520,137 results match your criteria intensive care


Association of obesity-related inflammatory pathways with lung function and exercise capacity.

Respir Med 2021 Apr 30;183:106434. Epub 2021 Apr 30.

From the Cardiovascular Research Center, Division of Massachusetts General Hospital, Boston, MA, USA; Cardiology Division of Massachusetts General Hospital, Boston, MA, USA. Electronic address:

Background: Obesity has multifactorial effects on lung function and exercise capacity. The contributions of obesity-related inflammatory pathways to alterations in lung function remain unclear.

Research Question: To examine the association of obesity-related inflammatory pathways with pulmonary function, exercise capacity, and pulmonary-specific contributors to exercise intolerance. Read More

View Article and Full-Text PDF

Concomitant valve-sparing aortic root replacement with tetralogy of Fallot repair in a 30-year-old patient: A case report.

Int J Surg Case Rep 2021 Apr 29;82:105930. Epub 2021 Apr 29.

Adult Cardiac Surgical Intensive Care Unit, Hanoi Heart Hospital, Hanoi, Viet Nam.

Introduction And Importance: Aortic regurgitation and aortic root dilatation are common features in adults with both repaired and unrepaired tetralogy of Fallot (TOF). Valve-sparing aortic root replacement (VSARR) is an effective repair for aortic regurgitation due to progressive aortic root dilatation with TOF after repair. However, the effectiveness of this technique for unrepaired patients has rarely been reported. Read More

View Article and Full-Text PDF

Firearm-Related Injuries: A Single Center Experience.

J Surg Res 2021 May 5;265:289-296. Epub 2021 May 5.

Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona. Electronic address:

Introduction: Firearm-related injuries (FRI) are an important public health crisis in the US. There is relatively less city level data examining the injury-related trends in Tucson, Arizona. Our study aims to examine FRI, in Southern Arizona's only Level I trauma center. Read More

View Article and Full-Text PDF

Discordance in Appendicitis Grading and the Association with Outcomes: A Post-Hoc Analysis of an EAST Multicenter Study.

J Surg Res 2021 May 5;265:259-264. Epub 2021 May 5.

Division of Trauma and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, Florida.

Background: The American Association for the Surgery of Trauma (AAST) appendicitis severity grading criteria use independent subscales for radiologists (Rad), surgeons (Surg), and pathologists (Path). We reviewed the EAST Multicenter Study of the Treatment of Appendicitis in America: Acute, Perforated, and Gangrenous (MUSTANG) database to determine rates of discordance and clinical consequences of inaccuracy.

Materials And Methods: A confusion matrix was constructed for pairs among Rad, Surg, and Path. Read More

View Article and Full-Text PDF

"We can't just have a casual conversation": An institutional ethnography-informed study of work in labour and birth.

Soc Sci Med 2021 Apr 29;279:113975. Epub 2021 Apr 29.

Wilson Centre for Research in Education, University Health Network, University of Toronto, Canada; University of Toronto's Centre for Interprofessional Education, University Health Network, Canada; Department of Speech-Language Pathology, University of Toronto, Canada.

Labour and delivery units often become contested workplaces with tensions between obstetrics, nursing, and midwifery practices. These tensions can impede communication and raise concerns about provider wellness and patient safety. Remedying such tensions requires inquiry into the drivers of recurrent problems in interprofessional practice. Read More

View Article and Full-Text PDF

Hypoxic acclimation improves cardiac redox homeostasis and protects heart against ischemia-reperfusion injury through upregulation of O-GlcNAcylation.

Redox Biol 2021 Apr 30;43:101994. Epub 2021 Apr 30.

Laboratory of Mitochondria and Metabolism, Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, 610041, China; Laboratory of Anesthesia and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China. Electronic address:

Ischemia-reperfusion (I/R) injury is detrimental to cardiovascular system. Alteration in glucose metabolism has been recognized as an important adaptive response under hypoxic conditions. However, the biological benefits underlying this metabolic phenotype remain to be elucidated. Read More

View Article and Full-Text PDF

Early warning of infection in patients undergoing hematopoietic stem cell transplantation using heart rate variability and serum biomarkers.

Transplant Cell Ther 2021 May 5. Epub 2021 May 5.

Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Departments of Critical Care Medicine and Surgery, The Ottawa Hospital, Ottawa, ON, Canada.

Background: Early warning of infection is critical to reduce risk of deterioration and mortality, especially in neutropenic patients following hematopoietic stem cell transplantation (HCT). Given that heart rate variability (HRV) is a sensitive and early marker for infection and serum inflammatory biomarkers can have high specificity for infection, we hypothesized their combination may be useful for accurate early warning of infection.

Purpose: Develop and evaluate a composite predictive model utilizing continuous HRV with daily serum biomarker measurements to provide risk stratification of future deterioration in HCT patients. Read More

View Article and Full-Text PDF

Loss of FOXO Transcription Factors in the Liver Mitigates Stress-Induced Hyperglycemia.

Mol Metab 2021 May 5:101246. Epub 2021 May 5.

Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Physiology, Perelman School of Medicine, University of Pennsylvania. Electronic address:

Objective: Stress-induced hyperglycemia is associated with poor outcomes in nearly all critical illnesses. This acute elevation in glucose after injury or illness is associated with increased morbidity and mortality including multiple organ failure. Stress-induced hyperglycemia is often attributed to insulin resistance as controlling glucose levels via exogenous insulin improves outcomes, but mechanisms are unclear. Read More

View Article and Full-Text PDF

Development of the APPD Global Educator Scholarship - Expanding Bidirectional Efforts in Global Health Education.

Acad Pediatr 2021 May 5. Epub 2021 May 5.

Department of Pediatrics, Division of Neonatal-Perinatal Medicine. University of Washington, 1959 NE Pacific Street, Seattle, WA 98195. Electronic address:

Background: The Board of the Association of Pediatric Program Directors (APPD) partnered with the APPD Global Health Learning Community (GHLC) to establish the APPD Global Pediatric Educator Scholarship. This award seeks to recognize pediatric educators who demonstrate leadership in improving pediatric education in low- and middle-income countries, and provide them with career development opportunities by attending the APPD Spring meeting. Two educators per year have been awarded the scholarship since 2017. Read More

View Article and Full-Text PDF

Klebsiella pneumoniae Harboring Carbapenemase Genes in Taiwan: Its Evolution over 20 Years, 1998-2019.

Int J Antimicrob Agents 2021 May 5:106354. Epub 2021 May 5.

Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Tainan; Department of Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:

Klebsiella pneumoniae is an important pathogen causing various types of human infections in Taiwan. Carbapenemases have increasingly been reported in Enterobacterales in the past two decades. Carbapenemase-producing K. Read More

View Article and Full-Text PDF

Sex Differences, Sleep Disturbance and Risk of Persistent Pain Associated With Groin Hernia Surgery: A Nationwide Register-Based Cohort Study.

J Pain 2021 May 5. Epub 2021 May 5.

Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden; Department of Surgery, Skåne University Hospital, Malmö, Sweden.

Persistent pain after groin hernia repair is a major health problem. Sleep disturbance is associated with heightened pain sensitivity. The main objective of this study was to examine the role of sleep disturbance in the development and long-term maintenance of chronic postherniorrhaphy inguinal pain (CPIP), with exploration of sex differences. Read More

View Article and Full-Text PDF

Current status of simulation usage in Canadian cardiac surgery training programs.

Can J Cardiol 2021 May 5. Epub 2021 May 5.

Department of Surgery, University of Alberta, Edmonton, Alberta.

The apprenticeship model of surgical education, relying solely on operating room training, may be insufficient to meet current needs of cardiac surgery trainees. Challenges such as resident duty hour restrictions, increasing case complexity, and novel techniques limit direct intraoperative experience. Simulation is a widely accepted educational tool in surgery. Read More

View Article and Full-Text PDF

Mortality after In-Hospital Cardiac Arrest in Patients with COVID-19: A Systematic Review and Meta-Analysis.

Resuscitation 2021 May 5. Epub 2021 May 5.

Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Italy; Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy. Electronic address:

Aim: To estimate the mortality rate, the rate of return of spontaneous circulation (ROSC) and survival with favorable neurological outcome in patients with COVID-19 after in-hospital cardiac arrest (IHCA) and attempted cardiopulmonary resuscitation (CPR).

Methods: PubMed, EMBASE, Web of Science, bioRxiv and medRxiv were surveyed up to 8th February 2021 for studies reporting data on mortality of patients with COVID-19 after IHCA. The primary outcome sought was mortality (in-hospital or at 30 days) after IHCA with attempted CPR. Read More

View Article and Full-Text PDF

Withdrawal of active treatments in terminally ill heart failure patients.

Int J Cardiol 2021 May 5. Epub 2021 May 5.

Intensive Cardiac Care Unit and "De Gasperis" Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

Introduction: Heart failure (HF) constitutes a growing public health problem in aging societies: when pharmacological therapies fail, HF can be sustained intensively if patients are eligible for either orthotopic heart transplantation (OHT) or mechanical ventricular assistance, otherwise additional treatments could be inappropriate. In December 2017 Italian Legislator brought in the provisions regarding the end-of-life choices, including indications for withdrawing and withholding life-sustaining therapies. The aim of our study was to provide an overview of the daily practice of our center with regard to terminally ill HF patients. Read More

View Article and Full-Text PDF

Identification of distinct clinical subphenotypes in critically ill patients with COVID-19.

Chest 2021 May 5. Epub 2021 May 5.

Center for Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Pulmonary, Allergy and Critical Care Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

Background: Subphenotypes have been identified in patients with sepsis and acute respiratory distress syndrome (ARDS), and are associated with different outcomes and response to therapies.

Research Question: Can unique subphenotypes be identified among critically ill patients with coronavirus disease 2019 (COVID-19)?

Study Design: & Methods: Using data from a multicenter cohort study that enrolled critically ill patients with COVID-19 from 67 hospitals across the United States, we randomly divided centers into Discovery and Replication cohorts. We utilized latent class analysis independently in each cohort to identify subphenotypes based on clinical and laboratory variables. Read More

View Article and Full-Text PDF

One year survival worse for lung retransplants relative to primary lung transplants.

Ann Thorac Surg 2021 May 5. Epub 2021 May 5.

Division of Cardiothoracic Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.

Background: Outcomes after lung re-transplantation (LRT) remain inferior compared to primary lung transplantation (PLT). We examined the impact of center volume on one-year survival after LRT.

Methods: Using the UNOS database, we abstracted patients undergoing PLT and LRT between January 2006 and December 2017, excluding combined heart-lung transplants and multiple re-transplants. Read More

View Article and Full-Text PDF

3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study.

Lancet Respir Med 2021 May 5. Epub 2021 May 5.

Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Institute for Life Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK. Electronic address:

Background: The consequences of COVID-19 in those who recover from acute infection requiring hospitalisation have yet to be clearly defined. We aimed to describe the temporal trends in respiratory outcomes over 12 months in patients hospitalised for severe COVID-19 and to investigate the associated risk factors.

Methods: In this prospective, longitudinal, cohort study, patients admitted to hospital for severe COVID-19 who did not require mechanical ventilation were prospectively followed up at 3 months, 6 months, 9 months, and 12 months after discharge from Renmin Hospital of Wuhan University, Wuhan, China. Read More

View Article and Full-Text PDF

Simulation-based ventilatory training for the caregivers at primary and rural health care workers in Central India for dealing with COVID-19 pandemic: recommendations.

J Complement Integr Med 2021 May 8. Epub 2021 May 8.

Anatomy, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India.

In 2020 COVID-19 made a major burden on health care system. The capacity of the healthcare system particularly emergency departments, ICU, hospital beds are insufficient to manage the increasing number of patients in cities and rural areas too. The primary health care centers and rural hospitals need preparedness for such disasters conditions. Read More

View Article and Full-Text PDF

Maternal haemodynamics during labour epidural analgesia with and without adrenaline.

Scand J Pain 2021 May 10. Epub 2021 May 10.

Department of Anaesthesia, Akershus University Hospital, Lørenskog, Norway.

Objectives: Labour is one of the most painful experiences in a woman's life. Epidural analgesia using low-concentration local anaesthetics and lipophilic opioids is the gold standard for pain relief during labour. Pregnancy in general, particularly labour, is associated with changes in maternal haemodynamic variables, such as cardiac output and heart rate, which increase and peak during uterine contractions. Read More

View Article and Full-Text PDF

Prolonged COVID-19 Disease in a Patient with Rheumatoid Arthritis on Rituximab Therapy.

J Infect Dis 2021 May 8. Epub 2021 May 8.

Division of Pulmonary, Critical Care, and Sleep Medicine. Department of Medicine. Northwell Health. New York, USA.

View Article and Full-Text PDF

Pulmonary Vascular Resistance Predicts Mortality and Graft Failure in Transplanted Portopulmonary Hypertension Patients.

Liver Transpl 2021 May 8. Epub 2021 May 8.

Division of Pulmonary, Critical Care, and Sleep Medicine, University of Cincinnati, Cincinnati, OH, USA.

Background & Aims: Portopulmonary hypertension (PoPH) is a type of pulmonary vascular disease associated with significant morbidity and mortality in patients with underlying liver disease, and confers a higher mortality in patients awaiting liver transplantation (LT). Although not a transplant indication, PoPH patients who undergo LT can experience significant clinical improvement, and those who maintain a mean pulmonary arterial pressure (mPAP) < 35mmHg and a pulmonary vascular resistance (PVR) < 5 Woods Units are granted Model for End Stage Liver Disease (MELD) exception points to expedite LT. The effect of PoPH on post-transplant outcomes such as mortality and graft failure, however, is not well defined. Read More

View Article and Full-Text PDF

Association between nutrition delivery, modified Nutrition Risk in Critically Ill score, and 28-day mortality.

Nutr Clin Pract 2021 May 8. Epub 2021 May 8.

Division of Biostatistics, National Institute of Nutrition, Hyderabad, Telangana, India.

Background: Nutrition delivery, is a key component in the management of critical illness. Traditional scoring systems are inadequate in the intensive care unit (ICU), as patients are sedated. Our study examines the associations between calorie and protein adequacy, 28-day mortality, and modified Nutrition Risk in Critically Ill (mNUTRIC) score and identify at-risk ICU patients who may benefit more from nutrition intervention. Read More

View Article and Full-Text PDF

Extremely preterm infants experienced good comfort with various nasal respiratory support techniques delivered with masks.

Acta Paediatr 2021 May 8. Epub 2021 May 8.

Division of Paediatrics and Neonatal Critical Care, A.Béclère Medical Centre, Paris Saclay University Hospitals, France.

Extremely preterm neonates often need ongoing support for chronic pulmonary insufficiency of prematurity. The simplest support is continuous positive airway pressure (CPAP). More complex techniques are bilevel positive airway pressure (BiPAP), non-invasive positive pressure ventilation (NIPPV) and non-invasive high-frequency oscillatory ventilation (NHFOV). Read More

View Article and Full-Text PDF

24-hour fluid administration in emergency department patients with suspected infection; a multicenter, prospective, observational study.

Acta Anaesthesiol Scand 2021 May 8. Epub 2021 May 8.

Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Denmark.

Background: To describe 24-hour fluid administration in emergency department (ED) patients with suspected infection.

Methods: A prospective, multicenter, observational study conducted in three Danish hospitals, January 20-March 2, 2020. We included consecutive adult ED-patients with suspected infection (drawing of blood culture and/or intravenous antibiotic administration within 6 hours of admission). Read More

View Article and Full-Text PDF

Ischemic vascular disease and long-term mortality in emergency abdominal surgical patients: a population-based cohort study.

Acta Anaesthesiol Scand 2021 May 8. Epub 2021 May 8.

Herlev Anaesthesia Critical and Emergency Care Science Unit (ACES) Department of Anaesthesiology, Copenhagen University Hospital Herlev-Gentofte, Herlev, Denmark.

Background: Emergency abdominal surgery carries a high mortality, as patients are often frail with significant comorbidity. We aimed to evaluate the association between co-existing ischemic vascular disease (IVD) and long-term mortality in patients undergoing emergency abdominal surgery.

Methods: We included adult emergency abdominal surgical patients operated on 13 Danish hospitals between January 1 2009 and December 31 2010. Read More

View Article and Full-Text PDF

Glycemic lability index and mortality in critically ill patients - a multicenter cohort study.

Acta Anaesthesiol Scand 2021 May 8. Epub 2021 May 8.

Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.

Background: Emerging evidence indicates a relationship between glycemic variability during intensive care unit (ICU) admission and death. We assessed whether mean glucose, hypoglycemia occurrence, or premorbid glycemic control modified this relationship.

Methods: In this retrospective, multicenter cohort study, we included adult patients admitted to five ICUs in Australia and Sweden with available pre-admission glycated hemoglobin A1c (HbA1c) and ≥3 glucose readings. Read More

View Article and Full-Text PDF

Hans-Henrik Bülow, Helle Petersen, Julie Benbenishty.

Authors:
Charles L Sprung

Acta Anaesthesiol Scand 2021 May 8. Epub 2021 May 8.

Holbaek Hospital, Department of Anaesthesiology and Intensive Care, Sjaelland, Holbaek, Denmark.

The purpose of this commentary is to help facilitating and improving communication in the ICU with patients and/or families when conducting end-of-life (EOL) conferences or advanced care planning (ACP). Only two papers have provided specific advice for improving communication in the ICU , hence we present a list of 22 hints and advice to help increase patient and family satisfaction and to help prevent that disproportionate care is provided to patients who will not benefit or who does not want it. Read More

View Article and Full-Text PDF

Reasons for physician-related variability in end-of-life decision-making in intensive care.

Acta Anaesthesiol Scand 2021 May 8. Epub 2021 May 8.

Department of Anesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Background: There is increasing evidence that the individual physician is the main factor influencing variability in end-of-life decision-making in intensive care units. End-of-life decisions are complex and should be adapted to each patient. Physician-related variability is problematic as it may result in unequal assessments that affect patient outcomes. Read More

View Article and Full-Text PDF