Journal of critical care
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Journal of critical care · Oct 2018
Letter Case ReportsIntraventricular CNS treatment with Colistin-Tigecycline combination: A case series.
"Healthcare-associated ventriculitis and meningitis" is a potentially devastating illness following neurosurgical procedures. Multidrug resistant (MDR) and extensively drug resistant (XDR) organisms such as Acinetobacter baumannii and Klebsiella pneumoniae have increasingly been isolated in ventriculitis and meningitis episodes. ⋯ The intraventricular (IVT) administration of antibiotics can be used as an adjunct to the intravenous (IV) treatment of Gram-negative MDR ventriculitis and meningitis, yet pertinent data is scarce. We present the successful management of three cases of healthcare-associated ventriculitis and meningitis due to XDR species with the combined intraventricular administration of colistin and off-label tigecycline, after the initial regimen of colistin given alone through both IVT and IV routes had failed.
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Journal of critical care · Oct 2018
Meta AnalysisNon-invasive ventilation in children and adults in low- and low-middle income countries: A systematic review and meta-analysis.
We systematically reviewed the effects of NIV for acute respiratory failure (ARF) in low- and low-middle income countries. ⋯ NIV for ARF in these settings appears to be effective.
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Journal of critical care · Oct 2018
Multicenter StudyDiagnosis, management, and prognosis of patients with acute kidney injury in Japanese intensive care units: The JAKID study.
To determine the proportion of diagnosis and outcomes of critically ill patients with acute kidney injury (AKI), and its association with mortality using the complete Kidney Disease Improving Global Outcomes (KDIGO) classification and Sepsis-3 definition. ⋯ AKI accounted for >40% of ICU patients with the KDIGO classification and was associated with increased risk of hospital mortality. Septic AKI was diagnosed in three-fourths of patients with sepsis, while the impact of AKI on hospital mortality among sepsis was not observed.
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Journal of critical care · Oct 2018
ReviewThe use of IgM-enriched immunoglobulin in adult patients with sepsis.
The administration of intravenous immunoglobulins (IVIG) is one of the adjunct therapies investigated and applied to sepsis patients, with the first studies being published nearly four decades ago. Intravenous immunoglobulin preparations have several mechanisms of action e.g. antigen neutralization, Fc-receptor blockade on phagocytic cells, modulation of cytokine responses and modulation of immune cell functions. ⋯ Nevertheless, the results of studies examining its value are contradicting. The purpose of this review is to summarize and present, clearly and thoroughly, the currently available data regarding established and future potential clinical uses of IVIgGM in patients with sepsis.
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Journal of critical care · Oct 2018
Observational StudyUse of regional citrate anticoagulation for continuous venovenous hemodialysis in critically ill cancer patients with acute kidney injury.
This study aimed to evaluate the safety and efficacy of a regional citrate anticoagulation (RCA) protocol for continuous venovenous hemodialysis (CVVHD) in cancer patients with acute kidney injury (AKI) in the intensive care unit (ICU) setting. ⋯ Filter patency was relatively short and clotting was associated with active cancer disease, genitourinary tumor, lower citrate dose and lower INR.