Risk Factors for Ventilator-Associated Events in a PICU*
Objective: The term ventilator-associated events includes ventilator-associated condition, infection-related ventilator-associated complication, and ventilator-associated pneumonia. We sought to identify potential new risk factors for ventilator-associated condition and infection-related ventilator-associated complication in the PICU population. Design: Matched case control study. Setting: Children’s hospital at a tertiary care academic medical center. Patients: During the study period, 606 patients were admitted to PICU and ventilated more than 48 hours; 70 children met ventilator-associated condition criteria. Interventions: None. Measurements and Main Results: We applied the definition for ventilator-associated condition (i.e., a sustained increase in ventilator settings after a period of stable or decreasing support) to our database. Within ventilator-associated condition cases, 40 cases were infection-related ventilator-associated complication and 30 cases were noninfectious-related ventilator-associated condition. We identified 140 controls and matched to ventilator-associated condition cases with regard to age, immunocompromised status, and ventilator days to event. Patients with ventilator-associated condition had longer ICU stay versus controls; 24 days median (12–43 interquartile range) versus 7 days (4–14); (p
Conditions: Infections, Respiratory; Ventilator Associated Pneumonia Interventions: Other: VCV20; Other: VCV40; Other: PCV; Other: PCV+Tins; Other: PSV Sponsor: Brazilian Institute of Higher Education of Censa Completed
Empyema is a complication of community-acquired pneumonia. We conducted a retrospective analysis of empyema patients discharged from 1996 to 2016, examining culture results according to timing of antibiotic administration. Blood culture decreased from 45% to 4% after antibiotics, and pleural fluid culture yield decreased from 67% to 30%. More than half of methicillin-resistant Staphylococcus aureus cases occurred from 2011 to 2016.
We describe the first case of histologically-confirmed NEC caused by S. maltophilia accompanied by bacteremia and pneumonia after salvage chemotherapy for acute myeloid leukemia relapse following a second hematopoietic stem cell transplantation. S. maltophilia should be included as a pathogenic organism of NEC in severely immunocompromised patients to prevent a delayed diagnosis, which carries a high risk of inappropriate antimicrobial selection and fatal outcome. PMID: 30101922 [PubMed - as supplied by publisher]
Conclusions The results of the present study suggest that hITLN-1 may be involved in the pathogenesis of ICEP and HP, and that an increase in the hITLN-1 concentration in the BAL fluid may represent a new biomarker for these diseases. PMID: 30101907 [PubMed - as supplied by publisher]
What We Already Know about This TopicHuman mesenchymal stromal cells diminish injury and enhance recovery and repair after ventilator-induced lung injury in animalsCurrent methods of isolating mesenchymal stromal cells result in a heterogeneous mix of cell types, which may be suboptimalWhat This Article Tells Us That Is NewPure subpopulations of bone marrow –derived human mesenchymal stromal cells were isolated on the basis of expression of the cell surface marker syndecan 2Intravenous injection of these cells attenuatedEscherichia coli–induced injury and enhanced resolution of ventilator-induced lung injury in...
Condition: Pneumonia Interventions: Other: Clinical History; Other: Physical Exam Findings; Other: Laboratory Findings; Other: Lung Ultrasound Sponsor: Patan Academy of Health Sciences Recruiting
Pneumonia is a common cause of respiratory infection, accounting for more than 800,000 hospitalizations in the United States annually. Presenting symptoms of pneumonia are typically cough, pleuritic chest pain, fever, fatigue, and loss of appetite. Children and the elderly have different presenting features of pneumonia, which include headache, nausea, abdominal pain, and absence of one or more of the prototypical symptoms. Knowledge of local bacterial pathogens and their antibiotic susceptibility and resistance profiles is the key for effective pharmacologic selection and treatment of pneumonia.
Introduction: We hypothesized that aromatic microbial metabolites (AMM), such as phenyllactic (PhLA), p-hydroxyphenylacetic (p-HPhAA), and p-hydroxyphenyllactic (p-HPhLA) acids, contribute to the pathogenesis of septic shock. Methods: Clinical and laboratory data of patients with community-acquired pneumonia were obtained on intensive care unit admission and the next day. Patients were divided into two groups based on septic shock presence or absence. The levels of AMM (PhLA, p-HPhAA, p-HPhLA, and their sum, ∑3AMM), catecholamine metabolites (3,4-dihydroxymandelic [DHMA], 3,4-dihydroxyphenylacetic [DOPAC], and hom...
Conclusions: Intraperitoneal LPS injection in ApoE3*Leiden mice triggers a profound systemic inflammatory response, but does not increase atherosclerotic plaque area or inflammatory cell density. This model of LPS-induced inflammation in atherosclerosis-prone mice argues against intraplaque alterations as an explanation for acute inflammation-induced cardiovascular event risk.
In this study, in vitro plantlets and callus of Silybum marianum were exploited as a stabilising agent for the synthesis of zinc oxide (ZnO) NPs using zinc acetate and sodium hydroxide as a substitute for chemical method. The contemporary investigation defines the synthesis of ZnO NPs prepared by chemical and bio-extract-assisted methods. Characterisation techniques such as X-ray diffraction, scanning electron microscopy, Fourier transform infrared spectroscopy and energy dispersive X-ray were used to confirm the synthesis. Although chemical and bio-assisted methods are suitable choices for NPs synthesis, the bio-assisted ...