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Neuroimaging in the Medical Intensive Care Unit: An Essential Complement to the Clinical ExaminationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - November 19, 2009 Category: Intensive Care Authors: Lee, K., Badjatia, N. Tags: Articles Source Type: journals

Respect for Persons: Beyond the Mortal WorldEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - November 19, 2009 Category: Intensive Care Authors: Bierer, G. Tags: Articles Source Type: journals

Circulatory Arrest in a Brain-Dead Organ Donor: Is the Use of Cardiac Compression Permissible?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Care of the brain-dead patient is common in intensive care practice. Aggressive donor management is advocated to increase supply of viable organs. Significant controversy exists over cardiac resuscitation in patients determined dead by cardiac criteria. The issue, till now, has not been addressed in brain dead patients. We discuss a case of cardiac resuscitation of a brain-dead donor to ensure organ donation. This case allows us to examine the use of brain death criteria to declare death, the controversy regarding cardiac resuscitation in organ donor patients, and the standards for use of cardiac resuscitation in the organ...
Source: Journal of Intensive Care Medicine - November 19, 2009 Category: Intensive Care Authors: Cummings, B., Noviski, N., Moreland, M. P., Paris, J. J. Tags: Articles Source Type: journals

Bi-Level Positive Airway Pressure Ventilation in Pediatric Oncology Patients With Acute Respiratory FailureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The aim of the study was to describe our experience with bi-level positive airway pressure (BiPAP) ventilation in oncology children with acute respiratory failure, hospitalized in a single tertiary pediatric tertiary center. This was a retrospective cohort study of all pediatric oncology patients in our center admitted to the intensive care unit with acute hypoxemic or hypercarbic respiratory failure from January 1999 through May 2006, who required mechanical ventilation with BiPAP. Fourteen patients met the inclusion criteria with a total of 16 events of respiratory failure or impending failure: 12 events were hypoxemic, ...
Source: Journal of Intensive Care Medicine - November 19, 2009 Category: Intensive Care Authors: Schiller, O., Schonfeld, T., Yaniv, I., Stein, J., Kadmon, G., Nahum, E. Tags: Articles Source Type: journals

Acute Hemodynamic Effects of Recruitment Maneuvers in Patients With Acute Respiratory Distress SyndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: A transient decrease in mean BP was observed during the RM, and its degree was correlated with the preload decrease, while cardiac contractility was maintained. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - November 19, 2009 Category: Intensive Care Authors: Kwang Joo Park, , Yoon Jung Oh, , Hyuk Jae Chang, , Seung Soo Sheen, , Choi, J., Keu Sung Lee, , Joo Hun Park, , Sung Chul Hwang, Tags: Articles Source Type: journals

The Role of Head Computer Tomographic Scans on the Management of MICU Patients With Neurological DysfunctionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study suggests that clinicians should have a low threshold for ordering a CT scan in MICU patients with acute neurological dysfunction. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - November 19, 2009 Category: Intensive Care Authors: Salerno, D., Marik, P. E., Daskalakis, C., Kolm, P., Leone, F. Tags: Articles Source Type: journals

Inhalational Anesthesia: Basic Pharmacology, End Organ Effects, and Applications in the Treatment of Status AsthmaticusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The potent inhalational anesthetic agents are used on a daily basis to provide intraoperative anesthesia. Given their beneficial effects on airway tone and reactivity, they also have a role in the treatment of status asthmaticus that is refractory to standard therapy. Although generally not of clinical significance, these agents can affect various physiological functions. The potent inhalational anesthetic agents decrease mean arterial pressure and myocardial contractility. The decrease in mean arterial pressure reduces renal and hepatic blood flow. Secondary effects on end-organ function may result from the metabolism of ...
Source: Journal of Intensive Care Medicine - November 19, 2009 Category: Intensive Care Authors: Tobias, J. D. Tags: Articles Source Type: journals

A Simple Physiologic Algorithm for Managing Hemodynamics Using Stroke Volume and Stroke Volume Variation: Physiologic Optimization ProgramEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Intravascular volume status and volume responsiveness continue to be important questions for the management of critically ill or injured patients. Goal-directed hemodynamic therapy has been shown to be of benefit to patients with severe sepsis and septic shock, acute lung injury and adult respiratory distress syndrome, and for surgical patients in the operating room. Static measures of fluid status, central venous pressure (CVP), and pulmonary artery occlusion pressure (PAOP) are not useful in predicting volume responsiveness. Stroke volume variation and pulse pressure variation related to changes in stroke volume during p...
Source: Journal of Intensive Care Medicine - November 19, 2009 Category: Intensive Care Authors: McGee, W. T. Tags: Articles Source Type: journals

Analytic Review: Hyponatremia in Heart FailureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hyponatremia is one of the newer and emerging risk factors for an adverse prognosis in chronic heart failure. Why decreased serum sodium is associated with worse prognosis remains unclear. It may reflect worsening heart failure and the deleterious effects of activation of neurohormones. The mechanism of hyponatremia in heart failure also remains unclear. A relatively greater degree of free-water retention compared to sodium retention is probably the major mechanism. The treatment of significant hyponatremia in heart failure is difficult. The conventional treatments such as fluid restriction, infusion of hypertonic saline, ...
Source: Journal of Intensive Care Medicine - November 19, 2009 Category: Intensive Care Authors: Chatterjee, K. Tags: Articles Source Type: journals

Can a broken heart be fixed?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - September 17, 2009 Category: Intensive Care Authors: Shamloo, B., Taylor, J. L., Yusufali, T., D' Attellis, N. Tags: Articles Source Type: journals

Techniques for Assessment of Intravascular Volume in Critically Ill PatientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Fluid replacement is considered the cornerstone of resuscitation in the ICU. However, only about 50% of critically ill hemodynamically unstable patients are fluid responsive; furthermore, both under-resuscitation and overzealous fluid administration adversely affect outcome Consequently, the resuscitation of critically ill patients requires an accurate assessment of the patients’ intravascular volume status and their volume responsiveness. This paper reviews the evolution and accuracy of methods for assessing fluid responsiveness in critically ill patients. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - September 17, 2009 Category: Intensive Care Authors: Marik, P. E. Tags: Articles Source Type: journals

Children With Respiratory Distress Treated With High-Flow Nasal CannulaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Our study indicates that high-flow nasal cannula improves the respiratory scale score, the oxygen saturation, and the patient’s COMFORT scale. Its mechanism of action is application of mild positive airway pressure and lung volume recruitment. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - September 17, 2009 Category: Intensive Care Authors: Spentzas, T., Minarik, M., Patters, A. B., Vinson, B., Stidham, G. Tags: Articles Source Type: journals

Fever During Pediatric Intensive Care Unit Admission Is Independently Associated With Increased MorbidityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Fever in critically ill children occurs frequently during PICU stay. Fever after 48 hours of admission or new episodes of fever after 48 nonfebrile hours were mainly caused by nosocomial infections and was independently associated with prolonged length of ventilatory support and PICU stay. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - September 17, 2009 Category: Intensive Care Authors: Gordijn, M. S., Plotz, F. B., Kneyber, M. C. J. Tags: Articles Source Type: journals

Sympathetic Overstimulation During Critical Illness: Adverse Effects of Adrenergic StressEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The term ‘‘adrenergic’’ originates from ‘‘adrenaline’’ and describes hormones or drugs whose effects are similar to those of epinephrine. Adrenergic stress is mediated by stimulation of adrenergic receptors and activation of post-receptor pathways. Critical illness is a potent stimulus of the sympathetic nervous system. It is undisputable that the adrenergic-driven ‘‘fight-flight response’’ is a physiologically meaningful reaction allowing humans to survive during evolution. However, in critical illness an overshooting stimulation of the sympathetic ne...
Source: Journal of Intensive Care Medicine - September 17, 2009 Category: Intensive Care Authors: Dunser, M. W., Hasibeder, W. R. Tags: Articles Source Type: journals

Analytic Review: Confirmation of Endotracheal Tube Position: A Narrative ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Endotracheal tube (ETT) insertion is the primary method of definitive airway protection and control in critically ill patients. Detection of ETT malposition in a timely fashion is crucial in both elective and emergent intubation. In this review, we describe classic tests and highlight several new technologies that may assist the practitioner in determining ETT position within the esophago-tracheal complex, namely ultrasonographic and impedance-based methods. Strengths and weaknesses of particular methods are highlighted. Although many physical examination maneuvers have been described, reliance on the physical examination ...
Source: Journal of Intensive Care Medicine - September 17, 2009 Category: Intensive Care Authors: Rudraraju, P., Eisen, L. A. Tags: Articles Source Type: journals

Book Review: The Trauma Manual: Trauma and Acute Care Surgery, 3rd Edition By Andrew Peitzman B. et al Lippincott, Williams & Wilkins, 2007. Price of Book: $49.95Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - July 20, 2009 Category: Intensive Care Authors: DeRoss, A. L. Tags: Article Source Type: journals

Intraoperative Diagnosis of Unsuspected Methemoglobinemia Due to Low Pulse Oximetry ValuesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe an adolescent with acute leukemia who presented to the operating room for placement of a Broviac catheter for permanent central venous access. Given a persistently low oxygen saturation as measured by pulse oximetry (92% to 94%) with no response to changes in the inspired oxygen concentration and the lack of physical findings on auscultation to explain the low oxygen saturation, the diagnosis of metHb was entertained and confirmed by laboratory analysis. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - July 20, 2009 Category: Intensive Care Authors: Tobias, J. D., Ramachandran, V. Tags: Article Source Type: journals

Massive Cerebrovascular Infarct Due to the Catastrophic Antiphospholipid Syndrome in a Patient With Idiopathic Thrombocytopenic PurpuraEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case of a patient with idiopathic thrombocytopenic purpura (ITP) who developed massive cerebral ischemia due to this entity. Prompt and aggressive treatment may prevent and actually resolve lethal complications caused by this devastating syndrome. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - July 20, 2009 Category: Intensive Care Authors: Modrykamien, A., Reddy, A., Guzman, J. A., Farha, S. Tags: Article Source Type: journals

A Comparison of Infusion Volumes in the Measurement of Intra-Abdominal PressureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Bladder pressure measurement through a foley catheter is the current standard in monitoring for intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Accurate pressure transduction requires a continuous fluid column with a small volume of transducing medium at the tip of the catheter. Infusing excessive fluid volume can falsely elevate the measured intra-abdominal pressure (IAP) due to bladder overdistention and can lead to intrinsic muscular contraction. This effect can be seen with volumes as low as 60 mL. Recent expert consensus has recommended 25 mL as the maximal infusion volume; however, 50 mL i...
Source: Journal of Intensive Care Medicine - July 20, 2009 Category: Intensive Care Authors: Kimball, E. J., Baraghoshi, G. K., Mone, M. C., Hansen, H. J., Adams, D. M., Alder, S. C., Jackson, P., Cannon, P., Horn, J., Wolfe, T. R. Tags: Article Source Type: journals

Increased Oxidants and Reduced Antioxidants in Irradiated Parenteral Nutrition Solutions May Contribute to the Inflammatory ResponseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Lipid hydroperoxides are formed in PN solutions and increase further following irradiation. This is associated with a significant reduction in vitamin E and antioxidant potential. The increase in urinary isoprostanes indicates a potentially proinflammatory effect of irradiated PN. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - July 20, 2009 Category: Intensive Care Authors: Richards, G. A., White, H., Grimmer, H., Ramoroka, C., Channa, K., Hopley, M., Fickl, H., Gulumian, M. Tags: Article Source Type: journals

Review of a Large Clinical Series: Insulin Resistance Despite Tight Glucose Control Is Associated With Mortality in Critically Ill Surgical PatientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: There was a large amount of variation in insulin resistance, as measured by an adapting multiplier, both across the population and within patients. In the setting of tight glucose control measures of glucose control (median blood glucose and percent in range) do not differentiate between patients who lived and died while measures of insulin resistance (median insulin dose and multiplier) do, suggesting that the insulin resistance is a better predictor of outcome. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - July 20, 2009 Category: Intensive Care Authors: Mowery, N. T., Dortch, M. J., Dossett, L. A., Norris, P. R., Diaz, J. J., Morris, J. A., May, A. K. Tags: Article Source Type: journals

The Use of Carbapenems in the Treatment of Serious InfectionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Inadequate initial antimicrobial treatment in serious infections leads to increased mortality. Achieving adequate treatment is increasingly difficult because of the increasing prevalence of multidrug-resistant (MDR) pathogens. The carbapenems are potent, broad-spectrum antibiotics that have been shown to be safe and efficacious therapies in the treatment of serious infections. This review is intended to compare the 4 major members of the carbapenem class, which include imipenem, meropenem, ertapenem, and doripenem, with other widely used antimicrobial agents in the intensive care unit (ICU). The carbapenems are potent, bro...
Source: Journal of Intensive Care Medicine - July 20, 2009 Category: Intensive Care Authors: Baughman, R. P. Tags: Article Source Type: journals

Analytic Reviews: High-Frequency Oscillatory Ventilation (HFOV) and Airway Pressure Release Ventilation (APRV): A Practical GuideEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Despite advances in ventilator management, 31% to 38% of patients with adult respiratory distress syndrome (ARDS) will die, some from progressive respiratory failure. Inability to adequately oxygenate patients with severe ARDS has prompted extensive efforts to identify what are now known as alternative modes of ventilation including high-frequency oscillatory ventilation and airway pressure release ventilation. Both modalities are based on the principles of the open-lung concept and aim to improve oxygenation by keeping the lung uniformly inflated for an extended period of time. Although a mortality benefit has not been pr...
Source: Journal of Intensive Care Medicine - July 20, 2009 Category: Intensive Care Authors: Stawicki, S.P., Goyal, M., Sarani, B. Tags: Article Source Type: journals

The Rapidly Expanding Therapeutic Role of Thymosin {alpha}-1 in the Management of Gastrointestinal and Systemic Infectious DisordersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - May 21, 2009 Category: Intensive Care Authors: Kapoor, S. Tags: Article Source Type: journals

In-hospital CPR: Performing it Better but Less OftenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - May 21, 2009 Category: Intensive Care Authors: Nader, A., Seneff, M. G. Tags: Article Source Type: journals

A Case of Kombucha Tea ToxicityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: While Kombucha tea is considered a healthy elixir, the limited evidence currently available raises considerable concern that it may pose serious health risks. Consumption of this tea should be discouraged, as it may be associated with life-threatening lactic acidosis. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - May 21, 2009 Category: Intensive Care Authors: SungHee Kole, A., Jones, H. D., Christensen, R., Gladstein, J. Tags: Article Source Type: journals

30-Year-old HIV-positive Female With Diffuse Alveolar HemorrhageEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present a case of Strongyloides stercoralis hyperinfection in a 30-year-old HIV positive female who presents with diffuse alveolar hemorrhage. We discuss the relevant differential diagnoses and characteristic imaging findings. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - May 21, 2009 Category: Intensive Care Authors: Agarwal, V. K., Khurana, H. S., Le, H. X., Mathisen, G., Kamangar, N. Tags: Article Source Type: journals

Design and Development of a Cardiopulmonary Resuscitation MattressEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study introduces the design and construction of a mattress insert to produce more effective cardiopulmonary resuscitation (CPR). The mattress insert deflates, making the mattress insert a rigid surface. Using a device that administers a constant compression depth onto a manikin, we were able to show that our mattress insert more effectively directed the compressive force to the manikin compared to the current practice of using a headboard on top of a mattress. The mattress insert produced a statistically significant increase in the compression efficiency when compared to the current practice of using the headboard (81...
Source: Journal of Intensive Care Medicine - May 21, 2009 Category: Intensive Care Authors: Delvaux, A. B., Trombley, M. T., Rivet, C. J., Dykla, J. J., Jensen, D., Smith, M. R., Gilbert, R. J. Tags: Article Source Type: journals

Decannulation Following Tracheostomy for Prolonged Mechanical VentilationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Decannulation was achieved in 35% of patients transferred to an LTAC for weaning from prolonged mechanical ventilation. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - May 21, 2009 Category: Intensive Care Authors: O'Connor, H. H., Kirby, K. J., Terrin, N., Hill, N. S., White, A. C. Tags: Article Source Type: journals

Review of A Large Clinical Series: Coronary Angiography Predicts Improved Outcome Following Cardiac Arrest: Propensity-adjusted AnalysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: CATH is more likely to be performed in certain patients and identifies a significant number of high-grade stenoses in this population. Receiving CATH was independently associated with good outcome. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - May 21, 2009 Category: Intensive Care Authors: Reynolds, J. C., Callaway, C. W., El Khoudary, S. R., Moore, C. G., Alvarez, R. J., Rittenberger, J. C. Tags: Article Source Type: journals

Decompressive Surgery for Severe Brain EdemaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Decompressive surgery has since long been a promising therapeutic approach for patients with acute severe brain injury at risk to develop severe brain edema. The underlying rationale of removing part of the cranium is to create space for the expanding brain to prevent secondary damage to vital brain tissue. However, until recently, randomized controlled trials that demonstrate the efficacy of decompressive surgery or benefit for outcome were missing. This has changed since the results of 3 randomized trials on hemicraniectomy in malignant infarction of the middle cerebral artery have been published in 2007. In this article...
Source: Journal of Intensive Care Medicine - May 21, 2009 Category: Intensive Care Authors: Diedler, J., Sykora, M., Blatow, M., Juttler, E., Unterberg, A., Hacke, W. Tags: Article Source Type: journals

Analytic Review: The Pathogenetic and Prognostic Value of Biologic Markers in Acute Lung InjuryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article provides a review of biologic markers in acute lung injury, with an emphasis on recent analysis of results from multicenter clinical trials. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - May 21, 2009 Category: Intensive Care Authors: Levitt, J. E., Gould, M. K., Ware, L. B., Matthay, M. A. Tags: Article Source Type: journals

Book Review: Atlas of Airway Management: Techniques and Tools By Steven Orebaugh Lippincott, Williams & Wilkins, 2006 Price of Book: $69.95Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - March 18, 2009 Category: Intensive Care Authors: Mueller, C. Tags: Article Source Type: journals

Bedside Insertion of Inferior Vena Cava Filters by a Medical Intensivist: Preliminary ResultsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a ``medical intensivist's'' experience with the placement of 13 percutaneous vena cava filters. Vena cava filters were successfully placed in 12 of 13 patients as confirmed by postplacement venacavograms; 1 placement attempt was aborted because of a completely occluded inferior vena cava. These results suggest that with appropriate training and supervision, medical intensivists can safely insert vena cava filters in the intensive care unit setting. Such a practice appears safe, reduces patient risk associated with intrahospital transport, and may promote cost containment. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - March 18, 2009 Category: Intensive Care Authors: Haley, M. W., Christmas, A. B., Sing, R. F. Tags: Article Source Type: journals

Mycobacterium avium Septicemia With ARDS in a Patient With Diabetes Mellitus and No Other Known Immune-compromising ConditionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 39-year-old diabetic male sustained 4 culture-proven episodes of disseminated Mycobacterium avium complex infection over a span of 6 years. The first, second, and fourth episodes were manifested clinically by osteomyelitis. The third episode was characterized by Mycobacterium avium complex septicemia (positive blood cultures for Mycobacterium avium complex) and acute respiratory failure with features of acute respiratory distress syndrome requiring mechanical ventilation and positive end-expiratory pressure for up to 30 days. Studies for impaired immunity including human immunodeficiency virus infection, idiopathic CD4+ ...
Source: Journal of Intensive Care Medicine - March 18, 2009 Category: Intensive Care Authors: Baylor, P., Larson, R. Tags: Article Source Type: journals

Brain Injury and Fever: Hospital Length of Stay and Cost OutcomesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Fever has been shown to be related to extended hospital stays in neurologically injured patients. We performed meta-analyses of the impact of fever on length of stay (LOS) in the Intensive Care Unit (ICU) and for total hospital length of stay, including all recent scholarship published since 1/1/1995 pertaining to thermoregulation of neurogenic fever and length of hospital stay. We also developed estimates of the financial impact on hospital costs. Fever was shown to have a large, statistically significant impact on both ICU and hospital LOS. For ICU LOS, combined effect size g = .88, Z = 4.24, P < .0001. For hospital L...
Source: Journal of Intensive Care Medicine - March 18, 2009 Category: Intensive Care Authors: Reaven, N. L., Lovett, J. E., Funk, S. E. Tags: Article Source Type: journals

The Effects of Ventilatory Mode on Lung Aeration Assessed With Computer Tomography: A Randomized Controlled StudyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Maintenance of spontaneous breathing superimposed on mechanical ventilation is suggested to improve gas exchange in patients with acute lung injury. The aim of this study was to evaluate the long-term effects of airway pressure release ventilation with maintained unsupported spontaneous breathing (APRV) and synchronized intermittent mandatory ventilation with pressure support (SIMV) on the amount of lung collapse in acute lung injury patients. Thirty-seven patients with acute lung injury were studied in a trial comparing APRV or SIMV. Computer-assisted tomography scannings (CT) were performed before randomization and at da...
Source: Journal of Intensive Care Medicine - March 18, 2009 Category: Intensive Care Authors: Varpula, T., Valta, P., Markkola, A., Pohjanen, K., Halavaara, J., Hynynen, M., Pettila, V. Tags: Article Source Type: journals

Recombinant Activated Factor VII Following Pediatric Cardiac SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Hemostasis occurred in 25 postoperative pediatric cardiac patients after recombinant activated Factor VII was given. In this setting, once conventional hemostatic therapy was optimized, recombinant activated Factor VII 180 µg/kg initially with intercostal losses greater than 10 mL/kg/h and a repeat dose after 2 hours if losses remained greater than 5 mL/kg/h was effective. No complications were found to have occurred and there was a coincidental reduction in annual returns to theatre for excessive bleeding. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - March 18, 2009 Category: Intensive Care Authors: Kylasam, S., Mos, K., Fijtin, S., Webster, B., Chard, R., Egan, J. Tags: Article Source Type: journals

Review of A Large Clinical Series: Intrahospital Transport of Critically Ill Patients: Outcomes, Timing, and PatternsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The purpose of this study was to analyze the relationship of intrahospital transport patterns with patient throughput and outcomes in an oncological intensive care unit. We retrospectively reviewed all patients admitted to a closed medical-surgical intensive care unit at a cancer center between January 1, 2004 and December 31, 2005. We compared the clinical characteristics and outcomes of patients with and without transport and analyzed all intrahospital transports in relation to intensive care unit occupancy, length of stay, and intensive care unit and hospital outcomes. Transport patterns were also assessed by day of wee...
Source: Journal of Intensive Care Medicine - March 18, 2009 Category: Intensive Care Authors: Voigt, L. P., Pastores, S. M., Raoof, N. D., Thaler, H. T., Halpern, N. A. Tags: Article Source Type: journals

Blood Pressure Management in Acute Head InjuryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Head injury remains a major cause of preventable death and serious morbidity in young adults. Based on the available evidence, it appears that a cerebral perfusion pressure of 50 to 70 mm Hg is generally adequate to ensure cerebral oxygen delivery and prevent ischemia. However, evidence suggests that perfusion requirements may not only vary across the injured brain but also differ depending on the time since injury. Such heterogeneity, both within and between subjects, suggests that individualized therapy may be an appropriate treatment strategy. Future studies should aim to assess which groups of patients, and what region...
Source: Journal of Intensive Care Medicine - March 18, 2009 Category: Intensive Care Authors: Trivedi, M., Coles, J. P. Tags: Article Source Type: journals

Analytic Reviews: Considerations in Caring for the Critically Ill Older PatientEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article will review important physiologic changes of aging, as well as sepsis and delirium and outcomes of older ICU patients. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - March 18, 2009 Category: Intensive Care Authors: Pisani, M. A. Tags: Article Source Type: journals

Multiple Organ Failure Following Near-fatal Exertional Heat StrokeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe the clinical features of a patient with near-fatal heat stroke who was admitted to our intensive care unit. A 14-year-old girl became convulsive and hyperthermic when participating in a strenuous hike under direct sunlight in a hilly area in Venezuela on a very hot and humid day. During the following days, she developed multiple organ failure, including neurological impairment, acute renal failure, disseminated intravascular coagulation, and extensive hepatic and muscle damage. Treatment consisted of ventilatory support, hemodialysis, corticosteroids, and enteral nutrition. This case of multiple organ failure f...
Source: Journal of Intensive Care Medicine - January 14, 2009 Category: Intensive Care Authors: Trujillo, M. H., Bellorin-Font, E., Fragachan, C. F., Perret-Gentil, R. Tags: Article Source Type: journals

Diagnostic Efficacy and Prognostic Value of Serum Procalcitonin Concentration in Patients With Suspected SepsisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The diagnostic accuracy of procalcitonin was higher than C-reactive protein and complement proteins. Procalcitonin in combination with Sequential Organ Failure Assessment was useful to diagnose infection. C-reactive protein, Sequential Organ Failure Assessment score, age, and gender showed to be helpful to improve the prediction of mortality risk, but not procalcitonin. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - January 14, 2009 Category: Intensive Care Authors: Ruiz-Alvarez, M.J., Garcia-Valdecasas, S., De Pablo, R., Sanchez Garcia, M., Coca, C., Groeneveld, T.W., Roos, A., Daha, M.R., Arribas, I. Tags: Article Source Type: journals

The Impact of a Simple, Low-cost Oral Care Protocol on Ventilator-associated Pneumonia Rates in a Surgical Intensive Care UnitEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The implementation of a simple, low-cost oral care protocol in the surgical intensive care unit led to a significantly decreased risk of acquiring ventilator-associated pneumonia. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - January 14, 2009 Category: Intensive Care Authors: Sona, C. S., Zack, J. E., Schallom, M. E., McSweeney, M., McMullen, K., Thomas, J., Coopersmith, C. M., Boyle, W. A., Buchman, T. G., Mazuski, J. E., Schuerer, D. J. E. Tags: Article Source Type: journals

A New Immunomodulatory Therapy for Severe Sepsis: Ulinastatin Plus Thymosin {alpha} 1Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Combined immunomodulatory therapy with ulinastatin plus thymosin 1 appears to yield improved survival for patients with sepsis; this finding should be verified in larger clinical trials. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - January 14, 2009 Category: Intensive Care Authors: Li Yumin, , Chen Hao, , Li Xun, , Zhou Wence, , He Minyan, , Chiriva-Internati, M., Wachtel, M.S., Frezza, E.E. Tags: Article Source Type: journals

Review of A Large Clinical Series: Association of Cumulative Fluid Balance on Outcome in Acute Lung Injury: A Retrospective Review of the ARDSnet Tidal Volume Study CohortEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Negative cumulative fluid balance at day 4 of acute lung injury is associated with significantly lower mortality, independent of other measures of severity of illness. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - January 14, 2009 Category: Intensive Care Authors: Rosenberg, A. L., Dechert, R. E., Park, P. K., Bartlett, R. H., NIH NHLBI ARDS Network Tags: Article Source Type: journals

The Utility of the Clinical Pulmonary Infection ScoreEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The most common infectious complication in critically ill patients is ventilator-associated pneumonia. Ventilator-associated pneumonia has significant morbidity and mortality, prolongs mechanical ventilation, and extends length of hospitalization. Despite its prevalence and impact, uniform diagnostic standards are lacking. The Centers for Disease Control, American Thoracic Society, and Infectious Diseases Society of America have recommended focus on improving preventive measures, establishing widely available and accurate diagnostic tools, and improving ventilator-associated pneumonia management with length of therapy guid...
Source: Journal of Intensive Care Medicine - January 14, 2009 Category: Intensive Care Authors: Rosbolt, M. B., Sterling, E. S., Fahy, B. G. Tags: Article Source Type: journals

Atrial Fibrillation After Cardiac Surgery: Does Prophylactic Therapy Decrease Adverse Outcomes Associated With Atrial FibrillationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Atrial fibrillation is a common problem following cardiac surgery. Atrial fibrillation occurs in 30% to 50% patients during postoperative period. Postoperative atrial fibrillation often results in increased length of hospital stay, increased cost of postoperative hospitalization, heart failure, and, less frequently, cerebrovascular accident and death. Because postoperative atrial fibrillation is such a significant problem, several studies have attempted to find a safe and effective treatment for its prevention. In this article, we review the evidence for various prophylactic therapies and make an attempt to answer the foll...
Source: Journal of Intensive Care Medicine - January 14, 2009 Category: Intensive Care Authors: Shrivastava, R., Smith, B., Caskey, D., Reddy, P. Tags: Article Source Type: journals

Analytic Reviews: Postoperative Infectious Complications of Abdominal Solid Organ TransplantationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There is a rapidly growing population of immunocompromised organ transplant recipients. These patients are at risk of a large variety of infections that have significant consequences on mortality, graft dysfunction, and graft loss. The diagnosis and treatment of these infections are facilitated by an understanding of the preoperative, perioperative, and postoperative risk factors; the typical pathogens; and their characteristic time of presentation. On the basis of these factors, we put forth an algorithm for diagnosing and treating suspected infections in solid organ transplant recipients. (Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - January 14, 2009 Category: Intensive Care Authors: Hlava, N., Niemann, C. U., Gropper, M. A., Melcher, M. L. Tags: Article Source Type: journals

Propylene Glycol Accumulation During Continuous-infusion Lorazepam in Critically Ill PatientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Intensive Care Medicine)
Source: Journal of Intensive Care Medicine - November 19, 2008 Category: Intensive Care Authors: Nelsen, J. L., Haas, C. E., Habtemariam, B. Tags: Article Source Type: journals