Search results for "critical illness."

showing 10 items of 91 documents

Respiratory support techniques to avoid desaturation in critically ill patients requiring endotracheal intubation: A systematic review and meta-analy…

2017

Abstract Purpose To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation. Methods We searched PubMed, Cochrane Library, Scopus and CINAHL databases. We included randomized (RCT) and non-randomized (non-RCT) studies investigating any method of respiratory support before/during ETI compared to a reference control. Results Apneic oxygenation (ApOx) was the most commonly investigated respiratory support technique for critically ill patients undergoing intubation (4 RCTs, 358 patients). Three of these studies investigated high-flow nasal cannula (HFNC) for ApOx while standard nasal cannula was used in …

Critical CareDatabases Factualmedicine.medical_treatmentAirway management; Apneic oxygenation; Endotracheal intubation; Noninvasive ventilation; Oxygen inhalation therapy; PreoxygenationCritical IllnessSettore MED/41 - AnestesiologiaEndotracheal intubationAirway managementCochrane LibraryCritical Care and Intensive Care Medicinemedicine.disease_causelaw.invention03 medical and health sciences0302 clinical medicineApneic oxygenationRandomized controlled triallawPreoxygenationmedicineIntubation IntratrachealIntubationCannulaHumansMED/41 - ANESTESIOLOGIAHypoxiabusiness.industryOxygen inhalation therapy030208 emergency & critical care medicineEndotracheal intubationRespiration ArtificialIntubation procedure030228 respiratory systemMeta-analysisAnesthesiaCritical IllneAirway managementbusinessRespiratory InsufficiencyNasal cannulaNoninvasive ventilationHuman
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Antimicrobial Lessons From a Large Observational Cohort on Intra-abdominal Infections in Intensive Care Units

2021

Severe intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by disease-specific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. I…

Drug Resistancemedicine.disease_causeSeverity of Illness Indexlaw.invention0302 clinical medicineENTEROBACTERIACEAElawDrug Resistance Multiple BacterialMedicine and Health SciencesPharmacology (medical)Cross InfectionbiologyBacterialAntimicrobialIntensive care unitAnti-Bacterial AgentsCommunity-Acquired InfectionsEuropeIntensive Care UnitsAnti-Bacterial Agents; Community-Acquired Infections; Critical Illness; Cross Infection; Europe; Humans; Intensive Care Units; Intraabdominal Infections; Microbial Sensitivity Tests; Peritonitis; Sepsis; Severity of Illness Index; Drug Resistance Multiple BacterialESCHERICHIA-COLI030220 oncology & carcinogenesisKLEBSIELLA-PNEUMONIAEBLOOD-STREAM INFECTIONSPYELONEPHRITISMultiplemedicine.medical_specialtyCritical IllnessMicrobial Sensitivity TestsPeritonitisEnterococcus faecalisNO03 medical and health sciencesIntra‑abdominal InfectionsAntibiotic resistanceFOODSepsisIntensive careInternal medicinemedicineHumansFLUOROQUINOLONE RESISTANCEPseudomonas aeruginosabusiness.industrySeptic shockMORTALITYbiology.organism_classificationmedicine.diseaseRISK-FACTORSIntraabdominal Infectionsbusiness030217 neurology & neurosurgeryEnterococcus faecium
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Immunological insights into the pathogenesis of active CMV infection in non-immunosuppressed critically ill patients.

2011

Dissociation of cytomegalovirus (CMV) DNA loads between the lower respiratory tract and blood, with high levels in the former compartment and low or undetectable levels in the latter, commonly occurs during active CMV infection in critically ill patients despite the presence of high frequencies of CMV-specific IFN-γ-producing CD8+ and CD4+ T cells in blood. Data presented in this case report suggest that inter-compartmental differences in interleukin-10 (IL-10) levels may, in part, explain the pathobiology of this phenomenon. In the absence of ganciclovir treatment, a significant correlation was observed between IL-10 levels and CMV DNA loads in lower respiratory tract specimens (P = 0.016)…

GanciclovirMalemedicine.medical_treatmentCritical IllnessRespiratory SystemCytomegalovirusPathogenesisVirologymedicineHumansInterleukin 6AgedAged 80 and overLungbiologyvirus diseasesImmunosuppressionMiddle AgedViral LoadVirologyInterleukin-10Interleukin 10Infectious Diseasesmedicine.anatomical_structureBloodImmunologyCytomegalovirus Infectionsbiology.proteinFemaleBronchoalveolar Lavage FluidCD8Respiratory tractmedicine.drugJournal of medical virology
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The heart in the elderly critically ill patient

2002

Cardiac complications such as myocardial infarction and congestive heart failure are the primary source of perioperative morbidity and mortality in elderly surgical patients. This is the result of structural and functional age-related changes in the heart and the vasculature and an increasing incidence of cardiovascular disorders. Appropriate perioperative management of the elderly patient should be based on the extent of functional compromise, the type and severity of pre-existing disease, and the invasiveness of the surgical procedure. Current studies suggest that appropriately administered medical therapy, particularly beta-adrenergic blockade, may reduce perioperative cardiovascular mor…

Heart FailureAgingClinical Trials as Topicmedicine.medical_specialtyCritically illbusiness.industryCritical IllnessIncidence (epidemiology)Psychological interventionAnemiaHeartDiseasePerioperativeCritical Care and Intensive Care Medicinemedicine.diseasePerioperative CareBlockadeRisk FactorsHeart failuremedicineHumansMyocardial infarctionbusinessIntensive care medicineAgedCurrent Opinion in Critical Care
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Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials…

2019

Pardo-Oviedo, Juan Mauricio/0000-0003-0084-3449; Lopez-Delgado, Juan Carlos/0000-0003-3324-1129; Corradi, Francesco/0000-0002-5588-2608; De Backer, Daniel/0000-0001-9841-5762; POTA, VINCENZO/0000-0001-9999-3388; Tomescu, Dana/0000-0001-9673-5754; Sabetian, Golnar/0000-0001-8764-2150; Girardis, Massimo/0000-0002-2453-0829; Brazzi, Luca/0000-0001-7059-0622; Leone, Marc/0000-0002-3097-758X; Zabolotskikh, Igor Borisovich/0000-0002-3623-2546; De Lange, Dylan/0000-0002-0191-7270; ALMEKHLAFI, GHALEB A./0000-0002-0323-7025; Elke, Gunnar/0000-0002-4948-1605; Grigoras, Ioana/0000-0001-9412-9574; Czuczwar, Miroslaw/0000-0002-9025-6717; Nora, David/0000-0002-1133-7368; Masjedi, Mansoor/0000-0001-6175-9…

Infection riskMaleBIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences.Antibiotic resistanceTracte gastrointestinal - MalaltiesDefinitionsCritical Care and Intensive Care MedicineTHERAPYDEFINITIONS:Infections::Intraabdominal Infections [DISEASES]0302 clinical medicineIntensive care; Intra-abdominal infection; Mortality; Multidrug resistance; Peritonitis; Sepsis;[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseasesObservational studySeptic shockIntensive care; Intra-abdominal infection; Mortality; Multidrug resistance; Peritonitis; SepsisComputingMilieux_MISCELLANEOUSCritical Illness/epidemiology[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseasesBIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti.Intraabdominal Infections/epidemiologyAbdominal infectionMulticenter study3. Good healthManagementClinical trialCohort[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/VirologyCohort analysisCommunity acquired infectionCohort studyHumanmedicine.medical_specialtyCarbapenem resistanceCritical IllnessPeritoneal dialysisPeritonitisVancomycin resistant enterococcusMajor clinical studyPeritonitisArticle03 medical and health sciencesAntibiotic resistance[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular systemIntensive careSepsisSettore MED/41 - ANESTESIOLOGIAHumansCritical care medicineHospital infectionAgedScience & TechnologyLiver failureAntibiotic therapymedicine.disease[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/BacteriologyEpidemiologic Studies030228 respiratory systemIntensive Care Unit; Sepsis (Diptera); Septic ShockRisk factorHuman medicineGeneral & internal medicineCongestive heart failureOriginalMultidrug resistanceCohort StudiesRisk FactorsCause of DeathEpidemiologyPrevalenceMedicine and Health SciencesAbdominal abscessSepsis/epidemiologyMiddle agedAntifungal therapy2. Zero hungerPeritonitiAntibiotic agentBiliary tract infectionIntensive care ; Intra-abdominal infection ; Mortality ; Multidrug resistance ; Peritonitis ; SepsisMiddle Aged:infecciones bacterianas y micosis::infección::infecciones intraabdominales [ENFERMEDADES]PREVALENCE:Infections::Sepsis [DISEASES]:técnicas de investigación::métodos epidemiológicos::características de los estudios epidemiológicos::estudios epidemiológicos::estudios de cohortes [TÉCNICAS Y EQUIPOS ANALÍTICOS DIAGNÓSTICOS Y TERAPÉUTICOS]Methicillin resistant staphylococcus aureusRaonament basat en casosFemaleCritically ill patientLife Sciences & BiomedicineAntifungal agentAdult:Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics::Epidemiologic Studies::Cohort Studies [ANALYTICAL DIAGNOSTIC AND THERAPEUTIC TECHNIQUES AND EQUIPMENT]Predictive value:infecciones bacterianas y micosis::infección::sepsis [ENFERMEDADES]NOSepsisIntra-abdominal infectionCritical Care MedicineInternal medicineGeneral & Internal MedicinemedicineMANAGEMENTJournal Article[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/ParasitologySepticèmiaMortalitybusiness.industrySeptic shockPancreas diseaseMalnutrition030208 emergency & critical care medicineTyphlitisToxic megacolonIntensive careIntraabdominal InfectionsTherapyLate onset disorderbusiness
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Good clinical practice for the use of vasopressor and inotropic drugs in critically ill patients: state-of-the-science and expert consensus

2021

Vasopressors and inotropic agents are widely used in critical care. However, strong evidence supporting their use in critically ill patients is lacking in many clinical scenarios. Thus, the Italian Society of Anesthesia and Intensive Care (SIAARTI) promoted a project aimed to provide indications for good clinical practice on the use of vasopressors and inotropes, and on the management of critically ill patients with shock. A panel of 16 experts in the field of intensive care medicine and hemodynamics has been established. Systematic review of the available literature was performed based on PICO questions. Basing on available evidence, the panel prepared a summary of evidences and then wrote…

Inotropemedicine.medical_specialtyConsensusCritical CareCritical IllnessMEDLINEshockCardiotonic AgentsCardiotonic agentsVasoconstrictor agentsCardiogenic shock; Cardiotonic agents; Septic shock; Vasoconstrictor agents03 medical and health sciences0302 clinical medicineVasoconstrictor agents030202 anesthesiologySeptic shockIntensive caremedicineHumansVasoconstrictor AgentsIntensive care medicineCardiogenic shockbusiness.industrySeptic shockCardiogenic shock030208 emergency & critical care medicinemedicine.diseaseAnesthesiology and Pain MedicinePharmaceutical PreparationsShock (circulatory)Good clinical practicemedicine.symptombusinessCardiotonic agents
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Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries

2018

Background: To better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study. Methods: This is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteris…

MaleARDSInternationality[SDV]Life Sciences [q-bio]humanoslnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]traqueostomíaCritical Care and Intensive Care MedicineSeverity of Illness IndexCohort StudiesPropensity-matched analysi0302 clinical medicineTracheostomyestudios prospectivosEpidemiologyAcute respiratory distress syndrome (ARDS)030212 general & internal medicineProspective Studiespuntuación de propensión10. No inequalityProspective cohort studyestudios de cohortesmediana edadancianoRespiratory Distress SyndromerespiraciónRespirationlcsh:Medical emergencies. Critical care. Intensive care. First aidMiddle Aged3. Good healthIntensive Care UnitsCohortArtificialCritical IllneFemaleAcute respiratory distress syndrome (ARDS); ICU; Propensity-matched analysis; Tracheostomy; Ventilation; Aged; Cohort Studies; Critical Illness; Female; Humans; Intensive Care Units; Internationality; Male; Middle Aged; Propensity Score; Prospective Studies; Respiration Artificial; Respiratory Distress Syndrome Adult; Severity of Illness Index; TracheostomyCohort studyHumanAdultmedicine.medical_specialtyCritical IllnessIntensive Care UnitSocio-culturaleunidades de cuidados intensivosenfermedad críticaPropensity-matched analysis03 medical and health sciencesAcute respiratory distress syndrome (ARDS); ICU; Propensity-matched analysis; Tracheostomy; VentilationSeverity of illnessSettore MED/41 - ANESTESIOLOGIAmedicineHumansíndice de gravedad de la enfermedadPropensity ScoreAgedbusiness.industryResearchRespiratory Distress Syndrome Adultinternacionalidadlcsh:RC86-88.9medicine.diseaseR1Respiration ArtificialVentilationProspective Studie030228 respiratory systemPropensity score matchingEmergency medicineICUObservational studyCohort Studiebusiness
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Medication errors and drug knowledge gaps among critical-care nurses: a mixed multi-method study

2019

Background Medication errors are a serious and complex problem in clinical practice, especially in intensive care units whose patients can suffer potentially very serious consequences because of the critical nature of their diseases and the pharmacotherapy programs implemented in these patients. The origins of these errors discussed in the literature are wide-ranging, although far-reaching variables are of particular special interest to those involved in training nurses. The main objective of this research was to study if the level of knowledge that critical-care nurses have about the use and administration of medications is related to the most common medication errors. Methods This was a m…

MaleHealth Knowledge Attitudes PracticeGaps in drug knowledgeCritical IllnessCritical Care NursingHealth informaticsHealth administration03 medical and health sciences0302 clinical medicinePharmacotherapyIntensive careCritical care nursingMedication errorsSurveys and QuestionnairesmedicineHumans030212 general & internal medicineIntubation Gastrointestinalbusiness.industry030503 health policy & servicesHealth PolicyMedical recordNursing researchlcsh:Public aspects of medicineError causelcsh:RA1-1270Focus GroupsMiddle Agedmedicine.diseaseFocus groupCritical careIntensive Care UnitsPharmaceutical PreparationsFemaleMedical emergency0305 other medical sciencebusinessResearch ArticleBMC Health Services Research
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DALI: Defining Antibiotic Levels in Intensive Care Unit Patients: Are Current -Lactam Antibiotic Doses Sufficient for Critically Ill Patients?

2014

Background. Morbidity and mortality for critically ill patients with infections remains a global healthcare problem. We aimed to determine whether α-lactam antibiotic dosing in critically ill patients achieves concentrations associated with maximal activity and whether antibiotic concentrations affect patient outcome.Methods. This was a prospective, multinational pharmacokinetic point-prevalence study including 8 α-lactam antibiotics. Two blood samples were taken from each patient during a single dosing interval. The primary pharmacokinetic/pharmacodynamic targets were free antibiotic concentrations above the minimum inhibitory concentration (MIC) of the pathogen at both 50% (50% f TMIC) an…

MaleInternational CooperationAntibioticsadverse eventintensive care unitlaw.invention0302 clinical medicinemeropenemModels[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseasesadverse events; continuous infusion; extended infusion; pharmacodynamics; pharmacokinetics; Aged; Anti-Bacterial Agents; Bacterial Infections; Blood Chemical Analysis; Female; Humans; Intensive Care Units; International Cooperation; Male; Microbial Sensitivity Tests; Middle Aged; Models Statistical; Prospective Studies; Treatment Outcome; beta-Lactams; Critical Illnessantibiotic therapyProspective Studiesamoxicillin plus clavulanic acidComputingMilieux_MISCELLANEOUSbeta lactam antibioticAPACHE0303 health sciencescritical illneadultclinical trial3. Good healthcontinuous infusion; extended infusion; adverse events; pharmacokinetics; pharmacodynamics.antiinfective agent[SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitologypriority journaldisease severitybeta-Lactamstatistical model Agedprospective studyHumanMicrobiology (medical)medicine.medical_specialtydrug exposureCritical IllnessImmunologybloodstream infectionMicrobial Sensitivity Testspiperacillin plus tazobactambeta-LactamsMicrobiologybeta lactam abdominal infection03 medical and health sciencescritically ill patientIntensive careAnti-Bacterial AgentcefepimepharmacodynamicsHumansDosingAdverse effectAgedModels Statistical030306 microbiologyOdds ratiomajor clinical studymortalityantibiotic sensitivityceftriaxoneProspective Studiemulticenter studypharmacodynamics.ampicillinBlood Chemical AnalysisCeftazidimeSettore MED/41 - AnestesiologiaInterquartile rangelaw030212 general & internal medicinepharmacokineticlung infectionMicrobial Sensitivity TestarticleBacterial InfectionsMiddle AgedStatisticalcontinuous infusionIntensive care unitAnti-Bacterial Agentsextended infusionIntensive Care UnitsInfectious DiseasesTreatment Outcomeadverse events; continuous infusion; extended infusion; pharmacodynamics; pharmacokinetics; Aged; Anti-Bacterial Agents; Bacterial Infections; Blood Chemical Analysis; Female; Humans; Intensive Care Units; International Cooperation; Male; Microbial Sensitivity Tests; Middle Aged; Models Statistical; Prospective Studies; Treatment Outcome; beta-Lactams; Critical Illness; Microbiology (medical); Infectious Diseasescefazolin[SDV.IMM]Life Sciences [q-bio]/Immunologyblood samplingFemalepharmacokineticsmedicine.drugmedicine.drug_classprevalencedoripenemminimum inhibitory concentrationBacterial InfectionInternal medicinemedicinecontrolled studyblood analysibusiness.industryBlood Chemical Analysiadverse eventsSurgerypharmacodynamicdrug blood levelbusiness
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Epidemiological characteristics, practice of ventilation, and clinical outcome in patients at risk of acute respiratory distress syndrome in intensiv…

2016

Background Scant information exists about the epidemiological characteristics and outcome of patients in the intensive care unit (ICU) at risk of acute respiratory distress syndrome (ARDS) and how ventilation is managed in these individuals. We aimed to establish the epidemiological characteristics of patients at risk of ARDS, describe ventilation management in this population, and assess outcomes compared with people at no risk of ARDS. Methods PRoVENT (PRactice of VENTilation in critically ill patients without ARDS at onset of ventilation) is an international, multicentre, prospective study undertaken at 119 ICUs in 16 countries worldwide. All patients aged 18 years or older who were rece…

MalePediatricsARDSmedicine.medical_treatmentlaw.inventionPositive-Pressure Respiration0302 clinical medicinelawRisk FactorsPrevalenceventilator–induced lung injuryProspective StudiesHospital MortalityProspective cohort studyTidal volumeeducation.field_of_studyRespiratory Distress SyndromeAcute respiratory distress syndrometidal volumeARDS critically ill ventilationMiddle AgedIntensive care unitIntensive Care UnitsCritical IllneFemaleHumanPulmonary and Respiratory Medicinemedicine.medical_specialtyCritical IllnessPopulationIntensive Care UnitLung injurymechanical ventilationNO03 medical and health sciencesIntensive caremedicineAcute respiratory distress syndrome mechanical ventilation ventilator–induced lung injury tidal volume positive end–expiratory pressureHumansMED/41 - ANESTESIOLOGIAeducationAgedMechanical ventilationbusiness.industryRisk FactorRespiratory Distress Syndrome Adult030208 emergency & critical care medicinemedicine.diseaseRespiration ArtificialMechanical ventilation Acute respiratory failure Acute respiratory distress syndromeProspective Studie030228 respiratory systemEmergency medicinepositive end–expiratory pressurebusiness
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