1,170 results match your criteria Journal of Intensive Care Medicine[Journal]


Cerebral Autoregulation-Guided Optimal Blood Pressure in Sepsis-Associated Encephalopathy: A Case Series.

J Intensive Care Med 2019 Feb 13:885066619828293. Epub 2019 Feb 13.

1 Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Background:: Impaired cerebral autoregulation and cerebral hypoperfusion may play a critical role in the high morbidity and mortality in patients with sepsis-associated encephalopathy (SAE). Bedside assessment of cerebral autoregulation may help individualize hemodynamic targets that optimize brain perfusion. We hypothesize that near-infrared spectroscopy (NIRS)-derived cerebral oximetry can identify blood pressure ranges that enhance autoregulation in patients with SAE and that disturbances in autoregulation are associated with severity of encephalopathy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066619828293DOI Listing
February 2019
1 Read

A Regional, Cost-Effective, Collaborative Model for Critical Care Fellows' Ultrasonography Education.

J Intensive Care Med 2019 Feb 12:885066619828951. Epub 2019 Feb 12.

2 Division of Pulmonary, Critical Care and Sleep Medicine, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.

Objective:: Training in critical care ultrasonography is an essential tool in critical care medicine and recommended for fellowship programs in pulmonary and critical care medicine. Major barriers to implementing competency-based training in individual fellowship programs include a lack of expert faculty, time, and funding. Our objective was to investigate whether regional collaboration to deliver an introductory critical care ultrasonography course for fellows might overcome these barriers while achieving international training standards. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066619828951DOI Listing
February 2019

The 24-Hour Intensivists Staffing Model Improves the Outcome for Nighttime Admitted Patients: A Matched Historical Control Study.

J Intensive Care Med 2019 Feb 11:885066619828338. Epub 2019 Feb 11.

1 Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.

Introduction:: We previously showed that a "10-hour daytime on-site" and "nighttime (NT) on-call" staffing strategy was associated with higher mortality for intensive care unit (ICU) patients admitted during NT than it was for patients admitted during office hours (OH). In here, we evaluated the clinical effects of a 24-hour intensivist staffing model.

Methods:: We formed an intervention group of 3034 consecutive ICU patients hospitalized from January 2013 to December 2015, and a control group of 2891 patients from our previous study (2009-2011). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066619828338DOI Listing
February 2019

The Risk of Acute Kidney Injury in Critically Ill Patients Receiving Concomitant Vancomycin With Piperacillin-Tazobactam or Cefepime.

J Intensive Care Med 2019 Feb 10:885066619828290. Epub 2019 Feb 10.

2 Department of Pharmacy Practice, Midwestern University College of Pharmacy-Glendale, Glendale, AZ, USA.

Purpose:: The objective of this study was to compare the incidence of acute kidney injury (AKI) among critically ill patients receiving combination therapy with vancomycin plus piperacillin-tazobactam (VPT) against patients receiving vancomycin plus cefepime (VC).

Methods:: A retrospective cohort study of adult patients admitted to an intensive care unit between September 2012 and December 2016 was conducted. Patients were included if they received combination therapy with VPT or VC for ≥48 hours. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066619828290DOI Listing
February 2019
1 Read

Current Use and Impact on 30-Day Mortality of Pulmonary Artery Catheter in Cardiogenic Shock Patients: Results From the CardShock Study.

J Intensive Care Med 2019 Feb 7:885066619828959. Epub 2019 Feb 7.

12 Critical Care Department, Hospital Sant Joan Despi Moisès Broggi, Consorci Sanitari Integral, University of Barcelona, Barcelona, Spain.

Background:: Cardiogenic shock (CS) is the most life-threatening manifestation of acute heart failure. Its complexity and high in-hospital mortality may justify the need for invasive monitoring with a pulmonary artery catheter (PAC).

Methods:: Patients with CS included in the CardShock Study, an observational, prospective, multicenter, European registry, were analyzed, aiming to describe the real-world use of PAC, evaluate its impact on 30-day mortality, and the ability of different hemodynamic parameters to predict outcomes. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066619828959DOI Listing
February 2019
1 Read

Effectiveness of Treatments and Diagnostic Tools and Declining Mortality in Patients With Severe Sepsis: A 12-Year Population-Based Cohort Study.

J Intensive Care Med 2019 Jan 30:885066619827270. Epub 2019 Jan 30.

2 Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou.

Sepsis is a major cause of morbidity and mortality worldwide. With the advance of medical care, the mortality of sepsis has decreased in the past decades. Many treatments and diagnostic tools still lack supporting evidence. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066619827270DOI Listing
January 2019

Nonbeneficial Intensive Care: Misalignments Between Provider Assessments of Benefit and Use of Invasive Treatments.

J Intensive Care Med 2019 Jan 29:885066619826044. Epub 2019 Jan 29.

2 Division of Respiratory and Critical Care Physiology and Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA.

Background:: The purpose of this study was to examine how frequently invasive intensive care unit (ICU) treatments are delivered to critically ill patients despite clinicians' impressions that ICU care may be nonbeneficial.

Methods:: Patients admitted to the medical ICU of an academic public hospital were prospectively categorized according to guidelines from the Society of Critical Care Medicine which classifies patients based on severity of illness and likelihood of recovery (categories 1-4). Clinical data and use of ICU treatments in patients with high (category 1) and low (category 3) likelihoods of benefit were collected by chart review. Read More

View Article

Download full-text PDF

Source
http://journals.sagepub.com/doi/10.1177/0885066619826044
Publisher Site
http://dx.doi.org/10.1177/0885066619826044DOI Listing
January 2019
3 Reads

Mortality and Prognostic Prediction in Very Elderly Patients With Severe Pneumonia.

J Intensive Care Med 2019 Jan 24:885066619826045. Epub 2019 Jan 24.

1 Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Republic of Korea.

Introduction:: Although prognostic prediction scores for pneumonia such as CURB-65 score or pneumonia severity index (PSI) are widely used, there were a few studies in very elderly patients. The aim of the study was to validate prognostic prediction scores for severe pneumonia and investigate risk factors associated with in-hospital mortality of severe pneumonia in very elderly patients.

Methods:: During the 6-year study period (from October 2012 to May 2018), 160 patients aged 80 or older admitted to medical intensive unit were analyzed retrospectively. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066619826045DOI Listing
January 2019
1 Read

Feasibility, Reliability, Responsiveness, and Validity of the Patient-Reported Functional Scale for the Intensive Care Unit: A Pilot Study.

J Intensive Care Med 2019 Jan 22:885066618824534. Epub 2019 Jan 22.

1 Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Institute of Applied Health Sciences, Hamilton, Ontario, Canada.

Background:: Although many performance-based measures assess patients' physical function in intensive care unit (ICU) survivors, to our knowledge, there are no patient-reported ICU rehabilitation-specific measures assessing function. We developed the Patient-Reported Functional Scale-ICU (PRFS-ICU), which measures patients' perceptions of their ability to perform 6 activities (rolling, sitting edge of bed, sit-to-stand and bed-to-chair transfers, ambulation, and stair climbing). Each item is scored from 0 (unable) to 10 (able to perform at pre-ICU level) to a maximum of 60. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618824534DOI Listing
January 2019

Current Status of Novel Biomarkers for the Diagnosis of Acute Kidney Injury: A Historical Perspective.

J Intensive Care Med 2019 Jan 17:885066618824531. Epub 2019 Jan 17.

1 Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

Acute kidney injury (AKI) is a common and serious medical condition associated with significant increases in morbidity, mortality, and cost of care. Because of the high incidence and poor outcomes associated with AKI, there has been significant interest in the development of new therapies for the prevention and treatment of the disease. A lack of efficacy in drug trials led to the concern that AKI was not being diagnosed early enough for an effective intervention and that a rise in serum creatinine itself is not a sensitive-enough marker. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618824531DOI Listing
January 2019
1 Read

A Nationwide Comparison Between Sepsis-2 and Sepsis-3 Definition in Japan.

J Intensive Care Med 2019 Jan 13:885066618823151. Epub 2019 Jan 13.

1 Department of Emergency Medicine, Asahikawa Medical University, Asahikawa, Japan.

Background:: Currently, it remains controversial whether the Sepsis-3 definition provides the most appropriate criteria for clinical use. The purpose of this study was to compare between the Sepsis-2 and Sepsis-3 definitions using Japan's nationwide registry.

Methods:: Data were obtained from a multicenter registry conducted at 42 intensive care units (ICUs) throughout Japan, in which patients received treatment for severe sepsis or septic shock between January 2011 and December 2013. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618823151DOI Listing
January 2019
6 Reads

Clinical Trial Assessment of Intermittent and Continuous Infusion Dose of N-Acetylcysteine on Redox Status of the Body in Patients with Sepsis Admitted to the ICU.

J Intensive Care Med 2019 Jan 13:885066618823152. Epub 2019 Jan 13.

6 Surgical Oncology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.

Purpose:: Conflicting results exist regarding the efficacy of N-acetyl cysteine (NAC) in sepsis treatment. A pivotal factor affecting the therapeutic potency of NAC in sepsis is timing and dosing of its infusion. We aimed to assess the effect of NAC on redox status of patients with sepsis and to compare its efficacy in intermittent and continuous infusion with the objective of developing the infusion regimen and optimizing the timing. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618823152DOI Listing
January 2019

Conservative Fluid Management After Sepsis Resuscitation: A Pilot Randomized Trial.

J Intensive Care Med 2019 Jan 10:885066618823183. Epub 2019 Jan 10.

1 Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.

Rationale:: The feasibility and clinical outcomes of conservative fluid management after sepsis resuscitation remain unknown.

Objectives:: To evaluate the effect of a conservative fluid management protocol on fluid balance and intensive care unit (ICU)-free days among patients with sepsis.

Methods:: In a single-center phase II/III randomized trial, we enrolled adults with suspected infection, ≥2 systemic inflammatory response syndrome criteria, and either shock (mean arterial pressure <60 mm Hg or vasopressors) or respiratory insufficiency (mechanical ventilation or oxygen saturation <97% and fraction of inspired oxygen ≥0. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618823183DOI Listing
January 2019
1 Read

Troponin I as an Early Biomarker of Cardiopulmonary Parameters Within the First 24 Hours After Nontraumatic Subarachnoid Hemorrhage in Intensive Care Unit Patients.

J Intensive Care Med 2019 Jan 8:885066618824568. Epub 2019 Jan 8.

2 Department of Neurosurgery, Bremen-Mitte Hospital, Bremen, Germany.

Objective:: The elevation of serum cardiac troponin I (TNI) in patients with nontraumatic subarachnoid hemorrhage (ntSAH) is a well-known phenomenon. However, the relation between elevated TNI and different cardiopulmonary parameters (CPs) within the first 24 hours after ntSAH is unknown. The present study was conducted to investigate the association between TNI and different CP in patients with ntSAH within the first 24 hours of intensive care unit (ICU) treatment. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618824568DOI Listing
January 2019
1 Read

The Effect of High-Flow Nasal Oxygen Therapy on Postoperative Pulmonary Complications and Hospital Length of Stay in Postoperative Patients: A Systematic Review and Meta-Analysis.

J Intensive Care Med 2018 Dec 26:885066618817718. Epub 2018 Dec 26.

1 Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.

Objective:: To evaluate the effect of high-flow nasal cannula oxygen (HFNO) therapy on hospital length of stay (LOS) and postoperative pulmonary complications (PPCs) in adult postoperative patients.

Data Sources:: PubMed, Embase, the Cochrane Library, Web of Science of Studies, China National Knowledge Index, and Wan Fang databases were searched until July 2018.

Study Selection:: Randomized controlled trials (RCTs) comparing HFNO with conventional oxygen therapy or noninvasive mechanical ventilation in adult postoperative patients were included. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618817718DOI Listing
December 2018
2 Reads

Passive Leg Raise: Feasibility and Safety of the Maneuver in Patients With Undifferentiated Shock.

J Intensive Care Med 2018 Dec 20:885066618820492. Epub 2018 Dec 20.

7 Division of Pulmonary and Critical Care, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.

Purpose:: Passive leg raise (PLR), in combination with technologies capable of capturing stroke volume changes, has been widely adopted in the management of shock. However, dedicated evaluation of safety, feasibility, and receptiveness of patients and nursing staff to PLR maneuver is missing.

Methods:: A noninterventional, prospective trial recruited adult patients with onset of undifferentiated shock within 24 hours with persistent vasopressor requirements despite fluid resuscitation. Read More

View Article

Download full-text PDF

Source
http://journals.sagepub.com/doi/10.1177/0885066618820492
Publisher Site
http://dx.doi.org/10.1177/0885066618820492DOI Listing
December 2018
2 Reads

Novel Vasopressors in the Treatment of Vasodilatory Shock: A Systematic Review of Angiotensin II, Selepressin, and Terlipressin.

J Intensive Care Med 2018 Dec 18:885066618818460. Epub 2018 Dec 18.

5 University of Illinois Medical Center, IL, USA.

Study Objective:: Vasodilatory shock is the most common type of shock. Catecholamine vasopressors are the cornerstone of hemodynamic therapy but carry risks. Angiotensin II (AT) was recently approved, and other novel agents (selepressin and terlipressin) are under investigation and used outside the United States (terlipressin). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618818460DOI Listing
December 2018
1 Read

Safety and Effectiveness of Intravenous Chlorpromazine for Agitation in Critically Ill Patients.

J Intensive Care Med 2018 Dec 17:885066618818787. Epub 2018 Dec 17.

1 Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA.

Background:: Agitation is common in the intensive care unit (ICU). Although antipsychotics are frequently used as first-line therapy, chlorpromazine has fallen out of favor due to risk of cardiovascular complications and severe hypotension. Although chlorpromazine is used anecdotally, there is a lack of data regarding its safety and effectiveness. Read More

View Article

Download full-text PDF

Source
http://journals.sagepub.com/doi/10.1177/0885066618818787
Publisher Site
http://dx.doi.org/10.1177/0885066618818787DOI Listing
December 2018
1 Read

Wells and Geneva Scores Are Not Reliable Predictors of Pulmonary Embolism in Critically Ill Patients: A Retrospective Study.

J Intensive Care Med 2018 Dec 16:885066618816280. Epub 2018 Dec 16.

4 Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.

Background:: Critically ill patients are at high risk for pulmonary embolism (PE). Specific PE prediction rules have not been validated in this population. The present study assessed the Wells and revised Geneva scoring systems as predictors of PE in critically ill patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618816280DOI Listing
December 2018

Authors' Response to the Intensive Care Unit Discharge Delay and In-Hospital Mortality.

J Intensive Care Med 2018 Dec 11:885066618816686. Epub 2018 Dec 11.

2 Laboratory for Computational Physiology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618816686DOI Listing
December 2018
20 Reads

The Role of Inflammatory Cytokines in Cardiac Arrest.

J Intensive Care Med 2018 Dec 10:885066618817518. Epub 2018 Dec 10.

1 Resuscitation Research Group, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA.

Introduction:: Post-cardiac arrest syndrome (PCAS) is characterized by systemic ischemia/reperfusion injury, anoxic brain injury, and post-arrest myocardial dysfunction superimposed on a precipitating pathology. The role of inflammatory cytokines in cardiac arrest remains unclear.

Aims:: We aimed to describe, with an emphasis on clinical applications, what is known about the role of inflammatory cytokines in cardiac arrest. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618817518DOI Listing
December 2018

Are Health-Care Providers Well Prepared in Providing Optimal End-of-Life Care to Critically Ill Patients? A Cross-Sectional Study at a Tertiary Care Hospital in the United States.

J Intensive Care Med 2018 Dec 3:885066618811794. Epub 2018 Dec 3.

4 Department of Pulmonary and Critical Care Medicine, Northwell Health Staten Island University Hospital, Staten Island, NY, USA.

It is important for health-care providers to be comfortable in providing end-of-life (EOL) care to critically ill patients and realizing when continuing aggressive measures would be futile. Therefore, there is a need to understand health-care providers' self-perceived skills and barriers to providing optimum EOL care. A total of 660 health-care providers from medicine and surgery departments were asked via e-mail to complete an anonymous survey assessing their self-reported EOL care competencies, of which 238 responses were received. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618811794DOI Listing
December 2018
1 Read

Intensive Care Unit Discharge Delay and In-Hospital Mortality.

J Intensive Care Med 2018 Dec 4:885066618816673. Epub 2018 Dec 4.

2 Department of Critical Care Medicine, Northeast Georgia Health System, Gainesville, GA, USA.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618816673DOI Listing
December 2018

Intensive Care Unit Capacity Strain and Outcomes of Critical Illness in a Resource-Limited Setting: A 2-Hospital Study in South Africa.

J Intensive Care Med 2018 Dec 4:885066618815804. Epub 2018 Dec 4.

8 Pietermaritzburg Department of Anaesthesia, Critical Care and Pain Management, Pietermaritzburg, South Africa.

Objective:: To measure the association of intensive care unit (ICU) capacity strain with processes of care and outcomes of critical illness in a resource-limited setting.

Methods:: We performed a retrospective cohort study of 5332 patients referred to the ICUs at 2 public hospitals in South Africa using the country's first published multicenter electronic critical care database. We assessed the association between multiple ICU capacity strain metrics (ICU occupancy, turnover, census acuity, and referral burden) at different exposure time points (ICU referral, admission, and/or discharge) with clinical and process of care outcomes. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618815804DOI Listing
December 2018
1 Read

Management Strategies for Intracranial Pressure Crises in Subarachnoid Hemorrhage.

J Intensive Care Med 2018 Dec 4:885066618813073. Epub 2018 Dec 4.

4 Department of Neurology, Division of Neuroendovascular Surgery and Neurocritical Care, Rutgers University-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.

Objectives: Standard management strategies for lowering intracranial pressure (ICP) in traumatic brain injury has been well-studied, but the use of lesser known interventions for ICP in subarachnoid hemorrhage (SAH) remains elusive. Searches were performed in PubMed and EBSCO Host to identify best available evidence for evaluation and management of medically refractory ICP in SAH. The role of standard management strategies such as head elevation, hyperventilation, mannitol and hypertonic saline as well as lesser known management such as sodium bicarbonate, indomethacin, tromethamine, decompressive craniectomy, decompressive laparotomy, hypothermia, and barbiturate coma are reviewed. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618813073DOI Listing
December 2018
1 Read

Bedside Ultrasound Assessment of Lung Reaeration in Patients With Blunt Thoracic Injury Receiving High-Flow Nasal Cannula Oxygen Therapy: A Retrospective Study.

J Intensive Care Med 2018 Dec 4:885066618815649. Epub 2018 Dec 4.

1 Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Background:: High-flow nasal cannula (HFNC) oxygen therapy has been shown to reduce the need for mechanical ventilation and decrease the duration of hospital and intensive care unit (ICU) stays for patients with a severely compromised respiratory system. This study aims to observe the evolution of lung aeration via lung ultrasound score (LUS) in a chest-injured population who had been treated with HFNC oxygen therapy, and to assess the benefit of the HFNC oxygen therapy in trauma patients.

Methods:: A retrospective study examined trauma patients with moderate to severe thoracic injuries who were admitted to the ICU at a tertiary hospital between October 2015 and March 2017. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618815649DOI Listing
December 2018
2 Reads

Devices to Reduce the Volume of Blood Taken for Laboratory Testing in ICU Patients: A Systematic Review.

J Intensive Care Med 2018 Nov 27:885066618810374. Epub 2018 Nov 27.

1 Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Background:: Intensive care unit (ICU) patients are at high risk of anemia, which is associated with adverse clinical outcomes and death. Blood sampling for diagnostic testing is a potentially modifiable contributor to anemia.

Methods:: We conducted a systematic review by searching MEDLINE and EMBASE from inception to October 5, 2017, for studies reporting the volume of blood taken for laboratory testing using blood sampling conservation devices compared to standard care or another intervention in adult ICU patients. Read More

View Article

Download full-text PDF

Source
http://journals.sagepub.com/doi/10.1177/0885066618810374
Publisher Site
http://dx.doi.org/10.1177/0885066618810374DOI Listing
November 2018
5 Reads

Clinical Predictors for Unsafe Direct Discharge Home Patients From Intensive Care Units.

J Intensive Care Med 2018 Nov 26:885066618811810. Epub 2018 Nov 26.

1 Division of Critical Care, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Purpose:: To describe factors (demographics and clinical characteristics) that predict patients who are at an increased risk of adverse events or unplanned return visits to a health-care facility following discharge direct to home (DDH) from intensive care units (ICUs).

Methods:: Prospective cohort study of all adult patients who survived their stay in our medical-surgical-trauma ICU between February 2016 and 2017 and were discharged directly home. Patients were followed for 8 weeks postdischarge. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618811810DOI Listing
November 2018
6 Reads

Prevalence and Predictors of Deep Vein Thrombosis in Critically Ill Medical Patients Who Underwent Diagnostic Duplex Ultrasonography.

J Intensive Care Med 2018 Nov 19:885066618813300. Epub 2018 Nov 19.

2 Department of Pulmonary and Critical Care Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Introduction:: Deep vein thrombosis (DVT) is a recognized but preventable cause of morbidity and mortality in the medical intensive care unit (MICU). We examined the prevalence and risk factors for DVT in MICU patients who underwent diagnostic venous duplex ultrasonography (DUS) and the potential effect on clinical outcomes.

Methods:: This is a retrospective study examining prevalence of DVT in 678 consecutive patients admitted to a tertiary care level academic MICU from July 2014 to 2015. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618813300DOI Listing
November 2018
8 Reads

Interhospital Transfer of Children in Septic Shock: A Clinician Interview Qualitative Study.

J Intensive Care Med 2018 Dec 14;33(12):671-679. Epub 2016 Dec 14.

2 Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan Health System, Ann Arbor, MI, USA.

Objective:: To determine the factors that influence the decision to transfer children in septic shock from level II to level I pediatric intensive care unit (PICU) care.

Design:: Interviews with level II PICU physicians in Michigan and Northwest Ohio. A hypothetical scenario of a 14-year-old boy in septic shock was presented. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066616683662DOI Listing
December 2018
6 Reads

Cytomorphometric Neutrophil and Monocyte Markers May Strengthen the Diagnosis of Sepsis.

J Intensive Care Med 2018 Dec 13;33(12):656-662. Epub 2016 Dec 13.

2 Medical Intensive Care Unit, Christian Medical College, Vellore, Tamil Nadu, India.

Background:: The diagnosis of sepsis is challenging in the absence of a gold standard test. Recent studies have explored the role of neutrophil and monocyte volume, conductivity, and scatter (VCS), derived from automated hematology analyzers, in diagnosing sepsis. We assessed the diagnostic accuracy of VCS parameters in critically ill patients with sepsis. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066616682940DOI Listing
December 2018
10 Reads

BiPAP Noninvasive Ventilation in Patients With Acute Heart Failure and Left Ventricular Systolic Dysfunction Without Control of Confusing Variables.

J Intensive Care Med 2018 12;33(12):695-696

1 Facultad de Ciencias Médicas, Universidad de Guayaquil, Ciudadela Universitaria Salvador Allende, Malecón del Salado entre Av Fortunato Safadi (Av Delta) y Av. Kennedy, Guayaquil, Guayas 090513, Ecuador.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618758616DOI Listing
December 2018
1 Read

Oncologic Emergencies-The Old, the New, and the Deadly.

J Intensive Care Med 2018 Nov 9:885066618803863. Epub 2018 Nov 9.

1 Critical Care Medicine Service, Department of Anesthesiology & Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Cancer continues to be a leading cause of death despite a broader understanding of its biology and the development of novel therapies. Nonetheless, with an increasing survival of this population, intensivists must be aware of the associated emergencies, both old and new. Oncologic emergencies can be seen as an initial presentation of the disease or precipitated by its treatment. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618803863DOI Listing
November 2018
9 Reads

Management of Hemophagocytic Lympho-Histiocytosis in Critically Ill Patients.

J Intensive Care Med 2018 Nov 1:885066618810403. Epub 2018 Nov 1.

1 Medical ICU, AP_HP Saint Louis hospital, Paris, France.

Hemophagocytic syndrome remains a rare but life-threatening complication and is associated with intensive care unit (ICU) admission. The pathophysiology is based on a defect of cytotoxicity in T cells that results in a state of hyperinflammation in the presence of a trigger. As a consequence, patients may develop multiorgan failure. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618810403DOI Listing
November 2018
1 Read

Effects of Early Enteral Nutrition on Immune Function and Prognosis of Patients With Sepsis on Mechanical Ventilation.

J Intensive Care Med 2018 Nov 1:885066618809893. Epub 2018 Nov 1.

1 Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

Objective:: To explore the therapeutic effects of early enteral nutrition (EEN) on patients with sepsis on mechanical ventilation.

Methods:: Patients with sepsis on mechanical ventilation in the medical intensive care unit (ICU) from January 2013 to March 2016 were treated with enteral nutrition. Patients treated within 48 hours of initiation of mechanical ventilation were assigned to the EEN group, and the rest were assigned to the delayed enteral nutrition (DEN) group. Read More

View Article

Download full-text PDF

Source
http://journals.sagepub.com/doi/10.1177/0885066618809893
Publisher Site
http://dx.doi.org/10.1177/0885066618809893DOI Listing
November 2018
4 Reads

Relationship Between Near-Infrared Spectroscopy-Derived Cerebral Oxygenation and Delirium in Critically Ill Patients: A Systematic Review.

J Intensive Care Med 2018 Oct 30:885066618807399. Epub 2018 Oct 30.

1 Division of Neurology, Department of Medicine, Queen's University, Kingston, Ontario, Canada.

Background:: A common neurological complication of critical illness is delirium, defined as an acute change in level of consciousness, with impaired attention and disorganized thinking. Patients with delirium have increased risk of long-term cognitive dysfunction and mortality. The cause is unknown, which limits our ability to design therapeutic interventions. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618807399DOI Listing
October 2018
3 Reads

The Accuracy of Urinary TIMP-2 and IGFBP7 for the Diagnosis of Cardiac Surgery-Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis.

J Intensive Care Med 2018 Oct 30:885066618807124. Epub 2018 Oct 30.

1 Intensive Care Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Province, PR China.

Background:: Tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) are recent promising markers for identification of cardiac surgery-associated acute kidney injury (CSA-AKI). The aim of this study was systematically and quantitatively to evaluate the accuracy of urinary TIMP-2 and IGFBP7 for the diagnosis of CSA-AKI.

Methods:: Three databases including PubMed, ISI web of knowledge, and Embase were systematically searched from inception to March 2018. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618807124DOI Listing
October 2018
11 Reads

Safety and Efficacy of Intermittent Bolus and Continuous Infusion Neostigmine for Acute Colonic Pseudo-Obstruction.

J Intensive Care Med 2018 Oct 29:885066618809010. Epub 2018 Oct 29.

1 Department of Pharmacotherapy and Pharmacy Services, University Health System, San Antonio, TX, USA.

Purpose:: To compare clinical response of intermittent bolus versus continuous infusion neostigmine for acute colonic pseudo-obstruction (ACPO). Acute colonic pseudo-obstruction occurs due to reduced colonic parasympathetic activity. Neostigmine is an acetylcholinesterase inhibitor that increases frequency of smooth muscle contraction by increasing acetylcholine at autonomic nervous system synapses. Read More

View Article

Download full-text PDF

Source
http://journals.sagepub.com/doi/10.1177/0885066618809010
Publisher Site
http://dx.doi.org/10.1177/0885066618809010DOI Listing
October 2018
14 Reads

Prevalence and Risk Factors for Augmented Renal Clearance in a Population of Critically Ill Patients.

J Intensive Care Med 2018 Oct 29:885066618809688. Epub 2018 Oct 29.

1 Department of Intensive Care, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.

Background:: Critically ill patients show a high, albeit variable, prevalence of augmented renal clearance (ARC). This condition has relevant consequences on the elimination of hydrophilic drugs. Knowledge of risk factors for ARC helps in the early identification of ARC. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618809688DOI Listing
October 2018

Right Heart Thrombi: Patient Outcomes by Treatment Modality and Predictors of Mortality: A Pooled Analysis.

J Intensive Care Med 2018 Oct 29:885066618808193. Epub 2018 Oct 29.

7 Division of Pulmonary, Critical Care and Sleep Medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, NY, USA.

Rationale:: Right heart thrombi (RiHT) is characterized by the presence of thrombus within the right atrium or right ventricle (RV). Current literature suggests pulmonary embolism (PE) with RiHT carries a high mortality. Guidelines lack recommendations in managing RiHT. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618808193DOI Listing
October 2018
18 Reads

Portable Ventilation/Perfusion Scanning is Useful for Evaluating Clinically Significant Pulmonary Embolism in the ICU Despite Abnormal Chest Radiography.

J Intensive Care Med 2018 Oct 22:885066618807859. Epub 2018 Oct 22.

1 Pulmonary & Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Objective:: Computed tomography angiography is limited in the intensive care unit (ICU) due to renal insufficiency, hemodynamic instability, and difficulty transporting unstable patients. A portable ventilation/perfusion (V/Q) scan can be used. However, it is commonly believed that an abnormal chest radiograph can result in a nondiagnostic scan. Read More

View Article

Download full-text PDF

Source
http://journals.sagepub.com/doi/10.1177/0885066618807859
Publisher Site
http://dx.doi.org/10.1177/0885066618807859DOI Listing
October 2018
6 Reads

Perceived Barriers to Mobility in a Medical ICU: The Patient Mobilization Attitudes & Beliefs Survey for the ICU.

J Intensive Care Med 2018 Oct 18:885066618807120. Epub 2018 Oct 18.

1 Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Purpose: Early mobilization in the intensive care unit (ICU) can improve patient outcomes but has perceived barriers to implementation. As part of an ongoing structured quality improvement project to increase mobilization of medical ICU patients by nurses and clinical technicians, we adapted the existing, validated Patient Mobilization Attitudes & Beliefs Survey (PMABS) for the ICU setting and evaluated its performance characteristics and results.

Materials And Methods: The 26-item PMABS adapted for the ICU (PMABS-ICU) was administered as an online survey to 163 nurses, clinical technicians, respiratory therapists, attending and fellow physicians, nurse practitioners, and physician assistants in one medical ICU. Read More

View Article

Download full-text PDF

Source
http://journals.sagepub.com/doi/10.1177/0885066618807120
Publisher Site
http://dx.doi.org/10.1177/0885066618807120DOI Listing
October 2018
10 Reads

Anesthesiologist and Emergency Medicine Physician Attitudes and Knowledge Regarding Etomidate for Intubation.

J Intensive Care Med 2018 Oct 18:885066618804989. Epub 2018 Oct 18.

2 Department of Medicine, Western University, London, Ontario, Canada.

Purpose: The use of etomidate as an induction agent for critically ill patients is controversial. While its favorable hemodynamic profile is enviable, etomidate has been shown to cause transient adrenal suppression. The clinical consequences of transient adrenal suppression are poorly understood. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618804989DOI Listing
October 2018

Authors' Response.

J Intensive Care Med 2018 Oct 18:885066618803883. Epub 2018 Oct 18.

1 Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618803883DOI Listing
October 2018

The ART of Antiretroviral Therapy in Critically Ill Patients With HIV.

J Intensive Care Med 2018 Oct 11:885066618803871. Epub 2018 Oct 11.

1 Avera McKennan Hospital & University Health Center, Sioux Falls, SD, USA.

The management of patients with human immunodeficiency virus (HIV) can be a complicated specialty within itself, made even more complex when there are so many unanswered questions regarding the care of critically ill patients with HIV. The lack of consensus on the use of antiretroviral medications in the critically ill patient population has contributed to an ongoing clinical debate among intensivists. This review focuses on the pharmacological complications of antiretroviral therapy (ART) in the intensive care setting, specifically the initiation of ART in patients newly diagnosed with HIV, immune reconstitution inflammatory syndrome (IRIS), continuation of ART in those who were on a complete regimen prior to intensive care unit admission, barriers of drug delivery alternatives, and drug-drug interactions. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618803871DOI Listing
October 2018
1 Read

Don't Sugar Coat It: Glycemic Control in the Intensive Care Unit.

J Intensive Care Med 2018 Oct 11:885066618801748. Epub 2018 Oct 11.

1 Department of Anesthesiology & Critical Care Medicine, Critical Care Medicine Service, Memorial Sloan Kettering Cancer Center, NY, USA.

Stress hyperglycemia is the transient increase in blood glucose as a result of complex hormonal changes that occur during critical illness. It has been described in the critically ill for nearly 200 years; patient harm, including increases in morbidity, mortality, and lengths of stay, has been associated with hyperglycemia, hypoglycemia, and glucose variability. However, there remains a contentious debate regarding the optimal glucose ranges for this population, most notably within the past 15 years. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618801748DOI Listing
October 2018
14 Reads

Pharmacologic Management of Delirium in the ICU: A Review of the Literature.

J Intensive Care Med 2018 Oct 11:885066618805965. Epub 2018 Oct 11.

3 Department of Pharmacy, Pharmacy and Therapeutics, UPMC Presbyterian Hospital, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA.

Purpose: Conflicting data exists on the pharmacologic management of intensive care unit (ICU) delirium. This review appraises the current evidence of pharmacologic management of ICU delirium.

Materials And Methods: A systematic literature search of MEDLINE and Embase was conducted to answer the population, intervention, comparison, and outcome (PICO) question of: "Does the use of a pharmacologic agent compared to standard of care or placebo improve ICU delirium in a critically ill patient population?"

Results: After application of the PICO question and the inclusion and exclusion criteria, 13 articles were included. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618805965DOI Listing
October 2018
16 Reads

Dynamic Assessment of Fluid Responsiveness in Surgical ICU Patients Through Stroke Volume Variation is Associated With Decreased Length of Stay and Costs: A Systematic Review and Meta-Analysis.

J Intensive Care Med 2018 Oct 11:885066618805410. Epub 2018 Oct 11.

2 Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Static indices, such as the central venous pressure, have proven to be inaccurate predictors of fluid responsiveness. An emerging approach uses dynamic assessment of fluid responsiveness (FT-DYN), such as stroke volume variation (SVV) or surrogate dynamic variables, as more accurate measures of volume status. Recent work has demonstrated that goal-directed therapy guided by FT-DYN was associated with reduced intensive care unit (ICU) mortality; however, no study has specifically assessed this in surgical ICU patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0885066618805410DOI Listing
October 2018
29 Reads

The Impact of Chronic Ozone and Particulate Air Pollution on Mortality in Patients With Sepsis Across the United States.

J Intensive Care Med 2018 Oct 7:885066618804497. Epub 2018 Oct 7.

1 Division of Critical Care Medicine, Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.

Objective: The impact of chronic exposure to air pollution on mortality in patients with sepsis is unknown. We attempted to quantify the relationship between air pollution, notably excess ozone, and particulate matter (PM), with in-hospital mortality in patients with sepsis nationwide.

Methods: The 2011 Nationwide Inpatient Sample (NIS) was linked with ambient air pollution data from the Environmental Protection Agency for both 8-hour ozone exposure and annual mean 2. Read More

View Article

Download full-text PDF

Source
http://journals.sagepub.com/doi/10.1177/0885066618804497
Publisher Site
http://dx.doi.org/10.1177/0885066618804497DOI Listing
October 2018
4 Reads