Chiari Syndrome and Respiratory Failure: A Literature Review
Conclusions:
Patients with CMs can have repeated extubation failures. Some of these patients have normal neurological examinations and studies and are not identified until they have an MRI study. Clinicians need to consider this possibility in patients who are difficult to wean. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - September 5, 2014 Category: Intensive Care Authors: Kijsirichareanchai, K., Limsuwat, C., Mankongpaisarnrung, C., Nantsupawat, N., Nugent, K. Tags: Analytic Reviews Source Type: research
Intensive Care Management Following Defibrillation of an Adolescent Girl After Recreational Inhalant Use: A Case Report and Review of the Literature
We report the successful out-of-hospital defibrillation and intensive care management of a 14-year-old girl who developed ventricular fibrillation following the inhalation of two 150-mL butane cigarette lighter refill canisters. Following ambulance transport to the nearest tertiary pediatric health care facility, her acute clinical course consisted of sinus tachycardia, fluctuating consciousness, and severe cerebral agitation and combativeness. Over a period of 2 weeks, her neurological function significantly improved to the point she was able to be discharged back into the community, however, not without a number of forma...
Source: Journal of Intensive Care Medicine - September 5, 2014 Category: Intensive Care Authors: Woods, D. T., Perry, A. W., Solomou, S. Tags: Analytic Reviews Source Type: research
Intraabdominal Infections in the Intensive Care Unit
Intraabdominal infections are frequent and dangerous entity in intensive care units. Mortality and morbidity are high, causes are numerous, and treatment options are variable. The intensivist is challenged to recognize and treat intraabdominal infections in a timely fashion to prevent complications and death. Diagnosis of intraabdominal infection is often complicated by confounding underlying disease or masked by overall comorbidity. Current research describes a wide heterogeneity of patient populations, making it difficult to suggest a general treatment regimen and stressing the need of an individualized approach to decis...
Source: Journal of Intensive Care Medicine - September 5, 2014 Category: Intensive Care Authors: Friedrich, A.-K. U., Cahan, M. Tags: Analytic Reviews Source Type: research
Accuracy of Noninvasive and Continuous Hemoglobin Measurement by Pulse Co-Oximetry During Preoperative Phlebotomy
Conclusion:
The current study demonstrates that the accuracy of continuous, noninvasive hemoglobin measurement was not affected by acute blood loss simulated by preoperative phlebotomy. Although the device provided a clinically acceptable correlation with the actual hemoglobin value and offers the value of a continuous trend monitor, given the precision of the device, it does not appear that actual transfusion decisions can be based on the device alone. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - July 8, 2014 Category: Intensive Care Authors: Dewhirst, E., Naguib, A., Winch, P., Rice, J., Galantowicz, M., McConnell, P., Tobias, J. D. Tags: Original Research Source Type: research
Plasma Brain Natriuretic Peptide and Troponin Levels in Severe Sepsis and Septic Shock: Relationships With Systolic Myocardial Dysfunction and Intensive Care Unit Mortality
The aim of this study was to evaluate and compare brain natriuretic peptide (BNP) and cardiac troponin I (cTnI) levels as mortality prognosticator and predictor for myocardial dysfunction in severe sepsis and septic shock. Baseline clinical and biological variables were collected from 47 patients with severe sepsis or septic shock. Ventricular systolic function assessed by echocardiography was measured over a 5-day period. Both cTnI and BNP plasmatic levels were determined at intensive care unit (ICU) admission and during the following 15 days. At admission, cTnI and BNP levels were compared to those of 12 control critical...
Source: Journal of Intensive Care Medicine - July 8, 2014 Category: Intensive Care Authors: Klouche, K., Pommet, S., Amigues, L., Bargnoux, A. S., Dupuy, A. M., Machado, S., Serveaux-Delous, M., Morena, M., Jonquet, O., Cristol, J. P. Tags: Original Research Source Type: research
SNAP II Index: An Alternative to the COMFORT Scale in Assessing the Level of Sedation in Mechanically Ventilated Pediatric Patients
Sedation monitoring is essential in pediatric patients on ventilatory support to achieve comfort and safety. The COMFORT scale was designed and validated to assess the level of sedation in intubated pediatric patients. However, it remains unreliable in pharmacologically paralyzed patients. The SNAP II index is calculated using an algorithm that incorporates high-frequency (80-420 Hz) electroencephalogram (EEG) components, known to be useful in discriminating between awake and unconscious states, unlike other measurements that only include low-frequency EEG segments such as the bispectral index score. Previous studies ...
Source: Journal of Intensive Care Medicine - July 8, 2014 Category: Intensive Care Authors: Nievas, I. F. F., Spentzas, T., Bogue, C. W. Tags: Original Research Source Type: research
Agitation During Prolonged Mechanical Ventilation at a Long-Term Acute Care Hospital: Risk Factors, Treatments, and Outcomes
Conclusion:
Agitation among the LTACH patients undergoing PMV is associated with greater delirium and use of antipsychotics and restraints but does not influence weaning success or LTACH stay. Strategies focused on agitation prevention and treatment in this population need to be developed and formally evaluated. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - July 8, 2014 Category: Intensive Care Authors: O'Connor, H., Al-Qadheeb, N. S., White, A. C., Thaker, V., Devlin, J. W. Tags: Review of a Large Clinical Series Source Type: research
Fluid Resuscitation in Septic Shock: The Effect of Increasing Fluid Balance on Mortality
Conclusion:
In patients with septic shock resuscitated according to current guidelines, a more positive fluid balance at 24 hours is associated with an increase in the risk of mortality. Optimal survival occurred at neutral fluid balance and up to 6-L positive fluid balance at 24 hours after the development of septic shock. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - July 8, 2014 Category: Intensive Care Authors: Sadaka, F., Juarez, M., Naydenov, S., O'Brien, J. Tags: Review of a Large Clinical Series Source Type: research
Cytomegalovirus Pneumonia in Hematopoietic Stem Cell Recipients
Cytomegalovirus (CMV) is a frequently encountered infection following hematopoietic cell transplantation, and tissue invasive pneumonia is a dreaded complication of the virus in this population. In this review of CMV pneumonia, we address epidemiology, pathogenesis, diagnostics, current therapy, and strategies to prevent the development of CMV. We also review emerging treatment and prevention options for this challenging disease. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - July 8, 2014 Category: Intensive Care Authors: Travi, G., Pergam, S. A. Tags: Analytic Reviews Source Type: research
New Drugs and Strategies for Management of Clostridium difficile Colitis
Approaches for management of Clostridium difficile infection continually evolve as research reveals shifts in epidemiology, microbial pathogenesis, disease severity states, and response to therapy. These new discoveries significantly impact diagnostic and therapeutic strategies, given the high morbidity associated with this common nosocomial infectious diarrhea. Critically ill patients are at an increased risk of developing diarrheal illness like C. difficile and succumbing to potentially fatal complications of this infection. Early diagnosis of severe disease state may improve patient outcomes. In this ar...
Source: Journal of Intensive Care Medicine - July 8, 2014 Category: Intensive Care Authors: Higa, J. T., Kelly, C. P. Tags: Analytic Reviews Source Type: research
Fluid Management in Acute Kidney Injury
Fluid management in critical illness has undergone extensive reevaluation in the past decade. Since a significant percentage of critically ill patients develop acute kidney injury (AKI), optimal fluid management is even more paramount to prevent the ill effects of either underhydration or overhydration. The concepts of early goal-directed fluid therapy (EGDT) and conservative late fluid management permeate current clinical research, and the independent association between fluid accumulation and mortality has been repeatedly demonstrated. A number of prospective randomized trials are planned to provide an adequately powered...
Source: Journal of Intensive Care Medicine - July 8, 2014 Category: Intensive Care Authors: Goldstein, S. L. Tags: Analytic Reviews Source Type: research
Multiorgan System Dysfunction in the Chylomicronemia Syndrome
Conclusions:
Severe chylomicronemia can cause multiorgan system dysfunction related to hyperviscosity. Early institution of plasmapheresis to reduce the triglyceride-rich lipoproteins can improve tissue perfusion and prevent further organ damage. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - May 1, 2014 Category: Intensive Care Authors: Argula, R. G., Strange, C., Budisavljevic, M. N. Tags: Case Report Source Type: research
Procedural and Educational Interventions to Reduce Ventilator-Associated Pneumonia Rate and Central Line-Associated Blood Stream Infection Rate
Conclusions:
Efforts to improve physician, patient, and staff education, and checklist implementation resulted in a decrease in VAP and CLA-BSI. This study confirms the applicability of best practice guidelines and suggests a benefit to the use of checklists. We utilize a practical approach for examining the success of these changes. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - May 1, 2014 Category: Intensive Care Authors: Kellie, S. P., Scott, M. J., Cavallazzi, R., Wiemken, T. L., Goss, L., Parker, D., Saad, M. Tags: Original Research Source Type: research
Percutaneous Intraperitoneal Catheters in Neonates Following Open Heart Surgery
Conclusions:
The PPC insertion can be easily performed at the bedside with minimal complications. Fluid balance management is facilitated, and ventilation is improved. The PPC insertion is a valuable addition to the armamentarium of the physician treating neonates in the intensive care unit after complex congenital heart surgery. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - May 1, 2014 Category: Intensive Care Authors: Averbuch, N., Birk, E., Frenkel, G., Gogia, O., Shulman, O. M., Bruckheimer, E., Nachum, E., Amir, G. Tags: Review of a Large Clinical Series Source Type: research
Patient Origin Is Associated With Duration of Endotracheal Intubation and PICU Length of Stay for Children With Status Asthmaticus
Conclusion:
Patients with status asthmaticus are more likely to be intubated when they are admitted from community hospital emergency rooms, although the duration of intubation and PICU stay is shorter. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - May 1, 2014 Category: Intensive Care Authors: Shibata, S., Khemani, R. G., Markovitz, B. Tags: Review of a Large Clinical Series Source Type: research
