Early infections in the intensive care unit after liver transplantation ‐etiology and risk factors: A single‐center experience
ConclusionInfections represent a major cause of early postoperative morbidity and mortality. The impact of single risk factors and the results of their preoperative management should be further investigated in order to reduce the incidence and evolution of postoperative infections.
AbstractPurposeTo determine clinical predictors associated with corticosteroid administration and its association with ICU mortality in critically ill patients with severe influenza pneumonia.MethodsSecondary analysis of a prospective cohort study of critically ill patients with confirmed influenza pneumonia admitted to 148 ICUs in Spain between June 2009 and April 2014. Patients who received corticosteroid treatment for causes other than viral pneumonia (e.g., refractory septic shock and asthma or chronic obstructive pulmonary disease [COPD] exacerbation) were excluded. Patients with corticosteroid therapy were compare...
ConclusionInfections represent a major cause of early postoperative morbidity and mortality. The impact of single risk factors and the results of their preoperative management should be further investigated in order to reduce the incidence and evolution of postoperative infections.This article is protected by copyright. All rights reserved.
Conclusion: Ventilator-associated pneumonia was associated with a significant increase in ICU length of stay, time on mechanical ventilation and different complications.
An independent 82-year-old woman presented with fever (40 ⁰C) less than24 hours after discharge from a prolonged (2-months) admission at another hospital due to an acute coronary syndrome and pulmonary edema which required intubation and mechanical ventilation. Hospitalization was complicated by septic shock due to nosocomial pneumonia due to extended-sp ectrum beta-lactamase (ESBL)-producing klebsiella pneumonia found in multiple sputum, blood and urine cultures. Prior multimorbidity included diabetes, hypertension, myocardial infarction, chronic obstructive pulmonary disease and laminectomy (L2-4).
Conclusions Expanded CURB-65 score is simple, objective and more accurate scoring system for evaluation of CAP severity and can improve the efficiency of predicting the mortality in CAP patients, better than CURB-65 and PSI scores. Also, Expanded CUEB-65 may generate new therapeutic and prognostic modality in CAP especially in patients with liver cirrhosis.
Discussion Several preoperative patient risk factors and postoperative complications greatly increased the odds for patient mortality following 30-days after initial surgery. Orthopaedic surgeons can utilize these predictive risk factors to better improve patient care. Level of evidence Retrospective study. Level IV.
Conclusions SMART – cop score is the most sensitive score in predicting 28-day mortality in the studied patient followed by SMART – co and PSI score). SMART-cop score is the most specific one (Specificity=93%) in followed by Modified ATS score (Specificity=90%).
CONCLUSION: In conclusion, our findings in a retrospective cohort of respiratory ICU patients with VAP or NP revealed high ICU, short- and long-term case fatality rates within 1 year of diagnosis, regardless of the diagnosis of NP after 48 h of initial admission or after induction of ventilator support. COPD and presence of septic shock are associated with high fatality rate and our findings speculate that as increasing compliance with infection control programs and close monitoring especially in 2 months of discharge might reduce high-case fatality rate in patients with VAP and NP. PMID: 26542131 [PubMed - as supplied by publisher]
This study prospectively looks at 106 patients with either DVT or PE who were identified as low risk based on the Hestia criteria. All of the patients were started on rivaroxaban (a Factor Xa inhibitor) and none had VTE recurrence (while on anticoagulation), major bleeding events or death due to VTE. This study further supports outpatient management for low risk VTE but a randomized controlled trial is needed (keep your eye out for the MERCURY-PE study) Recommended by Anand Swaminathan Further reading: SGEM #126: Take me to the Rivaroxaban — Outpatient treatment of VTE (The Skeptics Guide to EM) Research and critic...
Abstract This review article describes two protocols adapted from lung ultrasound: the bedside lung ultrasound in emergency (BLUE)-protocol for the immediate diagnosis of acute respiratory failure and the fluid administration limited by lung sonography (FALLS)-protocol for the management of acute circulatory failure. These applications require the mastery of 10 signs indicating normal lung surface (bat sign, lung sliding, A-lines), pleural effusions (quad and sinusoid sign), lung consolidations (fractal and tissue-like sign), interstitial syndrome (lung rockets), and pneumothorax (stratosphere sign and the lung po...