minimally invasive even non-invasive. It is a new requirement for emergency medicine in the new era to establish a minimally invasive emergency system and apply the minimally invasive technology in the first-aid and critical care area, to help the patients with acute and critical illness overcome difficulties, improve outcome, and enhance the quality of life...
November 2020: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Shawniqua Williams Roberson, Mayur B Patel, Wojciech Dabrowski, E Wesley Ely, Cezary Pakulski, Katarzyna Kotfis
Traumatic brain injury (TBI) can initiate a very complex disease of the central nervous system (CNS) starting with the primary pathology of the inciting trauma and subsequent inflammatory and CNS tissue response. Delirium has long been regarded as an almost inevitable consequence of moderate to severe TBI, but more recently has been recognized as an organ dysfunction syndrome with potentially mitigating interventions. The diagnosis of delirium is independently associated with prolonged hospitalization, increased mortality and worse cognitive outcome across critically ill populations...
January 19, 2021: Current Neuropharmacology
Alan Abdulla, Tim M J Ewoldt, Ilse M Purmer, Anouk E Muller, Diederik Gommers, Henrik Endeman, Birgit C P Koch
INTRODUCTION: : Emerging studies suggest that antibiotic pharmacokinetics (PK) are difficult to predict in critically ill patients. The high intra- and inter-patient PK variability makes it challenging to accurately predict the appropriate dosage required for a given patient. Identifying patients at risk could help clinicians to consider more individualized dosing regimens and perform therapeutic drug monitoring. We provide an overview of relevant predictors associated with target (non-)attainment of β-lactam antibiotics in critically ill patients...
January 19, 2021: Expert Opinion on Drug Metabolism & Toxicology
Bowen Li, Zhiwei Wang, Junmou Hong, Yanjia Che, Ruoshi Chen, Zhipeng Hu, Xiaoping Hu, Qi Wu, Junxia Hu, Min Zhang
BACKGROUND: Aortic dissection (AD) and aortic aneurysm (AA) are critical illnesses with an unclear pathogenetic mechanism that seriously threaten human life. Aortic medial degeneration (AMD) is the main pathological feature of AD and AA. Diseases of iron metabolism can cause a variety of physiological dysfunctions. In this study, we aimed to clarify the state of iron metabolism in patients with AD and AA, and to explore the effect of iron metabolism on AMD. METHODS: A total of 200 patients with AD or AA, and 60 patients with hypertension were included in the study...
January 2021: Clinical and Translational Medicine
Saad Nseir, Despoina Koulenti, Stijn Blot
No abstract text is available yet for this article.
January 15, 2021: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Lorenzo Peluso, Andrea Minini, Fabio Silvio Taccone
No abstract text is available yet for this article.
January 5, 2021: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Benoît Bataille, Jade de Selle, Pierre-Etienne Moussot, Philippe Marty, Stein Silva, Pierre Cocquet
BACKGROUND: Passive leg raising (PLR) predicts fluid responsiveness in critical illness, although restrictions in mobilising patients often preclude this haemodynamic challenge being used. We investigated whether machine learning applied on transthoracic echocardiography (TTE) data might be used as a tool for predicting fluid responsiveness in critically ill patients. METHODS: We studied, 100 critically ill patients (mean age: 62 yr [standard deviation: 14]) with severe sepsis or septic shock prospectively over 24 months...
January 15, 2021: British Journal of Anaesthesia
Sofia Dahlberg, Ulf Schött, Thomas Kander
BACKGROUND: Previous studies have indicated that vitamin K deficiency is common in non-bleeding critically ill patients with slightly prolonged prothrombin time-international normalized ratio (PT-INR). It has never been investigated thoroughly whether the administration of vitamin K to these patients could affect their PT-INR. Therefore, the aim of this registry study was to evaluate changes in PT-INR in response to vitamin K in critically ill patients with PT-INR in the range of 1.3-1...
January 18, 2021: Journal of Intensive Care
Yangli Liu, Weiping Tan, Haihong Chen, Ying Zhu, Li Wan, Ke Jiang, Yubiao Guo, Kejing Tang, Canmao Xie, Hui Yi, Yukun Kuang, Yifeng Luo
BACKGROUND: The lack of knowledge regarding the pathogenesis and host immune response during SARS-CoV-2 infection has limited the development of effective treatments. Thus, we longitudinally investigated the dynamic changes in peripheral blood lymphocyte subsets and parallel changes in cytokine levels in COVID-19 patients with different disease severities to further address disease pathogenesis. METHODS: A total of 67 patients (10 moderate, 38 severe and 19 critical cases) with COVID-19 admitted to a tertiary care hospital in Wuhan from February 8th to April 6th, 2020 were retrospectively studied...
January 18, 2021: BMC Infectious Diseases
Sanna Törnblom, Sara Nisula, Suvi T Vaara, Meri Poukkanen, Sture Andersson, Ville Pettilä, Eero Pesonen
We hypothesised that plasma concentrations of biomarkers of neutrophil activation and pro-inflammatory cytokines differ according to the phase of rapidly evolving sepsis. In an observational study, we measured heparin-binding protein (HBP), myeloperoxidase (MPO), IL-6 and IL-8 in 167 sepsis patients on intensive care unit admission. We prospectively used the emergence of the first sepsis-associated organ dysfunction (OD) as a surrogate for the sepsis phase. Fifty-five patients (of 167, 33%) developed the first OD > 1 h before, 74 (44%) within ± 1 h, and 38 (23%) > 1 h after intensive care unit admission...
January 18, 2021: Innate Immunity
Wei Hong, Fang Xiang Zhi, Tu Han Kun, Feng Jie Hua, Li Huan Ling, Fang Fang, Chen Wen, Wang Jie, Li Chao Yang
Although mechanical ventilation (MV) is indispensable to life-support therapy in critically ill patients, it may promote or aggravatelunginjury known asventilator-inducedlunginjury(VILI). 6-Gingerol is the principal ingredient of ginger with potential anti-inflammatory and antioxidant properties in various diseases. Nevertheless, the role and mechanism of 6-gingerol in the process of VILI has not been explicitly investigated. In the study, we found that pre-treatment with 6-gingerol significantly improved the histological changes and pulmonary oedema, inhibited neutrophil accumulation and the release of early pro-inflammatory cytokines and MPO, and reduced oxidative stress reactions after high MV...
January 15, 2021: International Immunopharmacology
Ganime Ayar, Sıddıka Songül Yalçın, Serhat Emeksiz, Anıl Yırün, Aylin Balcı, Belma Kocer-Gumusel, Pınar Erkekoğlu
We aim to evaluate urinary total BPA (tBPA) levels and association with medical devices used on patients in pediatric intensive care units. This cross-sectional descriptive study included 117 critically ill children. Urinary tBPA levels were determined using high-performance liquid chromatography. General estimating equations with repeated measures analyzed the effect of interventions and devices on urinary BPA levels. A total of 292 urine samples taken from 117 child intensive care patients were studied. When age, sex, and body mass index-for age z-scores were controlled, cases having endotracheal intubation showed higher urinary tBPA levels (p = 0...
January 15, 2021: Environmental Toxicology and Pharmacology
Otavio T Ranzani, Leonardo S L Bastos, João Gabriel M Gelli, Janaina F Marchesi, Fernanda Baião, Silvio Hamacher, Fernando A Bozza
BACKGROUND: Most low-income and middle-income countries (LMICs) have little or no data integrated into a national surveillance system to identify characteristics or outcomes of COVID-19 hospital admissions and the impact of the COVID-19 pandemic on their national health systems. We aimed to analyse characteristics of patients admitted to hospital with COVID-19 in Brazil, and to examine the impact of COVID-19 on health-care resources and in-hospital mortality. METHODS: We did a retrospective analysis of all patients aged 20 years or older with quantitative RT-PCR (RT-qPCR)-confirmed COVID-19 who were admitted to hospital and registered in SIVEP-Gripe, a nationwide surveillance database in Brazil, between Feb 16 and Aug 15, 2020 (epidemiological weeks 8-33)...
January 15, 2021: Lancet Respiratory Medicine
George L Anesi, Juliane Jablonski, Michael O Harhay, Joshua H Atkins, Jasmeet Bajaj, Cameron Baston, Patrick J Brennan, Christina L Candeloro, Lauren M Catalano, Maurizio F Cereda, John M Chandler, Jason D Christie, Tara Collins, Katherine R Courtright, Barry D Fuchs, Emily Gordon, John C Greenwood, Steven Gudowski, Asaf Hanish, C William Hanson Iii, Monica Heuer, Paul Kinniry, Zev Noah Kornfield, Gregory B Kruse, Meghan Lane-Fall, Niels D Martin, Mark E Mikkelsen, Dan Negoianu, Jose L Pascual, Maulik B Patel, Steven C Pugliese, Zaffer A Qasim, John P Reilly, John Salmon, William D Schweickert, Michael J Scott, Michael G S Shashaty, Corinna P Sicoutris, John K Wang, Wei Wang, Arshad A Wani, Brian J Anderson, Jacob T Gutsche
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic continues to surge in the United States and globally. OBJECTIVE: To describe the epidemiology of COVID-19-related critical illness, including trends in outcomes and care delivery. DESIGN: Single-health system, multihospital retrospective cohort study. SETTING: 5 hospitals within the University of Pennsylvania Health System. PATIENTS: Adults with COVID-19-related critical illness who were admitted to an intensive care unit (ICU) with acute respiratory failure or shock during the initial surge of the pandemic...
January 19, 2021: Annals of Internal Medicine
Stuart L Goldstein, Kelli A Krallman, Alexandra Schmerge, Lynn Dill, Bradley Gerhardt, Praneeta Chodaparavu, Abigail Radomsky, Cassie Kirby, David J Askenazi
BACKGROUND: Nephrotoxic medication exposure is a common cause of acute kidney injury (AKI) in hospitalized children. A key component of the NINJA quality improvement initiative is systematic daily serum creatinine assessment in non-critically ill children exposed to ≥ 3 nephrotoxic medications on 1 day, or intravenous aminoglycoside or vancomycin for ≥ 3 days. Daily venipuncture is invasive and associated with disposable and personnel healthcare costs. Urine neutrophil gelatinase-associated lipocalin (uNGAL) is a marker of renal tubular injury associated with certain nephrotoxic medications...
January 18, 2021: Pediatric Nephrology
Chandermani, Prarthna
The study intends to ascertain whether higher patient mortality occurs during weekends or nighttime or during a specific time of day. Time of death of all deceased in ICUs of a teaching hospital during study period (n = 844) was noted and analyzed. It was found that compared to daytime working hours, significantly higher mortality is not observed during Off Duty Hours (i.e. Evening/Night/Weekends/Holidays) and has no relationship with any particular time of the day. Patient deaths over time were found to conform to Poisson distribution...
January 18, 2021: Hospital Topics
Pedro Taffarel, Facundo Jorro Barón, Ana Paula Rodríguez, Jesica Widmer, Claudia Meregallia
Multisystem inflammatory syndrome in children related to COVID-19 is defined as the presence of persistent fever, inflammation, and organ dysfunction, with evidence of past or recent severe acute respiratory syndrome coronavirus 2 infection, and excluding other microbial causes. It overlaps with other inflammatory diseases (Kawasaki disease and toxic shock syndrome) and shares some features with hypercytokinemia conditions (hemophagocytic lymphohistiocytosis and macrophage activation syndrome). It differs from these and severe acute COVID-19 in its clinical presentation and laboratory parameters...
February 2021: Archivos Argentinos de Pediatría
Souvik Chatterjee, Scott M Wright
Caring for the critically ill is a humanistic endeavor that requires thoughtful collaboration by a multidisciplinary team. In recent times, patient care in ICUs has become more complex with technological advances in monitoring, diagnostic testing, and therapeutics; many of these advances have translated into improved patient outcomes. In this increasingly complicated system, local culture and goals for the unit can also be overwhelmed by the impersonal and overarching institutional objectives. Developing "ICU specific principles" is a structured approach to cultivate habits and encourage attitudes that are aligned with the values of the team; this can serve to optimize the work environment and prioritize excellent patient care...
January 2021: Critical care explorations
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