Search results for " Intensive Care Medicine"

Vitamin D serum levels in multiorgan failure critically ill patients undergoing continuous renal replacement therapies

2020

Introduction Severe vitamin D deficiency in critically ill patients is linked to mortality. There are no scientific data regarding vitamin D status in critically ill patients undergoing continuous renal replacement therapies. Material and methods We aimed to measure vitamin D serum levels in critically ill patients with multi-organ failure undergoing continuous renal replacement therapies. Vitamin D serum measurements in 12-hour time intervals were performed in 20 patients undergoing continuous renal replacement therapies through continuous veno-venous haemodiafiltration (the study group). The results were then compared with the historical control group (20 patients without renal replacemen…

High-flow nasal cannula versus non-invasive ventilation for acute hypercapnic respiratory failure in adults: a systematic review and meta-analysis of…

2022

Abstract Background Non-invasive ventilation (NIV) with bi-level positive pressure ventilation is a first-line intervention for selected patients with acute hypercapnic respiratory failure. Compared to conventional oxygen therapy, NIV may reduce endotracheal intubation, death, and intensive care unit length of stay (LOS), but its use is often limited by patient tolerance and treatment failure. High-flow nasal cannula (HFNC) is a potential alternative treatment in this patient population and may be better tolerated. Research question For patients presenting with acute hypercapnic respiratory failure, is HFNC an effective alternative to NIV in reducing the need for intubation? Methods We sear…

Impaired Cardiopulmonary Exercise Capacity in Patients With Hyperthyroidism

1996

Hyperthyroidism (H) has been implicated as a primary cause of decreased exercise tolerance. To our knowledge, analysis of respiratory gas exchange, an efficient noninvasive method in evaluating cardiopulmonary capacity, has not been performed in patients with H.Using cardiopulmonary exercise testing, 12 consecutive women with Graves' H were examined and controlled in euthyroidism (E). Eighteen women with E, in whom cardiac catheterization had ruled out heart disease, served as control subjects (C).The ventilatory anaerobic threshold was determined by means of the V-slope method. Ergometry was performed with patients in a semisupine position using a continuous ramp protocol of 20 W/min. Echo…

Sputum metalloproteinase-9/tissue inhibitor of metalloproteinase-1 ratio correlates with airflow obstruction in asthma and chronic bronchitis

1998

Asthma and chronic bronchitis are inflammatory diseases with extracellular matrix (ECM) remodeling and collagen deposition. Collagen homeostasis is controlled by metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). We evaluated MMP and TIMP balance in induced sputum of 10 control, 31 untreated asthmatic, and 16 chronic bronchitic subjects. We first performed zymographic analysis to identify the profile of MMPs. Zymography revealed a similar MMPs profile in all populations studied and that MMP-9 was the major enzyme released. We then measured, using enzyme immunoassay, the concentrations of MMP-9 and of its inhibitor TIMP-1 and evaluated whether airflow limitation m…

Increased Levels of Elastase and α1-Antitrypsin in Sputum of Asthmatic Patients

1998

Asthma and chronic bronchitis are inflammatory diseases associated with remodeling of the extracellular matrix (ECM). Elastin, a major component of the ECM in the airways, has been previously found to be disrupted in asthma and chronic bronchitis. This study was aimed at evaluating whether elastin disruption might be associated with an imbalance between elastase (active and total) and alpha1-proteinase inhibitor (alpha1-PI), the main inhibitor of elastase. We measured elastase and alpha1-PI in induced sputum obtained from 16 control subjects, 10 healthy smokers, 19 asthmatic patients, and 10 chronic bronchitis patients. We also assessed the possible origin of elastase, evaluating its levels…

Noninvasive ventilation in chest trauma: systematic review and meta-analysis

2013

Purpose: Single studies of Noninvasive Ventilation (NIV) in the management of acute respiratory failure in chest trauma patients have produced controversial findings. The aim of this study is to critically review the literature to investigate whether NIV reduces mortality, intubation rate, length of stay and complications in patients with chest trauma, compared to standard therapy. Methods: We performed a systematic review and meta-analysis of randomized controlled trials, prospective and retrospective observational studies, by searching PubMed, EMBASE and bibliographies of articles retrieved. We screened for relevance studies that enrolled adults with chest trauma who developed mild to sev…

Poor timing and failure of source control are risk factors for mortality in critically ill patients with secondary peritonitis

2022

PURPOSE: To describe data on epidemiology, microbiology, clinical characteristics and outcome of adult patients admitted in the intensive care unit (ICU) with secondary peritonitis, with special emphasis on antimicrobial therapy and source control. METHODS: Post hoc analysis of a multicenter observational study (Abdominal Sepsis Study, AbSeS) including 2621 adult ICU patients with intra-abdominal infection in 306 ICUs from 42 countries. Time-till-source control intervention was calculated as from time of diagnosis and classified into 'emergency' ( 6 h). Relationships were assessed by logistic regression analysis and reported as odds ratios (OR) and 95% confidence interval (CI). RESULTS: The…

Primary thromboprophylaxis for adult patients on home parenteral nutrition: A comment on the 2016 ESPEN guideline

2016

Transcranial Doppler ultrasonography in the assessment of cerebral circulation arrest: improving sensitivity by trancervical and transorbital carotid…

2009

INTRODUCTION: Transcranial Doppler (TCD) can detect the cerebral circulation arrest (CCA) in brain death. TCD is highly specific, but less sensitive because of false-negatives accounting for up to 10%. The aim of the study was to explore the diagnostic accuracy of TCD and to determine whether it can be augmented by strategies such as the insonation of the extracranial internal carotid artery (ICA) and sequential examinations. METHODS: Data of 184 patients, who met clinical criteria of brain death, observed from 1998 through 2006, were retrospectively reviewed. The study of cerebral arteries was performed through the transtemporal approach, suboccipital insonation of the vertebro-basilar sys…

How to evaluate first aid skills after training: a systematic review

2022

Abstract Background To be able to help and save lives, laypersons are recommended to undergo first aid trainings. The aim of this review was to explore the variety of the elements of the measuring systems to assess the effects of first aid trainings on different aspects of first aid skills including practical skills, knowledge, and emotional perspectives. Methods This systematic literature review used Scopus and PubMed databases and searched for studies published between January, 2000, and December, 2020. Out of 2,162 studies meeting the search criteria, 15 studies with quantitative and repeatable evaluation methods to assess first aid skills after first aid training for adults were include…