Journal of critical care
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Journal of critical care · Jun 2019
Review Case ReportsSevere acute respiratory distress syndrome (ARDS) induced by human adenovirus B21: Report on 2 cases and literature review.
Severe pneumonia and ARDS caused by human adenovirus B21 infections (HAdV-B21) is a rare, but a devastating disease with rapid progression to multiorgan failure and death. However, only a few cases were reported so far. Infections appear associated with increased disease severity and higher mortality in infected critically ill patients. ⋯ In conclusion, data on HAdV-B21 infections causing severe pneumonia or ARDS are scarce. Controlled clinical trials on the therapy of adenovirus pneumonia are non existent and thus there is no established therapy so far. ICU physicians should be aware of this potentially devastating disease and further studies are needed.
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Journal of critical care · Jun 2019
Lung nitroxidative stress in mechanically-ventilated septic patients: A pilot study.
During sepsis and mechanical ventilation oxidative stress is generated by endothelial and inflammatory lung cells. Our main objective was to study pulmonary NO (nitric oxide) production and nitroxidative stress in mechanically-ventilated septic patients. ⋯ We conclude that during early phases of sepsis there is an enhanced lung nitroxidative stress due to an increase of NO production leading to secondary NO-derived oxidants, which promote protein nitration and lipid peroxidation.
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Journal of critical care · Jun 2019
Diastolic pressure should be used to guide management of patients in shock: PRO.
Based primarily on the rational that adequate diastolic pressure is needed to maintain sufficient coronary blood for myocardial needs, diastolic pressure has been proposed as a treatment target for patients in shock. To date, clinical evidence supporting this is limited to observational data. ⋯ Targeting diastolic pressure can lead to over use of vasopressors, which studies have associated with worse outcome. Pressor management in shock should include assessment of indicators of tissue perfusion and changes in flow if possible.
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Journal of critical care · Jun 2019
Review Meta AnalysisWorldwide variation in Pseudomonas associated ventilator associated pneumonia. A meta-regression.
The objective here is to define the extent and possible reasons for geographic variation in Pseudomonas aeruginosa associated with Ventilator Associated Pneumonia (VAP). ⋯ Pseudomonas associated VAP incidence among reports from six geographic regions worldwide varies by less than twofold with some decline by year of publication. Trauma ICU admission is a significant factor underlying variations in incidence of VAP overall but not Pseudomonas associated VAP.