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Brain Oxygenation Optimization After Severe Traumatic Brain Injury: An Ode to Preventing Brain Hypoxia
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Brain Oxygen Optimization in Severe Traumatic Brain Injury and Outcome
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Long-Term Mortality in Extracorporeal Membrane Oxygenation
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

How Important is a Discharge Diagnosis of Critical Illness Polyneuromyopathy?
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

How Feasible and Effective Is Early Physical Therapy for Patients on Extracorporeal Membrane Oxygenator?
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Aspiration Pneumonia as a Cause of Death in Critically Ill Patients with Dysphagia After Extubation
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Effects of Tapered-Cuff Shape and Continuous Control of Cuff Pressure on Microaspiration: Against All Odds!
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Critical Care Organizations: Building and Integrating Academic Programs
Conclusions: We present the rationale for critical care programs to transition to integrated Critical Care Organizations within academic medical centers and provide recommendations and resources to facilitate this transition and foster Critical Care Organization effectiveness and future success. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Review Article Source Type: research

Prevalence of Anxiety and Depression Symptomatology in Adolescents Faced With the Hospitalization of a Loved One in the ICU*
Conclusions: Anxiety and depression symptomatology is common in adolescent family members of ICU patients. An open visiting policy for adolescents is recommended, with visit planning, information meetings, and individual support from ICU staff. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Brief Reports Source Type: research

Chloride and Other Electrolyte Concentrations in Commonly Available 5% Albumin Products
This study quantifies previously undocumented chloride concentrations of three 5% albumin solutions using biochemical analysis. Design: We performed blinded analysis of the electrolyte concentration of albumin samples obtained directly from the national blood supplier (Canadian Blood Services). Two-tailed independent t tests were performed for all possible comparative analyses. Analysis of variance testing was performed for relevant three-way comparisons. Significance threshold was set at p less than 0.05. Setting: All samples were analyzed in the core laboratory at an academic hospital associated with McMaster Unive...
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Brief Reports Source Type: research

Renal Tubular Cell Mitochondrial Dysfunction Occurs Despite Preserved Renal Oxygen Delivery in Experimental Septic Acute Kidney Injury
Conclusions: Renal dysfunction in sepsis occurs independently of hemodynamic instability or structural damage. Mitochondrial dysfunction mediated by circulating mediators that induce local oxidative stress may represent an important pathophysiologic mechanism. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Laboratory Investigation Source Type: research

Lack of Early Improvement Predicts Poor Outcome Following Acute Intracerebral Hemorrhage
Conclusions: Lack of clinical improvement at 24 hours robustly predicted poor outcome and showed good discrimination for individual patients who would do poorly. These findings are useful for prognostication and may also present as a potential early surrogate outcome for future intracerebral hemorrhage treatment trials. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Temporal Trends in Healthcare Costs and Outcome Following ICU Admission After Traumatic Brain Injury
Objective: To assess temporal trends in 1-year healthcare costs and outcome of intensive care for traumatic brain injury in Finland. Design: Retrospective observational cohort study. Setting: Multicenter study including four tertiary ICUs. Patients: Three thousand fifty-one adult patients (≥ 18 yr) with significant traumatic brain injury treated in a tertiary ICU during 2003–2013. Intervention: None. Measurements and Main Results : Total 1-year healthcare costs included the index hospitalization costs, rehabilitation unit costs, and social security reimbursements. All costs are reported as 2013 U....
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Medical Versus Surgical ICU Obese Patient Outcome: A Propensity-Matched Analysis to Resolve Clinical Trial Controversies
Objectives: To determine the short- and long-term mortality of obese ICU patients following medical as opposed to surgical admission and the relation between obesity and mortality. Design: Retrospective analysis of prospectively collected data, using a propensity score–matched analysis of patients with medical or surgical admission. Setting: One French mixed medical-surgical ICU. Patients: Critically ill obese patients (body mass index ≥ 30 kg/m2) and nonobese patients admitted during a 14-year period. Interventions: None. Measurements and Main Results: Seven-hundred ninety-one obese patien...
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

How Do You Feel? Subjective Perception of Recovery as a Reliable Surrogate of Cognitive and Functional Outcome in Cardiac Arrest Survivors
Objectives: To show that subjective estimate of patient’s condition is related to objective cognitive and functional outcome in cardiac arrest survivors. Design: Longitudinal cohort study. Setting: ICU and Neuropsychology Service in two hospitals in Switzerland. Patients: Fifty survivors included from a prospective cohort of 138 patients admitted at the ICU for cardiopulmonary arrest. Interventions: Comprehensive cognitive and functional evaluation at 6 months follow-up. Measurements and Main Results: Subjectively, 70% of survivors reported satisfactory recovery and 29% reported no complaints. Object...
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

The Cumulative Partial Pressure of Arterial Oxygen Is Associated With Neurological Outcomes After Cardiac Arrest Treated With Targeted Temperature Management
Conclusion: In a new method for PaO2 analysis, cumulative exposure to hyperoxia was associated with neurologic outcomes in a dose-dependent manner. Greater attention to oxygen supply during the first 6 hours appears to be important for outcome after cardiac arrest. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Age-Based Ignorance in Family-Centered Care*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Sepsis-Induced Renal Failure: Ischemia or Toxemia?*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Fueling the Flames: Hyperoxia and Comprehensive Postresuscitation Care*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Estimating Pediatric Acute Respiratory Distress Syndrome Outcomes From Oxygenation Variables*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Looking Into the Seeds of Time to Say Which Fevers Will Grow and Which Will Not*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

The First Steps in Understanding of Transfusion-Associated Circulatory Overload—We Are on a “Roll”*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Aftermath of Respiratory Failure: Recovery or Decline?*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

A Fine Balance for Oxygen in Acute Respiratory Distress Syndrome*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Missed Opportunities for Better Sepsis Care or Misplaced Blame? Deconstructing Patients’ Encounters in the Week Before Sepsis Hospitalizations*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

First, Most, and Best: The Implications of Delays in Implementing Surviving Sepsis Campaign Guidelines*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Using Big Data to See the Big Picture in Sepsis*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Corticosteroids in Pediatric Septic Shock Are Not Helpful
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Viewpoints Source Type: research

Corticosteroids in Pediatric Septic Shock Are Helpful
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Viewpoints Source Type: research

Septic Cardiomyopathy
Conclusions: Septic cardiomyopathy is an important contributor to organ dysfunction in sepsis. Guided treatment of septic cardiomyopathy may affect patients’ prognosis, especially when their cardiac index is substantially decreased. The implication of septic cardiomyopathy for both short- and long-term outcomes is an important area for future investigation. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Concise Definitive Review Source Type: research

Risk Stratification Using Oxygenation in the First 24 Hours of Pediatric Acute Respiratory Distress Syndrome*
Conclusion: Oxygenation measured between 6 and 12 hours of acute respiratory distress syndrome onset accurately stratified outcomes in children. Our results have critical implications for the design of trials, especially for interventions with greater impact in early acute respiratory distress syndrome. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research

Development and External Validation of an Automated Computer-Aided Risk Score for Predicting Sepsis in Emergency Medical Admissions Using the Patient’s First Electronically Recorded Vital Signs and Blood Test Results*
Conclusions: We have developed a novel, externally validated computer-aided risk of sepsis, with reasonably good performance for estimating the risk of sepsis for emergency medical admissions using the patient’s first, electronically recorded, vital signs and blood tests results. Since computer-aided risk of sepsis places no additional data collection burden on clinicians and is automated, it may now be carefully introduced and evaluated in hospitals with sufficient informatics infrastructure. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Dedicated Afternoon Rounds for ICU Patients’ Families and Family Satisfaction With Care
Conclusions: Dedicated afternoon rounds for families twice a week may not necessarily improve an ICU’s overall family satisfaction. Increased dissatisfaction among families who do not or cannot participate is possible. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Determinants of Health-Related Quality of Life After ICU: Importance of Patient Demographics, Previous Comorbidity, and Severity of Illness
Objectives: ICU survivors frequently report reduced health-related quality of life, but the relative importance of preillness versus acute illness factors in survivor populations is not well understood. We aimed to explore health-related quality of life trajectories over 12 months following ICU discharge, patterns of improvement, or deterioration over this period, and the relative importance of demographics (age, gender, social deprivation), preexisting health (Functional Comorbidity Index), and acute illness severity (Acute Physiology and Chronic Health Evaluation II score, ventilation days) as determinants of health-re...
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Effect of a National Standard for Deteriorating Patients on Intensive Care Admissions Due to Cardiac Arrest in Australia
Conclusions: Introducing a national standard to improve the care of deteriorating patients was associated with reduced cardiac arrest–related ICU admissions and subsequent in-hospital mortality of such patients. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Contemporary Risk Factors and Outcomes of Transfusion-Associated Circulatory Overload*
Objectives: Transfusion-associated circulatory overload is characterized by hydrostatic pulmonary edema following blood transfusion. Restrictive transfusion practice may affect the occurrence and severity of transfusion-associated circulatory overload in critically ill patients. We sought to examine contemporary risk factors and outcomes for transfusion-associated circulatory overload. Design: Case-control study. Setting: Four tertiary care hospitals. Patients: We prospectively enrolled 200 patients with transfusion-associated circulatory overload identified by active surveillance and 405 controls matched by tra...
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Decrease in Histidine-Rich Glycoprotein as a Novel Biomarker to Predict Sepsis Among Systemic Inflammatory Response Syndrome
Objectives: Many biomarkers for sepsis are used in clinical practice; however, few have become the standard. We measured plasma histidine-rich glycoprotein levels in patients with systemic inflammatory response syndrome. We compared histidine-rich glycoprotein, procalcitonin, and presepsin levels to assess their significance as biomarkers. Design: Single-center, prospective, observational cohort study. Setting: ICU at an university-affiliated hospital. Patients: Seventy-nine ICU patients (70 with systemic inflammatory response syndrome and 9 without systemic inflammatory response syndrome) and 16 healthy volunte...
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Long-Term Return to Functional Baseline After Mechanical Ventilation in the ICU*
Conclusions: At 1- and 5-year follow-up, many patients who received mechanical ventilation for acute respiratory failure from all causes are no longer alive or have new moderate-to-severe functional impairment. Functional recovery between year 1 and year 5 is possible and common. Sepsis, stroke, illness severity, age, and comorbidities predict long-term functional outcome at intubation. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Erythropoietin Does Not Alter Serum Profiles of Neuronal and Axonal Biomarkers After Traumatic Brain Injury: Findings From the Australian EPO-TBI Clinical Trial
Conclusions: Serum ubiquitin carboxy-terminal hydrolase L1 and phosphorylated neurofilament heavy-chain increase after traumatic brain injury reflecting early neuronal and progressive axonal injury. Consistent with lack of improved outcome in traumatic brain injury patients treated with erythropoietin, biomarker concentrations and profiles were not affected by erythropoietin. Pharmacokinetics of erythropoietin suggest that the dose given was possibly too low to exert neuroprotection. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

An Interpretable Machine Learning Model for Accurate Prediction of Sepsis in the ICU
Conclusions: Using data available in the ICU in real-time, Artificial Intelligence Sepsis Expert can accurately predict the onset of sepsis in an ICU patient 4–12 hours prior to clinical recognition. A prospective study is necessary to determine the clinical utility of the proposed sepsis prediction model. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Early Identification of Acute Respiratory Distress Syndrome in the Absence of Positive Pressure Ventilation: Implications for Revision of the Berlin Criteria for Acute Respiratory Distress Syndrome
Conclusions: Almost all patients with pulmonary bilateral infiltrates and a PaO2/FIO2 less than or equal to 300 mm Hg under standard oxygen fulfilled the acute respiratory distress syndrome criteria under noninvasive ventilation within the first 24 hours. Their mortality rate was similar to that reported in the Berlin definition of acute respiratory distress syndrome. Therefore, spontaneous breathing patients with the acute respiratory distress syndrome criteria could be identified early without positive pressure ventilation. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Cardiac Arrest and Mortality Related to Intubation Procedure in Critically Ill Adult Patients: A Multicenter Cohort Study
Objectives: To determine the prevalence of and risk factors for cardiac arrest during intubation in ICU, as well as the association of ICU intubation–related cardiac arrest with 28-day mortality. Design: Retrospective analysis of prospectively collected data. Setting: Sixty-four French ICUs. Patients: Critically ill patients requiring intubation in the ICU. Interventions: None. Measurements and Main Results: During the 1,847 intubation procedures included, 49 cardiac arrests (2.7%) occurred, including 14 without return of spontaneous circulation (28.6%) and 35 with return of spontaneous circulation (...
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Effect of Boarding on Mortality in ICUs
Conclusions: Mortality increased with boarding of critically ill patients. Further research is needed to identify safer practices for managing patients during periods of high ICU occupancy. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Oxygen Exposure Resulting in Arterial Oxygen Tensions Above the Protocol Goal Was Associated With Worse Clinical Outcomes in Acute Respiratory Distress Syndrome*
Conclusions: Oxygen exposure resulting in arterial oxygen tensions above the protocol goal occurred frequently and was associated with worse clinical outcomes at all levels of acute respiratory distress syndrome severity. (Source: Critical Care Medicine)
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Healthcare Utilization and Infection in the Week Prior to Sepsis Hospitalization*
Objectives: To quantify healthcare utilization in the week preceding sepsis hospitalization to identify potential opportunities to improve the recognition and treatment of sepsis prior to admission. Design: Retrospective study. Setting: Two large integrated healthcare delivery systems in the United States. Participants: Hospitalized sepsis patients. Interventions: None. Measurements and Main Results: We quantified clinician-based encounters in each of the 7 days preceding sepsis admission, as well as on the day of admission, and categorized them as: hospitalization, subacute nursing facility, emergency dep...
Source: Critical Care Medicine - March 15, 2018 Category: Emergency Medicine Tags: Feature Articles Source Type: research