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REVIEW
Riccardo Scagliola, Claudio Brunelli
A wide range of comorbidities play a pivotal role in worsening outcomes and increasing mortality risk in patients with heart failure (HF). Among them, renal dysfunction has been recognized as a highly prevalent prognostic variable, with a strong impact on prognosis, length of hospital stay and need for intensive care. In this context, recent evidence has pointed out the relevance of both systemic hypoperfusion and venous congestion on the imbalance of renal function as well as on the conditioning the pathophysiological crosstalk between heart and kidneys through a wide range of haemodynamic and biochemical pathways...
March 19, 2022: Reviews in Cardiovascular Medicine
#2
REVIEW
Emma Maria Bowcock, Anthony Mclean
Evaluating left atrial pressure (LAP) solely from the left ventricular preload perspective is a restrained approach. Accurate assessment of LAP is particularly relevant when pulmonary congestion and/or right heart dysfunction are present since it is the pressure most closely related to pulmonary venous pressure and thus pulmonary haemodynamic load. Amalgamation of LAP measurement into assessment of the 'transpulmonary circuit' may have a particular role in differentiating cardiac failure phenotypes in critical care...
August 13, 2022: Critical Care: the Official Journal of the Critical Care Forum
#3
REVIEW
Alexander Sarnowski, Rouvick M Gama, Alec Dawson, Hannah Mason, Debasish Banerjee
Hyperkalemia is a common clinical problem with potentially fatal consequences. The prevalence of hyperkalemia is increasing, partially due to wide-scale utilization of prognostically beneficial medications that inhibit the renin-angiotensin-aldosterone-system (RAASi). Chronic kidney disease (CKD) is one of the multitude of risk factors for and associations with hyperkalemia. Reductions in urinary potassium excretion that occur in CKD can lead to an inability to maintain potassium homeostasis. In CKD patients, there are a variety of strategies to tackle acute and chronic hyperkalemia, including protecting myocardium from arrhythmias, shifting potassium into cells, increasing potassium excretion from the body, addressing dietary intake and treating associated conditions, which may exacerbate problems such as metabolic acidosis...
2022: International Journal of Nephrology and Renovascular Disease
#4
REVIEW
Dustin Beyer, Jessica Hoff, Oliver Sommerfeld, Alexander Zipprich, Nikolaus Gaßler, Adrian T Press
Liver failure is a life-threatening complication of infections restricting the host's response to infection. The pivotal role of the liver in metabolic, synthetic, and immunological pathways enforces limits the host's ability to control the immune response appropriately, making it vulnerable to ineffective pathogen resistance and tissue damage. Deregulated networks of liver diseases are gradually uncovered by high-throughput, single-cell resolved OMICS technologies visualizing an astonishing diversity of cell types and regulatory interaction driving tolerogenic signaling in health and inflammation in disease...
July 30, 2022: Molecular Medicine
#5
REVIEW
Maria Giulia Mosconi, Maurizio Paciaroni
BACKGROUND AND AIM: Despite progress made over the last 30 years, stroke is still a leading cause of disability and mortality; likewise, its burden is expected to increase over the next decades, due to population growth and aging. The development of drugs with better safety-efficacy profiles as well as strategies able to improve ischemic stroke management from the pre-hospital setting is needed. SUMMARY: The pathophysiology of ischemic stroke involves multiple pathways resulting in cerebral artery obstruction and brain tissue ischemia...
2022: European Neurology
#6
JOURNAL ARTICLE
Luna Carrillo-Aleman, Elena Carrasco-Gónzalez, Maria João Araújo, Miguel Guia, Nuria Alonso-Fernández, Ana Renedo-Villarroya, Laura López-Gómez, Aurea Higon-Cañigral, Juan M Sanchez-Nieto, Andrés Carrillo-Alcaraz
INTRODUCTION AND PURPOSE: The impact of hypocapnia in the prognosis of cardiogenic acute pulmonary edema (CAPE) has not been sufficiently studied. The aim of this study was to analyse whether hypocapnia is a risk factor for non-invasive ventilation (NIV) failure and hospital mortality, in CAPE patients CAPE. METHODS: Retrospective observational study of all patients with CAPE treated with NIV. Patients were classified in three groups according to PaCO2 level (hypocapnic, eucapnic and hypercapnic)...
June 2022: Journal of Critical Care
#7
JOURNAL ARTICLE
Clemens Barends, Jaap Jan Vos, Bart Hiemstra, Anthony Absalom
No abstract text is available yet for this article.
January 10, 2022: European Journal of Anaesthesiology
#8
REVIEW
John E Brush, Jonathan Sherbino, Geoffrey R Norman
Research in cognitive psychology shows that expert clinicians make a medical diagnosis through a two step process of hypothesis generation and hypothesis testing. Experts generate a list of possible diagnoses quickly and intuitively, drawing on previous experience. Experts remember specific examples of various disease categories as exemplars, which enables rapid access to diagnostic possibilities and gives them an intuitive sense of the base rates of various diagnoses. After generating diagnostic hypotheses, clinicians then test the hypotheses and subjectively estimate the probability of each diagnostic possibility by using a heuristic called anchoring and adjusting...
January 5, 2022: BMJ: British Medical Journal
#9
JOURNAL ARTICLE
Saraschandra Vallabhajosyula, Nakeya Dewaswala, Pranathi R Sundaragiri, Huzefa M Bhopalwala, Wisit Cheungpasitporn, Rajkumar Doshi, P Elliott Miller, Malcolm R Bell, Mandeep Singh
BACKGROUND: There are limited data on the temporal trends, incidence, and outcomes of ST-segment-elevation myocardial infarction-cardiogenic shock (STEMI-CS). METHODS: Adult (>18 years) STEMI-CS admissions were identified using the National Inpatient Sample (2000-2017) and classified by tertiles of admission year (2000-2005, 2006-2011, 2012-2017). Outcomes of interest included temporal trends, acute organ failure, cardiac procedures, in-hospital mortality, hospitalization costs, and length of stay...
March 1, 2022: Shock
#10
JOURNAL ARTICLE
Wei Zhou, Chenyu Fan, Shuangjun He, Yi Chen, Cuiying Xie
BACKGROUND: The benefits of platelet thresholds for transfusion remain unclear. This study assessed the effect of two transfusion thresholds on the survival outcomes of patients with sepsis and thrombocytopenia. METHODS: In this retrospective cohort study, data of patients with sepsis admitted to an intensive care unit (ICU) and who had received platelet transfusion were extracted from the Medical Information Mart for Intensive Care IV database. Patients were classified into the lower-threshold group (below 20,000/μL) and higher-threshold group (20,000-50,000/μL), based on thresholds calculated from their pretransfusion platelet count...
April 1, 2022: Shock
#11
REVIEW
Mervyn Singer, Paul J Young, John G Laffey, Pierre Asfar, Fabio Silvio Taccone, Markus B Skrifvars, Christian S Meyhoff, Peter Radermacher
Oxygen (O2 ) toxicity remains a concern, particularly to the lung. This is mainly related to excessive production of reactive oxygen species (ROS). Supplemental O2 , i.e. inspiratory O2 concentrations (FI O2 ) > 0.21 may cause hyperoxaemia (i.e. arterial (a) PO2 > 100 mmHg) and, subsequently, hyperoxia (increased tissue O2 concentration), thereby enhancing ROS formation. Here, we review the pathophysiology of O2 toxicity and the potential harms of supplemental O2 in various ICU conditions...
December 19, 2021: Critical Care: the Official Journal of the Critical Care Forum
#12
MULTICENTER STUDY
Lucas M Fleuren, Tariq A Dam, Michele Tonutti, Daan P de Bruin, Robbert C A Lalisang, Diederik Gommers, Olaf L Cremer, Rob J Bosman, Sander Rigter, Evert-Jan Wils, Tim Frenzel, Dave A Dongelmans, Remko de Jong, Marco Peters, Marlijn J A Kamps, Dharmanand Ramnarain, Ralph Nowitzky, Fleur G C A Nooteboom, Wouter de Ruijter, Louise C Urlings-Strop, Ellen G M Smit, D Jannet Mehagnoul-Schipper, Tom Dormans, Cornelis P C de Jager, Stefaan H A Hendriks, Sefanja Achterberg, Evelien Oostdijk, Auke C Reidinga, Barbara Festen-Spanjer, Gert B Brunnekreef, Alexander D Cornet, Walter van den Tempel, Age D Boelens, Peter Koetsier, Judith Lens, Harald J Faber, A Karakus, Robert Entjes, Paul de Jong, Thijs C D Rettig, Sesmu Arbous, Sebastiaan J J Vonk, Mattia Fornasa, Tomas Machado, Taco Houwert, Hidde Hovenkamp, Roberto Noorduijn Londono, Davide Quintarelli, Martijn G Scholtemeijer, Aletta A de Beer, Giovanni Cinà, Adam Kantorik, Tom de Ruijter, Willem E Herter, Martijn Beudel, Armand R J Girbes, Mark Hoogendoorn, Patrick J Thoral, Paul W G Elbers
INTRODUCTION: Determining the optimal timing for extubation can be challenging in the intensive care. In this study, we aim to identify predictors for extubation failure in critically ill patients with COVID-19. METHODS: We used highly granular data from 3464 adult critically ill COVID patients in the multicenter Dutch Data Warehouse, including demographics, clinical observations, medications, fluid balance, laboratory values, vital signs, and data from life support devices...
December 27, 2021: Critical Care: the Official Journal of the Critical Care Forum
#13
LETTER
Zhonglei Wang, Liyan Yang
No abstract text is available yet for this article.
December 22, 2021: Journal of Medical Virology
#14
JOURNAL ARTICLE
Elisabeth Mahase
No abstract text is available yet for this article.
November 8, 2021: BMJ: British Medical Journal
#15
JOURNAL ARTICLE
Jing Yang, Haiyan Long, Ya Hu, Yu Feng, Alan McNally, Zhiyong Zong
Klebsiella oxytoca is actually a complex of nine species-Klebsiella grimontii, Klebsiella huaxiensis, Klebsiella michiganensis, K. oxytoca, Klebsiella pasteurii, Klebsiella spallanzanii, and three unnamed novel species. Phenotypic tests can assign isolates to the complex, but precise species identification requires genome-based analysis. The K. oxytoca complex is a human commensal but also an opportunistic pathogen causing various infections, such as antibiotic-associated hemorrhagic colitis (AAHC), urinary tract infection, and bacteremia, and has caused outbreaks...
January 19, 2022: Clinical Microbiology Reviews
#16
JOURNAL ARTICLE
David Green
The antiphospholipid syndrome is characterized by antibodies directed against phospholipid-binding proteins and phospholipids attached to cell membrane receptors, mitochondria, oxidized lipoproteins, and activated complement components. When antibodies bind to these complex antigens, cells are activated and the coagulation and complement cascades are triggered, culminating in thrombotic events and pregnancy morbidity that further define the syndrome. The phospholipid-binding proteins most often involved are annexins II and V, β2 -glycoprotein I, prothrombin, and cardiolipin...
July 2022: Thrombosis and Haemostasis
#17
RANDOMIZED CONTROLLED TRIAL
José Molina, Enrique Montero-Mateos, Julia Praena-Segovia, Eva León-Jiménez, Clara Natera, Luis E López-Cortés, Lucía Valiente, Clara M Rosso-Fernández, Marta Herrero, Ana I Aller-García, Ángela Cano, Belén Gutiérrez-Gutiérrez, Ignacio Márquez-Gómez, Rocío Álvarez-Marín, Carmen Infante, Cristina Roca, Adoración Valiente-Méndez, Jerónimo Pachón, José María Reguera, Juan Enrique Corzo-Delgado, Julián Torre-Cisneros, Jesús Rodríguez-Baño, José Miguel Cisneros
OBJECTIVE: To prove that 7-day courses of antibiotics for bloodstream infections caused by members of the Enterobacterales (eBSIs) allow a reduction in patients' exposure to antibiotics while achieving clinical outcomes similar to those of 14-day schemes. METHODS: A randomized trial was performed. Adult patients developing eBSI with appropriate source control were assigned to 7 or 14 days of treatment, and followed 28 days after treatment cessation; treatments could be resumed whenever necessary...
April 2022: Clinical Microbiology and Infection
#18
JOURNAL ARTICLE
Catherine M Brown, Johanna Vostok, Hillary Johnson, Meagan Burns, Radhika Gharpure, Samira Sami, Rebecca T Sabo, Noemi Hall, Anne Foreman, Petra L Schubert, Glen R Gallagher, Timelia Fink, Lawrence C Madoff, Stacey B Gabriel, Bronwyn MacInnis, Daniel J Park, Katherine J Siddle, Vaira Harik, Deirdre Arvidson, Taylor Brock-Fisher, Molly Dunn, Amanda Kearns, A Scott Laney
During July 2021, 469 cases of COVID-19 associated with multiple summer events and large public gatherings in a town in Barnstable County, Massachusetts, were identified among Massachusetts residents; vaccination coverage among eligible Massachusetts residents was 69%. Approximately three quarters (346; 74%) of cases occurred in fully vaccinated persons (those who had completed a 2-dose course of mRNA vaccine [Pfizer-BioNTech or Moderna] or had received a single dose of Janssen [Johnson & Johnson] vaccine ≥14 days before exposure)...
August 6, 2021: MMWR. Morbidity and Mortality Weekly Report
#19
REVIEW
Pierre-Grégoire Guinot, Audrey Martin, Vivien Berthoud, Pierre Voizeux, Loic Bartamian, Erminio Santangelo, Belaid Bouhemad, Maxime Nguyen
Despite the abundant literature on vasopressor therapy, few studies have focused on vasopressor-sparing strategies in patients with shock. We performed a scoping-review of the published studies evaluating vasopressor-sparing strategies by analyzing the results from randomized controlled trials conducted in patients with shock, with a focus on vasopressor doses and/or duration reduction. We analyzed 143 studies, mainly performed in septic shock. Our analysis demonstrated that several pharmacological and non-pharmacological strategies are associated with a decrease in the duration of vasopressor therapy...
July 18, 2021: Journal of Clinical Medicine
#20
JOURNAL ARTICLE
Nienke K Koopmans, Renate Stolmeijer, Ben C Sijtsma, Paul A van Beest, Christiaan E Boerma, Nic J Veeger, Ewoud Ter Avest
BACKGROUND: Little is known about optimal fluid therapy for patients with sepsis without shock who present to the ED. In this study, we aimed to quantify the effect of a fluid challenge on non-invasively measured Cardiac Index (CI) in patients presenting with sepsis without shock. METHODS: In a prospective cohort study, CI, stroke volume (SV) and systemic vascular resistance (SVR) were measured non-invasively in 30 patients presenting with sepsis without shock to the ED of a large teaching hospital in the Netherlands between May 2018 and March 2019 using the ClearSight system...
June 2021: Emergency Medicine Journal: EMJ
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