Safety of Propofol as an Induction Agent for Urgent Endotracheal Intubation in the Medical Intensive Care Unit
Conclusions:
Our results compare favorably with the complication rate of UEI reported in the critical care and anesthesiology literature and indicate that propofol is a useful agent for airway management in the ICU. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - October 29, 2015 Category: Intensive Care Authors: Koenig, S. J., Lakticova, V., Narasimhan, M., Doelken, P., Mayo, P. H. Tags: Review of a Large Clinical Series Source Type: research
Management of Atrial Fibrillation
Atrial fibrillation remains the most prevalent cardiac arrhythmia, and its incidence is increasing as the population ages. Common conditions associated with an increased incidence include advanced age, hypertension, heart failure, and valvular heart disease. Patients with atrial fibrillation may complain of palpitations, fatigue, and decreased exercise tolerance or may be completely asymptomatic. Options for treating patients who experience atrial fibrillation include rate-controlling drugs such as digoxin, β-blockers, and calcium channel blockers or a rhythm-controlling strategy with agents such as sodium channel blo...
Source: Journal of Intensive Care Medicine - October 29, 2015 Category: Intensive Care Authors: Zamani, P., Verdino, R. J. Tags: Analytic Reviews Source Type: research
Brain Tissue Oxygen Monitoring in Neurocritical Care
Brain injury results from ischemia, tissue hypoxia, and a cascade of secondary events. The cornerstone of neurocritical care management is optimization and maintenance of cerebral blood flow (CBF) and oxygen and substrate delivery to prevent or attenuate this secondary damage. New techniques for monitoring brain tissue oxygen tension (PtiO2) are now available. Brain PtiO2 reflects both oxygen delivery and consumption. Brain hypoxia (low brain PtiO2) has been associated with poor outcomes in patients with brain injury. Strategies to improve brain PtiO2 have focused mainly on increasing oxygen delivery either by increasing C...
Source: Journal of Intensive Care Medicine - October 29, 2015 Category: Intensive Care Authors: De Georgia, M. A. Tags: Analytic Reviews Source Type: research
A Review of and Recommendations for the Management of Patients With Life-Threatening Dabigatran-Associated Hemorrhage: A Single-Center University Hospital Experience
Dabigatran is an oral direct thrombin inhibitor that is approved for the prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. Dabigatran has several advantages over warfarin including predictable pharmacokinetics and pharmacodynamics which eliminates the need for routine laboratory monitoring, superiority over warfarin in preventing stroke, or systemic embolism without having an increased risk of bleeding. However, as with any anticoagulant, there remains a real chance of bleeding, including major or life-threatening hemorrhage. Many physicians feel comfortable managing bleeding complications on o...
Source: Journal of Intensive Care Medicine - October 29, 2015 Category: Intensive Care Authors: Kumar, R., Smith, R. E., Henry, B. L. Tags: Analytic Reviews Source Type: research
Surgical Management of Severe Colitis in the Intensive Care Unit
This article proposes some simple management algorithms for these clinical entities, with a focus on critically ill patients. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - October 29, 2015 Category: Intensive Care Authors: Halaweish, I., Alam, H. B. Tags: Analytic Reviews Source Type: research
Authors' Response
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - September 8, 2015 Category: Intensive Care Authors: Flam, B., Broome, M., Frenckner, B., Branstrom, R., Bell, M. Tags: Response from Authors Source Type: research
Miraculous Survival of a Patient With Pheochromocytoma and Takotsubo Syndrome
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - September 8, 2015 Category: Intensive Care Authors: Madias, J. E. Tags: Letter to the Editor Source Type: research
Pediatric Longitudinal Clivus Fracture: Survival With Minimal Morbidity
We report a case of longitudinal clivus fracture in a teenager with survival and complete neurological recovery. Our case is the first pediatric case of longitudinal clivus fracture caused by frontal impact and the first described pediatric case associated with transient diabetes insipidus (DI). (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - September 8, 2015 Category: Intensive Care Authors: Samraj, R. S., Stalets, E. L. Tags: Case Report Source Type: research
Characteristics and Outcomes of Ethics Consultations in an Oncologic Intensive Care Unit
Conclusion:
Our study showed that ethics consultations were helpful in resolving seemingly irreconcilable differences between the ICU team and the patients’ surrogates in the majority of cases. Additionally, these consultations identified the need for an increased provision of palliative care and chaplaincy visits for patients and their surrogates at the end of life. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - September 8, 2015 Category: Intensive Care Authors: Voigt, L. P., Rajendram, P., Shuman, A. G., Kamat, S., McCabe, M. S., Kostelecky, N., Pastores, S. M., Halpern, N. A. Tags: Original Research Source Type: research
Systematic Review and Meta-Analysis of End-Tidal Carbon Dioxide Values Associated With Return of Spontaneous Circulation During Cardiopulmonary Resuscitation
Conclusions:
Participants with ROSC after CPR have statistically higher levels of ETCO2. The average ETCO2 level of 25 mm Hg in participants with ROSC is notably higher than the threshold of 10 to 20 mm Hg to improve delivery of chest compressions. The ETCO2 goals during resuscitation may be higher than previously suggested and further investigation into appropriate targets during resuscitation is needed to diminish morbidity and mortality after cardiorespiratory arrest. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - September 8, 2015 Category: Intensive Care Authors: Hartmann, S. M., Farris, R. W. D., Di Gennaro, J. L., Roberts, J. S. Tags: Original Research Source Type: research
Coefficient of Variation of Coarsely Sampled Heart Rate is Associated With Early Vasopressor Independence in Severe Sepsis and Septic Shock
Conclusions:
Increased variability of coarsely sampled heart rate was associated with vasopressor independence at 24 hours after controlling for possible confounders. Sampling frequencies of once in 5 minutes may be similar to once in 30 seconds. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - September 8, 2015 Category: Intensive Care Authors: Brown, S. M., Tate, M. Q., Jones, J. P., Kuttler, K. G., Lanspa, M. J., Rondina, M. T., Grissom, C. K., Mathews, V. J. Tags: Review of a Large Clinical Series Source Type: research
Assessing the Influence of Intensive Care Unit Organizational Factors on Outcomes in Canada: Is There Residual Confounding?
Conclusions:
The lack of a consistent relationship between organizational factors and ICU outcomes, and relationships that show increased mortality associated with some advantageous factors, suggests that there is residual confounding in these relationships. Models that adjust for only conventional patient-level confounders are unlikely to provide valid estimates of the influence of organizational factors. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - September 8, 2015 Category: Intensive Care Authors: Dodek, P. M., Norena, M., Wong, H., Keenan, S., Martin, C. Tags: Review of a Large Clinical Series Source Type: research
Hemophagocytic Syndrome and Critical Illness: New Insights into Diagnosis and Management
Hemophagocytic lymphohistiocytosis (HLH) comprises a heterogeneous group of diseases that are characterized by a hyperinflammatory state due to uncontrolled T cell, macrophage, and histiocyte activation, accompanied by excessive cytokine production. This rare condition is almost uniformly fatal unless promptly recognized and treated. Much progress has been made in the last two decades in our understanding of the mechanisms underlying familial, and to a lesser extent, acquired cases of HLH. Recurrent mutations in more than 10 different genes have now been identified, involving biological pathways converging on intracellular...
Source: Journal of Intensive Care Medicine - September 8, 2015 Category: Intensive Care Authors: Tothova, Z., Berliner, N. Tags: Analytic Reviews Source Type: research
Connective Tissue Disease-Associated Interstitial Lung Disease: A Focused Review
The connective tissue diseases (CTDs) are a group of systemic disorders characterized by autoimmunity and autoimmune-mediated organ damage. The lung is a frequent target and all components of the respiratory system are at risk. Interstitial lung disease (ILD) represents a broad group of diffuse parenchymal lung injury patterns characterized by varying degrees of inflammation and fibrosis, is a common manifestation of CTD particularly common in systemic sclerosis, polymyositis/dermatomyositis, and rheumatoid arthritis, and is a leading cause of significant morbidity and mortality. The lung injury patterns of CTD-associated ...
Source: Journal of Intensive Care Medicine - September 8, 2015 Category: Intensive Care Authors: Solomon, J. J., Fischer, A. Tags: Analytic Reviews Source Type: research
Periodic Epileptiform Discharges Clarified for the Nonneurologist Intensivist: Clinical Implications and Current Management
This article is intended for the nonneurologist intensivist, reviews basic terminology and clinical implications (including causes, prognosis, and association with seizures), and suggests an approach to management. Several case vignettes are included to illustrate the clinical variability associated with PEDs. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - September 8, 2015 Category: Intensive Care Authors: Lahiri, S., Boro, A. D., Shiloh, A. L., Milstein, M. J., Savel, R. H. Tags: Analytic Reviews Source Type: research
