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Total 55 results found since Jan 2013.

A novel risk score to predict 1-year functional outcome after intracerebral hemorrhage and comparison with existing scores
IntroductionSpontaneous intracerebral hemorrhage (ICH) is one of leading causes of mortality and morbidity worldwide. Several predictive models have been developed for ICH; however, none of them have been consistently used in routine clinical practice or clinical research. In the study, we aimed to develop and validate a risk score for predicting 1-year functional outcome after ICH (ICH Functional Outcome Score, ICH-FOS). Furthermore, we compared discrimination of the ICH-FOS and 8 existing ICH scores with regard to 30-day, 3-month, 6-month, and 1-year functional outcome and mortality after ICH. Methods: The ICH-FOS was de...
Source: Critical Care - November 29, 2013 Category: Intensive Care Authors: Ruijun JiHaipeng ShenYuesong PanPenglian WangGaifen LiuYilong WangHao LiXingquan ZhaoYongjun Wang Source Type: research

Pavane for a pulse pressure variation defunct
Hemodynamic management of critically ill patients in the ICU or high-risk patients in the operating room has paradoxically shown progress in terms of outcome after the systematic application of volume responsiveness/flow optimization based on pulse pressure variation and/or stroke volume variation during controlled, positive-pressure ventilation in patients without spontaneous respiratory efforts. This assessment of circulatory optimization should ideally be based on an exhaustive, predictive and coherent physiological understanding of the cardiovascular system model. This paper sketches the extremely complex physiological...
Source: Critical Care - November 14, 2013 Category: Intensive Care Authors: Soren Sondergaard Source Type: research

Role of calcium desensitization in the treatment of myocardial dysfunction after deep hypothermic circulatory arrest
This study investigated the acute overall hemodynamic and metabolic effects of epinephrine and levosimendan, a calcium sensitizer, on myocardial function after rewarming from DHCA. Methods: Forty male Wistar rats (400--500 g) underwent cardiopulmonary bypass (CPB) through central cannulation and were cooled to a core temperature of 13[degree sign]C to 15[degree sign]C within 30 minutes. After DHCA (20 minutes) and CPB-assisted rewarming (60 minutes) rats were randomly assigned to 60 minute intravenous infusion with levosimendan (0.2 mug/kg/min; n = 15), epinephrine (0.1 mug/kg/min; n = 15) or saline (control; n = 10). Syst...
Source: Critical Care - October 20, 2013 Category: Intensive Care Authors: Alessio RungatscherSeth HallströmAlice GiacomazziDaniele LinardiElisabetta MilaniMaddalena TessariGiovanni LucianiTiziano ScarabelliAlessandro MazzuccoGiuseppe Faggian Source Type: research

Blood transfusion for upper gastrointestinal bleeding: is less more again?
The objective was to prove that the restrictive threshold for red blood cell transfusion in patients with acute upper GI bleeding (UGIB) was safer and more effective than a liberal transfusion strategy.Design: A single-center, randomized controlled trial was conducted.Setting: Patients with GI bleeding were admitted to the de la Santa Creu i Sant Pau hospital in Barcelona, Spain.Subjects: The subjects were adult intensive care unit patients admitted with high clinical suspicion of UGIB (hematomemesis, melena, or both). Patients were excluded if they had massive exsanguinating bleeding, acute coronary syndrome, symptomatic ...
Source: Critical Care - September 24, 2013 Category: Intensive Care Authors: Mohammed Al-JaghbeerSachin Yende Source Type: research

Pattern of brain injury in the acute setting of human septic shock
Conclusions: Brain MRI in septic shock patients who developed acute brain dysfunction can reveal leukoencephalopathy and ischemic stroke, which is associated with DIC and increased mortality.
Source: Critical Care - September 18, 2013 Category: Intensive Care Authors: Andrea PolitoFrédéric EischwaldAnne-Laure Le MahoAngelo PolitoEric AzabouDjillali AnnaneFabrice ChrétienRobert StevensRobert CarlierTarek Sharshar Source Type: research

Impact of early versus late enteral nutrition on cell mediated immunity and its relationship with Glucagon Like Peptide-1 in intensive care unit patients: a prospective study
Conclusions: Our findings suggest that early enteral feeding may cause amelioration in cell mediated immunity via factors other than GLP-1 in ICU patients with acute thromboembolic stroke. However, the possible deleterious effects of parenteral nutrition cannot be ruled out.
Source: Critical Care - June 20, 2013 Category: Intensive Care Authors: Okan BakinerEmre BozkirliSemih GirayZulfikar ArlierIlknur KozanogluNurzen SezginCagla SariturkEda Ertorer Source Type: research

Antithrombin attenuates myocardial dysfunction and reverses systemic fluid accumulation following burn and smoke inhalation injury: a randomized, controlled, experimental study
Conclusions: Based on these findings, the supplementation of rhAT may represent a valuable therapeutic approach for cardiovascular dysfunction and inflammation after burn and smoke inhalation injury.
Source: Critical Care - May 11, 2013 Category: Intensive Care Authors: Sebastian RehbergYusuke YamamotoEva BarthaLinda SousseCollette JonkamYong ZhuLillian TraberRobert CoxDaniel TraberPerenlei Enkhbaatar Source Type: research

Antiplatelet therapy: a double-edged sword in head injury?
Antiplatelet therapy for the treatment of cardiovascular diseases is common in the ageing population. Whether this therapy exacerbates brain injury after head trauma is an important, but unsettled, topic. In this issue of Critical Care, Fabbri and colleagues address the question of whether pre-injury intake of antiplatelet medication increases the risk profile of patients with posttraumatic intracranial lesions after head trauma. Antiplatelet medication, and in particular clopidogrel, increased the risk for haematoma progression, need for neurosurgical intervention and an unfavourable outcome. Clinicians should consider th...
Source: Critical Care - April 23, 2013 Category: Intensive Care Authors: Christopher BeynonOliver Sakowitz Source Type: research

Functional haemodynamics during surgery: should it be used for all high-risk cases?
The administration of a fluid bolus is done frequently in the perioperative period in order to increase the cardiac output. And yet, fluid loading fails to increase the cardiac output in more than 50% of critically ill and surgical patients. Thus, the assessment of fluid responsiveness (the slope of the left ventricular function curve) prior to fluid administration may not only help in the detecting patients in need of fluids (e.g., latent hypovolemia) but may also prevent unnecessary and harmful fluid overload. Unfortunately, commonly used hemodynamic parameters, including the cardiac output itself, are poor predictors of...
Source: Critical Care - January 28, 2013 Category: Intensive Care Authors: Azriel PerelMarit HabicherMichael Sander Source Type: research

Acute Stroke Care
Ken Uchino, Jennifer Pary, James Grotta: Acute Stroke Care. 2nd edition. Cambridge University Press, 2011, 234 pp., ISBN-13: 978-0521184847
Source: Critical Care - January 16, 2013 Category: Intensive Care Authors: Allyson ZazuliaMichael Diringer Source Type: research