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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 4.

New approaches to the use of insulin in patients with diabetic ketoacidosis.
Abstract Diabetic ketoacidosis (DKA) is one of the most common and serious acute complications of diabetes and is a significant cause of morbidity and mortality. In the last decade the mortality rate from DKA has declined because of greater recognition and improvements in its management. The current available guidelines state that the most effective means of insulin delivery during DKA is a continuous infusion of regular insulin, usually referred to as continuous low-dose insulin infusion. However, the cost of this treatment is usually quite high, because patients are required to be admitted to an intensive care un...
Source: European Journal of Internal Medicine - February 7, 2013 Category: Internal Medicine Authors: Barski L, Kezerle L, Zeller L, Zektser M, Jotkowitz A Tags: Eur J Intern Med Source Type: research

The Safety and Feasibility of Interventional Pulmonologists Performing Bedside Percutaneous Endoscopic Gastrostomy Tube Placement.
CONCLUSION: Bedside PEG placement can be performed safely and effectively by trained IP. As percutaneous tracheostomy is currently performed by IP, the ability to perform both PEG and tracheostomy placement at the same time has the potential for decreased costs, anesthesia exposure, procedural times, ventilator times, and ICU days. PMID: 23392239 [PubMed - as supplied by publisher]
Source: Chest - February 7, 2013 Category: Respiratory Medicine Authors: Yarmus L, Gilbert C, Lechtzin N, Imad M, Ernst A, Feller-Kopman D Tags: Chest Source Type: research

The Occurrence and Impact of Bacterial Organisms Complicating Critical Care Illness Associated with Influenza A(H1N1) infection.
CONCLUSION: Culture-based evidence of secondary infections commonly complicates Influenza A(H1N1)-related critical illness and is associated with worse clinical outcomes despite nearly ubiquitous antibiotic administration. PMID: 23392627 [PubMed - as supplied by publisher]
Source: Chest - February 7, 2013 Category: Respiratory Medicine Authors: Muscedere J, Ofner M, Kumar A, Long J, Lamontagne F, Cook D, McGeer A, Chant C, Marshall J, Jouvet P, Fowler R Tags: Chest Source Type: research

Anterolateral congenital diaphragmatic hernia with omphalocele: A case report and literature review
We report on a female newborn with this combination that had not been diagnosed prenatally. The patient suffered respiratory failure that persisted despite intensive care support, suggesting severe secondary pulmonary hypoplasia. Autopsy revealed the combination of an anterolateral CDH and omphalocele in the absence of other anomalies. We believe this to be the first such case to be reported in the literature. © 2013 Wiley Periodicals, Inc.
Source: American Journal of Medical Genetics Part A - February 7, 2013 Category: Genetics & Stem Cells Authors: Michael D. Scahill, Petruska Maak, Christian Kunder, Louis P. Halamek Tags: Clinical Report Source Type: research

RCT: Effect of daily chlorhexidine bathing on hospital-acquired infection
Source: N Engl J Med Area: News Single-centre, observational studies have suggested that daily bathing of patients with chlorhexidine may prevent hospital-acquired bloodstream infections and the acquisition of multidrug-resistant organisms (MDROs). This multicentre, randomised trial evaluated the usefulness of bathing with chlorhexidine to reduce the risks of MDRO acquisition and hospital-acquired bloodstream infection among patients at high risk for health care-associated infections. It was conducted at nine intensive care and bone marrow transplantation units in six hospitals and involved 7727 patients. The u...
Source: NeLM - News - February 7, 2013 Category: Drugs & Pharmacology Source Type: news

Enterococcal bacteraemia: factors influencing mortality, length of stay and costs of hospitalization
This study aimed to identify factors associated with mortality, LOS and hospitalization costs in patients with enterococcal bacteraemia and the impact of vancomycin resistance and antibiotic therapy on these outcomes. Data from 116 patients with vancomycin‐resistant Enterococci (VRE), matched 1:1 with patients with vancomycin‐susceptible Enterococcus (VSE), from two Australian hospitals were reviewed for clinical and economic outcomes. Univariable and multivariable logistic and quantile regression analyses identified factors associated with mortality, LOS and costs. Intensive care unit admission (OR, 8.57; 95% CI, 3.99...
Source: Clinical Microbiology and Infection - February 7, 2013 Category: Microbiology Authors: A. L. Y. Cheah, T. Spelman, D. Liew, T. Peel, B. P. Howden, D. Spelman, M. L. Grayson, R. L. Nation, D. C. M. Kong Tags: Original Article Source Type: research

Agreement between behavioral observation and polygraphy for the diagnosis of sleep‐wake states in preterm neonates
Abstract Sleep plays a major role in human well‐being and could influence the brain development and maturation in the neonatal period (1,2). REM sleep deprivation in neonatal animal models affects immediately the respiratory physiology and the subsequent brain development and behavior at adult age (3‐5). Consequently, protection and care of preterm neonates sleep in the neonatal intensive care unit (NICU) need to be considered as a potentially better practice (6). Only scarce data exist on the validity of behavioral observations in comparison with polygraphy recordings. ©2013 The Author(s)/Acta Pædiatrica ©2013 Foun...
Source: Acta Paediatrica - February 7, 2013 Category: Pediatrics Authors: Anna Sevestre, Emmanuel Oger, Valérie Bertelle, Dominique Mabin, Jacques Sizun Tags: Short Communication Source Type: research

Breast milk reduces risk of sepsis and intensive care costs in very-low-birth-weight infants
Feeding human breast milk to very-low-birth-weight infants greatly reduces risk for sepsis and significantly lowers associated neonatal intensive care unit (NICU) costs, according to a new study. A daily dose of 25 to 49.99 milliliters of human milk per kilogram cut NICU costs by more than $20,000, while 50 milliliters per kilogram per day lowered NICU costs by nearly $32,000.
Source: ScienceDaily Headlines - February 6, 2013 Category: Science Source Type: news

Findings of the International Nosocomial Infection Control Consortium (INICC), Part III: Effectiveness of a Multidimensional Infection Control Approach to Reduce Central Line–Associated Bloodstream Infections in the Neonatal Intensive Care Units of 4 Developing Countries
Victor Daniel Rosenthal, MD; Lourdes Dueñas, MD; Martha Sobreyra-Oropeza, MD; Khaldi Ammar, MD; Josephine Anne Navoa-Ng, MD; Ana Concepción Bran de Casares, RN; Lilian de Jesús Machuca, RN; Nejla Ben-Jaballah, MD; Asma Hamdi, MD; Victoria D. Villanueva, RN; María Corazon V. Tolentino, RN Infection Control and Hospital Epidemiology, Volume 34, Issue 3, Page 229-237, March 2013.
Source: Infect Control Hosp Epidemiol Latest Issue - February 6, 2013 Category: Epidemiology Tags: article Original Articles Source Type: research

Clinicians’ Knowledge, Attitudes, and Practices regarding Infections with Multidrug-Resistant Gram-Negative Bacilli in Intensive Care Units
Juyan Julia Zhou, MS, MPH; Sameer J. Patel, MD, MPH; Haomiao Jia, PhD; Scott A. Weisenberg, MD, MS, DTM&H; E. Yoko Furuya, MD, MS; Christine J. Kubin, PharmD; Luis Alba, BS; Kyu Rhee, MD, PhD; Lisa Saiman, MD, MPH Infection Control and Hospital Epidemiology, Volume 34, Issue 3, Page 274-283, March 2013.
Source: Infect Control Hosp Epidemiol Latest Issue - February 6, 2013 Category: Epidemiology Tags: article Original Articles Source Type: research

More People Are Dying At Home And In Hospice, But They Are Also Getting More Intense Hospital Care
More people over 65 are dying in hospice care and fewer are dying in hospitals. But this good news is tempered by a very different story. People are also being hospitalized more frequently in the last three months of their lives, are more likely to spend time in intensive care units, and are often receiving hospice care for just a few days before they die.
Source: Forbes.com Healthcare News - February 6, 2013 Category: Pharmaceuticals Authors: Howard Gleckman Source Type: news

End-Of-Life Care For Elderly Often Too Aggressive
There has been an increase in hospice usage and ICU utilization over the last ten years among elderly patients, researchers from Brown University reported in JAMA. The authors added that with more late health care transitions, repeat hospitalizations, does such aggressive care really represent what patients and their loved ones really want? Probably not. More seniors are dying with hospice care than ten years ago, the authors explained. However, a growing number of them are doing so for a very short time immediately after being in an ICU (intensive care unit)...
Source: Health News from Medical News Today - February 6, 2013 Category: Consumer Health News Tags: Palliative Care / Hospice Care Source Type: news

Is Increase In Hospice And ICU Usage What Elderly Patients Want?
There has been an increase in hospice usage and ICU utilization over the last ten years among elderly patients, researchers from Brown University reported in JAMA. The authors added that with more late health care transitions, repeat hospitalizations, does such aggressive care really represent what patients and their loved ones really want? Probably not. More seniors are dying with hospice care than ten years ago, the authors explained. However, a growing number of them are doing so for a very short time immediately after being in an ICU (intensive care unit)...
Source: Health News from Medical News Today - February 6, 2013 Category: Consumer Health News Tags: Palliative Care / Hospice Care Source Type: news

Hospitals Vary Widely in ICU Admissions
03/28/2012, Health Services Research, Hospitals vary widely in their admissions to intensive care units, which some experts believe are overused, costly and potentially dangerous. A new study in Health Services Research finds that the actions of hospitals - not the kinds of patients they attract - appear to be responsible for part of the difference in ICU use.
Source: Health Behavior News Service - February 6, 2013 Category: Consumer Health News Source Type: news

Patients with ICU Delirium More Likely to Die
12/06/2012, General Hospital Psychiatry, Delirium, a condition developed by many patients in hospital intensive care units (ICU), is associated with higher mortality rates, more complications, longer stays in the ICU, and longer hospitalizations, finds a new meta-analysis in General Hospital Psychiatry.
Source: Health Behavior News Service - February 6, 2013 Category: Consumer Health News Source Type: news

[Successful infection control in regional anesthesia procedures : Observational survey after introduction of the DGAI hygiene recommendations.]
CONCLUSION: Using a real-time computer-based tool for data capture makes a veritable detection of adverse events possible. Such a tool also has the power to monitor the effects of changes in clinical procedures (SOP). In this case it was possible to verify the successful introduction of an extended hygiene care bundle. The new regime significantly decreased the rate of infections in cPNB. PMID: 23381785 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - February 6, 2013 Category: Anesthesiology Authors: Reisig F, Neuburger M, Zausig YA, Graf BM, Büttner J Tags: Anaesthesist Source Type: research

Fewer Medicare Patients Dying in Hospitals
(Ivanhoe Newswire) – In a study that included data on more than 800,000 Medicare beneficiaries who died between 2000 – 2009, a lower proportion died in an acute care hospital in recent years, although both intensive care unit (ICU) use and the rate of health care transitions increased during the last month of life.
Source: Medical Headlines From Ivanhoe.com - February 6, 2013 Category: Consumer Health News Source Type: news

Breast milk reduces risk of sepsis and intensive care costs in very-low-birth-weight infants
(Rush University Medical Center) Feeding human breast milk to very-low-birth-weight infants greatly reduces risk for sepsis and significantly lowers associated neonatal intensive care unit costs, according to a study by Rush University Medical Center researchers.
Source: EurekAlert! - Social and Behavioral Science - February 6, 2013 Category: Global & Universal Source Type: news

Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury
Urine TIMP-2, and IGFBP7, two novel biomarkers for risk stratification of acute kidney injury, have been discovered and validated in more than 1000 critically ill patients.
Source: Critical Care - February 6, 2013 Category: Intensive Care Authors: Kianoush KashaniAli Al-KhafajiThomas ArdilesAntonio ArtigasSean BagshawMax BellAzra BihoracRobert BirkhahnCynthia CelyLakhmir ChawlaDanielle DavisonThorsten FeldkampLui ForniMichelle GongKyle GunnersonMichael HaaseJames HackettPatrick HonoreEric HosteOliv Source Type: research

The Brain after Critical Illness: Effect of Illness and Aging on Cognitive Function
This study has several limitations - including use of ICD-9-CM codes that identified primarily neurodegenerative types of dementia, the lack of a control group, and a high mortality rate during the first 6 months after hospital discharge - which the authors acknowledge. An important additional limitation of the study by Guerra and colleagues and all previous post-ICU cognitive outcome studies is the inability to determine what role, if any, cognitive impairments that existed before the critical illness contribute to the diagnosis of new post-ICU dementia and whether such cognitive impairments are stable over time or are pr...
Source: Critical Care - February 6, 2013 Category: Intensive Care Authors: Ramona Hopkins Source Type: research

Seniors Get 'Aggressive' Care in Final Days (CME/CE)
(MedPage Today) -- Although fewer Medicare patients died in acute care hospitals in 2009 than in 2000, the number of their trips to the intensive-care unit and healthcare transfers increased near the end of life, researchers found.
Source: MedPage Today State Required CME - February 5, 2013 Category: Consumer Health News Source Type: news

EHRs: “Sloppy and paste” endures despite patient safety risk
“During the winter holidays, a patient at Yale-New Haven Hospital in Connecticut had a large pressure ulcer with an abscess. A surgical intern made a note in the patient’s electronic health record that said, “Patient needs drainage, may need OR.” The problem? The same note appeared for several consecutive days, even after a surgical team successfully [...]
Source: ICMCC: The International Council on Medical and Care Compunetics - February 5, 2013 Category: Information Technology Authors: Lodewijk Tags: News Copy-and-paste Intensive care unit Notes Patient Safety Source Type: news

Acute respiratory failure caused by organizing pneumonia secondary to antineoplastic therapy for non-Hodgkin's lymphoma
Doenças difusas do parênquima pulmonar pertencem a um grupo de doenças de evolução geralmente subaguda ou crônica, mas que podem determinar insuficiência respiratória aguda. Paciente masculino, 37 anos, em terapia para linfoma não Hodgkin, admitido com tosse seca, febre, dispneia e insuficiência respiratória aguda hipoxêmica. Iniciadas ventilação mecânica e antibioticoterapia, porém houve evolução desfavorável. Tomografia computadorizada de tórax mostrava opacidades pulmonares em "vidro fosco" bilaterais. Devido ao paciente ter feito uso de três drogas relacionadas à pneumonia em organização (ciclof...
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Vascular access through the intraosseous route in pediatric emergencies
A obtenção do acesso venoso em crianças gravemente enfermas é um procedimento essencial para o restabelecimento da volemia e a administração de fármacos nas emergências pediátricas. A primeira opção para obtenção de acesso vascular é pela punção de uma veia periférica. Quando essa via não pode ser utilizada ou sua obtenção se torna demorada, a via intraóssea consiste em efetiva opção para obtenção de um acesso venoso rápido e seguro. O presente estudo possui caráter descritivo e exploratório, realizado por meio de pesquisa bibliográfica, com o objetivo de descrever os princípios técnicos, as ...
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Impact of supra-cuff suction on ventilator-associated pneumonia prevention
In conclusion, cannulae with a supra-cuff suction device enable the aspiration of subglottic secretions, providing benefits to critically ill patients by reducing the incidence of ventilator-associated pneumonia and, consequently, hospital costs - with no large-scale adverse effects.
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Plasmodium falciparum malaria: proteomic studies
A despeito dos avanços no tratamento e das campanhas de prevenção e de controle da malária nos distintos continentes nos quais a moléstia grassa, a entidade mórbida permanece com significativa relevância no mundo contemporâneo. O Plasmodium falciparum é o grande responsável pela malária grave, caracterizada por distúrbios em diferentes órgãos e sistemas, com possibilidade de evolução ao óbito. Embora incipientes, os estudos proteômicos na malária têm trazido boas perspectivas para melhor compreensão dos aspectos biológicos do Plasmodium, assim como dos mecanismos fisiopatológicos, diagnósticos, tera...
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Epidemiological characteristics and deaths of premature infants in a referral hospital for high-risk pregnancies
OBJETIVO: Analisar o processo da assistência prestada aos prematuros atendidos em uma unidade de terapia intensiva neonatal e os fatores associados à sua mortalidade. MÉTODOS: Estudo transversal de dados retrospectivos de prematuros de uma unidade de terapia intensiva no triênio 2008-2010. Descreveram-se características maternas e dos prematuros e realizou-se análise bivariada entre estas, o período de estudo e o desfecho "óbito" (hospitalar, neonatal e precoce) pelos testes do qui-quadrado de Pearson, exato de Fisher ou qui-quadrado de tendência linear. Aplicou-se a regressão logística bivariada e multivariáve...
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Nosocomial infections in a neonatal intensive care unit in South Brazil
CONCLUSIONS: The incidence of nosocomial infection in the hospital unit was higher than rates that have been reported in other national studies. The major types of nosocomial infection were primary bloodstream infection and pneumonia.
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Noninvasive ventilation in acute respiratory failure from respiratory syncytial virus bronchiolitis
OBJETIVOS: Analisar se a ventilação não invasiva diminui a necessidade de intubação endotraqueal e se alterou a evolução clínica, relativamente a complicações infecciosas, da bronquiolite por vírus sincicial respiratório com insuficiência respiratória. MÉTODOS: Estudo retrospectivo de coortes: cohorte A, de crianças internadas na unidade de cuidados intensivos e especiais pediátrica antes da introdução da ventilação não invasiva (2003-2005); cohorte B, de crianças internadas após a introdução de ventilação não invasiva (2006-2008). Excluindo a ventilação não invasiva, a terapêutica de supor...
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

The use of 2% chlorhexidine gel and toothbrushing for oral hygiene of patients receiving mechanical ventilation: effects on ventilator-associated pneumonia
CONCLUSION: Because the study was terminated due to futility, it was not possible to evaluate the impact of oral hygiene using 2% chlorhexidine and toothbrushing on the incidence of ventilator-associated pneumonia in this heterogeneous population of critical patients receiving long-term mechanical ventilation, and no beneficial effect was observed for this intervention.
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Relative adrenal insufficiency as a predictor of disease severity and mortality in severe septic shock
CONCLUSIONS: Increased basal cortisol is associated with mortality and disease severity. Cortisol responses upon adrenocorticotropic hormone stimulation were not related to outcome. The cortisol/albumin ratio does not predict unfavorable outcomes better than total cortisol levels or help to improve the accuracy of the adrenocorticotropic hormone test.
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Financial impact of nosocomial infections in the intensive care units of a charitable hospital in Minas Gerais, Brazil
OBJETIVO: As infecções nas unidades de terapia intensiva estão associadas a elevada morbidade e mortalidade, além de alto custo. A análise desses aspectos pode contribuir para a otimização de recursos financeiros relacionados. MÉTODOS: Estudo retrospectivo, realizado por meio de análise de banco de dados de gestão hospitalar e qualidade em medicina intensiva (Sistema de Gestão Hospitalar - SGH) e RM Janus®. A análise dos gastos foi realizada por meio de avaliação dos medicamentos e materiais utilizados na assistência médica direta. Os valores obtidos foram em moeda nacional (Real). Foi realizada análise d...
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Influence on prognosis and prevalence of stress hyperglycemia in a cohort of patients with acute coronary syndrome
OBJETIVO: Demonstrar a prevalência da hiperglicemia de estresse em coorte de pacientes com síndrome coronariana aguda e a correlação com óbito, insuficiência cardíaca e/ou disfunção ventricular esquerda sistólica, na fase intra-hospitalar. MÉTODOS: Estudo de coorte prospectiva inicial constituída por pacientes internados com síndrome coronariana aguda, com ou sem supradesnivelamento do segmento ST. Foram comparados os grupos para demonstrar a correlação entre hiperglicemia de estresse e eventos cardiovasculares. Na comparação entre os grupos com e sem hiperglicemia de estresse, foram usados o teste do qui-...
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Diabetes mellitus and impaired glucose tolerance are underdiagnosed in intensive care units
OBJETIVO: Avaliar a presença de diabetes mellitus e a intolerância à glicose em pacientes internados em unidades de terapia intensiva. MÉTODOS: Foram incluídos pacientes clínicos, em pós-operatório de cirurgias eletivas e de urgência, e excluídos aqueles com história de diabetes mellitus. Para o diagnóstico de alterações prévias da glicemia, utilizou-se a dosagem da hemoglobina glicada (HbA1c) na admissão do paciente, sendo classificado em normal (
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Quality of life before admission to the intensive care unit
CONCLUSION: In the sample studied, the SF-36 demonstrated good reliability when used to measure health-related quality of life in critically ill patients before admission to the intensive care unit. The worst score was role-physical and the best was general health. Health-related quality of life of patients before admission was not correlated with severity of illness or length of stay in the intensive care unit.
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

A managed protocol for treatment of deceased potential donors reduces the incidence of cardiac arrest before organ explant
OBJETIVO: Avaliar o efeito da aplicação de um protocolo gerenciado de manutenção de potenciais doadores falecidos de múltiplos órgãos em duas unidades hospitalares. MÉTODOS: Estudo antes (Fase 1)/depois (Fase 2) realizado em dois hospitais gerais que incluiu, consecutivamente, os potenciais doadores ingressados em duas unidades de terapia intensiva. Na Fase 1 (16 meses), os dados foram coletados retrospectivamente e as medidas de manutenção do potencial doador foram instituídas a critério do intensivista. Na Fase 2 (12 meses), a coleta de dados foi prospectiva e a manutenção foi guiada por um protocolo gerenc...
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Volume replacement with saline solutions during pancreatitis in rats and the hepatic profiles of apoptotic proteins and heat-shock proteins
OBJETIVO: A falência hepática é uma consequência da inflamação sistêmica após pancreatite aguda. Avaliou-se o efeito da reposição volêmica com soluções salinas fisiológicas ou hipertônica na produção hepática de citocinas e na expressão de proteínas ativadas por choque térmico e proteínas ligadas à apoptose durante a pancreatite aguda. MÉTODOS: Ratos Wistar foram divididos em quatro grupos: C - animais controles não submetidos à lesão e nem ao tratamento; NT - animais submetidos à indução de pancreatite aguda e não tratados; SN - animais submetidos à indução de pancreatite aguda e tratados...
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Intensive care provision: a global problem
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Do endotracheal tubes with suction above the cuff decrease the rate of ventilator-associated pneumonia, and are they cost-effective?
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Moving beyond the assessment of mortality and severity of diseases in critical patients: we are just getting started...
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

Importance of intensive care professionals for organ donation and transplantation
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

How do you prefer your resuscitation solution?: do you want a little bit more salt?
Source: Revista Brasileira de Terapia Intensiva - February 5, 2013 Category: Intensive Care Source Type: research

[Atrial chaotic tachycardia during a respiratory tract infection due to NL63 coronavirus.]
We report the case of a 3-month-old boy hospitalized with acute bronchiolitis. Respiratory distress was associated with cardiogenic shock caused by chaotic atrial tachycardia. The cause of bronchiolitis was a coronavirus NL63 viral infection, confirmed in nasopharyngeal aspirations. The patient required intensive care including diuretics (furosemide), anti-arrhythmic drugs (amiodarone and digoxin), and inotropic drugs (milrinone and levosimendan) associated with mechanical ventilation. The outcome was favorable in 10days and the sinusal cardiac rhythm was completely restored at discharge. PMID: 23394725 [PubMed - as supplied by publisher]
Source: Archives de Pediatrie - February 5, 2013 Category: Pediatrics Authors: Chantreuil J, Favrais G, Soule N, Maakaroun-Vermesse Z, Chaillon A, Chantepie A, Saliba E Tags: Arch Pediatr Source Type: research

Severe community‐acquired pneumonia treated with β‐lactam–respiratory quinolone vs. β‐lactam–macrolide combination
ConclusionThirty‐day mortality rate of SCAP patients did not differ whether they were treated with either βQ or βM combination.
Source: Acta Anaesthesiologica Scandinavica - February 5, 2013 Category: Anesthesiology Authors: J. KARHU, T. I. ALA‐ KOKKO, P. OHTONEN, H. SYRJÄLÄ Tags: Original Article Source Type: research

Effect of different blood glucose target levels on the incidence of hypoglycemia during insulin therapy in the intensive care unit (在重症监护病房中使用胰岛素治疗后不同的血糖目标水平对低血糖发生率的影响)
ConclusionsThe incidence of moderate hypoglycemia (<60 mg/dL) was significantly increased during the period when the target blood glucose level was <120 mg/dL. Changes in target blood glucose levels did not affect patient mortality. 摘要背景2003年以前，我们学院的血糖目标水平为<200 mg/dL。有研究报告患者血糖目标水平为80‐110 mg/dL时死亡率下降，随后的一些随机对照研究结果也证实了这一点，因此我们在2004年对这个目标进行了重新评估，并且于2006年进行了再次评估。本研究的目的是观察强化胰岛素治疗（IIT）后的低...
Source: Journal of Diabetes - February 5, 2013 Category: Endocrinology Authors: Makio Okawa, Fumio Kunimoto, Masafumi Kanamoto, Hajime Narahara, Hiroshi Hinohara, Masaru Tobe, Akihiro Yanagisawa, Shigeru Saito Tags: Original Article Source Type: research

Lower proportion of Medicare patients dying in hospitals
(JAMA and Archives Journals) In a study that included data on more than 800,000 Medicare beneficiaries who died between 2000 - 2009, a lower proportion died in an acute care hospital in recent years, although both intensive care unit use and the rate of health care transitions increased during the last month of life, according to a study appearing in the Feb. 6 issue of JAMA.
Source: EurekAlert! - Social and Behavioral Science - February 5, 2013 Category: Global & Universal Source Type: news

Expiratory time constant for determinations of plateau pressure, respiratory system compliance, and total resistance
Conclusions: We found the tauE method was just as good as the EIP method for determining Pplt, Crs, and Rtot for various modes of ventilatory support for patients with acute respiratory failure. It is unclear if the tauE method can be generalized to patients with chronic obstructive lung disease. tauE is determined during passive deflation of the lungs without the need for changing the ventilatory mode and disrupting a patient's breathing. The tauE method obviates the need to apply an EIP, allows for continuous and automatic surveillance of inspiratory Pplt so it can be maintained [less than or equal to] 30 cm H2O for lung...
Source: Critical Care - February 5, 2013 Category: Intensive Care Authors: Nawar Al-RawasMichael BannerNeil EulianoCarl TamsJeff BrownA Daniel MartinAndrea Gabrielli Source Type: research

Evaluation of early mini- bronchoalveolar lavage in the diagnosis of health-care associated pneumonia: a prospective study
IntroductionHealth care-associated pneumonia (HCAP) has been proposed as a new category of respiratory infection to identify patients at risk of multidrug-resistant (MDR) pathogens. The American Thoracic Society's recommendation for HCAP treatment is to use broad-spectrum and multiple antibiotics. However, this strategy may be economically expensive and promote antimicrobial resistance when a multisensible pathogen is not identified. Methods: We prospectively included all patients presenting with HCAP in the emergency department. Blood cultures and fiberoptic bronchoscope-guided distal protected small volume bronchoalveola...
Source: Critical Care - February 5, 2013 Category: Intensive Care Authors: Guillaume LacroixBertrand PrunetJulien BordesNathalie Cabon-AsencioYves AsencioTiphaine GaillardSandrine PonsErwan D'ArandaDelphine KerebelEric MeaudrePhilippe Goutorbe Source Type: research

Contribution of activated platelets to plasma IL-27 levels
Serum interleukin-27 (IL-27) protein concentration is predictive of bacterial infection in critically ill children. Here we show that upon activation platelets release functional IL-27 that is able to specifically induce B cell activation in vitro. These data highlight the inflammatory role of platelet-derived IL-27 and suggest that platelets could contribute to immune dysregulation in septic patients.
Source: Critical Care - February 5, 2013 Category: Intensive Care Authors: Hind HAMZEH-COGNASSEPauline DAMIENKim-Anh NGUYENFabrice ZENIBruno POZZETTOFabrice COGNASSEOlivier GARRAUD Source Type: research

Am J Respir Crit Care Med; +41 new citations
41 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results: Am J Respir Crit Care Med These pubmed results were generated on 2013/02/04PubMed, a service of the National Library of Medicine, includes over 15 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.
Source: Am J Respir Crit Car... - February 4, 2013 Category: Intensive Care Tags: Report Source Type: research