Management of Complications of End-Stage Liver Disease in the Intensive Care Unit
The management of critically ill patients with end-stage liver disease can be challenging due to the vulnerability of this population and the wide-ranging complications of the disease. This review proposes an approach based on the major organ systems affected, to provide a framework for managing the most common complications. Although considerable practice variation exists, a focus on the evidence behind the most common practices will ensure the development of the optimal skillset to appropriately manage this disease. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - January 4, 2016 Category: Intensive Care Authors: DellaVolpe, J. D., Garavaglia, J. M., Huang, D. T. Tags: Analytic Reviews Source Type: research
Syncope
is common representing approximately 3% of ED visits and up to 6% of hospital admissions, with a cost close to 2 billion dollars per year. Diagnostic testing is often poorly sensitive and evaluations commonly lack a standardized approach. A mindful and systematic approach can increase sensitivity and improve diagnostic accuracy. A thorough history and physical exam is paramount, as conclusions drawn from the history and exam will guide further assessment. Developing a strategy for the first and, if necessary, subsequent tests will improve the accuracy of identifying the etiology of syncope and reduce cost. Although syncop...
Source: Journal of Intensive Care Medicine - January 4, 2016 Category: Intensive Care Authors: Ray, J. C., Kusumoto, F., Goldschlager, N. Tags: Analytic Reviews Source Type: research
Authors Response
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - December 9, 2015 Category: Intensive Care Authors: Henry, B. L., Kumar, R., Smith, R. E. Tags: Response from Authors Source Type: research
Letter to the Editor: Managing Dabigatran-Related Bleeding
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - December 9, 2015 Category: Intensive Care Authors: Levy, J. H., Weitz, J. I., Bernstein, R. A., Eikelboom, J., Hylek, E., Huisman, M. V., Reilly, P. A., Steiner, T., Kamphuisen, P., Kam, C.-W., Pollack, C. V. Tags: Letter to the Editor Source Type: research
The Modified Apnea Test During Brain Death Determination: An Alternative in Patients With Hypoxia
Conclusion:
The modified apnea test does not require circuit disconnection and can be successfully applied to determine brain death without compromising safety in high-risk patients having severe hypoxia. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - December 9, 2015 Category: Intensive Care Authors: Ahlawat, A., Carandang, R., Heard, S. O., Muehlschlegel, S. Tags: Case Report Source Type: research
A National Survey of Critical Care Physicians Knowledge, Attitudes, and Perceptions of Antimicrobial Stewardship Programs
Conclusion:
Based on our survey results, Canadian intensivists are supportive of antimicrobial stewardship in ICUs and feel that ASPs provide a valuable service to both patients and clinicians. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - December 9, 2015 Category: Intensive Care Authors: Steinberg, M., Dresser, L. D., Daneman, N., Smith, O. M., Matte, A., Marinoff, N., Bell, C. M., Morris, A. M. Tags: Original Research Source Type: research
Chest Radiological Findings of Patients With Severe H1N1 Pneumonia Requiring Intensive Care
Conclusions:
Patients with H1N1 pneumonia admitted to the ICU had bilateral, extensive CXR, and CT abnormalities. Consolidations and ground-glass opacities were the most common imaging findings, predominantly affecting mid and lower lung zones. Imaging abnormalities were peribronchovascular and multifocal in a majority of patients. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - December 9, 2015 Category: Intensive Care Authors: Rohani, P., Jude, C. M., Chan, K., Barot, N., Kamangar, N. Tags: Original Research Source Type: research
Hypothalamic-Pituitary Function in Brain Death: A Review
The Uniform Determination of Death Act (UDDA) states that an individual is dead when "all functions of the entire brain" have ceased irreversibly. However, it has been questioned whether some functions of the hypothalamus, particularly osmoregulation, can continue after the clinical diagnosis of brain death (BD). In order to learn whether parts of the hypothalamus can continue to function after the diagnosis of BD, we performed 2 separate systematic searches of the MEDLINE database, corresponding to the functions of the posterior and anterior pituitary. No meta-analysis is possible due to nonuniformity in the clinical lite...
Source: Journal of Intensive Care Medicine - December 9, 2015 Category: Intensive Care Authors: Nair-Collins, M., Northrup, J., Olcese, J. Tags: Review of a Large Clinical Series Source Type: research
Long-Term Mortality After Pneumonia in Cardiac Surgery Patients: A Propensity-Matched Analysis
Conclusion:
Pneumonia remains a serious complication in patients operated for cardiac surgery and is associated with increased hospital mortality and reduced long-term survival. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - December 9, 2015 Category: Intensive Care Authors: Ibanez, J., Riera, M., Amezaga, R., Herrero, J., Colomar, A., Campillo-Artero, C., de Ibarra, J. I. S., Bonnin, O. Tags: Review of a Large Clinical Series Source Type: research
Cardiocerebral Resuscitation: An Approach to Improving Survival of Patients With Primary Cardiac Arrest
Out-of-hospital cardiac arrest (OHCA) is a major public health problem. In the United States, OHCA accounts for more premature deaths than any other cause. For over a half-century, the national "Guidelines" for resuscitation have recommended the same initial treatment of primary and secondary cardiac arrests. Using this approach, the overall survival of patients with OHCA, while quite variable, was generally very poor. One reason is that the etiologies of cardiac arrests are not all the same. The vast majority of nontraumatic OHCA in adults are due to a "primary" cardiac arrest, rather than secondary to respiratory arrest....
Source: Journal of Intensive Care Medicine - December 9, 2015 Category: Intensive Care Authors: Ewy, G. A., Bobrow, B. J. Tags: Analytic Reviews Source Type: research
Sleep in the Intensive Care Unit: A Review
Patients in the intensive care unit (ICU) are susceptible to sleep deprivation. Disrupted sleep is associated with increased morbidity and mortality in the critically ill patients. The etiology of sleep disruption is multifactorial. The article reviews the literature on sleep in the ICU, the effects of sleep deprivation, and strategies to promote sleep in the ICU. Until the impact of disrupted sleep is better explained, it is appropriate to provide critically ill patients with consolidated, restorative sleep. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - December 9, 2015 Category: Intensive Care Authors: Pulak, L. M., Jensen, L. Tags: Analytic Reviews Source Type: research
Evidence-Based Management of Common Gallstone-Related Emergencies
Gallstone-related disease is among the most common clinical problems encountered worldwide. The manifestations of cholelithiasis vary greatly, ranging from mild biliary colic to life-threatening gallstone pancreatitis and cholangitis. The vast majority of gallstone-related diseases encountered in an acute setting can be categorized as biliary colic, cholecystitis, choledocholithiasis, and pancreatitis, although these diagnoses can overlap. The management of these diseases is uniquely multidisciplinary, involving many specialties and treatment options. Thus, care may be compromised due to redundant tests, treatment delays, ...
Source: Journal of Intensive Care Medicine - December 9, 2015 Category: Intensive Care Authors: Demehri, F. R., Alam, H. B. Tags: Analytic Reviews Source Type: research
A 46-Year-Old Woman With Dyspnea From an Inhalational Exposure, Triggering Thyroid Storm and Subsequent Multi-Organ System Failure
Conclusion:
This patient represents, to the best of our knowledge, the first patient in whom the stress related to a severe asthma attack triggered the development of thyroid storm. She also is the first patient with no indication of cardiac dysfunction who developed fatal cardiac arrest after initiation of b-blockade for treatment of thyroid storm. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - October 29, 2015 Category: Intensive Care Authors: Moraco, A. H., Banauch, G., Kopec, S. Tags: Case Report Source Type: research
Cardiovascular Effects of Continuous Dexmedetomidine Infusion Without a Loading Dose in the Pediatric Intensive Care Unit
Conclusion:
A continuous infusion of 0.7 μg/kg/h of dexmedetomidine without a loading dose for up to 24 hours in critically ill children had tolerable effects on HR and BP. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - October 29, 2015 Category: Intensive Care Authors: Cummings, B. M., Cowl, A. S., Yager, P. H., El Saleeby, C. M., Shank, E. S., Noviski, N. Tags: Original Research Source Type: research
The Impact of Computed Tomography of the Chest on the Management of Patients in a Medical Intensive Care Unit
Conclusion:
Less than one-quarter of chest CTs in the MICU result in management. Intravenous contrast-enhanced CTs and CTs done on the day of ICU admission have increased odds of utility. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - October 29, 2015 Category: Intensive Care Authors: Awerbuch, E., Benavides, M., Gershengorn, H. B. Tags: Original Research Source Type: research
