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Jansen Tim C - - 2009
BACKGROUND: Hyperlactatemia and its reduction after admission in the intensive care unit (ICU) have been related to survival. Because it is unknown whether this equally applies to different groups of critically ill patients, we compared the prognostic value of repeated lactate levels (a) in septic patients versus patients with hemorrhage ...
Peck G - - 2009
BACKGROUND: It seems that a balance between anti and pro-inflammatory responses must be kept to eliminate the pathogen without inducing inflammatory damage in the host. Thus we determined the relation between macrophage activation and the severity and clinical outcome in septic patients. MATERIAL AND METHODS: This was a prospective study ...
Mesquida Jaume - - 2009
OBJECTIVE: To validate thenar oxygen saturation (StO(2)) measured by near-infrared spectroscopy (NIRS) as a noninvasive estimation of central venous saturation (ScvO(2)) in septic patients. DESIGN: Prospective observational study. SETTING: A 26-bed medical-surgical intensive care unit at a university-affiliated hospital. PATIENTS: Patients consecutively admitted to the ICU in the early phase ...
Cartotto Robert - - 2009
The purpose of this study was to evaluate the effectiveness of, and complications associated with High Frequency Oscillatory Ventilation (HFOV) in burn patients with the Acute Respiratory Distress Syndrome (ARDS) who have had a smoke inhalation injury, and to compare with those without an inhalation injury. Burn patients with progressive ...
Hamalainen Sari - - 2009
Infectious complications are the main reason for early treatment-related mortality after autologous stem cell transplantation (ASCT). We evaluated retrospectively microbiological aetiology, risk factors and clinical consequences of severe sepsis in this patient cohort. From 1996 to 2006 a total of 319 patients underwent ASCT at our institution. Antibacterial prophylaxis was ...
Hofer Stefan - - 2009
INTRODUCTION: Severe sepsis, septic shock, and resulting organ failure represent the most common cause of death in intensive care medicine, with mortality ranging from 40% to 70%. It is still unclear whether necrosis or apoptosis plays the predominant role in severe sepsis. Determining the prevalent mode of cell death would ...
Albright Joslyn M - - 2009
The purpose of this study was to screen burn patients for alcohol use disorders to identify those at increased risk for repeat injury and adverse effects of alcohol use. We examined associations of at-risk drinking and dependence symptoms as measured by a formal screening tool and blood alcohol concentration (BAC) ...
Lima Alexandre - - 2009
The prognostic value of continuous monitoring of tissue oxygen saturation (StO2) during early goal-directed therapy of critically ill patients has not been investigated. We conducted this prospective study to test the hypothesis that the persistence of low StO2 levels following intensive care admission is related to adverse outcome. We followed ...
Panwar Rakshit - - 2009
Activated Protein C [APC] improves outcome in immunocompetent patients with severe sepsis particularly in those who are perceived to have high mortality risk. Before embarking on a trial of APC administration in immunocompromised septic patients, a preliminary study on plasma levels of protein C in this cohort is essential. To ...
Rinaldi Laura - - 2008
Recombinant human activated protein C (rhAPC) has been approved for use in patients with severe sepsis at high risk of death. Because of the high risk of bleeding, liver transplantation (LT) patients have been excluded from the randomized control trials that evaluated efficacy and safety of rhAPC and, thus, few ...
Kase Yoichi - - 2008
Arachidonylethanolamide (AEA) and 2-arachidonylglycerol (2-AG) are endocannabinoids involved in septic shock, and 8-epi prostaglandin F2alpha (F2-isoprostane) is a biomarker of oxidative stress in biological systems. Because the antibiotic polymyxin B absorbs endocannabinoids as well as endotoxins, direct hemoperfusion therapy with polymyxin B-immobilized fibers (PMX-DHP) decreases serum levels of endocannabinoids. To ...
Kumagai T - - 2008
Sleep apnea syndrome (SAS) is common in patients with end-stage renal disease (ESRD). Although the treatment of choice is continuous positive airway pressure (CPAP) particularly for obstructive SAS, long-term compliance is not satisfactory. We investigated the effectiveness of nocturnal oxygen therapy on sleep apnea and autonomic nervous dysfunction in peritoneal ...
Putz Zsuzsanna - - 2008
BACKGROUND: Due to the sensory loss in the lower extremities, accidental foot injuries may develop in diabetic patients with distal sensorimotor polyneuropathy. Unusual etiologies of foot injury may be of interest. CASE REPORTS: Patient 1, a 51-year-old type 2 diabetic patient, was observed with a burn injury of the digits ...
Wibbenmeyer Lucy A - - 2008
Community-associated methicillin-resistant Staphylococcus aureus (MRSA), particularly USA300, is a major pathogen in the outpatient setting. We suspected that USA300 had been introduced into our burn-trauma unit (BTU) when three burn patients presented with numerous simultaneous abscesses. We did molecular typing on 206 MRSA isolates from all patients on the BTU ...
Paulius Karina - - 2008
Laptop computers are an uncommon source of burns to the thighs and perineum. Burns can result from the prolonged contact of hot surfaces at the base of the computer with the user's lap. The authors report a case of second-degree burns to the thigh of an otherwise healthy patient that ...
Gillett Brian - - 2008
OBJECTIVES: High-fidelity patient simulation provides lifelike medical scenarios with real-time stressors. Mass casualty drills must construct a realistic incident in which providers care for multiple injured patients while simultaneously coping with numerous stressors designed to tax an institution's resources. This study compared the value of high-fidelity simulated patients with live ...
Vriesendorp Titia M - - 2008
PURPOSE OF REVIEW: In contrast to patients with diabetes mellitus, data on consequences of hypoglycemia in critically ill patients are sparse. The purpose of this review is to summarize available data on prevalence of hypoglycemia, risk factors, and possible consequences of hypoglycemia in critically ill patients. RECENT FINDINGS: There is ...
Vecchio S - - 2008
AIM: Percutaneous coronary interventions are increasingly applied to high-risk patients. The availability of hemodynamic support devices offers a promising option to prevent and treat low-output syndrome in these patients. The aim of this study was to evaluate the feasibility, safety and efficacy of the Impella Recover'' LP 2.5 left ventricular ...
Sakr Yasser - - 2008
OBJECTIVES: We investigated the time course of lipopolysaccharide binding protein (LBP) plasma concentrations in patients in the surgical intensive care unit (ICU), their value in discriminating sepsis from systemic inflammatory response syndrome, and their association with severity of sepsis and outcome in these patients compared with interleukin (IL)-6, C-reactive protein, ...
Abbasi Saify - - 2008
The study objectives were to confirm the incidence of cholestasis and determine factors that contribute to its development and the natural course of cholestasis in neonates treated with extracorporeal membrane oxygenation (ECMO). This was a retrospective chart review including all patients receiving ECMO between 1995 and 2005 at Kosair Children's ...
Knight William A WA - - 2008
A 37-year-old man was severely burned while trying to fill a lighter with fuel while smoking. He sustained full-thickness (third-degree) burns over 60% to 70% of his body, including the oropharynx. A ground-based paramedic was unable to orotracheally intubate the patient after the administration of morphine and diazepam. The flight ...
Chapital Alyssa D - - 2008
BACKGROUND: Limited resources and the expense of Activated Protein C (APC) (drotrecogin alfa) may contribute to the reluctance to utilize this drug in sepsis. Employing the PROWESS criteria resulted in absolute reduction in 28-day mortality of 6.1%, representing a relative risk reduction of 19.4%. Additional patient categorization and selection may ...
Ansari Zahid - - 2008
BACKGROUND: General practitioners play a vital role in reducing risk for people with epilepsy through pharmacological prevention of seizures. Burns are the most common injury sustained during epileptic seizure. This article examines the risk of burns among patients with epilepsy in Victoria. METHODS: A case control study was conducted using ...
Lindholm Matias G - - 2008
It has been speculated that invasive revascularization prevents development of cardiogenic shock. Data from randomised trials comparing angioplasty with fibrinolysis on the development of cardiogenic shock are lacking. To elucidate the effect of angioplasty on in-hospital development of cardiogenic shock compared to fibrinolysis. To evaluate whether mortality in patients who ...
Creteur Jacques - - 2008
PURPOSE OF REVIEW: Tissue hypoperfusion is a common pathophysiologic process leading to multiple-organ dysfunction and death. An important goal of hemodynamic monitoring is the early detection of inadequate tissue perfusion and oxygenation. The use of simple, noninvasive monitoring techniques has the advantage of facilitating earlier initiation of therapy. Near-infrared spectroscopy ...
Gressner Olav A - - 2008
BACKGROUND: Immune paralysis of phagocytic cells due to excess of the complement activation product C5a has been proposed as a critical pathomechanism in sepsis. In vitro studies suggest an interaction of C5a with Group-specific globulin (Gc-globulin). STUDY OBJECTIVES: To examine the predictive value of serum concentrations of both, C5a and ...
Klinger M - - 2008
BACKGROUND: Despite civilization and progress, burns occur frequently in the world. Remarkable discoveries of wound healing mechanisms have been reported. On the other hand, long-term outcomes from burn injuries represent a barrier to improvement of patients' social, functional, and psychological condition. Lipofilling, described since the 1980s, currently is used for ...
Goyal Navin - - 2008
INTRODUCTION: Galactorrhea and/or amenorrhea, although uncommonly reported in post-burn patients, is a complex problem to treat. Patient is reluctant to volunteer history of these symptoms, unless asked specifically. AIM: To study profile of adult female patients with galactorrhea and/or amenorrhea in post burn period. MATERIALS AND METHOD: A prospective study ...
Bak Z - - 2008
OBJECTIVES: Using transoesophageal echocardiography (TEE) we investigated the occurrence, and the association of possible abnormalities of motion of the regional wall of the heart (WMA) or diastolic dysfunction with raised troponin concentrations, or both during fluid resuscitation in patients with severe burns. PATIENTS AND METHODS: Ten consecutive adults (aged 36-89 ...
Rivers Emanuel P - - 2008
PURPOSE OF REVIEW: Aggressive approaches to acute diseases such as acute myocardial infarction, trauma, and stroke have improved outcomes. Early goal-directed therapy for severe sepsis and septic shock represents a similar approach. An analysis of the literature assessing external validity and generalizability of this intervention is lacking. RECENT FINDINGS: Eleven ...
Memon Abdul Razak - - 2008
OBJECTIVE: To determine the mean difference of serum creatine phosphokinase according to the extent of tissue damage and prognosis of the patients suffering from electrical burn injuries. STUDY DESIGN: A case series study. PLACE AND DURATION OF STUDY: Department of Burns, Liaquat University Hospital, Hyderabad, from September 2005 to August ...
Loeb L M - - 2008
Glossodynia or burning mouth syndrome is a multifunctional disorder. The oral mucosa is apparently normal but patients report burning and dried mouth and painful tongue and lips. The present study reports biochemical and physiological markers in saliva of patients presenting glossodynia compared to normal subjects. Saliva-buffering capacity and contents of ...
Guarneri B - - 2008
BACKGROUND: Critical illness myopathy (CIM) and polyneuropathy (CIP), alone or in combination (CIP/CIM), are frequent complications in patients in the intensive care unit (ICU). There is no evidence that differentiating between CIP and CIM has any impact on patient prognosis. METHODS: 1-year prospective cohort study of patients developing CIP, CIM ...
Jaskille Amín D - - 2008
Vasoplegia resulting from severe burns may persist despite adequate fluid resuscitation and treatment with norepinephrine (NE), vasopressin (VP), and steroids. The adenylate cyclase inhibitor methylene blue (MB), currently used in the burn patient to treat methemoglobinemia, has been used to treat vasoplegia after cardiopulmonary bypass. We report the case of ...
Mosier Michael J - - 2008
Inhalation injuries occur in approximately one third of all major burns and account for a significant number of deaths in burn patients each year. Previous studies have examined ventilator-associated pneumonia in patients with inhalation injury, but no study to date has evaluated the incidence of bacterial contamination of the airways ...
Singh Christopher N - - 2008
PURPOSE: To identify clinical characteristics of burn patients requiring emergent orbital decompression for vision-threatening orbital compartment syndrome. METHODS: A retrospective review of 28 burn patients at a trauma center provided data regarding demographics, physical examination findings, and resuscitation fluid volumes. Patients requiring orbital decompression were compared with those who did ...
Sato Mitsuo - - 2008
We investigated differences in the depth of hypoxia produced by apneic events of the same duration (30 seconds) amongst patients with different degrees of OSAS according to their AIs (apnea indices). The relationship between apnea duration (seconds) and fall in oxygen saturation (%) was evaluated by means of a linear ...
Yen Ting-Shan - - 2008
Acute cardiopulmonary failure in patients with increased intracranial pressure is a significant management challenge to physicians. We report on a 21-year-old patient with traumatic brain injury who developed intractable hypoxemia and hypotension after undergoing a decompressive craniotomy. Venoarterial extracorporeal membrane oxygenation was initiated to resuscitate the patient. Extracorporeal membrane oxygenation ...
Fengler Brian T - - 2008
Etomidate is an agent often used by emergency medicine physicians for rapid-sequence intubation induction of critically ill patients because of its reliable pharmacokinetics and cardiovascular stability. Etomidate is known to inhibit endogenous cortisol production through inhibition of 11beta-hydroxylase. Previous studies in undifferentiated emergency department patients and healthy, elective surgical patients ...
Boldt Joachim - - 2008
Many strategies were proposed for fluid management in burn patients with different composition containing saline solution, colloids, or plasma. The actual clinical use of volume replacement regimen in burn patients in Europe was analysed by an international survey. A total of 187 questionnaires consisting of 20 multiple-choice questions were sent ...
Ugburo A O - - 2008
BACKGROUND: A retrospective study of the presentation, etiology, and prognosis of non-burn epidermal loss managed at the Lagos University Teaching Hospital Nigeria over a 12-year period. MATERIALS AND METHODS: Admission records of patients managed for non-burn skin loss were retrieved from the medical records. Demographic details of the patients, the ...
Silva Sandra - - 2008
Oxidative stress (OS) and monocyte HLA-DR expression are known to be predictive of mortality in sepsis; nevertheless, limited information exists regarding sepsis with acute kidney injury (AKI). The aim of the study was to correlate these markers with outcome in septic patients with AKI requiring continuous renal replacement therapy (CRRT). ...
Formica Francesco - - 2008
Although microporous polypropylene hollow fiber oxygenators are standard devices used for extracorporeal membrane oxygenation (ECMO), they have limitations such as development of plasma leakage. Poly-methylpentene (PMP) is a new material used for the last generation of oxygenators. We reviewed our experience with a new PMP oxygenator (Quadrox D) and a ...
Dellinger R Phillip - - 2008
OBJECTIVE: To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock," published in 2004. DESIGN: Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, ...
Mayes Theresa - - 2008
Respiratory failure is associated with a high mortality rate in burned children. Recently, a specialized pulmonary enteral formula (SPEF) was commercially introduced as an adjunct intervention in acute lung injury management. SPEF contains condition-specific nutrients to modulate the inflammatory response. The study examined SPEF impact in critically ill, pediatric burn ...
Farrell Rebecca T - - 2008
Obesity may contribute to the functional decline in elderly adults. It can also increase the risk of mortality in burn patients. However, little data exist regarding the relationship between obesity and functional outcomes in patients with burns. Data were collected regarding admission body mass index (BMI), length of stay, TBSA ...
Mustonen Kukka-Maaria - - 2008
The purpose of this study was to establish the incidence and mortality of burn patients with acute renal failure (ARF) at the Helsinki Burn Centre and to analyze the associated factors. The files of 238 intensive care (ICU) patients of a total of 1380 burn patients admitted to our institution ...
Myburgh John A - - 2008
Small-volume resuscitation of critically ill patients with hyperoncotic albumin offers a number of theoretical advantages, such as increasing intravascular volume in excess of the volume of fluid administered and reducing interstitial edema. Whilst iso-oncotic albumin has been shown to be equi-effective to isotonic saline for the resuscitation of critically ill ...
Cochran Amalia - - 2008
Microalbuminuria is a known finding in inflammatory states. We hypothesized that urinary albumin/creatinine ratio (ACR) would correlate with injury severity and resuscitation demands after acute burns. This pilot study evaluated 30 adults admitted within 12 hours of injury with burns > or =10% total body surface area burn injury (TBSA). ...
Bagshaw Sean M - - 2008
Fluid therapy is fundamental to the acute resuscitation of critically ill patients. In general, however, early and appropriate goal-directed fluid therapy contributes to a degree of fluid overload in most if not all patients. Recent data imply that a threshold may exist beyond which, after acute resuscitation, additional fluid therapy ...
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