ESICM LIVES 2016: part one : Milan, Italy. 1-5 October 2016 (original) (raw)
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Intensive Care Medicine Experimental, 2016
Citation for published version (APA): Rasmussen, B. S., Maltesen, R., Hanifa, M., Pedersen, S., Kristensen, S. R., & Wimmer, R. (2016). Metabonomics identifies early molecular changes associated with progression into postoperative hypoxemia in cardiac surgery patient: a human model that can provide new insights into the pathophysiology of acute lung injury and potentially identify specific biomarkers of lung tissue injury. Intensive Care Medicine Experimental, 4(Suppl. 1), 13. [A22]. https://doi.org/10.1186/s40635-016-0098-x
Intracerebral hemorrhage in ICU: is it worth treating?
Intensive Care Medicine Experimental, 2016
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. carbon dioxide 30 [27-35] mmHg and median temperature 37.1 [36.8-37.3]°C. After removal of artefacts, the mean monitoring time was 22 h08 (8 h54). All patients had impaired cerebral autoregulation during their monitoring time. The mean IAR index was 17 (9.5) %. During H 0 H 6 and H 18 H 24 , the majority of our patients; respectively 53 and 71 % had an IAR index > 10 %. Conclusion According to our data, patients with septic shock had impaired cerebral autoregulation within the first 24 hours of their admission in the ICU. In our patients, we described a variability of distribution of impaired autoregulation according to time. References Schramm P, Klein KU, Falkenberg L, et al. Impaired cerebrovascular autoregulation in patients with severe sepsis and sepsis-associated delirium. Crit Care 2012; 16: R181. Aries MJH, Czosnyka M, Budohoski KP, et al. Continuous determination of optimal cerebral perfusion pressure in traumatic brain injury. Crit. Care Med. 2012.
Identification of SIRS/sepsis signs by ward nurses reduces 30-days mortality in patients with sepsi
Intensive care Medicine Experimental, 2016
Introduction: SIRS and sepsis is easily identified with observation of vital signs and organ failure, but there is little focus on the effect of better observation and treatment for outcome in patients with suspected infection cared for at the ward level. Objectives:To evaluate if a“bundle” consisting of a SIRS and organ failure (SOF)-triage, flow chart response and alert system, and a SIRS/ sepsis training course for all wards nurses improved clinical observations, lead to fewer patients developing severe sepsis, decreased length of stay in the high-level care (LOS) and increased survival. Methods:A before and after intervention study in one emergency and community hospital within the Mid-Norway sepsis study catchment area. All patients with confirmed blood stream infection (BSI) and evidence of sepsis have been prospectively registered continuously since 1994. The severity of sepsis, observation frequency of vital signs, treatment data, LOS and mortality were retrospectively registered from the patients' medical journals until end 2013. Results:The pre-intervention group was patients with confirmed BSI from Jan 2008 to Dec 2010 (n = 472) whilst the postinterventions group was recruited between Nov 2011 to Dec 2013 (n = 409). The nurses' observation frequency of vital signs increased in BSI patients with and without severe organ failure comparing these periods. The post-intervention group had, in average, 2.4 days shorter LOS. Patients admitted without severe organ failure in the post-intervention group had a lower probability of developing severe organ failure (0.7, 95 % CI 0.4-0.9) than the pre-intervention group. Adjusted for differences in disease severity the post-intervention group also had higher odds of surviving 30 days (OR 2.7, 95 % CI 1.6-4.6). Conclusion:A sepsis specific triage-, flow chart alert and treatment system was an effective tool to increase ward nurses recognition and early treatment of patients with confirmed BSI. In addition to increased survival, the shorter LOS is important from a hospital perspective in term of resource utilization. Grant acknowledgment This study was supported by the liaison committee between NordTrøndelag Hospital Trust and Nord University
Intensive Care Medicine Experimental, 2016
Introduction: Critically ill children in the pediatric intensive care unit (PICU) are at high risk for developing nutritional deficiencies and undernutrition is known to be a risk factor for morbidity and mortality. Malnutrition represents a continuous spectrum ranging from marginal nutrient status to severe metabolic and functional alterations and this in turn, affects clinical outcome. Objectives: The aim of the study was to assess nutritional status of critically ill children admitted to the PICU and its association to clinical outcomes. Methods: Critically ill children age 6 months to 18 years were prospectively enrolled on PICU admission. Nutritional status was assessed by weight for age (WFA: underweight), weight for height (WFH: wasting), height for age (HFA: stunting) z-scores and mid upper arm circumference (MUAC: wasting) according to the WHO. (1,2) Malnutrition was defined as mild, moderate, and severe if z-scores were > −1, > − 2, and > −3, respectively. Hospital and PICU length of stay (LOS), duration of mechanical ventilation (MV), and risk of mortality (ROM) by the Pediatric Index of Mortality 2 (PIM2) were obtained. Sensitivity and specificity of the MUAC to identify children with wasting (WFH) were calculated. Results: Two hundred and fifty children (136 males), aged 81 months (23-167; median (25-75 th IQR)), were prospectively included in the study. The hospital LOS was 8 (4-16) days; PICU LOS: 2 (1-4) days; duration of MV, 0 (0-1.5) days;
Microcirculatory response to passive leg raising in recreational marathon runners
Critical Care, 2019
Introduction: The purpose of the study was to determine whether the preferential localization of the infection and age affect the prognostic value of the genetic marker AQP5 (1364A/C, rs3759129) in outcome prediction in sepsis patients. Studies by Adamzik and colleagues have demonstrated that aquaporin AQP5 polymorphism (1364A/C, rs3759129) associates with increased 30-day survival in sepsis patients presumably due to increased gene expression that enhance the leukocyte migration. To increase the informative value of the prediction and decrease the cost, it might be crucial to determine at a pre-test level the subset of patients who might benefit most from the prognostic genotyping. Methods: Sepsis and septic shock were defined in patients according to SEPSIS-3 (2016) recommendations. Study groups (n=152) included ICU patients with abdominal sepsis (AS, including pancreatitits, peritonitis, cholecystitis, appendicitis; n=98) and sepsis patients with other sources of infections. AQP5 polymorphism was studied by analyzing PCR products in a 2% agarose gel using a AQP5 1364A/C specific tetra primer set. Data were analyzed by Kaplan-Meyer plot and Fisher test, and odds ratios were calculated. Results: Distribution of alleles (A and C) and genotypes (AA, CA and CC) AQP5 1364A/C in patients with sepsis or sepsis subgroups (sepsis with no septic shock and sepsis shock patients) versus control group (healthy volunteers) did not differ. Although there was a trend to preferential survival of sepsis patients with genotype C AQP5 despite the source of infection, only patients with AQP5 CC or CA genotype and abdominal sepsis (Sepsis-3), or a subgroup of the same AQP5 genotype experiencing septic shock, demonstrated increased 30-day survival versus AA homozygotic patients (P<0.002). Conclusions: The informative value of detecting the AQP5 CC or CA genotype for prognosis of 30-day survival versus AA homozygotic patients is increased only in abdominal sepsis patients.
36th International Symposium on Intensive Care and Emergency Medicine
Critical Care, 2016
2. Chan JF et al. The lower serum immunoglobulin G2 level in severe cases than in mild cases of pandemic H1N1 2009 influenza is associated with cytokine dysregulation. Clin Vaccine Immunol 2011; 18:305-10. P003 Brain protective effects of intravenous immunoglobulin through inhibition of complement activation and apoptosis in a rat model of sepsis