Critical Care/Intensive Care Medical Journal Abstracts
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Inhaled Dornase alfa (Pulmozyme) as a noninvasive treatment of atelectasis in mechanically ventilated patients
Journal of Critical Care
Dec 2012
Inhaled Dornase alfa (Pulmozyme) as a noninvasive treatment of atelectasis in mechanically ventilated patients
Background: Lobar or segmental collapse of the lung in mechanically ventilated patients is a common occurrence in the intensive care unit. Management is labor and time intensive and not highly effective. Methods: We conducted a randomized, placebo-controlled, double-blind pilot study to determine whether nebulized..Clinical epidemiology of central venous catheter–related bloodstream infections in an intensive care unit in China
Journal of Critical Care
Dec 2012
Clinical epidemiology of central venous catheter–related bloodstream infections in an intensive care unit in China
Background: Central venous catheters (CVCs) are universally used during the treatment of critically ill patients. Their use, however, is associated with a substantial infection risk. At present, there are few studies on catheter-related bloodstream infections (CRBSIs) that are comparable with international similar..Improving the 2007 Infectious Disease Society of America/American Thoracic Society severe community-acquired pneumonia criteria to predict intensive care unit admission
Journal of Critical Care
Dec 2012
Improving the 2007 Infectious Disease Society of America/American Thoracic Society severe community-acquired pneumonia criteria to predict intensive care unit admission
Purpose: To improve 2007 Infectious Disease Society of America/American Thoracic Society (IDSA/ATS) severity criteria to predict intensive care unit (ICU) admission in patients hospitalized with pneumonia. Methods: A composite score that included the 2007 IDSA/ATS criteria for severe pneumonia and additional..A structured educational intervention to improve targeted temperature management utilization after cardiac arrest
Journal of Critical Care
Dec 2012
A structured educational intervention to improve targeted temperature management utilization after cardiac arrest
Purpose: Post-arrest targeted temperature management (TTM) has been shown to dramatically improve outcomes after resuscitation, yet studies have revealed inconsistent and slow adoption. Little is known about barriers to TTM implementation and methods to increase adoption. We hypothesized that a structured educational..Hypophosphatemia in critically ill patients
Journal of Critical Care
Dec 2012
Hypophosphatemia in critically ill patients
Purpose: The aim of this study was to assess the association of phosphate concentration with key clinical outcomes in a heterogeneous cohort of critically ill patients. Materials and Methods: This was a retrospective observational study at a general intensive care unit (ICU) of an Australian university teaching..Nurse-driven, protocol-directed weaning from mechanical ventilation improves clinical outcomes and is well accepted by intensive care unit physicians
Journal of Critical Care
Dec 2012
Nurse-driven, protocol-directed weaning from mechanical ventilation improves clinical outcomes and is well accepted by intensive care unit physicians
Purpose: Ventilator weaning protocols can improve clinical outcomes, but their impact may vary depending on intensive care unit (ICU) structure, staffing, and acceptability by ICU physicians. This study was undertaken to examine their relationship. Design/Methods: We prospectively examined outcomes of 102 mechanically..Determinants of renal function at hospital discharge of patients treated with renal replacement therapy in the intensive care unit
Journal of Critical Care
Dec 2012
Determinants of renal function at hospital discharge of patients treated with renal replacement therapy in the intensive care unit
Purpose: Identification of risk factors for impaired renal function at hospital discharge in critically ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT). Methods: A single-center retrospective cohort study was performed evaluating demographic and clinical parameters as potential..Prophylactic magnesium for improving neurologic outcome after aneurysmal subarachnoid hemorrhage: Systematic review and meta-analysis
Journal of Critical Care
Nov 2012
Prophylactic magnesium for improving neurologic outcome after aneurysmal subarachnoid hemorrhage: Systematic review and meta-analysis
Purpose: Neurologic disability is common after aneurysmal subarachnoid hemorrhage (aSAH). Our objective was to systematically review the prophylactic use of magnesium to improve neurologic outcomes in these patients. Methods: We searched MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials to..A comparison of the rapid shallow breathing index and complexity measures during spontaneous breathing trials after cardiac surgery
Journal of Critical Care
Nov 2012
A comparison of the rapid shallow breathing index and complexity measures during spontaneous breathing trials after cardiac surgery
Purpose: Extubation failure is associated with worse outcomes. Physicians use respiratory parameters to help them to decide to extubate or not. The purpose of this study is to determine if novel measures of respiratory physiology such as complexity and variability can identify patients who will tolerate extubation...Consecutive thrombelastography clot strength profiles in patients with severe sepsis and their association with 28-day mortality: A prospective study
Journal of Critical Care
Nov 2012
Consecutive thrombelastography clot strength profiles in patients with severe sepsis and their association with 28-day mortality: A prospective study
Purpose: The aim of this study was to assess associations between consecutive thrombelastography (TEG) profiles and standard coagulation tests and disease severity and mortality in patients with severe sepsis. Materials and Methods: This was a prospective observational study of adults with severe sepsis admitted to the..Cerebral desaturation events in the intensive care unit following cardiac surgery
Journal of Critical Care
Nov 2012
Cerebral desaturation events in the intensive care unit following cardiac surgery
Purpose: Patients may be at high risk for hemodynamic instability in the early postoperative period, with subsequent poor cerebral perfusion and the development of postoperative cerebral oxygen desaturation events (CDEs). Intraoperative CDEs have been associated with postoperative adverse events. However, none of these..A bedside communication tool did not improve the alignment of a multidisciplinary team's goals for intensive care unit patients
Journal of Critical Care
Nov 2012
A bedside communication tool did not improve the alignment of a multidisciplinary team's goals for intensive care unit patients
Purpose: Establishing well-understood daily patient care goals should improve healthcare team (HCT) communication, reduce errors, and improve patient outcomes. The purpose of this study was to test the hypothesis that implementation of a daily goals “Door Communication Card” (DCC) would improve goal alignment between..Cardiac output responses in a flow-driven protocol of resuscitation following cardiac surgery
Journal of Critical Care
Nov 2012
Cardiac output responses in a flow-driven protocol of resuscitation following cardiac surgery
Objective: Determine the role of cardiac output and central venous pressure (CVP) measurements in the clinical decisions that were based on the algorithm used in a randomized trial that compared a colloid to a crystalloid solution in the management of patients early after cardiac surgery (FACS trial, NCT00337805, Crit..Antipyretic therapy in febrile critically ill adults: A systematic review and meta-analysis
Journal of Critical Care
Nov 2012
Antipyretic therapy in febrile critically ill adults: A systematic review and meta-analysis
Purpose: To determine whether fever control with antipyretic therapy effects the mortality of febrile critically ill adults. Methods: Systematic review using MEDLINE, EMBASE, Cochrane Central Register for Controlled Trials, CINAHL, Google Scholar, and 2 clinical trial registries from inception to April 2012. Randomized..Impact of serum C-reactive protein measurements in the first 2 days on the 30-day mortality in hospitalized patients with severe community-acquired pneumonia: A cohort study
Journal of Critical Care
Nov 2012
Impact of serum C-reactive protein measurements in the first 2 days on the 30-day mortality in hospitalized patients with severe community-acquired pneumonia: A cohort study
Introduction: The purpose of the study is to evaluate the impact of daily consecutive measurements of C-reactive protein (CRP) in the initial 2 days of hospitalization on the 30-day all-cause mortality in patients with severe community-acquired pneumonia (CAP). Methods: We used 4 different thresholds of fractional..Cerebral herniation associated with central venous catheter insertion: Risk assessment
Journal of Critical Care
Nov 2012
Cerebral herniation associated with central venous catheter insertion: Risk assessment
Purpose: Central venous catheters (CVCs) are often necessary to treat acute brain-injured patients. Four cases of cerebral herniation immediately following central venous catheterization were the impetus for an investigation of clinical and radiologic parameters associated with this complication. Materials and Methods:..Risk of in-hospital mortality identified according to the typology of patients with acute heart failure: Classification tree analysis on data from the Acute Heart Failure Database–Main registry
Journal of Critical Care
Nov 2012
Risk of in-hospital mortality identified according to the typology of patients with acute heart failure: Classification tree analysis on data from the Acute Heart Failure Database–Main registry
Purpose: The purposes of this study are to identify the strongest clinical parameters in relation to in-hospital mortality, which are available in the earliest phase of the hospitalization of patients, and to create an easy tool for the early identification of patients at risk. Materials and Methods: The classification..A conceptual approach to improving care in pandemics and beyond: Severe lung injury centers
Journal of Critical Care
Nov 2012
A conceptual approach to improving care in pandemics and beyond: Severe lung injury centers
The events of the 2009 influenza pandemic sparked discussion regarding the need to optimize delivery of care to those most severely ill. We propose in this conceptual study that a tiered regionalization care system be instituted for patients with severe acute respiratory distress syndrome. Such system would be a..Motivation and job satisfaction of Tele-ICU nurses
Journal of Critical Care
Nov 2012
Motivation and job satisfaction of Tele-ICU nurses
Introduction: Although the first tele-ICU has been in existence for more than 12 years, little is known about the work of tele-ICU nurses. This study examines sources of motivation and satisfaction of tele-ICU nurses. Methods: A total of 50 nurses in 5 tele-ICUs were interviewed about reasons for working as a tele-ICU..Delirium assessment using Confusion Assessment Method for the Intensive Care Unit in Chinese critically ill patients
Journal of Critical Care
Nov 2012
Delirium assessment using Confusion Assessment Method for the Intensive Care Unit in Chinese critically ill patients
Purpose: The aim of this study was to provide a method for delirium evaluation in simplified Chinese for patients speaking this language via validation of a translation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Materials and Methods: Two phases were conducted including initial..Contributions of tele–intensive care unit (Tele-ICU) technology to quality of care and patient safety
Journal of Critical Care
Nov 2012
Contributions of tele–intensive care unit (Tele-ICU) technology to quality of care and patient safety
The deployment of remote monitoring of intensive care unit (ICU) patients, known as tele-ICU technology, promotes the efficient use of critical care resources. Although tele-ICU use has spread rapidly, the benefits vary widely among studies, and little is known about the specific characteristics of tele-ICU that..Urine biochemistry in septic and non-septic acute kidney injury: a prospective observational study
Journal of Critical Care
Nov 2012
Urine biochemistry in septic and non-septic acute kidney injury: a prospective observational study
Purpose: Determine whether there are unique patterns to the urine biochemistry profile in septic compared with non-septic acute kidney injury (AKI) and whether urinary biochemistry predicts worsening AKI, need for renal replacement therapy and mortality. Materials and Methods: Prospective cohort study of critically ill..Prediction of fluid responsiveness in patients admitted to the medical intensive care unit
Journal of Critical Care
Nov 2012
Prediction of fluid responsiveness in patients admitted to the medical intensive care unit
Purpose: Accurate prediction of fluid responsiveness is of importance in the treatment of patients admitted to the intensive care unit (ICU). We investigated whether physical examination, central venous pressure (CVP), central venous oxygen saturation (ScvO2), passive leg raising (PLR) test, and transpulmonary..Relationship between plasma high-mobility group box-1 levels and clinical outcomes of ischemic stroke
Journal of Critical Care
Nov 2012
Relationship between plasma high-mobility group box-1 levels and clinical outcomes of ischemic stroke
Purpose: High-mobility group box-1 (HMGB1) is regarded as a central mediator of inflammation and involved in many inflammatory diseases. This study aimed to investigate impact of plasma HMGB1 level on 1-year clinical outcomes of ischemic stroke. Methods: Plasma HMGB1 levels of 338 patients were quantified by..Effect of cardiopulmonary resuscitation on restoration of myocardial ATP in prolonged ventricular fibrillation
Resuscitation
Jun 2012
Effect of cardiopulmonary resuscitation on restoration of myocardial ATP in prolonged ventricular fibrillation
Background: There has been controversy over whether a short period of cardiopulmonary resuscitation (CPR) prior to defibrillation improves survival in patients who experienced a sudden cardiac arrest. However, there have been no reports about whether CPR restores the myocardial energy source during prolonged..Cold-induced medical equipment failure: lessons from Afghanistan
Resuscitation
Jun 2012
Cold-induced medical equipment failure: lessons from Afghanistan
Background: There has been controversy over whether a short period of cardiopulmonary resuscitation (CPR) prior to defibrillation improves survival in patients who experienced a sudden cardiac arrest. However, there have been no reports about whether CPR restores the myocardial energy source during prolonged..Uric acid, allopurinol therapy, and mortality in patients with acute heart failure—results of the Acute HEart FAilure Database registry
Journal of Critical Care
Jun 2012
Uric acid, allopurinol therapy, and mortality in patients with acute heart failure—results of the Acute HEart FAilure Database registry
Study Objective: The aim of this study was to explore the prognostic role of serum uric acid (UA) measurement in the hospital and long-term mortality assessment in subjects with acute heart failure (AHF) from the Acute HEart FAilure Database registry (AHEAD). The AHEAD registry comprised 4153 patients with AHF..Adrenal insufficiency and response to corticosteroids in hypotensive critically ill children with cancer
Journal of Critical Care
Jun 2012
Adrenal insufficiency and response to corticosteroids in hypotensive critically ill children with cancer
Background: Assessment and treatment of adrenal axis function in critically ill pediatric patients with oncologic disorders have not been well elucidated. Critically ill children with oncologic disorders may be at increased risk for adrenal insufficiency (AI). Objective: The aim of the present study was to evaluate the..Serial changes in adiponectin and resistin in critically ill patients with sepsis: Associations with sepsis phase, severity, and circulating cytokine levels
Journal of Critical Care
Jun 2012
Serial changes in adiponectin and resistin in critically ill patients with sepsis: Associations with sepsis phase, severity, and circulating cytokine levels
Purpose: The aim of the present study was to describe the variation in adiponectin and resistin levels, 2 adipokines with opposing effects on metabolism, in mechanically ventilated patients with sepsis and their relationships to disease severity and cytokine levels. Materials and Methods: An observational prospective..Acute respiratory distress syndrome related to influenza A H1N1 infection: Correlation of pulmonary computed tomography findings to extracorporeal membrane oxygenation treatment and clinical outcome
Journal of Critical Care
Jun 2012
Acute respiratory distress syndrome related to influenza A H1N1 infection: Correlation of pulmonary computed tomography findings to extracorporeal membrane oxygenation treatment and clinical outcome
Purpose: The aim of the present study was to correlate computed tomography appearances with clinical severity and outcome using a total lung disease (TLD) score in patients with acute respiratory distress syndrome (ARDS) related to influenza A H1N1 infection. Materials and Methods: Chest computed tomographic scans of..Adverse outcomes associated with delayed intensive care consultation in medical and surgical inpatients
Journal of Critical Care
Jun 2012
Adverse outcomes associated with delayed intensive care consultation in medical and surgical inpatients
Purpose: The impact of delay in obtaining an intensive care unit (ICU) consult from inpatient wards is unclear. The goal of this study was to examine the effect of time to ICU consult from medical and surgical wards on mortality and length of stay (LOS). Materials and Methods: This was a retrospective study of 241..Topical nitroglycerin and lidocaine locally vasodilate the radial artery without affecting systemic blood pressure: A dose-finding phase I study
Journal of Critical Care
Jun 2012
Topical nitroglycerin and lidocaine locally vasodilate the radial artery without affecting systemic blood pressure: A dose-finding phase I study
Purpose: Small radial artery diameter (RAD) and vasospasm are barriers to radial artery cannulation. We performed this study to determine if topical nitroglycerin and/or nitroglycerin plus topical lidocaine increases RAD without affecting systemic blood pressure. Materials and Methods: This was a randomized,..Emergent Pediatric Thoracotomy Following Traumatic Arrest
Resuscitation
Jun 2012
Emergent Pediatric Thoracotomy Following Traumatic Arrest
Objectives: Emergent thoracotomy is a potentially life-saving procedure following traumatic cardiac arrest. The procedure has been studied extensively in adults, but its role in pediatric traumatic cardiac arrest remains unclear. We aimed to determine the prevalence of survival following emergent resuscitative..Fluid balance and non-respiratory functions of the lung
Anaesthesia and Intensive Care Medicine
Dec 2011
Fluid balance and non-respiratory functions of the lung
The primary function of the lung is gas exchange between alveolar gas and the blood flowing through the nearby capillaries. This stage of gas exchange takes place by diffusion. Because gases such as oxygen diffuse relatively slowly through liquids it is essential that the fluid barrier is kept as short as possible...Diagnostic value of positron emission tomography combined with computed tomography for evaluating patients with septic shock of unknown origin
Journal of Critical Care
Dec 2011
Diagnostic value of positron emission tomography combined with computed tomography for evaluating patients with septic shock of unknown origin
Purpose: 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) combined with computed tomography (CT) is a promising new tool for the identification of infectious foci. The aim of our work was to evaluate the diagnostic value of FDG-PET/CT in critically ill patients with septic shock of unknown origin...Absolute eosinophils count as a marker of mortality in patients with severe sepsis and septic shock in an intensive care unit
Journal of Critical Care
Dec 2011
Absolute eosinophils count as a marker of mortality in patients with severe sepsis and septic shock in an intensive care unit
Introduction: Eosinophils in the circulating blood undergo apoptosis during sepsis syndromes induced by the action of certain cytokines. Objective: The aim of the study was to evaluate the absolute eosinophils count (EC) as a marker of mortality in severe sepsis and septic shock. Patients and Method: A prospective..Neisseria meningitidis: Biology, Microbiology, and Epidemiology.
Methods in Molecular Biology
Nov 2011
Neisseria meningitidis: Biology, Microbiology, and Epidemiology.
Neisseria meningitidis (the meningococcus) causes significant morbidity and mortality in children and young adults worldwide through epidemic or sporadic meningitis and/or septicemia. In this review, we describe the biology, microbiology, and epidemiology of this exclusive human pathogen. N.meningitidis is a..Classification and pathogenesis of meningococcal infections
Methods in Molecular Biology
Nov 2011
Classification and pathogenesis of meningococcal infections
The clinical symptoms induced by Neisseria meningitidis reflect compartmentalized intravascular and intracranial bacterial growth and inflammation. In this chapter, we describe a classification system for meningococcal disease based on the nature of the clinical symptoms. Meningococci invade the subarachnoid space and..Tube Thoracostomy: Complications and Its Management
Pulmonary Medicine
Oct 2011
Tube Thoracostomy: Complications and Its Management
Background. Tube thoracostomy is widely used throughout the medical, surgical, and critical care specialities. It is generally used to drain pleural collections either as elective or emergency. Complications resulting from tube thoracostomy can occasionally be life threatening. Aim. To present an update on the..Perioperative management of pulmonary hypertension in children with critical heart disease.
Current treatment options in cardiovascular medicine
Sep 2011
Perioperative management of pulmonary hypertension in children with critical heart disease.
Pulmonary hypertension (PHTN) is common to a variety of conditions occurring in infants and children presenting to the intensive care unit. A fundamental understanding of the response of the right ventricle to an increase in afterload and the clinical syndromes responsible for PHTN is essential for managing patients..Perioperative mechanical circulatory support in children with critical heart disease.
Current treatment options in cardiovascular medicine
Sep 2011
Perioperative mechanical circulatory support in children with critical heart disease.
The treatment of cardiovascular failure in the perioperative period with the use of mechanical circulatory support is a well-recognized, well-developed, and commonly utilized treatment modality. Regardless of the exact circumstances of initiation, the use of a support device is a “bridge.” Where there has been an acute..Is linezolid a risk factor for Gram-negative bacillus infections in intensive care unit patients? A comparative study with vancomycin
Scandinavian Journal of Infectious Diseases
Jun 2011
Is linezolid a risk factor for Gram-negative bacillus infections in intensive care unit patients? A comparative study with vancomycin
Background: Linezolid is frequently used in critically ill patients with ventilator-associated pneumonia. Its potent activity against Gram-positive microorganisms and its high tissue penetration may favour Gram-negative colonization and infection. The aim of our study was to evaluate the risk for Gram-negative..
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