120 research outputs found
Being Overweight Is Associated With Greater Survival in ICU Patients: Results From the Intensive Care Over Nations Audit
No full textA pilot-controlled study of a polymyxim B-immobilized hemoperfusion cartridge in patients with severe sepsis secondary to intra-abdominal infection
No full textSCOPUS: ar.jinfo:eu-repo/semantics/publishe
Toll-like Receptor 4 Modulation as a Strategy to Treat Sepsis
No full textDespite a decrease in mortality over the last decade, sepsis remains the tenth leading causes of death in western countries and one of the most common cause of death in intensive care units. The recent discovery of Toll-like receptors and their downstream signalling pathways allowed us to better understand the pathophysiology of sepsis-related disorders. Particular attention has been paid to Toll-like receptor 4, the receptor for Gram-negative bacteria outer membrane lipopolysaccharide or endotoxin. Since most of the clinical trial targeting single inflammatory cytokine in the treatment of sepsis failed, therapeutic targeting of Toll-like receptor 4, because of its central role, looks promising. The purpose of this paper is to focus on the recent data of various drugs targeting TLR4 expression and pathway and their potential role as adjunctive therapy in severe sepsis and septic shock
Diagnosis of middle lobe atelectasis with lung ultrasonography.
No full textA 67-year-old man with a history of right upper lobectomy was admitted to our intensive care unit and started on mechanical ventilation because of bilateral pneumonia. Despite appropriate antibiotic therapy, the patient’s respiratory status rapidly worsened with increased oxygen requirements and the development of a marked respiratory acidosis. Chest X-ray remained unchanged and showed bilateral diffuse infiltrates. Complete lung consolidation in the upper anteromedial thoracic zone was observed using lung ultrasonography. [...
A worldwide perspective of sepsis epidemiology and survival according to age: Observational data from the ICON audit
No full textMethods: We performed a secondary analysis of data from the prospective ICON audit, in which all adult ( >16 years ) patients admitted to participating ICUs between May 8 and 18, 2012, were included, except admissions for routine postoperative observation. For this sub-analysis, the 10,012 patients with completed age data were included. They were divided into five age groups - = 50, 51-60, 61-70, 71-80, >80 years. Sepsis was defined as infection plus at least one organ failure.[Marjanek, Z.] Javorszky Odon Hosp, Vac, Hungary.[Kokarev, E.] Railway Hosp Khabarovsk, Khabarovsk, Russia.[Ma, S.] Tongji Univ, Shanghai East Hosp, Shanghai, Peoples R China.[Kang, Y.] West China Hosp, Scu, Peoples R China.[Yu, L.] Wuhan Ctr Hosp, Wuhan, Hubei, Peoples R China.[Peng, Q.] Xiangya Hosp, Changsha, Hunan, Peoples R China.[Sun, R.] Zhejiang Prov Peoples Hosp, Hangzhou, Zhejiang, Peoples R China.[Yeung, A.] Pamela Youde Nethersole Eastern Hosp, Hong Kong, Peoples R China.[Wan, W.] Princess Margaret Hosp, Hong Kong, Peoples R China.[Sin, K.] Queen Elizabeth Hosp, Hong Kong, Peoples R China.[Lee, K.] United Christian Hosp Hong Kong SAR, Hong Kong, Peoples R China.[Wei, Y.] Yantai Yuhuangding Hosp, Yantai, Peoples R China.[Zhang, W.] Yantaishan Hosp, Yantai, Shandong, Peoples R China.[Wijanti, M.] Anestesi, Yogyakarta, Indonesia.[Widodo, U.] Pku Muhammadiyah Bantu, Yogyakarta, Indonesia.[Samsirun, H.] Rd Mattaher Hosp Jambi, Jambi City, Indonesia.[Cosar, A.] Gulhane Mil Med Acad, Ankara, Turkey.[Villagomez, A.] Hosp 1 Octubre, Issste, Mexico.[Samaddar, D.] Tata Main Hosp, Jamshedpur, Jharkhand, India.[Gusu, D.] Notre Dame, Brussels, Belgium.[Kalaitzis, E.] CHR Dax, Dax, France.Purpose: To investigate age-related differences in outcomes of critically ill patients with sepsis around the world.Results: A total of 2963 patients had sepsis, with similar proportions across the age groups (= 50 = 25.2%: 51-60 = 30.3%; 61-70 = 32.8%; 71-80 = 30.7%; >80 = 30.9%). Hospital mortality increased with age and in patients >80 years was almost twice that of patients = 50 years (493% vs 25.2%, p .05). The maximum rate of increase in mortality was about 0.75% per year, occurring between the ages of 71 and 77 years. In multilevel analysis, age > 70 years was independently associated with increased risk of dying.[Sakr, Y.] Uniklinikum Jena, Jena, Germany.Conclusions: The odds for death in ICU patients with sepsis increased with age with the maximal rate of increase occurring between the ages of 71 and 77 years. (C) 2019 Elsevier Inc. All rights reserved.C1 [Kotfis, Katarzyna] Pomeranian Med Univ, Dept Anaesthesiol Intens Therapy ; Acute Intoxica, Szczecin, Poland.[Wittebole, Xavier] UCL, Clin Univ St Luc, Dept Crit Care, Brussels, Belgium.[Jaschinski, Ulrich] Klinikum Augsburg, Klin Anasthesiol ; Operat Intens Med, Augsburg, Germany.[Sole-Violan, Jordi] Hosp Univ Gran Canaria Dr Negrin, Dept Intens Care, Las Palmas Gran Canaria, Spain.[Kashyap, Rahul] Mayo Clin, Dept Anesthesia Ei Perioperat Med, Rochester, MN USA.[Leone, Marc] Aix Marseille Univ, Hop Nord, AP HM, Serv Anesthesie ; Reanimat, Marseille, France.[Nanchal, Rahul] Med Coll Wisconsin, Dept Med, Milwaukee, WI 53226 USA.[Fontes, Luis E.] Hosp Alcides Carneiro, Petropolis Med Sch, Dept Intens Care ; Evidence Based Med, Petropolis, Brazil.[Sakr, Yasser] Uniklinikum Jena, Dept Anesthesiol ; Intens Care, Jena, Germany.[Vincent, Jean-Louis] Univ Libre Bruxelles, Erasme Univ Hosp, Dept Intens Care, Route Lenn 808, B-1070 Brussels, Belgium.[Tomas, E.] Clin Sagrada Esperanca, Luanda, Angola.[Bibonge, E. Amisi] Clin Univ Kinshasa, Kinshasa, DEM REP CONGO.[Charra, B.] Chu Ibn Rochd Casablanca, Casablanca, Morocco.[Faroudy, M.] Ibn Sina Hosp, Rabat, Morocco.[Doedens, L.] Chris Hani Baragwanath Acad Hosp, Soweto, South Africa.[Farina, Z.] Grays Hosp, Pietermaritzburg, South Africa.[Adler, D.] Sandton Medi Clin, Sandton, South Africa.[Balkema, C.] Tygerberg Hosp, Cape Town, South Africa.[Kok, A.] Union Hosp Alberton, Alberton, South Africa.[Alaya, S.] Bizerte Hosp, Bizerte, Tunisia.[Gharsallah, H.] Mil Hosp Tunis, Tunis, Tunisia.[Muzha, D.] Natl Trauma Ctr ; Mil Hosp, Tirana, Albania.[Manak, J.] Charles Univ Hosp, Prague, Czech Republic.[Kieslichova, E.] IKEM, Prague, Czech Republic.[Turek, R.] KNTB Zlin AS, Prague, Czech Republic.[Fischer, M.] Krajska Nemocnice Liberec, Prague, Czech Republic.[Valkova, R.] Masarykova Nemocnice V Usti Labem, Labem, Czech Republic.[Dadak, L.] St Annes Univ Hosp Brno, Brno, Czech Republic.[Pilvinis, V] Hosp Lithuanian Univ Hlth Sci Kauno Klinikos, Kaunas, Lithuania.[Temelkov, A.] Alexandrovska Univ Hosp, Sofia, Bulgaria.[Georgiev, G.] Emergency Univ Hosp Pirogov, Sofia, Bulgaria.[Simeonov, G.] Tokuda Hosp Sofia, Sofia, Bulgaria.[Tsaryanski, G.] Uh St Ekaterina Sofia, Sofia, Bulgaria.[Georgiev, S.] Univ Hosp Obstet ; Gynaecol, Sofia, Bulgaria.[Seliman, A.] Univ Hosp Sveta Marina Varna, Varna, Bulgaria.[Vrankovic, S.] Gen Hosp Siben, Shibenik, Croatia.[Vucicevic, Z.] Univ Hosp Ctr Sestre Milosrdnice, Zagreb, Croatia.[Gornik, I] Univ Hosp Ctr Zagreb, Zagreb, Croatia.[Barsic, B.] Univ Hosp Infect Dis, Zagreb, Croatia.[Husedzinovic, I] Univ Hosp Dubrava, Zagreb, Croatia.[Pavlik, P.] Ctr Cardiovasc ; Transplant Surg, Prague, Czech Republic.[Dostal, P.] Univ Hosp Haradec Kralove, Haradec Kralove, Czech Republic.[Malaska, J.] Univ Hosp Brno, Brno, Czech Republic.[Hajek, R.] Univ Hosp Olomouc, Olomouc, Czech Republic.[Zidkova, A.] Univ Hosp Plzen, Plzen, Czech Republic.[Lavicka, P.] Charles Univ Hosp Plzen, Plzen, Czech Republic.[Starkopf, J.] Tartu Univ Hosp, Tartu, Estonia.[Kheladze, Z.] Crit Care Med Inst, Gainesville, Georgia.[Chkhaidze, M.] Jo Ann Med Ctr, Tbilisi, Georgia.[Kaloiani, V] Kipshidze Cent Univ Hosp, Tbilisi, Georgia.[Medve, L.] Dr Kenessey Albert Hosp, Balassagyarmat, Hungary.[Krupnova, I] Infectol Ctr Latvia, Riga, Latvia.[Vanags, I] Paul Stradins Clin Univ Hosp, Riga, Latvia.[Sarkany, A.] Fejer Cty St George Teaching Hosp, Szekesfehervar, Hungary.[Kremer, I] Flor Ferenc Cty Hosp, Budapest, Hungary.[Tamasi, P.] Peterfy Hosp Budapest, Budapest, Hungary.[Liguts, V] Riga East Clin Univ Hosp, Riga, Latvia.[Vosylius, S.] Vilnius Univ Hosp, Vilnius, Lithuania.[Kekstas, G.] HSICU, Vilnius Univ Hosp Santariskiu Clin, Vilnius, Lithuania.[Balciunas, M.] CICU, Vilnius Univ Hosp Santariskiu Clin, Vilnius, Lithuania.[Kolbusz, A.] Csk Mswia, Warsaw, Poland.[Kubler, A.] Med Univ, Wroclaw, Poland.[Mielczarek, B.] Med Univ Wroclaw, Wroclaw, Poland.[Mikaszewska-Sokolewicz, M.] Med Univ Warsaw, Warsaw, Poland.[Kotfis, K.] Pomeranian Med Univ, Szczecin, Poland.[Tamowicz, B.] Reg Hosp Poznan, Poznan, Poland.[Sulkowski, W.] Szpital Powiatowy W Ostrowi Mazowieckiej, Ostrow Mazowiecka, Poland.[Smuszkiewicz, P.] Univ Hosp, Poznan, Poland.[Pihowicz, A.] Wojewodzki Szpital Zakazny, Torun, Poland.[Trejnowska, E.] Wojewodzkie Ctr Med, Warsaw, Poland.[Hagau, N.] Emergency Cty Hosp Cluj, Cluj Napoca, Romania.[Filipescu, D.] Emergency Inst Cardiovasc Dis, Bucharest, Romania.[Droc, G.] Fundeni Clin Inst, Bucharest, Romania.[Lupu, M.] Galati Hosp, Bucharest, Romania.[Nica, A.] Lnbi Prof Dr Matei Bals, Bucharest, Romania.[Stoica, R.] Inst Pulmonol Marius Nasta, Bucharest, Romania.[Tomescu, D.] Inst Clin Fundeni, Bucharest, Romania.[Constantinescu, D.] Sfantul Pantelimon Hosp, Bucharest, Romania.[Zbaganu, G. Valcoreanu] Spitalul Cf 2 Bucuresti, Bucharest, Romania.[Slavcovici, A.] Iuliu Hatieganu Univ Med ; Pharm, Teaching Hosp Infect Dis, Cluj Napoca, Romania.[Bagin, V] City Clin Hosp 40, St Petersburg, Russia.[Belsky, D.] City Hosp 40, St Petersburg, Russia.[Palyutin, S.] Clin Hosp NVNV Solovyev, Yaroslavl, Russia.[Shlyapnikov, S.] Emergency Res Inst NA Djanelidze, St Petersburg, Russia.[Bikkulova, D.] Fed Res Ctr Paediat Haematol Oncol ; Immunol, Moscow, Russia.[Gritsan, A.] Krasnoyarsk State Med Univ, Krasnoyarsk Reg Hosp, Krasnoyarsk, Russia.[Natalia, G.] Med Assoc Novaya Bolnitsa, Ekaterinburg, Russia.[Makarenko, E.] Mil Med Acad, Ekaterinburg, Russia.[Kokhno, V] Novosibirsk Med Univ, Novosibirsk, Russia.[Tolkach, A.] Omsk Reg Clin Hosp, Omsk, Russia.[Belotserkovskiy, B.] St Alexy Hosp, St Louis, France.[Zolotukhin, K.] State Dist Hosp, Moscow, Russia.[Kulabukhov, V] Vishnevsky Inst Surg, Moscow, Russia.[Soskic, L.] Clin Ctr Serbia, Clin Cardiac Surg, Belgrade, Serbia.[Palibrk, I] Clin Ctr Serbia, Clin Digest Surg, Belgrade, Serbia.[Jankovic, R.; Jovanovic, B.] Clin Ctr Nis, Clin Vasc Surg, Nish, Serbia.[Pandurovic, M.] Clin Ctr Serbia, Emergency Ctr, Belgrade, Serbia.[Bumbasirevic, V] Clin Ctr Belgrade, Emergency Ctr, Belgrade, Serbia.[Uljarevic, B.] Gen Univ Hosp, Belgrade, Serbia.[Surbatovic, M.] Mil Med Acad, Belgrade, Serbia.[Ladjevic, N.] Urol Hosp, Belgrade, Serbia.[Slobodianiuk, G.] Dist Hosp, Bratislava, Slovakia.[Sobona, V] Fac Hosp, Bratislava, Slovakia.[Cikova, A.] Univ Hosp Bratislava, Hosp Ruzinov ICU, Bratislava, Slovakia.[Gebhardtova, A.] Univ Hosp Ruzinov Bratislava, Bratislava, Slovakia.[Jun, C.] Qingdao Univ, Tertiary Hosp, Qingdao, Shandong, Peoples R China.[Yunbo, S.] Qingdao Univ, Affiliated Hosp, Med Coll, Qingdao, Shandong, Peoples R China.[Dong, U.] Beijing Canc Hosp, Beijing Inst Canc Res, Beijing, Peoples R China.[Feng, S.] Beijing Chaoyang Hosp, Beijing, Peoples R China.[Duan, M.] Beijing Friendship Hosp, Beijing, Peoples R China.[Xu, Y.] Capital Med Univ, Beijing Tongren Hosp, Beijing, Peoples R China.[Xue, X.] Beijing Univ Peoples Hosp, Beijing, Peoples R China.[Gao, T.] Beijing Luhe Hosp, Beijing, Peoples R China.[Xing, X.] Chinese Acad Med Sci, Canc Hosp, Beijing, Peoples R China.[Zhao, X.] China Acad Chinese Med Sci, Guang An Men Hosp, Beijing, Peoples R China.[Li, C.] Peoples Hosp, Chuxiong, Yunnan, Peoples R China.[Gengxihua, G.] Donge Cty Peoples Hosp Shandong Prov, Liaocheng, Shandong, Peoples R China.[Tan, H.] Chinese Acad Med Sci, Fu Wai Hosp, Beijing, Peoples R China.[Xu, J.] Fujian Prov Hosp, Fuzhou, Fujian, Peoples R China.[Jiang, L.] Capital Med Univ, Fuxing Hosp, Beijing, Peoples R China.[Tiehe, Q.] Guangdong Gen Hosp, Guangzhou, Guangdong, Peoples R China.[Bingyu, Q.] Henan Prov Peoples Hosp, Zhengzhou, Henan, Peoples R China.[Shi, Q.] Xi An Jiao Tong Univ, Coll Med, Xian, Shaanxi, Peoples R China.[Lv, Z.] Kunming Third Peoples Hosp, Kunming, Yunnan, Peoples R China.[Zhang, L.] Lanzhou Univ, Hosp 2, Lanzhou, Gansu, Peoples R China.[Jingtao, L.] 309th Hosp, Beijing, Peoples R China.[Zhen, Z.] China Med Univ, Hosp 1, Beijing, Peoples R China.[Wang, Z.] Peking Univ, Shougang Hosp, Beijing, Peoples R China.[Wang, T.] Peking Univ, Hosp 3, Beijing, Peoples R China.[Yuhong, L.] Pla Navy Gen Hosp, Beijing, Peoples R China.[Zhai, Q.] Shandong Univ, Qilu Hosp, Jinan, Shandong, Peoples R China.[Chen, Y.] Jiaotong Univ, Affiliated Med Sch, Ruijin Hosp, Shanghai, Peoples R China.[Wang, C.] Shandong Prov Hosp, Jinan, Shandong, Peoples R China.[Jiang, W.] Shanghai 10th Peoples Hosp, Shanghai, Peoples R China.[Ruilan, W.] Shanghai First Peoples Hosp, Shanghai, Peoples R China.[Chen, Y.; Xiaobo, H.] Sichuan Prov Peoples Hosp, Chengdu, Sichuan, Peoples R China.[Ge, H.] Sir Run Run Shaw Hosp, Hangzhou, Zhejiang, Peoples R China.[Yan, T.] Affiliated Guiyang Med Coll, Guiyang, Guizhou, Peoples R China.[Yuhui, C.] Fudan Univ, Peoples Hosp Shanghai 5, Shanghai, Peoples R China.[Zhang, J.] Dalian Med Univ, Affiliated Hosp 1, Dalian, Peoples R China.[Jian-Hong, F.] Suzhou Univ, Affiliated Hosp 1, Suzhou, Peoples R China.[Zhu, H.] Xinjiang Med Univ, Affiliated Hosp 1, Urumqi, Peoples R China.[Huo, F.; Wang, Y.] Jilin Univ, Hosp 1, Changchun, Jilin, Peoples R China.[Li, C.] First Peoples Hosp Kunming, Kunming, Yunnan, Peoples R China.[Zhuang, M.] Gen Hosp Shenyang Mil Reg, Shenyang, Liaoning, Peoples R China.[Ma, Z.] Peoples Hosp Cangzhou, Cangzhou, Peoples R China.[Sun, J.] Jilin Univ, Hosp 2, Changchun, Jilin, Peoples R China.[Liuqingyue, L.] Second Peoples Hosp Liaocheng City Shandong Prov, Liaocheng, Shandong, Peoples R China.[Yang, M.] Third Xiangya Hosp, Changsha, Hunan, Peoples R China.[Meng, J.] Tongde Hosp Zhejiang Prov, Hangzhou, Zhejiang, Peoples R China.[Sugiman, T.] Rumah Sakit Pantai Lndah Kapuk, North Jakarta, Indonesia.[Wisudarti, C.] Sardjito Hosp, Yogyakarta, Indonesia.[Maskoen, T.] Sch Med Unpad, Hasan Sadikin Hosp, Bandung, Indonesia.[Hata, N.] Nippon Med Sch, Chiba Hokusoh Hosp, Inzai, Japan.[Kobe, Y.] Chiba Univ Hosp, Chiba, Japan.[Nishida, O.] Fujita Hlth Univ, Sch Med, Toyoake, Aichi, Japan.[Miyazaki, D.] Japanese Red Cross Maebashi Hosp, Maebashi, Gumma, Japan.[Nunomiya, S.] Jichi Med Univ Hosp, Shimotsuke, Japan.[Uchino, S.] Jikei Univ, Sch Med, Tokyo, Japan.[Kitamura, N.] Kimitsu Chuo Hosp, Kisarazu, Japan.[Yamashita, K.] Kochi Med Sch, Nankoku, Kochi, Japan.[Hashimoto, S.] Kyoto Prefectural Univ Med, Kyoto, Japan.[Fukushima, H.] Nara Med Univ Hosp, Kashihara, Nara, Japan.[Adib, N. Nik] Hosp Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia.[Tai, L.] Kuala Lumpur Hosp, Kuala Lumpur, Malaysia.[Tony, B.] Queen Elizabeth Hosp 2, Kota Kinabalu, Malaysia.[Bigornia, R.] Cebu Velez Gen Hosp, Cebu, Philippines.[Bigornia, R.] Perpetual Succour Hosp, Cebu, Philippines.[Palo, J.] Med City, Pasig, Philippines.[Chatterjee, S.] Alexandra Hosp, Singapore, Singapore.[Tan, B.] Natl Univ Hlth Syst, Singapore, Singapore.[Kong, A.] Singapore Gen Hosp, Singapore, Singapore.[Goh, S.] Tan Tock Seng Hosp, Singapore, Singapore.[Lee, C.] Natl Taiwan Univ Hosp, Taipei, Taiwan.[Pothirat, C.] Chiaingmai Univ, Maharaj Nakorn Chiangmai Hosp, Chiang Mai, Thailand.[Khwannimit, B.] Prince Songkla Univ, Hat Yai, Thailand.[Theerawit, P.] Ramathibodi Hosp, Bangkok, Thailand.[Pornsuriyasak, P.] Ramathibodi Hosp, Somdech Phra Debaratana Med Ctr, Bangkok, Thailand.[Piriyapatsom, A.] Mahidol Univ, Siriraj Hosp, Bangkok, Thailand.[Mukhtar, A.] Cairo Univ, Giza, Egypt.[Dsicu] Demerdash Surg Intens Care Unit, Cairo, Egypt.[Hamdy, A. Nabil] Ain Shams Fac Med, Cairo, Egypt.[Hosny, H.] Zaitoun Specialized Hosp, Cairo, Egypt.[Ashraf, A.] Gums, Tehran, Iran.[Mokhtari, M.] Sbums, Imam Hossein Hosp, Tehran, Iran.[Nowruzinia, S.] Imamreza Hosp, Mashhad, Razavi Khorasan, Iran.[Lotfi, A.] Laleh Hosp, Tehran, Iran.[Zand, F.] Shiraz Anesthesiol ; Crit Care Res Ctr, Shiraz, Iran.[Nikandish, R.] Shiraz Univ Med Sci, Shiraz, Iran.[Moghaddam, O. Moradi] Tehran Med Sci Univ, Tehran, Iran.[Cohen, J.] Rabin Med Ctr, Petah Tiqwa, Israel.[Sold, O.] Sourasky Tel Aviv Med Ctr, Tel Aviv, Israel.[Sfeir, T.] Ctr Hosp Nord, Ettelbruck, Luxembourg.[Hasan, A.] Sohar Hosp, Sohar, Oman.[Abugaber, D.] Specialized Arab Hosp, Nablus, Palestine.[Ahmad, H.] Almana Gen Hosp, Khobar, Saudi Arabia.[Tantawy, T.] KFSHRC, Riyadh, Saudi Arabia.[Baharoom, S.] King Abdulaziz Med City Riyadh, Riyadh, Saudi Arabia.[Algethamy, H.] King Abdulaziz Univ, Jeddah, Saudi Arabia.[Amr, A.] King Saud Med City, Riyadh, Saudi Arabia.[Almekhlafi, G.] Riyadh Mil Hosp, Riyadh, Saudi Arabia.[Coskun, R.] Erciyes Univ, Med Fac, Kayseri, Turkey.[Sungur, M.] Erciyes Univ, Med Sch, Kayseri, Turkey.[Gucyetmez, B.] Int Hosp, Istanbul, Turkey.[Demirkiran, O.] Istanbul Univ, Cerrahpasa Med Sch Hosp, Istanbul, Turkey.[Senturk, E.] Istanbul Univ, Istanbul Med Fac, Istanbul, Turkey.[Ulusoy, H.] Karadeniz Tech Univ, Med Fac, Trabzon, Turkey.[Atalan, H.] Mem Atasehir Hosp, Istanbul, Turkey.[Serin, S.] Pamukkale Univ, Denizli, Turkey.[Kati, I] Yuzuncu Yil Univ, Med Fac, Van, Turkey.[Alnassrawi, Z.] Dubai Hosp, Dubai, U Arab Emirates.[Almemari, A.] Mafraq Hosp, Abu Dhabi, U Arab Emirates.[Krishnareddy, K.] Sheikh Khalifa Med City, Abu Dhabi, U Arab Emirates.[Kashef, S.] Tawam Hosp, Al Ain, U Arab Emirates.[Alsabbah, A.] City Hosp, Dubai, U Arab Emirates.[Poirier, G.] Hop Charles Lemoyne, Longueuil, PQ, Canada.[Marshall, J.] St Michaels Hosp, Toronto, ON, Canada.[Herridge, M.] Toronto Gen Hosp, Toronto, ON, Canada.[Herridge, M.] Toronto Western Hosp, Toronto, ON, Canada.[Fernandez-Medero, R.] San Juan Hosp, San Juan, PR USA.[Fulda, G.] Christiana Care Hlth Syst, Newark, DE USA.[Banschbach, S.] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH 45229 USA.[Quintero, J.] El Camino Hosp, Mountain View, CA USA.[Schroeder, E.] George Washington Hosp, Washington, DC USA.[Sicoutris, C.] Hosp Univ Penn, Philadelphia, PA 19104 USA.[Gueret, R.] John H Stroger Hosp Cook Cty, Chicago, IL USA.[Ryan, A.] Washington Hosp Ctr, 2H, Washington, DC USA.[Ryan, A.] Washington Hosp Ctr, 2G, Washington, DC USA.[Ryan, A.] Washington Hosp Ctr, 3H, Washington, DC USA.[Ryan, A.] Washington Hosp Ctr, 3G, Washington, DC USA.[Kashyap, R.] Mayo Clin, CCM, Rochester, MN USA.[Bauer, P.] Mayo Clin, PCC, Rochester, MN USA.[Freebairn, R.] Hawkes Bay Hosp, Hastings, New Zealand.[Nistor, D.] Palmerston North Hosp, Midcent Hlth, Palmerston North, New Zealand.[Oxley, C.] Middlemore Hosp, Auckland, New Zealand.[Young, P.] Wellington Hosp, Wellington, New Zealand.[Nanchal, R.] Med Coll Wisconsin, Milwaukee, WI 53226 USA.[Wunderink, R.] Northwestern Mem Hosp, Chicago, IL 60611 USA.[Jimenez, E.] Orlando Reg Med Ctr Inc, Orlando, FL USA.[Ryan, A.] Washington Hosp Ctr, Washington, DC 20010 USA.[Ryan, A.] Washington Hosp Ctr, 4H, Washington, DC USA.[Ryan, A.] Washington Hosp Ctr, CVRR, Washington, DC USA.[Prince, D.] Armadale Hlth Serv, Mount Nasura, WA, Australia.[Edington, J.] Bendigo Hosp, Bendigo, Vic, Australia.[Van Haren, F.] Canberra Hosp, Canberra, ACT, Australia.[Bersten, A.] Flinders Med Ctr, Bedford Pk, SA, Australia.[Hawkins, D. J.] Joondalup Hlth Campus, Joondalup, WA, Australia.[Kilminster, M.] Lismore Base Hosp, Lismore, NSW, Australia.[Sturgess, D.] Mater Adult Hosp, South Brisbane, Qld, Australia.[Ziegenfuss, M.] Prince Charles Hosp, Brisbane, Qld, Australia.[O'Connor, S.] Royal Adelaide Hosp, Adelaide, SA, Australia.[Lipman, J.] Royal Brisbane ; Womens Hosp, Brisbane, Qld, Australia.[Campbell, L.] Royal Darwin Hosp, Tiwi, NT, Australia.[Mcallister, R.] Royal Hobart Hosp, Hobart, Tas, Australia.[Roberts, B.] Sir Charles Gairdner Hosp, Nedlands, WA, Australia.[Williams, P.] Queen Elizabeth Hosp, Woodville, SA, Australia.[Parke, R.] Auckland Dist Hlth Board, Auckland, New Zealand.[Seigne, P.] Christchurch Hosp, Christchurch, New Zealand.[Valentini, R.] Cemic, Buenos Aires, DF, Argentina.[Wainsztein, N.] Fleni, Buenos Aires, DF, Argentina.[Comignani, P.] Hosp Aleman, Buenos Aires, DF, Argentina.[Casaretto, M.] Hosp Cent San Isidro, Buenos Aires, DF, Argentina.[Sutton, G.] Hosp Fernandez, Buenos Aires, DF, Argentina.[Villegas, P.] Hosp Francisco Lopez Lima Area Programa Gen Roca, Gen Roca, Argentina.[Galletti, C.] Sanatorio Allende, Cordoba, Argentina.[Neira, J.] Sanatorio Trinidad Palermo, Buenos Aires, DF, Argentina.[Rovira, D.] Sanatorio Julio Corzo Rosario, Rosario, Santa Fe, Argentina.[Hidalgo, J.] Karl Heusner Mem Hosp, Belize City, Belize.[Hidalgo, J.] Belize Healthcare Partner, Belize City, Belize.[Sandi, F.] Hosp Obrero 1, La Paz, Bolivia.[Caser, E.] Cias Unimed Vitoria, Vitoria, ES, Brazil.[Thompson, M.] Evangelical Hosp Cachoeiro De Itapemirim, Cachoeiro De Itapemirim, Brazil.[D'agostino Dias, M.] Hosp 9 Julho, Sao Paulo, Brazil.[Fontes, L.] Hosp Alcides Carneiro, Petropolis, Brazil.[Lunardi, M.] Hosp Clin Luzia De Pinho Melo, Mogi Das Cruzes, Brazil.[Youssef, N.] Hosp Nacoes Curitiba, Curitiba, Parana, Brazil.[Lobo, S.] Hosp Base Famerp, Sao Jose Do Rio Preto, Brazil.[Silva, R.] Hosp Clin Niteroi, Niteroi, RJ, Brazil.[Sales Jr, J.] Hosp Clin Padre Miguel, Rio De Janeiro, Brazil.[Madeira Campos Melo, L.] Hosp Terapia Intens, Sao Paulo, Brazil.[Oliveira, M.] Hosp Trabalhador, Curitiba, Parana, Brazil.[Fonte, M.] Hosp Esperanza, Olinda, PE, Brazil.[Grion, C.] Hosp Evangel Londrina, Londrina, Brazil.[Feijo, C.] Hosp Geral Fortaleza, Fortaleza, Ceara, Brazil.[Rezende, V] Hosp Geral Roraima, Boa Vista, Brazil.[Assuncao, M.] Hosp Israelita Albert Einstein, Sao Paulo, Brazil.[Neves, A.] Hosp Mater Dei, Belo Horizonte, MG, Brazil.[Gusman, P.; Dalcomune, D.] Hosp Meridional, Cariacica, ES, Brazil.[Teixeira, C.] Hosp Moinhos Vento, Porto Alegre, RS, Brazil.[Kaefer, K.] Hosp Municipal Ruth Cardoso, Balneario, Brazil.[Maia, I] Hosp Nereu Ramos, Florianopolis, SC, Brazil.[Souza Dantas, V] Hosp Pasteur, Rio De Janeiro, Brazil.[Costa Filho, R.] Hosp Pro Cardiaco, Rio De Janeiro, Brazil.[Amorim, F.] Hosp Reg Samambaia, Brasilia, DF, Brazil.[Assef, M.] Hosp Reg Hans Dieter Schmidt, Joinville, Brazil.[Schiavetto, P.] Hosp Santa Casa Campo Mourao, Campo Mourao, PR, Brazil.[Houly, J.] Hosp Santa Paula, Sao Paulo, SP, Brazil.[Houly, J.] Hosp Santapaula, Sao Paulo, Brazil.[Bianchi, F.] Hosp Sao Jose Avai, Itaperuna, RJ, Brazil.[Dias, F.] Hosp Sao Lucas Pucrs, Porto Alegre, RS, Brazil.[Avila, C.] Hosp Sao Vicente Paula, Rio De Janeiro, RJ, Brazil.[Gomez, J.] Hosp Sao Vicente Paulo, Rio De Janeiro, Brazil.[Rego, L.] Hosp Saude Mulher, Belem, Para, Brazil.[Castro, P.] Hosp Tacchini, Bento Goncalves, RS, Brazil.[Passos, J.] Hosp Unimed Costa Do Sol Macae Rj, Macae, RJ, Brazil.[Mendes, C.] Hosp Univ Ufpb Joao Pessoa, Joao Pessoa, Paraiba, Brazil.[Grion, C.] Hosp Univ Londrina, Londrina, Brazil.[Colozza Mecatti, G.] Hosp Univ Sao Francisco, Braganca Paulista, SP, Brazil.[Ferrreira, M.] Santa Casa Caridade Diamantina, Diamantina, MG, Brazil.[Irineu, V] Santa Casa Misericordia Tatui, Tatui, Brazil.[Guerreiro, M.] Sao Francisco de Paula Hosp, Sao Francisco De Paula, RS, Brazil.[Ugarte, S.] Clin Indisa, Providencia, Chile.[Tomicic, V] Clin Las Lilas, Providencia, Chile.[Godoy, C.] Hosp Carlos Van Buren, Valparaiso, Chile.[Samaniego, W.] Hosp Trabajador Santiago, Santiago, Chile.[Escamilla, I] Hosp El Pino, San Bernardo, Chile.[Escamilla, I] Hosp Mutual De Seguridad, Santiago, Chile.[Castro Castro, L.] Ctr Med Imbanaco, Valle Del Cauca, Colombia.[Libreros Duque, G.] Clin Colombia Cali, Cali, Colombia.[Diaz-Guio, D.] Clin De
Prevalence and Outcomes of Infection among Patients in Intensive Care Units in 2017
No full textImportance: Infection is frequent among patients in the intensive care unit (ICU). Contemporary information about the types of infections, causative pathogens, and outcomes can aid the development of policies for prevention, diagnosis, treatment, and resource allocation and may assist in the design of interventional studies. Objective: To provide information about the prevalence and outcomes of infection and the available resources in ICUs worldwide. Design, Setting, and Participants: Observational 24-hour point prevalence study with longitudinal follow-up at 1150 centers in 88 countries. All adult patients (aged ≥18 years) treated at a participating ICU during a 24-hour period commencing at 08:00 on September 13, 2017, were included. The final follow-up date was November 13, 2017. Exposures: Infection diagnosis and receipt of antibiotics. Main Outcomes and Measures: Prevalence of infection and antibiotic exposure (cross-sectional design) and all-cause in-hospital mortality (longitudinal design). Results: Among 15202 included patients (mean age, 61.1 years [SD, 17.3 years]; 9181 were men [60.4%]), infection data were available for 15165 (99.8%); 8135 (54%) had suspected or proven infection, including 1760 (22%) with ICU-acquired infection. A total of 10640 patients (70%) received at least 1 antibiotic. The proportion of patients with suspected or proven infection ranged from 43% (141/328) in Australasia to 60% (1892/3150) in Asia and the Middle East. Among the 8135 patients with suspected or proven infection, 5259 (65%) had at least 1 positive microbiological culture; gram-negative microorganisms were identified in 67% of these patients (n = 3540), gram-positive microorganisms in 37% (n = 1946), and fungal microorganisms in 16% (n = 864). The in-hospital mortality rate was 30% (2404/7936) in patients with suspected or proven infection. In a multilevel analysis, ICU-acquired infection was independently associated with higher risk of mortality compared with community-acquired infection (odds ratio [OR], 1.32 [95% CI, 1.10-1.60]; P =.003). Among antibiotic-resistant microorganisms, infection with vancomycin-resistant Enterococcus (OR, 2.41 [95% CI, 1.43-4.06]; P =.001), Klebsiella resistant to β-lactam antibiotics, including third-generation cephalosporins and carbapenems (OR, 1.29 [95% CI, 1.02-1.63]; P =.03), or carbapenem-resistant Acinetobacter species (OR, 1.40 [95% CI, 1.08-1.81]; P =.01) was independently associated with a higher risk of death vs infection with another microorganism. Conclusions and Relevance: In a worldwide sample of patients admitted to ICUs in September 2017, the prevalence of suspected or proven infection was high, with a substantial risk of in-hospital mortality
Early hyperlactatemia predicts pancreatic fistula after surgery.
No full textBackground: Postoperative pancreatic fistula (POPF) is a major complication after pancreatic surgery and results from an impaired healing of the pancreatic enteric anastomosis. Whether perioperative hemodynamic fluid management aiming to provide an adequate tissue perfusion could influence the occurrence of POPF is unknown. Serum lactate level is a well-recognized marker of decreased tissue perfusion and is known to be associated with higher morbidity and mortality in various postoperative settings. We aimed to determine in a retrospective high-volume center's cohort whether postoperative hyperlactatemia could predict POPF occurrence. Method: We conducted a retrospective analysis of 96 consecutive patients admitted in the intensive care unit (ICU) after pancreaticoduodenectomy or distal pancreatectomy. Univariate analysis was conducted to compare lactate levels at 6 h between patients evolving with versus without POPF. A logistic regression model was developed and included potential confounding factors. Results: POPF occurred in 28 patients (29 %). Serum lactate level 6 h after admission was significantly higher in the POPF group (2.8 mmol/L [95 % confidence interval (CI): 2.1-3.5] versus 1.8 mmol/L [95 % CI: 1.8-2.4], p-value = 0.04) whereas it did not differ at ICU admission or at 12 h. Despite similar cumulative fluid balance, fluid intake and vasopressor use, hyperlactatemia > 2.5 mmol/L (Odds ratio (OR): 3.58; 95 % CI: 1.22-10.48; p-value = 0.020) and red blood cells transfusion (OR: 1.24; 95 % CI: 1.03-1.49; p-value = 0.022) were found to be independent predictive factors of POPF occurrence. Conclusion: In patients undergoing partial pancreatectomy, hyperlactatemia measured 6 h after ICU admission is a predictive factor for the occurrence of POPF. Inflammatory changes after surgery may account for this observation and should be further evaluated
NEUTROPHIL-TO-LYMPHOCYTE RATIO IS ASSOCIATED WITH MORTALITY IN CRITICALLY-ILL CIRRHOTIC PATIENTS
No full textRôle du kinésithérapeute respiratoire dans un service d'accueil des urgences pour adultes
No full textDans un service d’accueil des urgences (SAU), les kinésithérapeutes respiratoires interviennent principalement lors de la prise en charge des décompensations respiratoires aiguës. Ils recourent à diverses méthodes de désencombrement bronchique, évaluent et adaptent les moyens à mettre en oeuvre pour l’oxygénothérapie, l’aérosolthérapie ainsi que pour la ventilation non invasive. Enfin, ils aident le patient à expectorer pour obtenir un prélèvement en vue d’analyses microbiologiques. Dans ces situations aiguës, des aptitudes et des compétences spécifiques sont nécessaires. L’analyse de la situation du patient doit être rapide et constante afin de ne pas négliger des signes éventuels d’aggravation ou au contraire d’amélioration. En raison des interventions qu’ils sont capables d’effectuer, de leurs connaissances et expériences spécifiques du domaine, les kinésithérapeutes respiratoires devraient occuper une place privilégiée au sein de l’équipe pluridisciplinaire en charge du patient en décompensation respiratoire aiguë
A Modified Aerosol Mask Could Significantly Save Oxygen Supplies during SARS COV 2 Pandemic
No full textinfo:eu-repo/semantics/publishe
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