Effect of Normal Saline and Half Normal Saline on Serum Electrolytes During Recovery Phase of Diabetic Ketoacidosis
Conclusions: Hyperchloremia resulting in nonanion gap acidosis can occur and may prolong the duration of insulin infusion and length of PICU stay in patients receiving NS as post-bolus rehydration fluid. Alternatively, the use of half NS may result in a decrease in serum-corrected sodium. Providers need to be vigilant toward this while using higher or lower sodium chloride when managing children with DKA. Larger trials are required to study the clinical significance of the results of this study. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - January 3, 2014 Category: Intensive Care Authors: Basnet, S., Venepalli, P. K., Andoh, J., Verhulst, S., Koirala, J. Tags: Original Research Source Type: research
Outcome of Pediatric Hematopoietic Stem Cell Transplant Recipients Requiring Mechanical Ventilation
Conclusions:
Six-month survival of pediatric HSCT patients was 25% and the odds of death were increased by cardiovascular failure but not by MOF. Receipt of mechanical support (ventilation, CRRT) or cardiovascular support (inotropic agents) decreased the likelihood of long-term survival. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - January 3, 2014 Category: Intensive Care Authors: Aspesberro, F., Guthrie, K. A., Woolfrey, A. E., Brogan, T. V., Roberts, J. S. Tags: Review of a Large Clinical Series Source Type: research
Nicotine Replacement Therapy in the Intensive Care Unit: A Systematic Review
Conclusions:
We conclude that NRT should not be routinely prescribed to patients admitted to intensive care settings. With only equivocal evidence of efficacy and signals suggesting increased toxicity, we believe that its use should be limited to selected patients where the potential benefit clearly outweighs the risk. There is a need for adequately powered randomized controlled trials to confirm the benefits and risks of NRT in the ICU overall but also in its unique subpopulations. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - January 3, 2014 Category: Intensive Care Authors: Wilby, K. J., Harder, C. K. Tags: Analtyic Reviews Source Type: research
ICU 2020: Five Interventions to Revolutionize Quality of Care in the ICU
This article demonstrates that each of these initiatives has the potential to revolutionize the quality of future ICU care in the United States. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - January 3, 2014 Category: Intensive Care Authors: Bauman, K. A., Hyzy, R. C. Tags: Analtyic Reviews Source Type: research
Ethical Challenges With Deactivation of Durable Mechanical Circulatory Support at the End of Life: Left Ventricular Assist Devices and Total Artificial Hearts
Left ventricular assist devices (LVADs) and total artificial hearts (TAHs) are surgically implanted as permanent treatment of unrecoverable heart failure. Both LVADs and TAHs are durable mechanical circulatory support (MCS) devices that can prolong patient survival but also alter end-of-life trajectory. The permissibility of discontinuing assisted circulation is controversial because device deactivation is a life-ending intervention. Durable MCS is intended to successfully replace native physiological functions in heart disease. We posit that the presence of new lethal pathophysiology (ie, a self-perpetuating cascade of ab...
Source: Journal of Intensive Care Medicine - January 3, 2014 Category: Intensive Care Authors: Rady, M. Y., Verheijde, J. L. Tags: Analtyic Reviews Source Type: research
Cardiac Arrest Following Ketamine Administration for Rapid Sequence Intubation
We present 2 critically ill patients who experienced cardiac arrest following the administration of ketamine for rapid sequence intubation (RSI). The literature regarding the use of etomidate and ketamine for RSI in critically ill patients is reviewed and options for sedation during endotracheal intubation in this population are discussed. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - November 11, 2013 Category: Intensive Care Authors: Dewhirst, E., Frazier, W. J., Leder, M., Fraser, D. D., Tobias, J. D. Tags: Case Report Source Type: research
The Weaning Index as Predictor of Weaning Success
Conclusions. The WI is a simple and reproducible parameter that integrates breathing pattern, compliance, inspiratory muscle strength, and ventilatory demand and is the most accurate predictor of weaning success. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - November 11, 2013 Category: Intensive Care Authors: Huaringa, A. J., Wang, A., Haro, M. H., Leyva, F. J. Tags: Original Research Source Type: research
The GENESIS Project (GENeralized Early Sepsis Intervention Strategies): A Multicenter Quality Improvement Collaborative
Conclusions: Patients with severe sepsis and septic shock receiving the RB in community and tertiary hospitals experience similar and significant reductions in mortality and hospital length of stay. These findings remained consistent when examined in both before-and-after and concurrent analyses. Early sepsis intervention strategies are associated with 1 life being saved for every 7 treated. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - November 11, 2013 Category: Intensive Care Authors: Cannon, C. M., Holthaus, C. V., Zubrow, M. T., Posa, P., Gunaga, S., Kella, V., Elkin, R., Davis, S., Turman, B., Weingarten, J., Milling,, T. J., Lidsky, N., Coba, V., Suarez, A., Yang, J. J., Rivers, E. P. Tags: Review of a Large Clinical Series Source Type: research
ICU Management of Aneurysmal Subarachnoid Hemorrhage
Conclusions. The ICU management of the patient with SAH can be particularly challenging and requires an awareness of all potential neurologic and medical complications and their urgent treatments. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - November 11, 2013 Category: Intensive Care Authors: Green, D. M., Burns, J. D., DeFusco, C. M. Tags: Analtyic Reviews Source Type: research
A Case of Severe Heatstroke and Review of Pathophysiology, Clinical Presentation, and Treatment
We present an illustrative case report and review of literature. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - November 11, 2013 Category: Intensive Care Authors: Horseman, M. A., Rather-Conally, J., Saavedra, C., Surani, S. Tags: Analtyic Reviews Source Type: research
Toxic Inhalational Exposures
Respirable toxicants are a spectrum of irritant and nonirritant gases, vapors, fumes, and airborne particles that can be entrained into the body through the respiratory tract, resulting in exposures that cause pulmonary injury and/or systemic disease. Sources of respirable toxicants include structural fires, industrial accidents, domestic mishaps, and intentional releases of injurious agents on the battleground (warfare) or in civilian settings (acts of terrorism). Acute toxic inhalational exposures may result in respiratory failure, multisystem organ dysfunction, and death. Management of victims includes assessment and pr...
Source: Journal of Intensive Care Medicine - November 11, 2013 Category: Intensive Care Authors: Chen, T.-M. B., Malli, H., Maslove, D. M., Wang, H., Kuschner, W. G. Tags: Analtyic Reviews Source Type: research
Reality Bites: A Case of Severe Rattlesnake Envenomation
We present a rare case of rattlesnake envenomation resulting in severe systemic effects and syndrome relapse. Management considerations and patient course are described in the context of the current literature. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - August 30, 2013 Category: Intensive Care Authors: Lefkowitz, R. Y., Taylor, J., Balfe, D. Tags: Case Report Source Type: research
Red Cell Distribution Width and Outcome in Patients With Septic Shock
Conclusions: Red cell distribution width on day 1 of septic shock is a robust predictor of mortality. The RDW is inexpensive and commonly measured. The RDW fared better than either APACHE II or SOFA, and the sum of RDW and APACHE II was a stronger predictor of mortality than either one alone. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - August 30, 2013 Category: Intensive Care Authors: Sadaka, F., O'Brien, J., Prakash, S. Tags: Original Research Source Type: research
Associations Between the Use of Critical Care Procedures and Change in Functional Status at Discharge
Quality improvement initiatives in intensive care units (ICUs) have increased survival rates. Changes in functional status following ICU care have been studied, but results are inconclusive because of insufficient consideration of the combinations of critical care procedures used. Using the Japanese administrative database including the Barthel Index (BI) at admission and discharge, we measured the changes in functional status among the adult patients and determined whether longer ICU stay or use of various critical care procedures was associated with functional deterioration. Of the 12 502 528 patients admitted ...
Source: Journal of Intensive Care Medicine - August 30, 2013 Category: Intensive Care Authors: Kuwabara, K., Matsuda, S., Fushimi, K., Ishikawa, K. B., Horiguchi, H., Fujimori, K. Tags: Review of a Large Clinical Series Source Type: research
Extracorporeal Therapies in Sepsis
The treatment of sepsis is an ongoing challenge for clinicians; despite the wide choice of effective antibiotics to treat infection, sepsis remains the leading cause of morbidity and mortality for patients admitted to an intensive care unit. Dysregulation of the immune response is now recognized to be a key factor in multiple organ dysfunction, yet our therapy for inflammation remains ineffective. It has been advocated for more than a decade that cytokine reduction in blood compartment could lead to a reduction in mortality in sepsis. Over the years, multiple extracorporeal techniques have evolved, with the intent of influ...
Source: Journal of Intensive Care Medicine - August 30, 2013 Category: Intensive Care Authors: Panagiotou, A., Gaiao, S., Cruz, D. N. Tags: Analtyic Reviews Source Type: research
