Intensive care medicine
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Intensive care medicine · Dec 2012
Associations of markers of inflammation and coagulation with delirium during critical illness.
To assess the associations between a priori-selected markers of inflammation and coagulation and delirium during critical illness. ⋯ In this study, MMP-9, protein C, and sTNFR1 were independently associated with subsequent ICU delirium. These results suggest that specific aspects of inflammation and coagulation may play a role in the evolution of delirium during critical illness and that these markers should be examined in larger studies of ICU patients.
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Intensive care medicine · Dec 2012
Comparative StudyCardiac function in Ghanaian children with severe malaria.
The aim was to assess whether impaired cardiac function contributes to symptoms of severe malaria in general or to metabolic acidosis in particular in children living in endemic regions. ⋯ Increased CI reflecting high output status is associated with low hemoglobin levels while metabolic acidosis is linked to parasite levels.
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Intensive care medicine · Dec 2012
Comparative StudyDiaphragm electromyographic activity as a predictor of weaning failure.
To compare breathing pattern descriptors and diaphragm electromyographic activity (EAdi)-derived indices obtained from a neurally adjusted ventilatory assist catheter during a spontaneous breathing trial (SBT) in patients successfully and unsuccessfully separated from the ventilator and to assess their performance as a potential marker to discriminate these two categories of patients. ⋯ EAdi-derived indices provide reliable and early predictors of weaning outcome. However, the performance of these indices is not better than the RR/V (T).
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Intensive care medicine · Dec 2012
Comparative StudyPathophysiology of Escherichia coli ventilator-associated pneumonia: implication of highly virulent extraintestinal pathogenic strains.
To characterize Escherichia coli ventilator-associated pneumonia (VAP) in intensive care unit (ICU) patients by determining antibioresistance and genotypic characteristics of E. coli isolates responsible for VAP or lung colonization, by comparing them with their oropharyngeal and rectal counterparts and by assessing representative isolates' virulence in a pneumonia mouse model. ⋯ This is the first study establishing antibioresistance and genotypic characteristics of E. coli isolates responsible for VAP in adult ICU patients. These isolates are highly virulent specific extraintestinal pathogenic E. coli strains expressing virulence factors, representing potential targets for new therapies.
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Intensive care medicine · Dec 2012
Hypertriglyceridemia: a potential side effect of propofol sedation in critical illness.
Hypertriglyceridemia (hyperTG) is common among intensive care unit (ICU) patients, but knowledge about hyperTG risk factors is scarce. The present study aims to identify risk factors favoring its development in patients requiring prolonged ICU treatment. ⋯ HyperTG is frequent in the ICU but is not associated with adverse outcome. Propofol and accompanying lipid emulsion are the strongest risk factors. Our results suggest that plasma TG should be monitored at least twice weekly in patients on propofol. The clinical consequences of propofol-related hyperTG should be investigated in further studies.