173 results on '"Nassar, AP Jr"'
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2. Spontaneous Breathing in Early Acute Respiratory Distress Syndrome
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van Haren F., Pham T., Brochard L., Bellani G., Laffey J., Dres M., Fan E., Goligher E. C., Heunks L., Lynch J., Wrigge H., McAuley D, Pesenti A, Laffey JG, Brochard L, Esteban A, Gattinoni L, van Haren F, Larsson A, McAuley DF, Ranieri M, Rubenfeld G, Thompson BT, Wrigge H, Slutsky AS, Rios F, Sottiaux T, Depuyd P, Lora FS, Azevedo LC, Fan E, Bugedo G, Qiu H, Gonzalez M, Silesky J, Cerny V, Nielsen J, Jibaja M, Pham T, Matamis D, Ranero JL, Amin P, Hashemian SM, Clarkson K, Bellani G, Kurahashi K, Villagomez A, Zeggwagh AA, Heunks LM, Laake JH, Palo JE, Fernandes ADV, Sandesc D, Arabi Y, Bumbasierevic V, Nin N, Lorente JA, Piquilloud L, Abroug F, McNamee L, Hurtado J, Bajwa E, Démpaire G, Sula H, Nunci L, Cani A, Zazu A, Dellera C, Insaurralde CS, Alejandro RV, Daldin J, Vinzio M, Fernandez RO, Cardonnet LP, Bettini LR, Bisso MC, Osman EM, Setten MG, Lovazzano P, Alvarez J, Villar V, Pozo NC, Grubissich N, Plotnikow GA, Vasquez DN, Ilutovich S, Tiribelli N, Chena A, Pellegrini CA, Saenz MG, Estenssoro E, Brizuela M, Gianinetto H, Gomez PE, Cerrato VI, Bezzi MG, Borello SA, Loiacono FA, Fernandez AM, Knowles S, Reynolds C, Inskip DM, Miller JJ, Kong J, Whitehead C, Bihari S, Seven A, Krstevski A, Rodgers HJ, Millar RT, Mckenna TE, Bailey IM, Hanlon GC, Aneman A, Lynch JM, Azad R, Neal J, Woods PW, Roberts BL, Kol MR, Wong HS, Riss KC, Staudinger T, Wittebole X, Berghe C, Bulpa PA, Dive AM, Verstraete R, Lebbinck H, Depuydt P, Vermassen J, Meersseman P, Ceunen H, Rosa JI, Beraldo DO, Piras C, Rampinelli AM, Nassar AP Jr, Mataloun S, Moock M, Thompson MM, Gonçalves CH, Antônio ACP, Ascoli A, Biondi RS, Fontenele DC, Nobrega D, Sales VM, Shindhe S, Pg Hj Ismail DMAB, Laffey J, Beloncle F, Davies KG, Cirone R, Manoharan V, Ismail M, Goligher EC, Jassal M, Nishikawa E, Javeed A, Curley G, Rittayamai N, Parotto M, Ferguson ND, Mehta S, Knoll J, Pronovost A, Canestrini S, Bruhn AR, Garcia PH, Aliaga FA, Farías PA, Yumha JS, Ortiz CA, Salas JE, Saez AA, Vega LD, Labarca EF, Martinez FT, Carreño NG, Lora P, Liu L, Tang R, Luo X, An Y, Zhao H, Gao Y, Zhai Z, Ye ZL, Wang W, Li W, Li Q, Zheng R, Yu W, Shen J, Li X, Yu T, Lu W, Wu YQ, Huang XB, He Z, Lu Y, Han H, Zhang F, Sun R, Wang HX, Qin SH, Zhu BH, Zhao J, Liu J, Li B, Liu JL, Zhou FC, Li QJ, Zhang XY, Li-Xin Z, Xin-Hua Q, Jiang L, Gao YN, Zhao XY, Li YY, Li XL, Wang C, Yao Q, Yu R, Chen K, Shao H, Qin B, Huang QQ, Zhu WH, Hang AY, Hua MX, Li Y, Xu Y, Di YD, Ling LL, Qin TH, Wang SH, Qin J, Han Y, Zhou S, Vargas MP, Silesky Jimenez JI, González Rojas MA, Solis-Quesada JE, Ramirez-Alfaro CM, Máca J, Sklienka P, Gjedsted J, Christiansen A, Villamagua BG, Llano M, Burtin P, Buzancais G, Beuret P, Pelletier N, Mortaza S, Mercat A, Chelly J, Jochmans S, Terzi N, Daubin C, Carteaux G, de Prost N, Chiche JD, Daviaud F, Fartoukh M, Barberet G, Biehler J, Dellamonica J, Doyen D, Arnal JM, Briquet A, Hraiech S, Papazian L, Follin A, Roux D, Messika J, Kalaitzis E, Dangers L, Combes A, Au SM, Béduneau G, Carpentier D, Zogheib EH, Dupont H, Ricome S, Santoli FL, Besset SL, Michel P, Gelée B, Danin PE, Goubaux B, Crova PJ, Phan NT, Berkelmans F, Badie JC, Tapponnier R, Gally J, Khebbeb S, Herbrecht JE, Schneider F, Declercq PM, Rigaud JP, Duranteau J, Harrois A, Chabanne R, Marin J, Bigot C, Thibault S, Ghazi M, Boukhazna M, Zein SO, Richecoeur JR, Combaux DM, Grelon F, Le Moal C, Sauvadet EP, Robine A, Lemiale V, Reuter D, Dres M, Demoule A, Goldgran-Toledano D, Baboi L, Guérin C, Lohner R, Kraßler J, Schäfer S, Zacharowsk KD, Meybohm P, Reske AW, Simon P, Hopf HF, Schuetz M, Baltus T, Papanikolaou MN, Papavasilopoulou TG, Zacharas GA, Ourailogloy V, Mouloudi EK, Massa EV, Nagy EO, Stamou EE, Kiourtzieva EV, Oikonomou MA, Avila LE, Cortez CA, Citalán JE, Jog SA, Sable SD, Shah B, Gurjar M, Baronia AK, Memon M, Muthuchellappan R, Ramesh VJ, Shenoy A, Unnikrishnan R, Dixit SB, Rhayakar RV, Ramakrishnan N, Bhardwaj VK, Mahto HL, Sagar SV, Palaniswamy V, Ganesan D, Mohammadreza Hashemian S, Jamaati H, Heidari F, Meaney EA, Nichol A, Knapman KM, O'Croinin D, Dunne ES, Breen DM, Clarkson KP, Jaafar RF, Dwyer R, Amir F, Ajetunmobi OO, O'Muircheartaigh AC, Black CS, Treanor N, Collins DV, Altaf W, Zani G, Fusari M, Spadaro S, Volta CA, Graziani R, Brunettini B, Palmese S, Formenti P, Umbrello M, Lombardo A, Pecci E, Botteri M, Savioli M, Protti A, Mattei A, Schiavoni L, Tinnirello A, Todeschini M, Giarratano A, Cortegiani A, Sher S, Rossi A, Antonelli MM, Montini LM, Casalena P, Scafetti S, Panarello G, Occhipinti G, Patroniti N, Pozzi M, Biscione RR, Poli MM, Raimondi F, Albiero D, Crapelli G, Beck E, Pota V, Schiavone V, Molin A, Tarantino F, Monti G, Frati E, Mirabella L, Cinnella G, Fossali T, Colombo R, Ilaria Pattarino PT, Mojoli F, Braschi A, Borotto EE, Cracchiolo AN, Palma DM, Raponi F, Foti G, Vascotto ER, Coppadoro A, Brazzi L, Floris L, Iotti GA, Venti A, Yamaguchi O, Takagi S, Maeyama HN, Watanabe E, Yamaji Y, Shimizu K, Shiozaki K, Futami S, Ryosuke S, Saito K, Kameyama Y, Ueno K, Izawa M, Okuda N, Suzuki H, Harasawa T, Nasu M, Takada T, Ito F, Nunomiya S, Koyama K, Abe T, Andoh K, Kusumoto K, Hirata A, Takaba A, Kimura H, Matsumoto S, Higashijima U, Honda H, Aoki N, Imai H, Ogino Y, Mizuguchi I, Ichikado K, Nitta K, Mochizuki K, Hashida T, Tanaka H, Nakamura T, Niimi D, Ueda T, Kashiwa Y, Uchiyama A, Sabelnikovs O, Oss P, Haddad Y, Liew KY, Ñamendys-Silva SA, Jarquin-Badiola YD, Sanchez-Hurtado LA, Gomez-Flores SS, Marin MC, Villagomez AJ, Lemus JS, Fierro JM, Ramirez Cervantes M, Mejia FJF, Dector D, Dector DM, Gonzalez DR, Estrella CR, Sanchez-Medina JR, Ramirez-Gutierrez A, George FG, Aguirre JS, Buensuseso JA, Poblano M, Dendane T, Balkhi H, Elkhayari M, Samkaoui N, Ezzouine H, Benslama A, Amor M, Maazouzi W, Cimic N, Beck O, Bruns MM, Schouten JA, Rinia M, Raaijmakers M, Van Wezel HM, Heines SJ, Strauch U, Buise MP, Simonis FD, Schultz MJ, Goodson JC, Browne TS, Navarra L, Hunt A, Hutchison RA, Bailey MB, Newby L, Mcarthur C, Kalkoff M, Mcleod A, Casement J, Hacking DJ, Andersen FH, Dolva MS, Barratt-Due A, Noremark KAL, Søreide E, Sjøbø BÅ, Guttormsen AB, Leon Yoshido HH, Aguilar RZ, Montes Oscanoa FA, Alisasis AU, Robles JB, Pasanting-Lim RAB, Tan BC, Andruszkiewicz P, Jakubowska K, Coxo CM, Alvarez AM, Oliveira BS, Montanha GM, Barros NC, Pereira CS, Messias AM, Monteiro JM, Araujo AM, Catorze NT, Marum SM, Bouw MJ, Gomes RM, Brito VA, Castro S, Estilita JM, Barros FM, Serra IM, Martinho AM, Tomescu DR, Marcu A, Bedreag OH, Papurica M, Corneci DE, Negoita SI, Grigoriev E, Gritsan AI, Gazenkampf AA, Almekhlaf G, Albarrak MM, Mustafa GM, Maghrabi KA, Salahuddin N, Aisa TM, Al Jabbary AS, Tabhan E, Arabi YM, Trinidad OA, Al Dorzi HM, Tabhan EE, Bolon S, Smith O, Mancebo J, Aguirre-Bermeo H, Lopez-Delgado JC, Esteve F, Rialp G, Forteza C, De Haro C, Artigas A, Albaiceta GM, De Cima-Iglesias S, Seoane-Quiroga L, Ceniceros-Barros A, Ruiz-Aguilar AL, Claraco-Vega LM, Soler JA, Lorente MDC, Hermosa C, Gordo F, Prieto-González M, Perez MP, Perez CP, Allue RM, Roche-Campo F, Ibañez-Santacruz M, Temprano S, Pintado MC, De Pablo R, Gómez PRA, Ruiz SR, Iglesias Moles S, Jurado MT, Arizmendi A, Piacentini EA, Franco N, Honrubia T, Cheng MP, Losada EP, Blanco J, Yuste LJ, Carbayo-Gorriz C, Cazorla-Barranquero FG, Alonso JG, Alda RS, Algaba Á, Navarro G, Cereijo E, Diaz-Rodriguez E, Marcos DP, Montero LA, Para LH, Sanchez RJ, Navalpotro MAB, Abad RD, González RM, Toribio DP, Castro AG, Artiga MJD, Penuelas O, Roser TP, Olga MF, Curto EG, Sánchez RM, Imma VP, Elisabet GM, Claverias L, Magret M, Pellicer AM, Rodriguez LL, Sánchez-Ballesteros J, González-Salamanca Á, Jimenez AG, Huerta FP, Sotillo Diaz JCJ, Lopez EB, Llinares Moya DD, Tallet Alfonso AA, Eugenio Luis PS, Cesar PS, Rafael SI, Virgilio CG, Recio NN, Adamsson RO, Rylander CC, Holzgraefe B, Broman LM, Wessbergh J, Persson L, Schiöler F, Kedelv H, Tibblin AO, Appelberg H, Hedlund L, Helleberg J, Eriksson KE, Glietsch R, Larsson N, Nygren I, Nunes SL, Morin AK, Kander T, Adolfsson A, Zender HO, Leemann-Refondini C, Elatrous S, Bouchoucha S, Chouchene I, Ouanes I, Ben Souissi A, Kamoun S, Demirkiran O, Aker M, Erbabacan E, Ceylan I, Girgin NK, Ozcelik M, Ünal N, Meco BC, Akyol OO, Derman SS, Kennedy B, Parhar K, Srinivasa L, Hopkins P, Mellis C, Kakar V, Hadfield D, Vercueil A, Bhowmick K, Humphreys SK, Ferguson A, Mckee R, Raj AS, Fawkes DA, Watt P, Twohey L, Jha RR, Thomas M, Morton A, Kadaba V, Smith MJ, Hormis AP, Kannan SG, Namih M, Reschreiter H, Camsooksai J, Kumar A, Rugonfalvi S, Nutt C, O'Neill O, Seasman C, Dempsey G, Scott CJ, Ellis HE, Mckechnie S, Hutton PJ, Di Tomasso NN, Vitale MN, Griffin RO, Dean MN, Cranshaw JH, Willett EL, Ioannou N, Gillis S, Csabi P, Macfadyen R, Dawson H, Preez PD, Williams AJ, Boyd O, De Gordoa LO, Bramall J, Chau SK, Wenham T, Szakmany T, Toth-Tarsoly P, McCalman KH, Alexander P, Stephenson L, Collyer T, Chapman R, Cooper R, Allan RM, Sim M, Wrathall DW, Irvine DA, Zantua KS, Adams JC, Burtenshaw AJ, Sellors GP, Welters ID, Williams KE, Hessell RJ, Oldroyd MG, Battle CE, Pillai S, Kajtor I, Sivashanmugavel M, O'Kane SC, Donnelly A, Frigyik AD, Careless JP, May MM, Stewart R, Trinder TJ, Hagan SJ, Wise MP, Cole JM, MacFie CC, Dowling AT, Nuñez E, Pittini G, Rodriguez R, Imperio MC, Santos C, Deicas A, Serra C, Uppalapati A, Kamel G, Banner-Goodspeed VM, Beitler JR, Mukkera SR, Kulkarni S, Lee J, Mesar T, Shinn JO 3rd, Gomaa D, Tainter C, Yeatts DJ, Warren J, Lanspa MJ, Miller RR, Grissom CK, Brown SM, Bauer PR, Gosselin RJ, Kitch BT, Cohen JE, Beegle SH, Gueret RM, Tulaimat A, Choudry S, Stigler W, Batra H, Huff NG, Lamb KD, Oetting TW, Mohr NM, Judy C, Saito S, Kheir FM, Kheir F, Schlichting AB, Delsing A, Crouch DR, Elmasri M, Ismail D, Dreyer KR, Blakeman TC, Baron RM, Grijalba CQ, Hou PC, Seethala R, Aisiku I, Henderson G, Frendl G, Hou SK, Owens RL, Schomer A, Bumbasirevic V, Jovanovic B, Surbatovic M, Veljovic M., Intensive Care Medicine, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, van Haren F., Pham T., Brochard L., Bellani G., Laffey J., Dres M., Fan E., Goligher E.C., Heunks L., Lynch J., Wrigge H., McAuley D, Pesenti A, Laffey JG, Brochard L, Esteban A, Gattinoni L, van Haren F, Larsson A, McAuley DF, Ranieri M, Rubenfeld G, Thompson BT, Wrigge H, Slutsky AS, Rios F, Sottiaux T, Depuyd P, Lora FS, Azevedo LC, Fan E, Bugedo G, Qiu H, Gonzalez M, Silesky J, Cerny V, Nielsen J, Jibaja M, Pham T, Wrigge H, Matamis D, Ranero JL, Amin P, Hashemian SM, Clarkson K, Bellani G, Kurahashi K, Villagomez A, Zeggwagh AA, Heunks LM, Laake JH, Palo JE, Fernandes ADV, Sandesc D, Arabi Y, Bumbasierevic V, Nin N, Lorente JA, Larsson A, Piquilloud L, Abroug F, McAuley DF, McNamee L, Hurtado J, Bajwa E, Démpaire G, Sula H, Nunci L, Cani A, Zazu A, Dellera C, Insaurralde CS, Alejandro RV, Daldin J, Vinzio M, Fernandez RO, Cardonnet LP, Bettini LR, Bisso MC, Osman EM, Setten MG, Lovazzano P, Alvarez J, Villar V, Pozo NC, Grubissich N, Plotnikow GA, Vasquez DN, Ilutovich S, Tiribelli N, Chena A, Pellegrini CA, Saenz MG, Estenssoro E, Brizuela M, Gianinetto H, Gomez PE, Cerrato VI, Bezzi MG, Borello SA, Loiacono FA, Fernandez AM, Knowles S, Reynolds C, Inskip DM, Miller JJ, Kong J, Whitehead C, Bihari S, Seven A, Krstevski A, Rodgers HJ, Millar RT, Mckenna TE, Bailey IM, Hanlon GC, Aneman A, Lynch JM, Azad R, Neal J, Woods PW, Roberts BL, Kol MR, Wong HS, Riss KC, Staudinger T, Wittebole X, Berghe C, Bulpa PA, Dive AM, Verstraete R, Lebbinck H, Depuydt P, Vermassen J, Meersseman P, Ceunen H, Rosa JI, Beraldo DO, Piras C, Rampinelli AM, Nassar AP Jr, Mataloun S, Moock M, Thompson MM, Gonçalves CH, Antônio ACP, Ascoli A, Biondi RS, Fontenele DC, Nobrega D, Sales VM, Shindhe S, Pg Hj Ismail DMAB, Laffey J, Beloncle F, Davies KG, Cirone R, Manoharan V, Ismail M, Goligher EC, Jassal M, Nishikawa E, Javeed A, Curley G, Rittayamai N, Parotto M, Ferguson ND, Mehta S, Knoll J, Pronovost A, Canestrini S, Bruhn AR, Garcia PH, Aliaga FA, Farías PA, Yumha JS, Ortiz CA, Salas JE, Saez AA, Vega LD, Labarca EF, Martinez FT, Carreño NG, Lora P, Qiu H, Liu L, Tang R, Luo X, An Y, Zhao H, Gao Y, Zhai Z, Ye ZL, Wang W, Li W, Li Q, Zheng R, Yu W, Shen J, Li X, Yu T, Lu W, Wu YQ, Huang XB, He Z, Lu Y, Han H, Zhang F, Sun R, Wang HX, Qin SH, Zhu BH, Zhao J, Liu J, Li B, Liu JL, Zhou FC, Li QJ, Zhang XY, Li-Xin Z, Xin-Hua Q, Jiang L, Gao YN, Zhao XY, Li YY, Li XL, Wang C, Yao Q, Yu R, Chen K, Shao H, Qin B, Huang QQ, Zhu WH, Hang AY, Hua MX, Li Y, Xu Y, Di YD, Ling LL, Qin TH, Wang SH, Qin J, Han Y, Zhou S, Vargas MP, Silesky Jimenez JI, González Rojas MA, Solis-Quesada JE, Ramirez-Alfaro CM, Máca J, Sklienka P, Gjedsted J, Christiansen A, Nielsen J, Villamagua BG, Llano M, Burtin P, Buzancais G, Beuret P, Pelletier N, Mortaza S, Mercat A, Chelly J, Jochmans S, Terzi N, Daubin C, Carteaux G, de Prost N, Chiche JD, Daviaud F, Pham T, Fartoukh M, Barberet G, Biehler J, Dellamonica J, Doyen D, Arnal JM, Briquet A, Hraiech S, Papazian L, Follin A, Roux D, Messika J, Kalaitzis E, Dangers L, Combes A, Au SM, Béduneau G, Carpentier D, Zogheib EH, Dupont H, Ricome S, Santoli FL, Besset SL, Michel P, Gelée B, Danin PE, Goubaux B, Crova PJ, Phan NT, Berkelmans F, Badie JC, Tapponnier R, Gally J, Khebbeb S, Herbrecht JE, Schneider F, Declercq PM, Rigaud JP, Duranteau J, Harrois A, Chabanne R, Marin J, Bigot C, Thibault S, Ghazi M, Boukhazna M, Zein SO, Richecoeur JR, Combaux DM, Grelon F, Le Moal C, Sauvadet EP, Robine A, Lemiale V, Reuter D, Dres M, Demoule A, Goldgran-Toledano D, Baboi L, Guérin C, Lohner R, Kraßler J, Schäfer S, Zacharowsk KD, Meybohm P, Reske AW, Simon P, Hopf HF, Schuetz M, Baltus T, Papanikolaou MN, Papavasilopoulou TG, Zacharas GA, Ourailogloy V, Mouloudi EK, Massa EV, Nagy EO, Stamou EE, Kiourtzieva EV, Oikonomou MA, Avila LE, Cortez CA, Citalán JE, Jog SA, Sable SD, Shah B, Gurjar M, Baronia AK, Memon M, Muthuchellappan R, Ramesh VJ, Shenoy A, Unnikrishnan R, Dixit SB, Rhayakar RV, Ramakrishnan N, Bhardwaj VK, Mahto HL, Sagar SV, Palaniswamy V, Ganesan D, Mohammadreza Hashemian S, Jamaati H, Heidari F, Meaney EA, Nichol A, Knapman KM, O'Croinin D, Dunne ES, Breen DM, Clarkson KP, Jaafar RF, Dwyer R, Amir F, Ajetunmobi OO, O'Muircheartaigh AC, Black CS, Treanor N, Collins DV, Altaf W, Zani G, Fusari M, Spadaro S, Volta CA, Graziani R, Brunettini B, Palmese S, Formenti P, Umbrello M, Lombardo A, Pecci E, Botteri M, Savioli M, Protti A, Mattei A, Schiavoni L, Tinnirello A, Todeschini M, Giarratano A, Cortegiani A, Sher S, Rossi A, Antonelli MM, Montini LM, Casalena P, Scafetti S, Panarello G, Occhipinti G, Patroniti N, Pozzi M, Biscione RR, Poli MM, Raimondi F, Albiero D, Crapelli G, Beck E, Pota V, Schiavone V, Molin A, Tarantino F, Monti G, Frati E, Mirabella L, Cinnella G, Fossali T, Colombo R, Ilaria Pattarino PT, Mojoli F, Braschi A, Borotto EE, Cracchiolo AN, Palma DM, Raponi F, Foti G, Vascotto ER, Coppadoro A, Brazzi L, Floris L, Iotti GA, Venti A, Yamaguchi O, Takagi S, Maeyama HN, Watanabe E, Yamaji Y, Shimizu K, Shiozaki K, Futami S, Ryosuke S, Saito K, Kameyama Y, Ueno K, Izawa M, Okuda N, Suzuki H, Harasawa T, Nasu M, Takada T, Ito F, Nunomiya S, Koyama K, Abe T, Andoh K, Kusumoto K, Hirata A, Takaba A, Kimura H, Matsumoto S, Higashijima U, Honda H, Aoki N, Imai H, Ogino Y, Mizuguchi I, Ichikado K, Nitta K, Mochizuki K, Hashida T, Tanaka H, Nakamura T, Niimi D, Ueda T, Kashiwa Y, Uchiyama A, Sabelnikovs O, Oss P, Haddad Y, Liew KY, Ñamendys-Silva SA, Jarquin-Badiola YD, Sanchez-Hurtado LA, Gomez-Flores SS, Marin MC, Villagomez AJ, Lemus JS, Fierro JM, Ramirez Cervantes M, Mejia FJF, Dector D, Dector DM, Gonzalez DR, Estrella CR, Sanchez-Medina JR, Ramirez-Gutierrez A, George FG, Aguirre JS, Buensuseso JA, Poblano M, Dendane T, Zeggwagh AA, Balkhi H, Elkhayari M, Samkaoui N, Ezzouine H, Benslama A, Amor M, Maazouzi W, Cimic N, Beck O, Bruns MM, Schouten JA, Rinia M, Raaijmakers M, Heunks LM, Van Wezel HM, Heines SJ, Strauch U, Buise MP, Simonis FD, Schultz MJ, Goodson JC, Browne TS, Navarra L, Hunt A, Hutchison RA, Bailey MB, Newby L, Mcarthur C, Kalkoff M, Mcleod A, Casement J, Hacking DJ, Andersen FH, Dolva MS, Laake JH, Barratt-Due A, Noremark KAL, Søreide E, Sjøbø BÅ, Guttormsen AB, Leon Yoshido HH, Aguilar RZ, Montes Oscanoa FA, Alisasis AU, Robles JB, Pasanting-Lim RAB, Tan BC, Andruszkiewicz P, Jakubowska K, Coxo CM, Alvarez AM, Oliveira BS, Montanha GM, Barros NC, Pereira CS, Messias AM, Monteiro JM, Araujo AM, Catorze NT, Marum SM, Bouw MJ, Gomes RM, Brito VA, Castro S, Estilita JM, Barros FM, Serra IM, Martinho AM, Tomescu DR, Marcu A, Bedreag OH, Papurica M, Corneci DE, Negoita SI, Grigoriev E, Gritsan AI, Gazenkampf AA, Almekhlaf G, Albarrak MM, Mustafa GM, Maghrabi KA, Salahuddin N, Aisa TM, Al Jabbary AS, Tabhan E, Arabi YM, Trinidad OA, Al Dorzi HM, Tabhan EE, Bolon S, Smith O, Mancebo J, Aguirre-Bermeo H, Lopez-Delgado JC, Esteve F, Rialp G, Forteza C, De Haro C, Artigas A, Albaiceta GM, De Cima-Iglesias S, Seoane-Quiroga L, Ceniceros-Barros A, Ruiz-Aguilar AL, Claraco-Vega LM, Soler JA, Lorente MDC, Hermosa C, Gordo F, Prieto-González M, Perez MP, Perez CP, Allue RM, Roche-Campo F, Ibañez-Santacruz M, Temprano S, Pintado MC, De Pablo R, Gómez PRA, Ruiz SR, Iglesias Moles S, Jurado MT, Arizmendi A, Piacentini EA, Franco N, Honrubia T, Cheng MP, Losada EP, Blanco J, Yuste LJ, Carbayo-Gorriz C, Cazorla-Barranquero FG, Alonso JG, Alda RS, Algaba Á, Navarro G, Cereijo E, Diaz-Rodriguez E, Marcos DP, Montero LA, Para LH, Sanchez RJ, Navalpotro MAB, Abad RD, González RM, Toribio DP, Castro AG, Artiga MJD, Penuelas O, Roser TP, Olga MF, Curto EG, Sánchez RM, Imma VP, Elisabet GM, Claverias L, Magret M, Pellicer AM, Rodriguez LL, Sánchez-Ballesteros J, González-Salamanca Á, Jimenez AG, Huerta FP, Sotillo Diaz JCJ, Lopez EB, Llinares Moya DD, Tallet Alfonso AA, Eugenio Luis PS, Cesar PS, Rafael SI, Virgilio CG, Recio NN, Adamsson RO, Rylander CC, Holzgraefe B, Broman LM, Wessbergh J, Persson L, Schiöler F, Kedelv H, Tibblin AO, Appelberg H, Hedlund L, Helleberg J, Eriksson KE, Glietsch R, Larsson N, Nygren I, Nunes SL, Morin AK, Kander T, Adolfsson A, Piquilloud L, Zender HO, Leemann-Refondini C, Elatrous S, Bouchoucha S, Chouchene I, Ouanes I, Ben Souissi A, Kamoun S, Demirkiran O, Aker M, Erbabacan E, Ceylan I, Girgin NK, Ozcelik M, Ünal N, Meco BC, Akyol OO, Derman SS, Kennedy B, Parhar K, Srinivasa L, McNamee L, McAuley D, Hopkins P, Mellis C, Kakar V, Hadfield D, Vercueil A, Bhowmick K, Humphreys SK, Ferguson A, Mckee R, Raj AS, Fawkes DA, Watt P, Twohey L, Jha RR, Thomas M, Morton A, Kadaba V, Smith MJ, Hormis AP, Kannan SG, Namih M, Reschreiter H, Camsooksai J, Kumar A, Rugonfalvi S, Nutt C, O'Neill O, Seasman C, Dempsey G, Scott CJ, Ellis HE, Mckechnie S, Hutton PJ, Di Tomasso NN, Vitale MN, Griffin RO, Dean MN, Cranshaw JH, Willett EL, Ioannou N, Gillis S, Csabi P, Macfadyen R, Dawson H, Preez PD, Williams AJ, Boyd O, De Gordoa LO, Bramall J, Chau SK, Wenham T, Szakmany T, Toth-Tarsoly P, McCalman KH, Alexander P, Stephenson L, Collyer T, Chapman R, Cooper R, Allan RM, Sim M, Wrathall DW, Irvine DA, Zantua KS, Adams JC, Burtenshaw AJ, Sellors GP, Welters ID, Williams KE, Hessell RJ, Oldroyd MG, Battle CE, Pillai S, Kajtor I, Sivashanmugavel M, O'Kane SC, Donnelly A, Frigyik AD, Careless JP, May MM, Stewart R, Trinder TJ, Hagan SJ, Wise MP, Cole JM, MacFie CC, Dowling AT, Hurtado J, Nin N, Hurtado J, Nuñez E, Pittini G, Rodriguez R, Imperio MC, Santos C, Deicas A, Serra C, Uppalapati A, Kamel G, Banner-Goodspeed VM, Beitler JR, Mukkera SR, Kulkarni S, Lee J, Mesar T, Shinn JO 3rd, Gomaa D, Tainter C, Mesar T, Yeatts DJ, Warren J, Lanspa MJ, Miller RR, Grissom CK, Brown SM, Bauer PR, Gosselin RJ, Kitch BT, Cohen JE, Beegle SH, Gueret RM, Tulaimat A, Choudry S, Stigler W, Batra H, Huff NG, Lamb KD, Oetting TW, Mohr NM, Judy C, Saito S, Kheir FM, Kheir F, Schlichting AB, Delsing A, Crouch DR, Elmasri M, Ismail D, Dreyer KR, Blakeman TC, Gomaa D, Baron RM, Grijalba CQ, Hou PC, Seethala R, Aisiku I, Henderson G, Frendl G, Hou SK, Owens RL, Schomer A, Bumbasirevic V, Jovanovic B, Surbatovic M, Veljovic M., Van Haren, F, Pham, T, Brochard, L, Bellani, G, Laffey, J, Dres, M, Fan, E, Goligher, E, Heunks, L, Lynch, J, Wrigge, H, Mcauley, D, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (MGD) Services des soins intensifs, and Intensive care medicine
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Male ,Respiratory rate ,medicine.medical_treatment ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,Clinical Investigations ,Respiration, Artificial/methods ,mechanical ventilation ,Critical Care and Intensive Care Medicine ,NO ,Positive-Pressure Respiration ,03 medical and health sciences ,0302 clinical medicine ,acute respiratory distress syndrome, controlled mechanical ventilation, spontaneous breathing, supported ventilation ,Respiratory Rate ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Artificial/methods ,Mechanical ventilation ,Respiratory Distress Syndrome ,business.industry ,Respiration ,Confounding ,030208 emergency & critical care medicine ,Odds ratio ,Tidal Waves ,acute respiratory distress syndrome ,Middle Aged ,Respiration, Artificial ,3. Good health ,controlled mechanical ventilation ,Treatment Outcome ,030228 respiratory system ,Anesthesia ,supported ventilation ,Breathing ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,spontaneous breathing ,Respiratory Distress Syndrome, Adult/physiopathology ,Observational study ,ARDS ,Female ,Adult/physiopathology ,business ,Respiratory Insufficiency ,Cohort study - Abstract
Supplemental Digital Content is available in the text., Objectives: To describe the characteristics and outcomes of patients with acute respiratory distress syndrome with or without spontaneous breathing and to investigate whether the effects of spontaneous breathing on outcome depend on acute respiratory distress syndrome severity. Design: Planned secondary analysis of a prospective, observational, multicentre cohort study. Setting: International sample of 459 ICUs from 50 countries. Patients: Patients with acute respiratory distress syndrome and at least 2 days of invasive mechanical ventilation and available data for the mode of mechanical ventilation and respiratory rate for the 2 first days. Interventions: Analysis of patients with and without spontaneous breathing, defined by the mode of mechanical ventilation and by actual respiratory rate compared with set respiratory rate during the first 48 hours of mechanical ventilation. Measurements and Main Results: Spontaneous breathing was present in 67% of patients with mild acute respiratory distress syndrome, 58% of patients with moderate acute respiratory distress syndrome, and 46% of patients with severe acute respiratory distress syndrome. Patients with spontaneous breathing were older and had lower acute respiratory distress syndrome severity, Sequential Organ Failure Assessment scores, ICU and hospital mortality, and were less likely to be diagnosed with acute respiratory distress syndrome by clinicians. In adjusted analysis, spontaneous breathing during the first 2 days was not associated with an effect on ICU or hospital mortality (33% vs 37%; odds ratio, 1.18 [0.92–1.51]; p = 0.19 and 37% vs 41%; odds ratio, 1.18 [0.93–1.50]; p = 0.196, respectively ). Spontaneous breathing was associated with increased ventilator-free days (13 [0–22] vs 8 [0–20]; p = 0.014) and shorter duration of ICU stay (11 [6–20] vs 12 [7–22]; p = 0.04). Conclusions: Spontaneous breathing is common in patients with acute respiratory distress syndrome during the first 48 hours of mechanical ventilation. Spontaneous breathing is not associated with worse outcomes and may hasten liberation from the ventilator and from ICU. Although these results support the use of spontaneous breathing in patients with acute respiratory distress syndrome independent of acute respiratory distress syndrome severity, the use of controlled ventilation indicates a bias toward use in patients with higher disease severity. In addition, because the lack of reliable data on inspiratory effort in our study, prospective studies incorporating the magnitude of inspiratory effort and adjusting for all potential severity confounders are required.
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- 2019
3. Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study.
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Zampieri FG, Cavalcanti AB, Taniguchi LU, Lisboa TC, Serpa-Neto A, Azevedo LCP, Nassar AP Jr, Miranda TA, Gomes SPC, de Alencar Filho MS, da Silva RTA, Lacerda FH, Veiga VC, de Oliveira Manoel AL, Biondi RS, Maia IS, Lovato WJ, de Oliveira CD, Pizzol FD, Filho MC, Amendola CP, Westphal GA, Figueiredo RC, Caser EB, de Figueiredo LM, de Freitas FGR, Fernandes SS, Gobatto ALN, Paranhos JLR, de Melo RMV, Sousa MT, de Almeida GMB, Ferronatto BR, Ferreira DM, Ramos FJS, Thompson MM, Grion CMC, Santos RHN, Damiani LP, and Machado FR
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Background: Nosocomial sepsis is a major healthcare issue, but there are few data on estimates of its attributable mortality. We aimed to estimate attributable mortality fraction (AF) due to nosocomial sepsis., Methods: Matched 1:1 case-control study in 37 hospitals in Brazil. Hospitalized patients in participating hospitals were included. Cases were hospital non-survivors and controls were hospital survivors, which were matched by admission type and date of discharge. Exposure was defined as occurrence of nosocomial sepsis, defined as antibiotic prescription plus presence of organ dysfunction attributed to sepsis without an alternative reason for organ failure; alternative definitions were explored. Main outcome measurement was nosocomial sepsis-attributable fractions, estimated using inversed-weight probabilities methods using generalized mixed model considering time-dependency of sepsis occurrence., Results: 3588 patients from 37 hospitals were included. Mean age was 63 years and 48.8% were female at birth. 470 sepsis episodes occurred in 388 patients (311 in cases and 77 in control group), with pneumonia being the most common source of infection (44.3%). Average AF for sepsis mortality was 0.076 (95% CI 0.068-0.084) for medical admissions; 0.043 (95% CI 0.032-0.055) for elective surgical admissions; and 0.036 (95% CI 0.017-0.055) for emergency surgeries. In a time-dependent analysis, AF for sepsis rose linearly for medical admissions, reaching close to 0.12 on day 28; AF plateaued earlier for other admission types (0.04 for elective surgery and 0.07 for urgent surgery). Alternative sepsis definitions yield different estimates., Conclusion: The impact of nosocomial sepsis on outcome is more pronounced in medical admissions and tends to increase over time. The results, however, are sensitive to sepsis definitions., (© 2023. The Author(s).)
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- 2023
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4. Short-term survival of patients with advanced pancreatic cancer admitted to intensive care unit: a retrospective cohort study.
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de Almeida MJ, Camandaroba MPG, Nassar AP Jr, and de Jesus VHF
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Background: Little is known about the outcomes of patients with advanced pancreatic cancer admitted to the intensive care unit (ICU) due to medical complications. We designed a study to evaluate their short-term (30-day) survival, predictors of short-term survival and chances of additional chemotherapy., Methods: We reviewed all patients with advanced (stage III or IV) pancreatic adenocarcinoma admitted to an ICU in a dedicated Brazilian cancer centre from 2009 to 2018 due to medical reasons. We fitted multivariate regression models to identify predictors of 30-day survival and additional systemic chemotherapy., Results: The study population consisted of 171 patients. Ninety-four patients (55.0%) had Eastern Cooperative Oncology Group (ECOG) performance status 2-4 and 146 (85.4%) had metastatic disease. Most patients ( N = 75; 43.9%) were admitted to the ICU during first-line treatment. Median overall survival was 32 days (95% confidence interval (95% CI): 20-49). Survival rate at 30 days was 50.6%. ECOG performance status 2-4 was the only variable associated with lower probability of survival at 30 days in multivariate analysis (odds ratio: 0.28; 95% CI: 0.14-0.54; p < 0.001). Overall, 58 patients (33.9%) received additional chemotherapy and among all patients, 13.5% experienced clinical benefit from this treatment., Conclusion: Patients with advanced pancreatic cancer admitted to the ICU for medical reasons have a dismal prognosis. Early palliative care and refined tools to establish those who would benefit from an ICU trial could help improve patients' care., Competing Interests: None., (© the authors; licensee ecancermedicalscience.)
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- 2022
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5. IMPACTO-MR: a Brazilian nationwide platform study to assess infections and multidrug resistance in intensive care units.
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Tomazini BM, Nassar AP Jr, Lisboa TC, Azevedo LCP, Veiga VC, Catarino DGM, Fogazzi DV, Arns B, Piastrelli FT, Dietrich C, Negrelli KL, Jesuíno IA, Reis LFL, Mattos RR, Pinheiro CCG, Luz MN, Spadoni CCDS, Moro EE, Bueno FR, Sampaio CSJC, Silva DP, Baldassare FP, Silva ACA, Veiga T, Barbante L, Lambauer M, Campos VB, Santos E, Santos RHN, Laranjeiras LN, Valeis N, Santucci E, Miranda TA, Patrocínio ACLD, Carvalho A, Sousa EMC, Sousa AHF, Malheiro DT, Bezerra IL, Rodrigues MB, Malicia JC, Silva SSD, Gimenes BDP, Sesin GP, Zavascki AP, Sganzerla D, Medeiros GS, Santos RDRMD, Silva FKR, Cheno MY, Abrahão CF, Oliveira Junior HA, Rocha LL, Nunes Neto PA, Pereira VC, Paciência LEM, Bueno ES, Caser EB, Ribeiro LZ, Fernandes CCF, Garcia JM, Silva VFF, Santos AJD, Machado FR, Souza MA, Ferronato BR, Urbano HCA, Moreira DCA, Souza-Dantas VC, Duarte DM, Coelho J, Figueiredo RC, Foreque F, Romano TG, Cubos D, Spirale VM, Nogueira RS, Maia IS, Zandonai CL, Lovato WJ, Cerantola RB, Toledo TGP, Tomba PO, Almeida JR, Sanches LC, Pierini L, Cunha M, Sousa MT, Azevedo B, Dal-Pizzol F, Damasio DC, Bainy MP, Beduhn DAV, Jatobá JDVN, Moura MTF, Rego LRM, Silva AVD, Oliveira LP, Sodré Filho ES, Santos SSD, Neves IL, Leão VCA, Paes JLL, Silva MCM, Oliveira CD, Santiago RCB, Paranhos JLDR, Wiermann IGDS, Pedroso DFF, Sawada PY, Prestes RM, Nascimento GC, Grion CMC, Carrilho CMDM, Dantas RLAM, Silva EP, Silva ACD, Oliveira SMB, Golin NA, Tregnago R, Lima VP, Silva KGND, Boschi E, Buffon V, Machado AS, Capeletti L, Foernges RB, Carvalho AS, Oliveira Junior LC, Oliveira DC, Silva EM, Ribeiro J, Pereira FC, Salgado FB, Deutschendorf C, Silva CFD, Gobatto ALN, Oliveira CB, Dracoulakis MDA, Alvaia NOS, Souza RM, Araújo LLC, Melo RMV, Passos LCS, Vidal CFL, Rodrigues FLA, Kurtz P, Shinotsuka CR, Tavares MB, Santana IDV, Gavinho LMDS, Nascimento AB, Pereira AJ, and Cavalcanti AB
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- Humans, Prospective Studies, Brazil, Drug Resistance, Multiple, Bacterial, Intensive Care Units, Cross Infection epidemiology
- Abstract
Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria., Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform., Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database., Conclusion: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials.
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- 2022
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6. Identifying associations between diabetes and acute respiratory distress syndrome in patients with acute hypoxemic respiratory failure: an analysis of the LUNG SAFE database
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Boyle A. J., Madotto F., Laffey J. G., Bellani G., Pham T., Pesenti A., Thompson B. T., O'Kane C. M., Deane A. M., McAuley D. F, Rios F, Van Haren F, Faruq MO, Sottiaux T, Depuydt P, Lora FS, Azevedo LC, Fan E, Bugedo G, Qiu H, Gonzalez M, Silesky J, Cerny V, Nielsen J, Jibaja M, Pham T, Wrigge H, Matamis D, Ranero JL, Gomersall C, Amin P, Hashemian SM, Clarkson K, Bellani G, Kurahashi K, Koh Y, Villagomez A, Zeggwagh AA, Heunks LM, Laake JH, Kashif W, Synclair J, Palo JE, do Vale Fernandes A, Sandesc D, Arabi Y, Bumbasierevic V, Nin N, Lorente JA, Larsson A, Piquilloud L, Patjanasoontorn B, Abroug F, McAuley DF, McNamee L, Hurtado J, Bajwa E, Démpaire G, Francois GM, Rabboni F, Conti S, Sula H, Cani A, Zazu A, Dellera C, Alejandro RV, Daldin J, Fernandez RO, Cardonnet LP, Bettini LR, Bisso MC, Osman EM, Setten MG, Lovazzano P, Alvarez J, Villar V, Pozo NC, Grubissich N, Plotnikow GA, Vasquez DN, Ilutovich S, Tiribelli N, Chena A, Pellegrini CA, Saenz MG, Estenssoro E, Brizuela M, Gianinetto H, Gomez PE, Cerrato VI, Bezzi MG, Borello SA, Loiacono FA, Fernandez AM, Knowles S, Reynolds C, Inskip DM, Miller JJ, Kong J, Whitehead C, Bihari S, Seven A, Krstevski A, Rodgers HJ, Millar RT, Mckenna TE, Bailey IM, Hanlon GC, Aneman A, Lynch JM, Azad R, Neal J, Woods PW, Roberts BL, Kol MR, Wong HS, Riss KC, Staudinger T, Wittebole X, Bulpa PA, Dive AM, Verstraete R, Lebbinck H, Vermassen J, Philippe M, Ceunen H, Rosa JI, Beraldo DO, Piras C, Rampinelli AM, Nassar AP Jr, Mataloun S, Moock M, Thompson MM, Gonçalves CH, Antônio ACP, Ascoli A, Biondi RS, Fontenele DC, Nobrega D, Sales VM, Shindhe S, Pg Hj Ismail DMAB, Laffey J, Beloncle F, Davies KG, Cirone R, Manoharan V, Ismail M, Goligher EC, Jassal M, Ferguson ND, Nishikawa E, Javeed A, Curley G, Rittayamai N, Parotto M, Mehta S, Knoll J, Pronovost A, Bruhn SCAR, Garcia PH, Aliaga FA, Farías PA, Yumha JS, Ortiz CA, Salas JE, Saez AA, Vega LD, Labarca EF, Martinez FT, Carreño NG, Lora P, Liu H, Liu L, Tang R, Luo X, An Y, Zhao H, Gao Y, Zhai Z, Ye ZL, Wang W, Li W, Li Q, Zheng R, Yu W, Shen J, Li X, Yu T, Lu W, Wu YQ, Huang XB, He Z, Lu Y, Han H, Zhang F, Sun R, Wang HX, Qin SH, Zhu BH, Zhao J, Liu J, Li B, Liu JL, Zhou FC, Li QJ, Zhang XY, Li-Xin Z, Xin-Hua Q, Jiang L, Gao YN, Zhao XY, Li YY, Li XL, Wang C, Yao Q, Yu R, Chen K, Shao H, Qin B, Huang QQ, Zhu WH, Hang AY, Hua MX, Li Y, Xu Y, Di YD, Ling LL, Qin TH, Wang SH, Qin J, Han Y, Zhou S, Vargas MP, Silesky Jimenez JI, González Rojas MA, Solis-Quesada JE, Ramirez-Alfaro CM, Máca J, Sklienka P, Gjedsted J, Christiansen A, Rigshopitalet, Villamagua BG, Llano M, Burtin P, Buzancais G, Beuret P, Pelletier N, Mortaza S, Mercat A, Chelly J, Jochmans S, Terzi N, Daubin C, Carteaux G, de Prost N, Chiche JD, Daviaud F, Fartoukh M, Barberet G, Biehler J, Dellamonica J, Doyen D, Arnal JM, Briquet A, Klasen F, Papazian L, Follin A, Roux D, Messika J, Kalaitzis E, Dangers L, Combes A, Au SM, Béduneau G, Carpentier D, Zogheib EH, Dupont H, Ricome S, Santoli FL, Besset SL, Michel P, Gelée B, Danin PE, Goubaux B, Crova PJ, Phan NT, Berkelmans F, Badie JC, Tapponnier R, Gally J, Khebbeb S, Herbrecht JE, Schneider F, Declercq PM, Rigaud JP, Duranteau J, Harrois A, Chabanne R, Marin J, Constantin JM, Thibault S, Ghazi M, Boukhazna M, Zein SO, Richecoeur JR, Combaux DM, Grelon F, Le Moal C, Sauvadet EP, Robine A, Lemiale V, Reuter D, Dres M, Demoule A, Goldgran-Toledano D, Baboi L, Guérin C, Lohner R, Kraßler J, Schäfer S, Zacharowski KD, Meybohm P, Reske AW, Simon P, Hopf HF, Schuetz M, Baltus T, Papanikolaou MN, Papavasilopoulou TG, Zacharas GA, Ourailogloy V, Mouloudi EK, Massa EV, Nagy EO, Stamou EE, Kiourtzieva EV, Oikonomou MA, Avila LE, Cortez CA, Citalán JE, Jog SA, Sable SD, Shah B, Gurjar M, Baronia AK, Memon M, Muthuchellappan R, Ramesh VJ, Shenoy A, Unnikrishnan R, Dixit SB, Rhayakar RV, Ramakrishnan N, Bhardwaj VK, Mahto HL, Sagar SV, Palaniswamy V, Ganesan D, Jamaati H, Heidari F, Meaney EA, Nichol A, Knapman KM, O'Croinin D, Dunne ES, Breen DM, Clarkson KP, Jaafar RF, Dwyer R, Amir F, Ajetunmobi OO, O'Muircheartaigh AC, Black CS, Treanor N, Collins DV, Altaf W, Zani G, Fusari M, Spadaro S, Volta CA, Graziani R, Brunettini B, Palmese S, Formenti P, Umbrello M, Lombardo A, Pecci E, Botteri M, Savioli M, Protti A, Mattei A, Schiavoni L, Tinnirello A, Todeschini M, Giarratano A, Cortegiani A, Sher S, Rossi A, Antonelli MM, Montini LM, Casalena P, Scafetti S, Panarello G, Occhipinti G, Patroniti N, Pozzi M, Biscione RR, Poli MM, Raimondi F, Albiero D, Crapelli G, Beck E, Pota V, Schiavone V, Molin A, Tarantino F, Monti G, Frati E, Mirabella L, Cinnella G, Fossali T, Colombo R, Pattarino PTI, Mojoli F, Braschi A, Borotto EE, Cracchiolo AN, Palma DM, Raponi F, Foti G, Vascotto ER, Coppadoro A, Brazzi L, Floris L, Iotti GA, Venti A, Yamaguchi O, Takagi S, Maeyama HN, Watanabe E, Yamaji Y, Shimizu K, Shiozaki K, Futami S, Ryosuke S, Saito K, Kameyama Y, Ueno K, Izawa M, Okuda N, Suzuki H, Harasawa T, Nasu M, Takada T, Ito F, Nunomiya S, Koyama K, Abe T, Andoh K, Kusumoto K, Hirata A, Takaba A, Kimura H, Matsumoto S, Higashijima U, Honda H, Aoki N, Imai H, Ogino Y, Mizuguchi I, Ichikado K, Nitta K, Mochizuki K, Hashida T, Tanaka H, Nakamura T, Niimi D, Ueda T, Kashiwa Y, Uchiyama A, Sabelnikovs O, Oss P, Haddad Y, Liew KY, Ñamendys-Silva SA, Jarquin-Badiola YD, Sanchez-Hurtado LA, Gomez-Flores SS, Marin MC, Villagomez AJ, Lemus JS, Fierro JM, Cervantes MR, Mejia FJF, Dector D, Dector DM, Gonzalez DR, Estrella CR, Sanchez-Medina JR, Ramirez-Gutierrez A, George FG, Aguirre JS, Buensuseso JA, Poblano M, Dendane T, Balkhi H, Elkhayari M, Samkaoui N, Ezzouine H, Benslama A, Amor M, Maazouzi W, Cimic N, Beck O, Bruns MM, Schouten JA, Rinia M, Raaijmakers M, Van Wezel HM, Heines SJ, Strauch U, Buise MP, Simonis FD, Schultz MJ, Goodson JC, Browne TS, Navarra L, Hunt A, Hutchison RA, Bailey MB, Newby L, Mcarthur C, Kalkoff M, Mcleod A, Casement J, Hacking DJ, Andersen FH, Dolva MS, Barratt-Due A, Noremark KAL, Søreide E, Sjøbø BÅ, Guttormsen AB, Leon Yoshido HH, Aguilar RZ, Montes Oscanoa FA, Alisasis AU, Robles JB, Pasanting-Lim RAB, Tan BC, Andruszkiewicz P, Jakubowska K, Coxo CM, Alvarez AM, Oliveira BS, Montanha GM, Barros NC, Pereira CS, Messias AM, Monteiro JM, Araujo AM, Catorze NT, Marum SM, Bouw MJ, Gomes RM, Brito VA, Castro S, Estilita JM, Barros FM, Serra IM, Martinho AM, Tomescu DR, Marcu A, Bedreag OH, Papurica M, Corneci DE, Negoita SI, Grigoriev E, Gritsan AI, Gazenkampf AA, Almekhlafi G, Albarrak MM, Mustafa GM, Maghrabi KA, Salahuddin N, Aisa TM, Al Jabbary AS, Tabhan E, Arabi YM, Trinidad OA, Al Dorzi HM, Tabhan EE, Bolon S, Smith O, Mancebo J, Aguirre-Bermeo H, Lopez-Delgado JC, Esteve F, Rialp G, Forteza C, De Haro C, Artigas A, Albaiceta GM, De Cima-Iglesias S, Seoane-Quiroga L, Ceniceros-Barros A, Ruiz-Aguilar AL, Claraco-Vega LM, Soler JA, Del Carmen Lorente M, Hermosa C, Gordo F, Prieto-González M, López-Messa JB, Perez MP, Perez CP, Allue RM, Roche-Campo F, Ibañez-Santacruz M, Temprano S, Pintado MC, De Pablo R, Gómez PRA, Ruiz SR, Moles SI, Jurado MT, Arizmendi A, Piacentini EA, Franco N, Honrubia T, Cheng MP, Losada EP, Blanco J, Yuste LJ, Carbayo-Gorriz C, Cazorla-Barranquero FG, Alonso JG, Alda RS, Algaba Á, Navarro G, Cereijo E, Diaz-Rodriguez E, Marcos DP, Montero LA, Para LH, Sanchez RJ, Navalpotro MAB, Abad RD, González RM, Toribio DP, Castro AG, Artiga MJD, Penuelas O, Roser TP, Olga MF, Curto EG, Sánchez RM, Imma VP, Elisabet GM, Claverias L, Magret M, Pellicer AM, Rodriguez LL, Sánchez-Ballesteros J, González-Salamanca Á, Jimenez AG, Huerta FP, Llinares Moya DD, Tallet Alfonso AA, Luis PSE, Cesar PS, Rafael SI, Virgilio CG, Recio NN, Adamsson RO, Rylander CC, Holzgraefe B, Broman LM, Wessbergh J, Persson L, Schiöler F, Kedelv H, Tibblin AO, Appelberg H, Hedlund L, Helleberg J, Eriksson KE, Glietsch R, Larsson N, Nygren I, Nunes SL, Morin AK, Kander T, Adolfsson A, Zender HO, Leemann-Refondini C, Elatrous S, Bouchoucha S, Chouchene I, Ouanes I, Souissi AB, Kamoun S, Demirkiran O, Aker M, Erbabacan E, Ceylan I, Girgin NK, Ozcelik M, Ünal N, Meco BC, Akyol OO, Derman SS, Kennedy B, Parhar K, Srinivasa L, McAuley D, Hopkins P, Mellis C, Kakar V, Hadfield D, Vercueil A, Bhowmick K, Humphreys SK, Ferguson A, Mckee R, Raj AS, Fawkes DA, Watt P, Twohey L, JhaMatthew Thomas RR, Morton A, Kadaba V, Smith MJ, Hormis AP, Kannan SG, Namih M, Reschreiter H, Camsooksai J, Kumar A, Rugonfalvi S, Nutt C, Oneill O, Seasman C, Dempsey G, Scott CJ, Ellis HE, Mckechnie S, Hutton PJ, Di Tomasso NN, Vitale MN, Griffin RO, Dean MN, Cranshaw JH, Willett EL, Ioannou N, Gillis S, Csabi P, Macfadyen R, Dawson H, Preez PD, Williams AJ, Boyd O, De Gordoa LO, Bramall J, Symmonds S, Chau SK, Wenham T, Szakmany T, Toth-Tarsoly P, Mccalman KH, Alexander P, Stephenson L, Collyer T, Chapman R, Cooper R, Allan RM, Sim M, Wrathall DW, Irvine DA, Zantua KS, Adams JC, Burtenshaw AJ, Sellors GP, Welters ID, Williams KE, Hessell RJ, Oldroyd MG, Battle CE, Pillai S, Kajtor I, Sivashanmugavel M, Okane SC, Donnelly A, Frigyik AD, Careless JP, May MM, Stewart R, John Trinder T, Hagan 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M, Mehta S, Knoll J, Pronovost A, Bruhn SCAR, Garcia PH, Aliaga FA, Farías PA, Yumha JS, Ortiz CA, Salas JE, Saez AA, Vega LD, Labarca EF, Martinez FT, Carreño NG, Lora P, Liu H, Qiu H, Liu L, Tang R, Luo X, An Y, Zhao H, Gao Y, Zhai Z, Ye ZL, Wang W, Li W, Li Q, Zheng R, Yu W, Shen J, Li X, Yu T, Lu W, Wu YQ, Huang XB, He Z, Lu Y, Han H, Zhang F, Sun R, Wang HX, Qin SH, Zhu BH, Zhao J, Liu J, Li B, Liu JL, Zhou FC, Li QJ, Zhang XY, Li-Xin Z, Xin-Hua Q, Jiang L, Gao YN, Zhao XY, Li YY, Li XL, Wang C, Yao Q, Yu R, Chen K, Shao H, Qin B, Huang QQ, Zhu WH, Hang AY, Hua MX, Li Y, Xu Y, Di YD, Ling LL, Qin TH, Wang SH, Qin J, Han Y, Zhou S, Vargas MP, Silesky Jimenez JI, González Rojas MA, Solis-Quesada JE, Ramirez-Alfaro CM, Máca J, Sklienka P, Gjedsted J, Christiansen A, Rigshopitalet, Nielsen J, Villamagua BG, Llano M, Burtin P, Buzancais G, Beuret P, Pelletier N, Mortaza S, Mercat A, Chelly J, Jochmans S, Terzi N, Daubin C, Carteaux G, de Prost N, Chiche JD, Daviaud F, Pham T, Fartoukh M, Barberet G, Biehler J, Dellamonica J, Doyen D, Arnal JM, Briquet A, Klasen F, Papazian L, Follin A, Roux D, Messika J, Kalaitzis E, Dangers L, Combes A, Au SM, Béduneau G, Carpentier D, Zogheib EH, Dupont H, Ricome S, Santoli FL, Besset SL, Michel P, Gelée B, Danin PE, Goubaux B, Crova PJ, Phan NT, Berkelmans F, Badie JC, Tapponnier R, Gally J, Khebbeb S, Herbrecht JE, Schneider F, Declercq PM, Rigaud JP, Duranteau J, Harrois A, Chabanne R, Marin J, Constantin JM, Thibault S, Ghazi M, Boukhazna M, Zein SO, Richecoeur JR, Combaux DM, Grelon F, Le Moal C, Sauvadet EP, Robine A, Lemiale V, Reuter D, Dres M, Demoule A, Goldgran-Toledano D, Baboi L, Guérin C, Lohner R, Kraßler J, Schäfer S, Zacharowski KD, Meybohm P, Reske AW, Simon P, Hopf HF, Schuetz M, Baltus T, Papanikolaou MN, Papavasilopoulou TG, Zacharas GA, Ourailogloy V, Mouloudi EK, Massa EV, Nagy EO, Stamou EE, Kiourtzieva EV, Oikonomou MA, Avila LE, Cortez CA, Citalán JE, Jog SA, Sable SD, Shah B, Gurjar M, Baronia AK, Memon M, Muthuchellappan R, Ramesh VJ, Shenoy A, Unnikrishnan R, Dixit SB, Rhayakar RV, Ramakrishnan N, Bhardwaj VK, Mahto HL, Sagar SV, Palaniswamy V, Ganesan D, Hashemian SM, Jamaati H, Heidari F, Meaney EA, Nichol A, Knapman KM, O'Croinin D, Dunne ES, Breen DM, Clarkson KP, Jaafar RF, Dwyer R, Amir F, Ajetunmobi OO, O'Muircheartaigh AC, Black CS, Treanor N, Collins DV, Altaf W, Zani G, Fusari M, Spadaro S, Volta CA, Graziani R, Brunettini B, Palmese S, Formenti P, Umbrello M, Lombardo A, Pecci E, Botteri M, Savioli M, Protti A, Mattei A, Schiavoni L, Tinnirello A, Todeschini M, Giarratano A, Cortegiani A, Sher S, Rossi A, Antonelli MM, Montini LM, Casalena P, Scafetti S, Panarello G, Occhipinti G, Patroniti N, Pozzi M, Biscione RR, Poli MM, Raimondi F, Albiero D, Crapelli G, Beck E, Pota V, Schiavone V, Molin A, Tarantino F, Monti G, Frati E, Mirabella L, Cinnella G, Fossali T, Colombo R, Pattarino PTI, Mojoli F, Braschi A, Borotto EE, Cracchiolo AN, Palma DM, Raponi F, Foti G, Vascotto ER, Coppadoro A, Brazzi L, Floris L, Iotti GA, Venti A, Yamaguchi O, Takagi S, Maeyama HN, Watanabe E, Yamaji Y, Shimizu K, Shiozaki K, Futami S, Ryosuke S, Saito K, Kameyama Y, Ueno K, Izawa M, Okuda N, Suzuki H, Harasawa T, Nasu M, Takada T, Ito F, Nunomiya S, Koyama K, Abe T, Andoh K, Kusumoto K, Hirata A, Takaba A, Kimura H, Matsumoto S, Higashijima U, Honda H, Aoki N, Imai H, Ogino Y, Mizuguchi I, Ichikado K, Nitta K, Mochizuki K, Hashida T, Tanaka H, Nakamura T, Niimi D, Ueda T, Kashiwa Y, Uchiyama A, Sabelnikovs O, Oss P, Haddad Y, Liew KY, Ñamendys-Silva SA, Jarquin-Badiola YD, Sanchez-Hurtado LA, Gomez-Flores SS, Marin MC, Villagomez AJ, Lemus JS, Fierro JM, Cervantes MR, Mejia FJF, Dector D, Dector DM, Gonzalez DR, Estrella CR, Sanchez-Medina JR, Ramirez-Gutierrez A, George FG, Aguirre JS, Buensuseso JA, Poblano M, Dendane T, Zeggwagh AA, Balkhi H, Elkhayari M, Samkaoui N, Ezzouine H, Benslama A, Amor M, Maazouzi W, Cimic N, Beck O, Bruns MM, Schouten JA, Rinia M, Raaijmakers M, Heunks LM, Van Wezel HM, Heines SJ, Strauch U, Buise MP, Simonis FD, Schultz MJ, Goodson JC, Browne TS, Navarra L, Hunt A, Hutchison RA, Bailey MB, Newby L, Mcarthur C, Kalkoff M, Mcleod A, Casement J, Hacking DJ, Andersen FH, Dolva MS, Laake JH, Barratt-Due A, Noremark KAL, Søreide E, Sjøbø BÅ, Guttormsen AB, Leon Yoshido HH, Aguilar RZ, Montes Oscanoa FA, Alisasis AU, Robles JB, Pasanting-Lim RAB, Tan BC, Andruszkiewicz P, Jakubowska K, Coxo CM, Alvarez AM, Oliveira BS, Montanha GM, Barros NC, Pereira CS, Messias AM, Monteiro JM, Araujo AM, Catorze NT, Marum SM, Bouw MJ, Gomes RM, Brito VA, Castro S, Estilita JM, Barros FM, Serra IM, Martinho AM, Tomescu DR, Marcu A, Bedreag OH, Papurica M, Corneci DE, Negoita SI, Grigoriev E, Gritsan AI, Gazenkampf AA, Almekhlafi G, Albarrak MM, Mustafa GM, Maghrabi KA, Salahuddin N, Aisa TM, Al Jabbary AS, Tabhan E, Arabi YM, Arabi YM, Trinidad OA, Al Dorzi HM, Tabhan EE, Bolon S, Smith O, Mancebo J, Aguirre-Bermeo H, Lopez-Delgado JC, Esteve F, Rialp G, Forteza C, De Haro C, Artigas A, Albaiceta GM, De Cima-Iglesias S, Seoane-Quiroga L, Ceniceros-Barros A, Ruiz-Aguilar AL, Claraco-Vega LM, Soler JA, Del Carmen Lorente M, Hermosa C, Gordo F, Prieto-González M, López-Messa JB, Perez MP, Perez CP, Allue RM, Roche-Campo F, Ibañez-Santacruz M, Temprano S, Pintado MC, De Pablo R, Gómez PRA, Ruiz SR, Moles SI, Jurado MT, Arizmendi A, Piacentini EA, Franco N, Honrubia T, Cheng MP, Losada EP, Blanco J, Yuste LJ, Carbayo-Gorriz C, Cazorla-Barranquero FG, Alonso JG, Alda RS, Algaba Á, Navarro G, Cereijo E, Diaz-Rodriguez E, Marcos DP, Montero LA, Para LH, Sanchez RJ, Navalpotro MAB, Abad RD, González RM, Toribio DP, Castro AG, Artiga MJD, Penuelas O, Roser TP, Olga MF, Curto EG, Sánchez RM, Imma VP, Elisabet GM, Claverias L, Magret M, Pellicer AM, Rodriguez LL, Sánchez-Ballesteros J, González-Salamanca Á, Jimenez AG, Huerta FP, Llinares Moya DD, Tallet Alfonso AA, Luis PSE, Cesar PS, Rafael SI, Virgilio CG, Recio NN, Adamsson RO, Rylander CC, Holzgraefe B, Broman LM, Wessbergh J, Persson L, Schiöler F, Kedelv H, Tibblin AO, Appelberg H, Hedlund L, Helleberg J, Eriksson KE, Glietsch R, Larsson N, Nygren I, Nunes SL, Morin AK, Kander T, Adolfsson A, Piquilloud L, Zender HO, Leemann-Refondini C, Elatrous S, Bouchoucha S, Chouchene I, Ouanes I, Souissi AB, Kamoun S, Demirkiran O, Aker M, Erbabacan E, Ceylan I, Girgin NK, Ozcelik M, Ünal N, Meco BC, Akyol OO, Derman SS, Kennedy B, Parhar K, Srinivasa L, McNamee L, McAuley D, Hopkins P, Mellis C, Kakar V, Hadfield D, Vercueil A, Bhowmick K, Humphreys SK, Ferguson A, Mckee R, Raj AS, Fawkes DA, Watt P, Twohey L, JhaMatthew Thomas RR, Morton A, Kadaba V, Smith MJ, Hormis AP, Kannan SG, Namih M, Reschreiter H, Camsooksai J, Kumar A, Rugonfalvi S, Nutt C, Oneill O, Seasman C, Dempsey G, Scott CJ, Ellis HE, Mckechnie S, Hutton PJ, Di Tomasso NN, Vitale MN, Griffin RO, Dean MN, Cranshaw JH, Willett EL, Ioannou N, Gillis S, Csabi P, Macfadyen R, Dawson H, Preez PD, Williams AJ, Boyd O, De Gordoa LO, Bramall J, Symmonds S, Chau SK, Wenham T, Szakmany T, Toth-Tarsoly P, Mccalman KH, Alexander P, Stephenson L, Collyer T, Chapman R, Cooper R, Allan RM, Sim M, Wrathall DW, Irvine DA, Zantua KS, Adams JC, Burtenshaw AJ, Sellors GP, Welters ID, Williams KE, Hessell RJ, Oldroyd MG, Battle CE, Pillai S, Kajtor I, Sivashanmugavel M, Okane SC, Donnelly A, Frigyik AD, Careless JP, May MM, Stewart R, John Trinder T, Hagan SJ, Wise MP, Cole JM, MacFie CC, Dowling AT, Hurtado J, Nin N, Hurtado J, Nuñez E, Pittini G, Rodriguez R, Imperio MC, Santos C, França AG, Ebeid A, Deicas A, Serra C, Uppalapati A, Kamel G, Banner-Goodspeed VM, Beitler JR, Mukkera SR, Kulkarni S, Lee J, Mesar T, Shinn Iii JO, Gomaa D, Tainter C, Lee J, Mesar T, Lee J, Yeatts DJ, Warren J, Lanspa MJ, Miller RR, Grissom CK, Brown SM, Bauer PR, Gosselin RJ, Kitch BT, Cohen JE, Beegle SH, Gueret RM, Tulaimat A, Choudry S, Stigler W, Batra H, Huff NG, Lamb KD, Oetting TW, Mohr NM, Judy C, Saito S, Kheir FM, Kheir F, Schlichting AB, Delsing A, Crouch DR, Elmasri M, Crouch DR, Ismail D, Dreyer KR, Blakeman TC, Dreyer KR, Gomaa D, Baron RM, Grijalba CQ, Hou PC, Seethala R, Aisiku I, Henderson G, Frendl G, Hou SK, Owens RL, Schomer A, Bumbasirevic V, Jovanovic B, Surbatovic M, Veljovic M., UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (SLuc) Service de soins intensifs, and UCL - (MGD) Services des soins intensifs
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Adult ,Male ,Diabetes mellitu ,LUNG SAFE ,Organ Dysfunction Scores ,humanos ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,Socio-culturale ,Organ Dysfunction Score ,Diabetes Complications ,Diabetes mellitus ,puntuaciones de disfunción orgánica ,Risk Factors ,Diabetes Complication ,estudios prospectivos ,Humans ,factores de riesgo ,Prospective Studies ,Hospital Mortality ,Hypoxia ,mediana edad ,Acute hypoxemic respiratory failure ,Aged ,Respiratory Distress Syndrome ,anciano ,Acute respiratory distress syndrome ,Research ,Respiration ,respiración ,Respiratory Distress Syndrome, Adult ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,lcsh:RC86-88.9 ,Middle Aged ,Respiration, Artificial ,insuficiencia respiratoria ,Prospective Studie ,Artificial ,Diabetes Mellitus ,Female ,Respiratory Insufficiency ,mortalidad hospitalaria ,complicaciones de la diabetes ,Human - Abstract
Background: Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARDS in critically ill patients with acute hypoxemic respiratory failure (AHRF). Methods: An ancillary analysis of a global, multi-centre prospective observational study (LUNG SAFE) was undertaken. LUNG SAFE evaluated all patients admitted to an intensive care unit (ICU) over a 4-week period, that required mechanical ventilation and met AHRF criteria. Patients who had their AHRF fully explained by cardiac failure were excluded. Important clinical characteristics were included in a stepwise selection approach (forward and backward selection combined with a significance level of 0.05) to identify a set of independent variables associated with having ARDS at any time, developing ARDS (defined as ARDS occurring after day 2 from meeting AHRF criteria) and with hospital mortality. Furthermore, propensity score analysis was undertaken to account for the differences in baseline characteristics between patients with and without diabetes mellitus, and the association between diabetes mellitus and outcomes of interest was assessed on matched samples. Results: Of the 4107 patients with AHRF included in this study, 3022 (73.6%) patients fulfilled ARDS criteria at admission or developed ARDS during their ICU stay. Diabetes mellitus was a pre-existing co-morbidity in 913 patients (22.2% of patients with AHRF). In multivariable analysis, there was no association between diabetes mellitus and having ARDS (OR 0.93 (0.78-1.11); p = 0.39), developing ARDS late (OR 0.79 (0.54-1.15); p = 0.22), or hospital mortality in patients with ARDS (1.15 (0.93-1.42); p = 0.19). In a matched sample of patients, there was no association between diabetes mellitus and outcomes of interest. Conclusions: In a large, global observational study of patients with AHRF, no association was found between diabetes mellitus and having ARDS, developing ARDS, or outcomes from ARDS., This work was supported by the European Society of Intensive Care Medicine (ESICM), Brussels, Belgium who funded the original LUNG SAFE study.
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- 2018
7. Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries
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Abe T., Madotto F., Pham T., Nagata I., Uchida M., Tamiya N., Kurahashi K., Bellani G., Laffey J. G, Francois GM, Rabboni F, Madotto F, Conti S, Laffey JG, Bellani G, Pham T, Fan E, Pesenti A, Brochard L, Esteban A, Gattinoni L, van Haren F, Larsson A, McAuley DF, Ranieri M, Rubenfeld G, Thompson BT, Wrigge H, Slutsky AS, Rios F, Sottiaux T, Depuydt P, Lora FS, Azevedo LC, Bugedo G, Qiu H, Gonzalez M, Silesky J, Cerny V, Nielsen J, Jibaja M, Matamis D, Ranero JL, Amin P, Hashemian SM, Clarkson K, Kurahashi K, Villagomez A, Zeggwagh AA, Heunks LM, Laake JH, Palo JE, do Vale Fernandes A, Sandesc D, Arabi Y, Bumbasierevic V, Nin N, Lorente JA, Piquilloud L, Abroug F, McNamee L, Hurtado J, Bajwa E, Démpair G, Sula H, Nunci L, Cani A, Zazu A, Dellera C, Insaurralde CS, Alejandro RV, Daldin J, Vinzio M, Fernandez RO, Cardonnet LP, Bettini LR, Bisso MC, Osman EM, Setten MG, Lovazzano P, Alvarez J, Villar V, Milstein C, Pozo NC, Grubissich N, Plotnikow GA, Vasquez DN, Ilutovich S, Tiribelli N, Chena A, Pellegrini CA, Saenz MG, Estenssoro E, Brizuela M, Gianinetto H, Gomez PE, Cerrato VI, Bezzi MG, Borello SA, Loiacono FA, Fernandez AM, Knowles S, Reynolds C, Inskip DM, Miller JJ, Kong J, Whitehead C, Bihari S, Seven A, Krstevski A, Rodgers HJ, Millar RT, Mckenna TE, Bailey IM, Hanlon GC, Aneman A, Lynch JM, Azad R, Neal J, Woods PW, Roberts BL, Kol MR, Wong HS, Riss KC, Wittebole X, Berghe C, Bulpa PA, Dive AM, Verstraete R, Lebbinck H, Vermassen J, Meersseman P, Ceunen H, Rosa JI, Beraldo DO, Piras C, Rampinelli AM, Nassar AP Jr, Mataloun S, Moock M, Thompson MM, Gonçalves CH, Antônio ACP, Ascoli A, Biondi RS, Fontenele DC, Nobrega D, Sales VM, Shindhe S, Ismail DHMABPH, Laffey J, Beloncle F, Davies KG, Cirone R, Manoharan V, Ismail M, Goligher EC, Jassal M, Nishikawa E, Javeed A, Curley G, Rittayamai N, Parotto M, Ferguson ND, Mehta S, Knoll J, Pronovost A, Chile SC, Bruhn AR, Garcia PH, Aliaga FA, Farías PA, Yumha JS, Ortiz CA, Salas JE, Saez AA, Vega LD, Labarca EF, Martinez FT, Carreño NG, Lora P, Liu H, Liu L, Tang R, Luo X, An Y, Zhao H, Gao Y, Zhai Z, Ye ZL, Wang W, Li W, Li Q, Zheng R, Yu W, Shen J, Li X, Yu T, Lu W, Wu YQ, Huang XB, He Z, Lu Y, Han H, Zhang F, Sun R, Wang HX, Qin SH, Zhu BH, Zhao J, Liu J, Li B, Liu JL, Zhou FC, Li QJ, Zhang XY, Li-Xin Z, Xin-Hua Q, Jiang L, Gao YN, Zhao XY, Li YY, Li XL, Wang C, Yao Q, Yu R, Chen K, Shao H, Qin B, Huang QQ, Zhu WH, Hang AY, Hua MX, Li Y, Xu Y, Di YD, Ling LL, Qin TH, Wang SH, Qin J, Han Y, Vargas MP, Silesky Jimenez JI, González Rojas MA, Solis-Quesada JE, Ramirez-Alfaro CM, Máca J, Sklienka P, Gjedsted J, Villamagua BG, Llano M, Burtin P, Buzancais G, Beuret P, Pelletier N, Mortaza S, Mercat A, Chelly J, Jochmans S, Terzi N, Daubin C, Carteaux G, de Prost N, Chiche JD, Daviaud F, Fartoukh M, Barberet G, Biehler J, Dellamonica J, Doyen D, Arnal JM, Briquet A, Hraiech S, Papazian L, Roux D, Messika J, Kalaitzis E, Médicale R, Dangers L, Combes A, Au SM, Béduneau G, Carpentier D, Zogheib EH, Dupont H, Ricome S, Santoli FL, Besset SL, Michel P, Gelée B, Danin PE, Goubaux B, Crova PJ, Phan NT, Berkelmans F, Badie JC, Tapponnier R, Gally J, Khebbeb S, Herbrecht JE, Schneider F, Declercq PM, Rigaud JP, Duranteau J, Harrois A, Chabanne R, Marin J, Bigot C, Thibault S, Ghazi M, Boukhazna M, Zein SO, Richecoeur JR, Combaux DM, Grelon F, Le Moal C, Sauvadet EP, Robine A, Lemiale V, Reuter D, Dres M, Demoule A, Goldgran-Toledano D, Baboi L, Guérin C, Lohner R, Kraßler J, Schäfer S, Zacharowski KD, Meybohm P, Reske AW, Simon P, Hopf HF, Schuetz M, Baltus T, Papanikolaou MN, Papavasilopoulou TG, Zacharas GA, Ourailogloy V, Mouloudi EK, Massa EV, Nagy EO, Stamou EE, Kiourtzieva EV, Oikonomou MA, Avila LE, Cortez CA, Citalán JE, Jog SA, Sable SD, Shah B, Gurjar M, Baronia AK, Memon M, Muthuchellappan R, Ramesh VJ, Shenoy A, Unnikrishnan R, Dixit SB, Rhayakar RV, Ramakrishnan N, Bhardwaj VK, Mahto HL, Sagar SV, Palaniswamy V, Ganesan D, Jamaati H, Heidari F, Meaney EA, Nichol A, Knapman KM, O'Croinin D, Dunne ES, Breen DM, Clarkson KP, Jaafar RF, Dwyer R, Amir F, Ajetunmobi OO, O'Muircheartaigh AC, Black CS, Treanor N, Collins DV, Altaf W, Zani G, Fusari M, Spadaro S, Volta CA, Graziani R, Brunettini B, Palmese S, Formenti P, Umbrello M, Lombardo A, Pecci E, Botteri M, Savioli M, Protti A, Mattei A, Schiavoni L, Tinnirello A, Todeschini M, Giarratano A, Cortegiani A, Sher S, Rossi A, Antonelli MM, Montini LM, Casalena P, Scafetti S, Panarello G, Occhipinti G, Patroniti N, Pozzi M, Biscione RR, Poli MM, Raimondi F, Albiero D, Crapelli G, Beck E, Pota V, Schiavone V, Molin A, Tarantino F, Monti G, Frati E, Mirabella L, Cinnella G, Fossali T, Colombo R, Pattarino PTI, Mojoli F, Braschi A, Borotto EE, Cracchiolo AN, Palma DM, Raponi F, Foti G, Vascotto ER, Coppadoro A, Brazzi L, Floris L, Iotti GA, Venti A, Yamaguchi O, Takagi S, Maeyama HN, Watanabe E, Yamaji Y, Shimizu K, Shiozaki K, Futami S, Ryosuke S, Saito K, Kameyama Y, Ueno K, Izawa M, Okuda N, Suzuki H, Harasawa T, Nasu M, Takada T, Ito F, Nunomiya S, Koyama K, Abe T, Andoh K, Kusumoto K, Hirata A, Takaba A, Kimura H, Matsumoto S, Higashijima U, Honda H, Aoki N, Imai H, Ogino Y, Mizuguchi I, Ichikado K, Nitta K, Mochizuki K, Hashida T, Tanaka H, Nakamura T, Niimi D, Ueda T, Kashiwa Y, Uchiyama A, Sabelnikovs O, Lebanon PO, Haddad Y, Liew KY, Ñamendys-Silva SA, Jarquin-Badiola YD, Sanchez-Hurtado LA, Gomez-Flores SS, Marin MC, Villagomez AJ, General H, Lemus JS, Fierro JM, Cervantes MR, Mejia FJF, Dector D, Dector DM, Gonzalez DR, Estrella CR, Sanchez-Medina JR, Ramirez-Gutierrez A, George FG, Aguirre JS, Buensuseso JA, Poblano M, Dendane T, Balkhi H, Elkhayari M, Samkaoui N, Ezzouine H, Benslama A, Amor M, Maazouzi W, Cimic N, Beck O, Bruns MM, Schouten JA, Rinia M, Raaijmakers M, Van Wezel HM, Heines SJ, Strauch U, Buise MP, Simonis FD, Schultz MJ, Goodson JC, Browne TS, Navarra L, Hunt A, Hutchison RA, Bailey MB, Newby L, Mcarthur C, Kalkoff M, Mcleod A, Casement J, Hacking DJ, Andersen FH, Dolva MS, Barratt-Due A, Noremark KAL, Søreide E, Sjøbø BÅ, Guttormsen AB, Leon Yoshido HH, Aguilar RZ, Montes Oscanoa FA, Alisasis AU, Robles JB, Pasanting-Lim RAB, Tan Poland BC, Andruszkiewicz P, Jakubowska K, Coxo CM, Alvarez AM, Oliveira BS, Montanha GM, Barros NC, Pereira CS, Messias AM, Monteiro JM, Araujo AM, Catorze NT, Marum SM, Bouw MJ, Gomes RM, Brito VA, Castro S, Estilita JM, Barros FM, Serra IM, Romania A, Tomescu DR, Marcu A, Bedreag OH, Papurica M, Corneci DE, Negoita SI, Grigoriev E, Gritsan AI, Gazenkampf AA, Almekhlafi G, Albarrak MM, Mustafa GM, Maghrabi KA, Salahuddin N, Aisa TM, Al Jabbary AS, Tabhan E, Arabim YM, Arabi YM, Trinidad OA, Al Dorzi HM, Tabhan EE, Bolon S, Smith O, Mancebo J, Aguirre-Bermeo H, Lopez-Delgado JC, Esteve F, Rialp G, Forteza C, de Haro C, Artigas A, Albaiceta GM, de Cima-Iglesias S, Seoane-Quiroga L, Ceniceros-Barros A, Ruiz-Aguilar AL, Claraco-Vega LM, Soler JA, Del Carmen Lorente M, Hermosa C, Gordo F, Prieto-González M, López-Messa JB, Perez MP, Perez CP, Allue RM, Roche-Campo F, Ibañez-Santacruz M, Temprano S, Pintado MC, de Pablo R, Gómez PRA, Ruiz SR, Moles SI, Jurado MT, Arizmendi A, Piacentini EA, Franco N, Honrubia T, Cheng MP, Losada EP, Blanco J, Yuste LJ, Carbayo-Gorriz C, Cazorla-Barranquero FG, Alonso JG, Alda RS, Algaba Á, Navarro G, Cereijo E, Diaz-Rodriguez E, Marcos DP, Montero LA, Para LH, Sanchez RJ, Navalpotro MAB, Abad RD, González RM, Toribio DP, Castro AG, Artiga MJD, Penuelas O, Roser TP, Olga MF, Curto EG, Sánchez RM, Imma VP, Elisabet GM, Claverias L, Magret M, Pellicer AM, Rodriguez LL, Sánchez-Ballesteros J, González-Salamanca Á, Jimenez AG, Huerta FP, Sotillo Diaz JCJ, Lopez EB, Llinares Moya DD, Tallet Alfonso AA, Luis PSE, Cesar PS, Rafael SI, Virgilio CG, Recio NN, Adamsson RO, Rylander CC, Holzgraefe B, Broman LM, Wessbergh J, Persson L, Schiöler F, Kedelv H, Tibblin AO, Appelberg H, Hedlund L, Helleberg J, Eriksson KE, Glietsch R, Larsson N, Nygren I, Nunes SL, Morin AK, Kander T, Adolfsson A, Zender HO, Leemann-Refondini C, Elatrous S, Bouchoucha S, Chouchene I, Ouanes I, Souissi AB, Kamoun S, Demirkiran O, Aker M, Erbabacan E, Ceylan I, Girgin NK, Ozcelik M, Ünal N, Meco BC, Akyol OO, Derman SS, Kennedy B, Parhar K, Srinivasa L, McAuley D, Hopkins P, Mellis C, Kakar V, Hadfield D, Vercueil A, Bhowmick K, Humphreys SK, Ferguson A, Mckee R, Raj AS, Fawkes DA, Watt P, Twohey L, JhaMatthew Thomas RR, Morton A, Kadaba V, Smith MJ, Hormis AP, Kannan SG, Namih M, Reschreiter H, Camsooksai J, Kumar A, Rugonfalvi S, Nutt C, Oneill O, Seasman C, Dempsey G, Scott CJ, Ellis HE, Mckechnie S, Hutton PJ, Di Tomasso NN, Vitale MN, Griffin R, Dean MN, Cranshaw JH, Willett EL, Ioannou N, Gillis S, Csabi P, Macfadyen R, Dawson H, Preez PD, Williams AJ, Boyd O, de Gordoa LO, Bramall J, Symmonds S, Chau SK, Wenham T, Szakmany T, Toth-Tarsoly P, Mccalman KH, Alexander P, Stephenson L, Collyer T, Chapman R, Cooper R, Allan RM, Sim M, Wrathall DW, Irvine DA, Zantua KS, Adams JC, Burtenshaw AJ, Sellors GP, Welters ID, Williams KE, Hessell RJ, Oldroyd MG, Battle CE, Pillai S, Okane SC, Donnelly A, Frigyik AD, Careless JP, May MM, Stewart R, John Trinder T, Hagan SJ, Wise MP, Cole JM, MacFie CC, Dowling AT, Nuñez E, Pittini G, Rodriguez R, Imperio MC, Santos C, França AG, Ebeid A, Deicas A, Uppalapati A, Kamel G, Banner-Goodspeed VM, Beitler JR, Mukkera SR, Kulkarni S, Lee J, Mesar T, Shinn Iii JO, Gomaa D, Tainter C, Yeatts DJ, Warren J, Lanspa MJ, Miller RR, Grissom CK, Brown SM, Bauer PR, Gosselin RJ, Kitch BT, Cohen JE, Beegle SH, Gueret RM, Tulaimat A, Choudry S, Stigler W, Batra H, Huff NG, Lamb KD, Oetting TW, Mohr NM, Judy C, Saito S, Kheir FM, Kheir F, Schlichting AB, Delsing A, Crouch DR, Elmasri M, Ismail D, Dreyer KR, Blakeman TC, Baron RM, Grijalba CQ, Hou PC, Seethala R, Aisiku I, Henderson G, Frendl G, Hou SK, Owens RL, Schomer A, Bumbasirevic V, Jovanovic B, Surbatovic M, Veljovic M., UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service de soins intensifs, UCL - (MGD) Services des soins intensifs, Department of Medicine and Surgery [Monza, Italy] (Research Center on Public Health), Università degli Studi di Milano-Bicocca [Milano] (UNIMIB), Sorbonne Université (SU), Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), ACS - Heart failure & arrhythmias, AII - Inflammatory diseases, Graduate School, Intensive Care Medicine, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Abe, T, Madotto, F, Pham, T, Nagata, I, Uchida, M, Tamiya, N, Kurahashi, K, Bellani, G, Laffey, J, Abe, T., Madotto, F., Pham, T., Nagata, I., Uchida, M., Tamiya, N., Kurahashi, K., Bellani, G., Laffey, J. 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M., Tulaimat, A., Choudry, S., Stigler, W., Batra, H., Huff, N. G., Lamb, K. D., Oetting, T. W., Mohr, N. M., Judy, C., Saito, S., Kheir, F. M., Kheir, F., Schlichting, A. B., Delsing, A., Crouch, D. R., Elmasri, M., Ismail, D., Dreyer, K. R., Blakeman, T. C., Baron, R. M., Grijalba, C. Q., Hou, P. C., Seethala, R., Aisiku, I., Henderson, G., Frendl, G., Hou, S. K., Owens, R. L., Schomer, A., Bumbasirevic, V., Jovanovic, B., Surbatovic, M., Veljovic, M., Abe T., Madotto F., Pham T., Nagata I., Uchida M., Tamiya N., Kurahashi K., Bellani G., Laffey J.G, and Francois GM, Rabboni F, Madotto F, Conti S, Laffey JG, Bellani G, Pham T, Fan E, Pesenti A, Brochard L, Esteban A, Gattinoni L, van Haren F, Larsson A, McAuley DF, Ranieri M, Rubenfeld G, Thompson BT, Wrigge H, Slutsky AS, Rios F, Sottiaux T, Depuydt P, Lora FS, Azevedo LC, Bugedo G, Qiu H, Gonzalez M, Silesky J, Cerny V, Nielsen J, Jibaja M, Pham T, Matamis D, Ranero JL, Amin P, Hashemian SM, Clarkson K, Kurahashi K, Villagomez A, Zeggwagh AA, Heunks LM, Laake JH, Palo JE, do Vale Fernandes A, Sandesc D, Arabi Y, Bumbasierevic V, Nin N, Lorente JA, Piquilloud L, Abroug F, McNamee L, Hurtado J, Bajwa E, Démpair G, Sula H, Nunci L, Cani A, Zazu A, Dellera C, Insaurralde CS, Alejandro RV, Daldin J, Vinzio M, Fernandez RO, Cardonnet LP, Bettini LR, Bisso MC, Osman EM, Setten MG, Lovazzano P, Alvarez J, 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G, Hou SK, Owens RL, Schomer A, Bumbasirevic V, Jovanovic B, Surbatovic M, Veljovic M.
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Male ,ARDS ,Internationality ,[SDV]Life Sciences [q-bio] ,humanos ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,traqueostomía ,Critical Care and Intensive Care Medicine ,Severity of Illness Index ,Cohort Studies ,Propensity-matched analysi ,0302 clinical medicine ,Tracheostomy ,estudios prospectivos ,Epidemiology ,Acute respiratory distress syndrome (ARDS) ,030212 general & internal medicine ,Prospective Studies ,puntuación de propensión ,10. No inequality ,Prospective cohort study ,estudios de cohortes ,mediana edad ,anciano ,Respiratory Distress Syndrome ,respiración ,Respiration ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,Middle Aged ,3. Good health ,Intensive Care Units ,Cohort ,Artificial ,Critical Illne ,Female ,ICU ,Propensity-matched analysis ,Ventilation ,Aged ,Critical Illness ,Humans ,Propensity Score ,Respiration, Artificial ,Respiratory Distress Syndrome, Adult ,Cohort study ,Human ,Adult ,medicine.medical_specialty ,Intensive Care Unit ,Socio-culturale ,unidades de cuidados intensivos ,enfermedad crítica ,03 medical and health sciences ,Severity of illness ,Settore MED/41 - ANESTESIOLOGIA ,medicine ,índice de gravedad de la enfermedad ,business.industry ,Research ,internacionalidad ,lcsh:RC86-88.9 ,medicine.disease ,R1 ,Prospective Studie ,030228 respiratory system ,Propensity score matching ,Emergency medicine ,Observational study ,Cohort Studie ,business - Abstract
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 characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1-2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort. Results: Of the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1-Q3, 7-21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample. Conclusions: Most patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality., This work was funded and supported by the European Society of Intensive Care Medicine (ESICM), Brussels, Belgium, by St Michael's Hospital, Toronto, Canada, and by the University of Milan-Bicocca, Monza, Italy. This work was supported by JSPS KAKENHI JP 16 K15388, Japan.
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- 2018
8. Impact of intensive care unit admission during handover on mortality: propensity matched cohort study.
- Author
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Midega TD, Leite Filho NCV, Nassar AP Jr, Alencar RM, Capone Neto A, Ferraz LJR, and Corrêa TD
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- Adult, Cohort Studies, Hospital Mortality, Humans, Intensive Care Units, Retrospective Studies, Patient Handoff
- Abstract
Objective: To investigate the impact of intensive care unit admission during medical handover on mortality., Methods: Post-hoc analysis of data extracted from a prior study aimed at addressing the impacts of intensive care unit readmission on clinical outcomes. This retrospective, single-center, propensity-matched cohort study was conducted in a 41-bed general open-model intensive care unit. Patients were assigned to one of two cohorts according to time of intensive care unit admission: Handover Group (intensive care unit admission between 6:30 am and 7:30 am or 6:30 pm and 7:30 pm) or Control Group (intensive care unit admission between 7:31 am and 6:29 pm or 7:31 pm and 6:29 am). Patients in the Handover Group were propensity-matched to patients in the Control Group at a 1:2 ratio., Results: A total of 6,650 adult patients were admitted to the intensive care unit between June 1st 2013 and May 31st 2015. Following exclusion of non-eligible participants, 5,779 patients (389; 6.7% and 5,390; 93.3%, Handover and Control Group) were deemed eligible for propensity score matching. Of these, 1,166 were successfully matched (389; 33.4% and 777; 66.6%, Handover and Control Group). Following propensity-score matching, intensive care unit admission during handover was not associated with increased risk of intensive care unit (OR: 1.40; 95%CI: 0.92-2.11; p=0.113) or in-hospital (OR: 1.23; 95%CI: 0.85-1.75; p=0.265) mortality., Conclusion: Intensive care unit admission during medical handover did not affect in-hospital mortality in this propensity-matched, single-center cohort study.
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- 2021
- Full Text
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9. Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): study protocol for a randomized controlled trial
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Jr, Santiago, RR, Hirota, AS, Park, M, Azevedo, LC, Malbouison, LM, Costa, MC, Taniguchi, L, Pompílio, CE, Baruzzi, C, Andrade, AH, Taira, EE, Taino, B, Oliveira, CS, Silva, AC, Ísola, A, Rezende, E, Rodrigues, RG, Rangel, VP, Luzzi, S, Giacomassi, IW, Nassar, AP Jr, Souza, AR, Rahal, L, Nunes, AL, Giannini, F, Menescal, B, Morais, JE, Toledo, D, Morsch, RD, Merluzzi, T, Amorim, DS, Bastos, AC, Santos, PL, Silva, SF, Gallego, RC, Santos, GD, Tucci, M, Costa, RT, Santos, LS, Demarzo, SE, Schettino, GP, Suzuki, VC, Patrocinio, AC, Martins, ML, Passos, DB, Cappi, SB, Gonçalves, I. Jr, Borges, MC, Lovato, W, Tavares, MV, Morales, D, Machado, LA, Torres, FC, Gomes, TM, Cerantola, RB, Góis, A, Marraccini, T, Margarida, K, Cavalcante, E, Machado, FR, Mazza, BF, Santana, HB, Mendez, VM, Xavier, PA, Rabelo, MV, Schievano, FR, Pinto, WA, Francisco, RS, Ferreira, EM, Silva, DC, Arduini, RG, Aldrighi, JR, Amaro, AF, Conde, KA, Pereira, CA, Tarkieltaub, E, Oliver, WR, Guadalupe, EG, Acerbi, PS, Tomizuka, CI, Oliveira, TA, Geha, NN, Mecatti, GC, Piovesan, MZ, Salomão, MC, Moreno, MS, Orsatti, VN, Miranda, W, Ray, A, Guerra, A, Filho, ML, Ferreira, FH Jr, Filho, EV, Canzi, RA, Giuberti, AF, Garcez, MC, Sala, AD, Suguitani, EO, Kazue, P, Oliveira, LR, Infantini, RM, Carvalho, FR, Andrade, LC, Santos, TM, Carmona, CV, Figueiredo, LC, Falcão, A, Dragosavak, D, Filho, WN, Lunardi, MC, Lago, R, Gatti, C, Chiasso, TM, Santos, GO, Araujo, AC, Ornellas, IB, Vieira, VM, Hajjar, LA, Figueiredo, AC, Damasceno, B, Hinestrosa, A, Diaz Quijano, FA, CORTEGIANI, Andrea, RAINERI, Santi Maurizio, Cavalcanti, AB, Berwanger, O, Suzumura, ÉA, Amato, MB, Tallo, FS, Rezende, AC, Telles, MM, Romano, E, Guimarães, HP, Regenga, MM, Takahashi, LN, Oliveira, RP, Carvalho, VO, Díaz-Quijano, FA, Carvalho, CR, Kodama, AA, Ribeiro, GF, Abreu, MO, Oliveira, IM, Guyatt, G, Ferguson, N, Walter, S, Vasconcelos, MO, Segundo, VJ, Ferraz, ÍL, Silva, RS, de Oliveira Filho, W, Silva, NB, Heirel, C, Takatani, RR, Neto, JA, Neto, JC, Almeida, SD, Chamy, G, Neto, GJ, Dias, AP, Silva, RR, Tavares, RC, Souza, ML, Decio, JC, Lima, CM, Neto, FF, Oliveira, KR, Dias, PP, Brandão, AL, Ramos, JE Jr, Vasconcelos, PT, Flôres, DG, Filho, GR, Andrade, IG, Martinez, A, França, GG, Monteiro, LL, Correia, EI, Ribeiro, W, Pereira, AJ, Andrade, W, Leite, PA, Feto, JE, Holanda, MA, Amorim, FF, Margalho, SB, Domingues, SM Jr, Ferreira, CS, Ferreira, CM, Rabelo, LA, Duarte, JN, Lima, FB, Kawaguchi, IA, Maia, MO, Correa, FG, Ribeiro, RA, Caser, E, Moreira, CL, Marcilino, A, Falcão, JG, Jesus, KR, Tcherniakovisk, L, Dutra, VG, Thompson, MM, Piras, C, Giuberti, J Jr, Silva, AS, Santos, JR, Potratz, JL, Paula, LN, Bozi, GG, Gomes, BC, Vassallo, PF, Rocha, E, Lima, MH, Ferreira, A F, Gonçalves, F, Pereira, SA, Nobrega, MS, Caixeta, CR, Moraes, AP, Carvalho, AG, Alves, JD, Carvalho, FB, Moreira, FB, Starling, CM, Couto, WA, Bitencourt, WS, Silva, SG, Felizardo, LR, Nascimento, FJ, Santos, D, Zanta, CC, Martins, MF, Naves, SA, Silva, FD, Laube, G Jr, Galvão, EL, Sousa, MF, Souza, MM, Carvalho, FL, Bergo, RR, Rezende, CM, Tamazato, EY, Sarat, SC Jr, Almeida, PS, Gorski, AG, Matsui, M, Neto, EE, Nomoto, SH, Lima, ZB, Inagaki, AS, Gil, FS, Araújo, MF, Oliveira, AE, Correa, TA, Mendonça, A, Reis, H, Carneiro, SR, Rego, LR, Cunha, AF, Barra, WF, Carneiro, M, Batista, RA, Zoghbi, KK, Machado, NJ, Ferreira, R, Apoena, P, Leão, RM, Martins, ER, Oliveira, ME, Odir, I, Kleber, W, Tavares, D, Araújo, ME, Brilhante, YN, Tavares, DC, Carvalho, WL, Winveler, GF, Filho, AC, Cavalcanti, RA, Grion, CM, Reis, AT, Festti, J, Gimenez, FM, Larangeira, AS, Cardoso, LT, Mezzaroba, TS, Kauss, IA, Duarte, PA, Tozo, TC, Peliser, P, Germano, A, Gurgel, SJ, Silva, SR, Kuroda, CM, Herek, A, Yamada, SS, Schiavetto, PM, Wysocki, N, Matsubara, RR, Sales, JA Jr, Laprovita, MP, Pena, FM, Sá, A, Vianna, A, Verdeal, JC, Martins, GA, Salgado, DR, Coelho, AM, Coelho, M, Morong, AS, Poquiriqui, RM, Ferreira, AP, Lucena, DN, Marino, NF, Moreira, MA, Uratani, CC, Severino, MA, Silva, PN, Medeiros, LG, Filho, FG, Guimarães, DM, Rezende, VM, Carbonell, RC, Trindade, RS, Pellegrini, JA, Boniatti, MM, Santos, MC, Boldo, R, Oliveira, VM, Corrêa, VM, Nedel, W, Teixeira, C, Schaich, F, Tagliari, L, Savi, A, Schulz, LF, Maccari, JG, Seeger, GM, Foernges, RB, Rieder, MM, Becker, DA, Broilo, FP, Schwarz, P, Alencastro, A, Berto, P, Backes, F, Dias, FS, Blattner, C, Martins, ET, Scaglia, NC, Vieira, SR, Prado, KF, Fialkow, L, Franke, C, Vieira, DF, Moraes, RB, Marques, LS, Hopf, JL, Wawrzeniak, IC, Rech, TH, Albuquerque, RB, Guerreiro, MO, Teixeira, LO, Macedo, PL, Bainy, MP, Ferreira, EV, Martins, MA, Andrade, LA, Machado, FO, Burigo, AC, Pincelli, M, Kretzer, L, Maia, IS, Cordeiro, RB, Westphal, G, Cramer, AS, Dadam, MM, Barbosa, PO, Caldeira, M, Brilenger, CO, Horner, MB, Oliveira, GL, Germiniani, BC, Duarte, R, Assef, MG, Rosso, D, Bigolin, R, Vanzuita, R, Prado, LF, Oliveira, V, Reis, DL, Morais, MO, Bastos, RS, Santana, HS, Silva, AO, Cacau, LA, Almeida, MS, Canavessi, HS, Nogueira, EE, Pavia, CL, Araujo, JF, Lira, JA, Nienstedt, EC, Smith, TC, Romano, M, Barros D, Costa, AF, Takahashi, L, Werneck, V, Farran, J, Henriques, LA, Miura, C, Lopes, RD, Vendrame, LS, Sandri, P, Galassi, MS, Amato, P, Toufen, C Jr, Santiago, RR, Hirota, AS, Park, M, Azevedo, LC, Malbouison, LM, Costa, MC, Taniguchi, L, Pompílio, CE, Baruzzi, C, Andrade, AH, Taira, EE, Taino, B, Oliveira, CS, Silva, AC, Ísola, A, Rezende, E, Rodrigues, RG, Rangel, VP, Luzzi, S, Giacomassi, IW, Nassar, AP Jr, Souza, AR, Rahal, L, Nunes, AL, Giannini, F, Menescal, B, Morais, JE, Toledo, D, Morsch, RD, Merluzzi, T, Amorim, DS, Bastos, AC, Santos, PL, Silva, SF, Gallego, RC, Santos, GD, Tucci, M, Costa, RT, Santos, LS, Demarzo, SE, Schettino, GP, Suzuki, VC, Patrocinio, AC, Martins, ML, Passos, DB, Cappi, SB, Gonçalves, I Jr, Borges, MC, Lovato, W, Tavares, MV, Morales, D, Machado, LA, Torres, FC, Gomes, TM, Cerantola, RB, Góis, A, Marraccini, T, Margarida, K, Cavalcante, E, Machado, FR, Mazza, BF, Santana, HB, Mendez, VM, Xavier, PA, Rabelo, MV, Schievano, FR, Pinto, WA, Francisco, RS, Ferreira, EM, Silva, DC, Arduini, RG, Aldrighi, JR, Amaro, AF, Conde, KA, Pereira, CA, Tarkieltaub, E, Oliver, WR, Guadalupe, EG, Acerbi, PS, Tomizuka, CI, Oliveira, TA, Geha, NN, Mecatti, GC, Piovesan, MZ, Salomão, MC, Moreno, MS, Orsatti, VN, Miranda, W, Ray, A, Guerra, A, Filho, ML, Ferreira, FH Jr, Filho, EV, Canzi, RA, Giuberti, AF, Garcez, MC, Sala, AD, Suguitani, EO, Kazue, P, Oliveira, LR, Infantini, RM, Carvalho, FR, Andrade, LC, Santos, TM, Carmona, CV, Figueiredo, LC, Falcão, A, Dragosavak, D, Filho, WN, Lunardi, MC, Lago, R, Gatti, C, Chiasso, TM, Santos, GO, Araujo, AC, Ornellas, IB, Vieira, VM, Hajjar, LA, Figueiredo, AC, Damasceno, B, Hinestrosa, A, Diaz-Quijano, FA, Raineri, SM, and Cortegiani, A
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Research design ,ARDS ,medicine.medical_specialty ,Time Factors ,Ventilator-Induced Lung Injury ,Alveolar recruitment ,Treatment outcome ,Randomized ,Medicine (miscellaneous) ,Settore MED/41 - Anestesiologia ,Hospital mortality ,law.invention ,Positive-Pressure Respiration ,Study Protocol ,Mechanical ventilation ,Clinical trials ,Randomized controlled trial ,Clinical Protocols ,law ,Medicine ,Humans ,Pharmacology (medical) ,Hospital Mortality ,PEEP ,Protocol (science) ,Respiratory Distress Syndrome ,Acute respiratory distress syndrome ,business.industry ,respiratory system ,Length of Stay ,medicine.disease ,Clinical trial ,Pulmonary Alveoli ,Intensive Care Units ,Treatment Outcome ,Multicenter study ,Barotrauma ,Research Design ,Physical therapy ,business ,Brazil - Abstract
Background Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH2O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure ≤30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method. Trial registration ClinicalTrials.gov Identifier: NCT01374022
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- 2012
10. Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database.
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Midega TD, Bozza FA, Machado FR, Guimarães HP, Salluh JI, Nassar AP Jr, Normílio-Silva K, Schultz MJ, Cavalcanti AB, and Serpa Neto A
- Abstract
Background: Survival benefit from low tidal volume (V
T ) ventilation (LTVV) has been demonstrated for patients with acute respiratory distress syndrome (ARDS), and patients not having ARDS could also benefit from this strategy. Organizational factors may play a role on adherence to LTVV. The present study aimed to identify organizational factors with an independent association with adherence to LTVV., Methods: Secondary analysis of the database of a multicenter two-phase study (prospective cohort followed by a cluster-randomized trial) performed in 118 Brazilian intensive care units. Patients under mechanical ventilation at day 2 were included. LTVV was defined as a VT ≤ 8 ml/kg PBW on the second day of ventilation. Data on the type and number of beds of the hospital, teaching status, nursing, respiratory therapists and physician staffing, use of structured checklist, and presence of protocols were tested. A multivariable mixed-effect model was used to assess the association between organizational factors and adherence to LTVV., Results: The study included 5719 patients; 3340 (58%) patients received LTVV. A greater number of hospital beds (absolute difference 7.43% [95% confidence interval 0.61-14.24%]; p = 0.038), use of structured checklist during multidisciplinary rounds (5.10% [0.55-9.81%]; p = 0.030), and presence of at least one nurse per 10 patients during all shifts (17.24% [0.85-33.60%]; p = 0.045) were the only three factors that had an independent association with adherence to LTVV., Conclusions: Number of hospital beds, use of a structured checklist during multidisciplinary rounds, and nurse staffing are organizational factors associated with adherence to LTVV. These findings shed light on organizational factors that may improve ventilation in critically ill patients.- Published
- 2020
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11. Organizational factors associated with target sedation on the first 48 h of mechanical ventilation: an analysis of checklist-ICU database.
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Nassar AP Jr, Zampieri FG, Salluh JI, Bozza FA, Machado FR, Guimarães HP, Damiani LP, and Cavalcanti AB
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- Adult, Aged, Brazil, Checklist statistics & numerical data, Cohort Studies, Conscious Sedation methods, Female, Hospital Mortality, Humans, Hypnotics and Sedatives adverse effects, Hypnotics and Sedatives therapeutic use, Intensive Care Units organization & administration, Intensive Care Units statistics & numerical data, Length of Stay, Logistic Models, Male, Middle Aged, Organ Dysfunction Scores, Prospective Studies, Respiration, Artificial mortality, Simplified Acute Physiology Score, Checklist standards, Deep Sedation methods, Respiration, Artificial methods
- Abstract
Background: Although light sedation levels are associated with several beneficial outcomes for critically ill patients on mechanical ventilation, the majority of patients are still deeply sedated. Organizational factors may play a role on adherence to light sedation levels. We aimed to identify organizational factors associated with a moderate to light sedation target on the first 48 h of mechanical ventilation, as well as the association between early achievement of within-target sedation and mortality., Methods: This study is a secondary analysis of a multicenter two-phase study (prospective cohort followed by a cluster-randomized controlled trial) performed in 118 Brazilian ICUs. We included all critically ill patients who were on mechanical ventilation 48 h after ICU admission. A moderate to light level of sedation or being alert and calm (i.e., the Richmond Agitation-Sedation Scale of - 3 to 0) was the target for all patients on mechanical ventilation during the study period. We collected data on the type of hospital (public, private, profit and private, nonprofit), hospital teaching status, nursing and physician staffing, and presence of sedation, analgesia, and weaning protocols. We used multivariate random-effects regression with ICU and study phase as random-effects and correction for patients' Simplified Acute Physiology Score 3 and Sequential Organ Failure Assessment. We also performed a mediation analysis to explore whether sedation level was just a mediator of the association between organizational factors and mortality., Results: We included 5719 patients. Only 1710 (29.9%) were on target sedation levels on day 2. Board-certified intensivists on the morning and afternoon shifts were associated with an adequate sedation level on day 2 (OR = 2.43; CI 95%, 1.09-5.38). Target sedation levels were associated with reduced hospital mortality (OR = 0.63; CI 95%, 0.55-0.72). Mediation analysis also suggested such an association, but did not suggest a relationship between the physician staffing model and hospital mortality., Conclusions: Board-certified intensivists on morning and afternoon shifts were associated with an increased number of patients achieving lighter sedation goals. These findings reinforce the importance of organizational factors, such as intensivists' presence, as a modifiable quality improvement target.
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- 2019
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12. Accounting for single center effects in systematic reviews cannot be overlooked.
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Besen BAMP, Park M, and Nassar AP Jr
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- 2017
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13. Is APACHE II a useful tool for clinical research?
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Moreno RP and Nassar AP Jr
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- Critical Illness, Humans, Prognosis, APACHE, Critical Care methods, Intensive Care Units
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- 2017
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14. Applicability of respiratory variations in stroke volume and its surrogates for dynamic fluid responsiveness prediction in critically ill patients: a systematic review of the prevalence of required conditions.
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Taniguchi LU, Zampieri FG, and Nassar AP Jr
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- Adult, Humans, Prevalence, Respiration, Respiration, Artificial methods, Tidal Volume physiology, Critical Illness, Fluid Therapy methods, Stroke Volume physiology
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Objective:: The present systematic review searched for published data on the prevalence of required conditions for proper assessment in critically ill patients., Methods:: The Medline, Scopus and Web of Science databases were searched to identify studies that evaluated the prevalence of validated conditions for the fluid responsiveness assessment using respiratory variations in the stroke volume or another surrogate in adult critically ill patients. The primary outcome was the suitability of the fluid responsiveness evaluation. The secondary objectives were the type and prevalence of pre-requisites evaluated to define the suitability., Results:: Five studies were included (14,804 patients). High clinical and statistical heterogeneity was observed (I2 = 98.6%), which prevented us from pooling the results into a meaningful summary conclusion. The most frequent limitation identified is the absence of invasive mechanical ventilation with a tidal volume ≥ 8mL/kg. The final suitability for the fluid responsiveness assessment was low (in four studies, it varied between 1.9 to 8.3%, in one study, it was 42.4%)., Conclusion:: Applicability of the dynamic indices of preload responsiveness requiring heart-lung interactions might be limited in daily practice.
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- 2017
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15. Sepsis-3 definitions predict ICU mortality in a low-middle-income country.
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Besen BAMP, Romano TG, Nassar AP Jr, Taniguchi LU, Azevedo LCP, Mendes PV, Zampieri FG, and Park M
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Background: Sepsis-3 definitions were published recently and validated only in high-income countries. The aim of this study was to assess the new criteria's accuracy in stratifying mortality as compared to its predecessor (Sepsis-2) in a Brazilian public intensive care unit (ICU) and to investigate whether the addition of lactate values would improve stratification., Methods: Retrospective cohort study conducted between 2010 and 2015 in a public university's 19-bed ICU. Data from patients admitted to the ICU with sepsis were retrieved from a prospectively collected database. ICU mortality was compared across categories of both Sepsis-2 definitions (sepsis, severe sepsis and septic shock) and Sepsis-3 definitions (infection, sepsis and septic shock). Area under the receiving operator characteristic curves were constructed, and the net reclassification index and integrated discrimination index for the addition of lactate as a categorical variable to each stratum of definition were evaluated., Results: The medical records of 957 patients were retrieved from a prospectively collected database. Mean age was 52 ± 19 years, median SAPS 3 was 65 [50,79], respiratory tract infection was the most common cause (42%, 402 patients), and 311 (32%) patients died in ICU. The ICU mortality rate was progressively higher across categories of sepsis as defined by the Sepsis-3 consensus: infection with no organ dysfunction-7/103 (7%); sepsis-106/419 (25%); and septic shock-198/435 (46%) (P < 0.001). For Sepsis-2 definitions, ICU mortality was different only across the categories of severe sepsis [43/252-(17%)] and septic shock [250/572-(44%)] (P < 0.001); sepsis had a mortality of 18/135-(13%) (P = 0.430 vs. severe sepsis). When combined with lactate, the definitions' accuracy in stratifying ICU mortality only improved with lactate levels above 4 mmol/L. This improvement occurred in the severe sepsis and septic shock groups (Sepsis-2) and the no-dysfunction and septic shock groups (Sepsis-3). Multivariate analysis demonstrated similar findings., Conclusions: In a Brazilian ICU, the new Sepsis-3 definitions were accurate in stratifying mortality and were superior to the previous definitions. We also observed that the new definitions' accuracy improved progressively with severity. Serum lactate improved accuracy for values higher than 4 mmol/L in the no-dysfunction and septic shock groups.
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- 2016
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16. ICU physicians are unable to accurately predict length of stay at admission: a prospective study.
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Nassar AP Jr and Caruso P
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- Aged, Brazil, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Intensive Care Units, Length of Stay statistics & numerical data, Physicians
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Objective: To evaluate the accuracy of prediction of intensive care unit length of stay made by physicians at patient admission., Design: Prospective cohort study., Setting: Three medical-surgical intensive care units in an oncology hospital., Patients: All patients admitted between January and December 2014., Interventions: None., Main Outcome Measurements: Intensive care unit (ICU) length of stay was estimated by the physicians responsible for patient admission and categorized as <48 h, 2-5 days or more than 5 days. Agreement between predicted and actual intensive care unit length of stay was calculated., Results: A total of 2955 patients were admitted during the study period. Physicians accurately predicted ICU length of stay in 1557 (52.7%) admissions. ICU length of stay was underestimated in 864 (29.2%) and overestimated in 534 (18.1%) cases. Agreement between predicted and actual intensive care unit length of stay was poor (Kappa = 0.22) and not associated with physician characteristics. Predictions of an intensive care unit length of stay of >5 days were significantly less accurate than those of <48 h and of 2-5 days (31.1, 59.8 and 53.1%, respectively, P < 0.001)., Conclusions: The intensive care unit length of stay prediction in these oncological intensive care units is inaccurate and, ideally, should not be made at admission., (© The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.)
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- 2016
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17. Importance of a registered and structured protocol when conducting systematic reviews: comments about nebulized antibiotics for ventilator-associated pneumonia.
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Zampieri FG, Nassar AP Jr, Gusmao-Flores D, Taniguchi LU, Torres A, and Ranzani OT
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- Humans, Anti-Bacterial Agents administration & dosage, Nebulizers and Vaporizers, Pneumonia, Ventilator-Associated drug therapy, Pneumonia, Ventilator-Associated etiology, Respiration, Artificial adverse effects
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- 2015
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18. Nebulized antibiotics for ventilator-associated pneumonia: a systematic review and meta-analysis.
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Zampieri FG, Nassar AP Jr, Gusmao-Flores D, Taniguchi LU, Torres A, and Ranzani OT
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- Humans, Pneumonia, Ventilator-Associated diagnosis, Randomized Controlled Trials as Topic methods, Anti-Bacterial Agents administration & dosage, Nebulizers and Vaporizers, Pneumonia, Ventilator-Associated drug therapy, Pneumonia, Ventilator-Associated etiology, Respiration, Artificial adverse effects
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Introduction: Nebulized antibiotics are a promising new treatment option for ventilator-associated pneumonia. However, more evidence of the benefit of this therapy is required., Methods: The Medline, Scopus, EMBASE, Biological Abstracts, CAB Abstracts, Food Science and Technology Abstracts, CENTRAL, Scielo and Lilacs databases were searched to identify randomized controlled trials or matched observational studies that compared nebulized antibiotics with or without intravenous antibiotics to intravenous antibiotics alone for ventilator-associated pneumonia treatment. Two reviewers independently collected data and assessed outcomes and risk of bias. The primary outcome was clinical cure. Secondary outcomes were microbiological cure, ICU and hospital mortality, duration of mechanical ventilation, ICU length of stay and adverse events. A mixed-effect model meta-analysis was performed. Trial sequential analysis was used for the main outcome of interest., Results: Twelve studies were analyzed, including six randomized controlled trials. For the main outcome analysis, 812 patients were included. Nebulized antibiotics were associated with higher rates of clinical cure (risk ratio (RR) = 1.23; 95% confidence interval (CI), 1.05 to 1.43; I(2) = 34%; D(2) = 45%). Nebulized antibiotics were not associated with microbiological cure (RR = 1.24; 95% CI, 0.95 to 1.62; I(2) = 62.5), mortality (RR = 0.90; CI 95%, 0.76 to 1.08; I(2) = 0%), duration of mechanical ventilation (standardized mean difference = -0.10 days; 95% CI, -1.22 to 1.00; I(2) = 96.5%), ICU length of stay (standardized mean difference = 0.14 days; 95% CI, -0.46 to 0.73; I(2) = 89.2%) or renal toxicity (RR = 1.05; 95% CI, 0.70 to 1.57; I(2) = 15.6%). Regarding the primary outcome, the number of patients included was below the information size required for a definitive conclusion by trial sequential analysis; therefore, our results regarding this parameter are inconclusive., Conclusions: Nebulized antibiotics seem to be associated with higher rates of clinical cure in the treatment of ventilator-associated pneumonia. However, the apparent benefit in the clinical cure rate observed by traditional meta-analysis does not persist after trial sequential analysis. Additional high-quality studies on this subject are highly warranted., Trial Registration Number: CRD42014009116 . Registered 29 March 2014.
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- 2015
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19. Changes of Procalcitonin Kinetics According to Renal Clearance in Critically Ill Patients with Primary Gram-Negative Bloodstream Infections.
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Özger, Hasan Selçuk, Çorbacıoğlu, Şeref Kerem, Boyacı-Dündar, Nazlıhan, Yıldız, Mehmet, Helvacı, Özant, Altın, Fatma Betül, Türkoğlu, Melda, Aygencel, Gülbin, and Dizbay, Murat
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- 2024
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20. Clinical outcomes of patients requiring ventilatory support in Brazilian intensive care units: a multicenter, prospective, cohort study.
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Azevedo LC, Park M, Salluh JI, Rea-Neto A, Souza-Dantas VC, Varaschin P, Oliveira MC, Tierno PF, dal-Pizzol F, Silva UV, Knibel M, Nassar AP Jr, Alves RA, Ferreira JC, Teixeira C, Rezende V, Martinez A, Luciano PM, Schettino G, and Soares M
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- Adult, Aged, Aged, 80 and over, Brazil epidemiology, Cohort Studies, Female, Humans, Male, Middle Aged, Noninvasive Ventilation mortality, Noninvasive Ventilation trends, Prospective Studies, Respiration, Artificial trends, Treatment Outcome, Hospital Mortality trends, Intensive Care Units trends, Respiration, Artificial mortality
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Introduction: Contemporary information on mechanical ventilation (MV) use in emerging countries is limited. Moreover, most epidemiological studies on ventilatory support were carried out before significant developments, such as lung protective ventilation or broader application of non-invasive ventilation (NIV). We aimed to evaluate the clinical characteristics, outcomes and risk factors for hospital mortality and failure of NIV in patients requiring ventilatory support in Brazilian intensive care units (ICU)., Methods: In a multicenter, prospective, cohort study, a total of 773 adult patients admitted to 45 ICUs over a two-month period requiring invasive ventilation or NIV for more than 24 hours were evaluated. Causes of ventilatory support, prior chronic health status and physiological data were assessed. Multivariate analysis was used to identifiy variables associated with hospital mortality and NIV failure., Results: Invasive MV and NIV were used as initial ventilatory support in 622 (80%) and 151 (20%) patients. Failure with subsequent intubation occurred in 54% of NIV patients. The main reasons for ventilatory support were pneumonia (27%), neurologic disorders (19%) and non-pulmonary sepsis (12%). ICU and hospital mortality rates were 34% and 42%. Using the Berlin definition, acute respiratory distress syndrome (ARDS) was diagnosed in 31% of the patients with a hospital mortality of 52%. In the multivariate analysis, age (odds ratio (OR), 1.03; 95% confidence interval (CI), 1.01 to 1.03), comorbidities (OR, 2.30; 95% CI, 1.28 to 3.17), associated organ failures (OR, 1.12; 95% CI, 1.05 to 1.20), moderate (OR, 1.92; 95% CI, 1.10 to 3.35) to severe ARDS (OR, 2.12; 95% CI, 1.01 to 4.41), cumulative fluid balance over the first 72 h of ICU (OR, 2.44; 95% CI, 1.39 to 4.28), higher lactate (OR, 1.78; 95% CI, 1.27 to 2.50), invasive MV (OR, 2.67; 95% CI, 1.32 to 5.39) and NIV failure (OR, 3.95; 95% CI, 1.74 to 8.99) were independently associated with hospital mortality. The predictors of NIV failure were the severity of associated organ dysfunctions (OR, 1.20; 95% CI, 1.05 to 1.34), ARDS (OR, 2.31; 95% CI, 1.10 to 4.82) and positive fluid balance (OR, 2.09; 95% CI, 1.02 to 4.30)., Conclusions: Current mortality of ventilated patients in Brazil is elevated. Implementation of judicious fluid therapy and a watchful use and monitoring of NIV patients are potential targets to improve outcomes in this setting., Trial Registration: ClinicalTrials.gov NCT01268410.
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21. Epidemiology, ventilation management and outcomes of COVID–19 ARDS patients versus patients with ARDS due to pneumonia in the Pre–COVID era.
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van der Ven, Fleur–Stefanie L. I. M., Blok, Siebe G., Azevedo, Luciano C., Bellani, Giacomo, Botta, Michela, Estenssoro, Elisa, Fan, Eddy, Ferreira, Juliana Carvalho, Laffey, John G., Martin–Loeches, Ignacio, Motos, Ana, Pham, Tai, Peñuelas, Oscar, Pesenti, Antonio, Pisani, Luigi, Neto, Ary Serpa, Schultz, Marcus J., Torres, Antoni, Tsonas, Anissa M., and Paulus, Frederique
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ADULT respiratory distress syndrome ,ARTIFICIAL respiration ,VENTILATION ,CRITICAL care medicine ,DESCRIPTIVE statistics - Abstract
Background: Ventilation management may differ between COVID–19 ARDS (COVID–ARDS) patients and patients with pre–COVID ARDS (CLASSIC–ARDS); it is uncertain whether associations of ventilation management with outcomes for CLASSIC–ARDS also exist in COVID–ARDS. Methods: Individual patient data analysis of COVID–ARDS and CLASSIC–ARDS patients in six observational studies of ventilation, four in the COVID–19 pandemic and two pre–pandemic. Descriptive statistics were used to compare epidemiology and ventilation characteristics. The primary endpoint were key ventilation parameters; other outcomes included mortality and ventilator–free days and alive (VFD–60) at day 60. Results: This analysis included 6702 COVID–ARDS patients and 1415 CLASSIC–ARDS patients. COVID–ARDS patients received lower median V
T (6.6 [6.0 to 7.4] vs 7.3 [6.4 to 8.5] ml/kg PBW; p < 0.001) and higher median PEEP (12.0 [10.0 to 14.0] vs 8.0 [6.0 to 10.0] cm H2 O; p < 0.001), at lower median ΔP (13.0 [10.0 to 15.0] vs 16.0 [IQR 12.0 to 20.0] cm H2 O; p < 0.001) and higher median Crs (33.5 [26.6 to 42.1] vs 28.1 [21.6 to 38.4] mL/cm H2 O; p < 0.001). Following multivariable adjustment, higher ΔP had an independent association with higher 60–day mortality and less VFD–60 in both groups. Higher PEEP had an association with less VFD–60, but only in COVID–ARDS patients. Conclusions: Our findings show important differences in key ventilation parameters and associations thereof with outcomes between COVID–ARDS and CLASSIC–ARDS. Trial registration: Clinicaltrials.gov (identifier NCT05650957), December 14, 2022. [ABSTRACT FROM AUTHOR]- Published
- 2024
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22. 16S rRNA amplicon sequencing and antimicrobial resistance profile of intensive care units environment in 41 Brazilian hospitals.
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Carolina de Bastiani, Daniela, Vallone Silva, Claudia, Paula Christoff, Ana, Flores Cruz, Giuliano Netto, Daniel Tavares, Leonardo, Rodrigues de Araújo, Luana Silva, Martins Tomazini, Bruno, Arns, Beatriz, Teixeira Piastrelli, Filipe, Biasi Cavalcanti, Alexandre, Valter de Oliveira, Luiz Felipe, and Jose Pereira, Adriano
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- 2024
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23. Characteristics, management, and outcomes of patients with lung cancer admitted to a tertiary care intensive care unit over more than 20 years.
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Al-Dorzi, Hasan M., Atham, Sadeem, Khayat, Faten, Alkhunein, Jullanar, Alharbi, Bushra T., Alageel, Norah, Tlayjeh, Mohamed, Tlayjeh, Haytham, and Arabi, Yaseen M.
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TREATMENT of lung tumors ,T-test (Statistics) ,FISHER exact test ,LOGISTIC regression analysis ,SYMPTOMS ,TREATMENT effectiveness ,TERTIARY care ,HOSPITAL patients ,DESCRIPTIVE statistics ,MANN Whitney U Test ,CHI-squared test ,MULTIVARIATE analysis ,ODDS ratio ,INTENSIVE care units ,DATA analysis software ,CONFIDENCE intervals - Abstract
RATIONALE: The prognosis of patients with lung cancer admitted to the intensive care unit (ICU) is often perceived as poor. We described the characteristics, management, and outcomes of critically ill patients with lung cancer and determined the predictors of mortality. METHODS: We retrospectively studied patients with lung cancer who were admitted to the ICU of a tertiary care hospital between 1999 and 2021 for the reasons other than routine postoperative care. We noted their characteristics, ICU management, and outcomes. We performed the multivariable logistic regression analysis to determine the predictors of hospital mortality. RESULTS: In the 23-year period, 306 patients with lung cancer were admitted to the ICU (median age = 63.0 years, 68.3% males, 45.6% with moderate/severe functional disability, most had advanced lung cancer, and median Acute Physiology and Chronic Health Evaluation II score = 24.0). Life support measures included invasive mechanical ventilation (47.1%), vasopressors (34.0%), and new renal replacement therapy (8.8%). Do-Not-Resuscitate orders were implemented during ICU stay in 30.1%. The hospital mortality was 43.8% with a significantly lower rate in patients admitted after 2015 (28.0%). The predictors of mortality were moderate/severe baseline disability (odds ratio [OR] 2.65, 95% confidence interval [CI] 1.22, 5.78), advanced lung cancer (OR 8.36, 95% CI 1.81, 38.58), lactate level (OR 1.45, 95% CI 1.12, 1.88, invasive mechanical ventilation (OR 10.92, 95% CI 4.98, 23.95), and admission period after 2015 (OR 0.37, 95% CI 0.16, 0.85). CONCLUSIONS: The mortality rates in patients with lung cancer admitted to the ICU during a 23-year period decreased after 2015. Functional disability, advanced lung cancer stage, vasopressor use, and invasive mechanical ventilation predicted mortality. [ABSTRACT FROM AUTHOR]
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- 2024
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24. Timing of Renal Replacement Therapy In Mechanically Ventilated Patients
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- 2023
25. Problematic meta-analyses: Bayesian and frequentist perspectives on combining randomized controlled trials and non-randomized studies.
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Moran, John L. and Linden, Ariel
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RANDOMIZED controlled trials ,RANDOM effects model ,CONFIDENCE intervals ,PROBABILITY theory - Abstract
Purpose: In the literature, the propriety of the meta-analytic treatment-effect produced by combining randomized controlled trials (RCT) and non-randomized studies (NRS) is questioned, given the inherent confounding in NRS that may bias the meta-analysis. The current study compared an implicitly principled pooled Bayesian meta-analytic treatment-effect with that of frequentist pooling of RCT and NRS to determine how well each approach handled the NRS bias. Materials & methods: Binary outcome Critical-Care meta-analyses, reflecting the importance of such outcomes in Critical-Care practice, combining RCT and NRS were identified electronically. Bayesian pooled treatment-effect and 95% credible-intervals (BCrI), posterior model probabilities indicating model plausibility and Bayes-factors (BF) were estimated using an informative heavy-tailed heterogeneity prior (half-Cauchy). Preference for pooling of RCT and NRS was indicated for Bayes-factors > 3 or < 0.333 for the converse. All pooled frequentist treatment-effects and 95% confidence intervals (FCI) were re-estimated using the popular DerSimonian-Laird (DSL) random effects model. Results: Fifty meta-analyses were identified (2009–2021), reporting pooled estimates in 44; 29 were pharmaceutical-therapeutic and 21 were non-pharmaceutical therapeutic. Re-computed pooled DSL FCI excluded the null (OR or RR = 1) in 86% (43/50). In 18 meta-analyses there was an agreement between FCI and BCrI in excluding the null. In 23 meta-analyses where FCI excluded the null, BCrI embraced the null. BF supported a pooled model in 27 meta-analyses and separate models in 4. The highest density of the posterior model probabilities for 0.333 < Bayes factor < 1 was 0.8. Conclusions: In the current meta-analytic cohort, an integrated and multifaceted Bayesian approach gave support to including NRS in a pooled-estimate model. Conversely, caution should attend the reporting of naïve frequentist pooled, RCT and NRS, meta-analytic treatment effects. [ABSTRACT FROM AUTHOR]
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- 2024
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26. Outcome of Cancer Patients with an Unplanned Intensive Care Unit Admission: Predictors of Mortality and Long‑term Survival.
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AlSaied, Ghiath, Lababidi, Hani, AlHawdar, Taher, AlZahrani, Saud, AlMotairi, Abdullah, and AlMaani, Mohamad
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CANCER patients ,INTENSIVE care units ,HOSPITAL admission & discharge ,ARTIFICIAL respiration ,FEBRILE neutropenia - Abstract
Background: Understanding the characteristics and outcomes of cancer patients with unplanned ICU admission is imperative for therapeutic decisions and prognostication purposes. Objective: To describe the clinical characteristics of patients with hematological and non-hematological malignancies (NHM) who require unplanned ICU admission and to determine the predictors of mortality and long-term survival. Methods: This retrospective study included all patients with cancer who had an unplanned ICU admission between 2011 and 2016 at a tertiary hospital in Saudi Arabia. The following variables were collected: age, gender, ICU length of stay (LOS), APACHE II score, type of malignancy, febrile neutropenia, source and time of admission, and need for mechanical ventilation (MV), renal replacement therapy (RRT), and treatment with vasopressors (VP). Predictors of mortality and survival rates at 28 days and 3, 6, and 12 months were calculated. Results: The study included 410 cancer patients with 466 unplanned ICU admissions. Of these, 52% had NHM. The average LOS in the ICU was 9.6 days and the mean APACHE score was 21.9. MV was needed in 73% of the patients, RRT in 15%, and VP in 24%, while febrile neutropenia was present in 24%. There were statistically significant differences between survivors and non-survivors in the APACHE II score (17.7 ± 8.0 vs. 25.6 ± 9.2), MV use (52% vs. 92%), need for RRT (6% vs. 23%), VP use (42% vs. 85%), and presence of febrile neutropenia (18% vs. 30%). The predictors of mortality were need for MV (OR = 4.97), VP (OR = 3.43), RRT (OR = 3.31), and APACHE II score (OR = 1.10). Survival rates at 28 days, 3, 6, and 12 months were 52%, 28%, 22%, and 15%, respectively. Conclusion: The survival rate of cancer patients with an unplanned admission to the ICU remains low. Predictors of mortality include need for MV, RRT, and VP and presence of febrile neutropenia. About 85% of cancer patients died within 1 year after ICU admission. [ABSTRACT FROM AUTHOR]
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- 2024
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27. The Incidence, Risk Factors, and Effects of Constipation in Critical Patients: An Observational Cross-sectional Study.
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Özdemir, Şeyma, Yılmaz, Arzu Akman, and Özdemir, Esra
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CONSTIPATION -- Risk factors ,C-reactive protein ,LENGTH of stay in hospitals ,INTENSIVE care units ,STATISTICAL power analysis ,PILOT projects ,DIURETICS ,STATISTICS ,KRUSKAL-Wallis Test ,BODY temperature ,SCIENTIFIC observation ,CONSTIPATION ,LEUCOCYTES ,CROSS-sectional method ,MECHANICAL ventilators ,ONE-way analysis of variance ,CRITICALLY ill patient psychology ,MANN Whitney U Test ,RISK assessment ,VOMITING ,COMPARATIVE studies ,CHI-squared test ,GLASGOW Coma Scale ,ENTERAL feeding ,DATA analysis software ,DATA analysis ,DISEASE complications - Abstract
Objective: This study aimed to investigate the early, late, and total constipation frequency, related factors, and their effects on the hospitalization day, gastric residual volume, vomiting, distension, and diarrhea, the feeding type, white blood cells, and C-reactive protein levels, and body temperature. Method: Data from this observational cross-sectional study were collected in an anesthesia and reanimation intensive care unit of a public hospital in Bolu, Turkey. The sample included 116 patients who met the criteria of the study. The sample size was determined using power analysis according to the results of a pilot study. The patient information form, daily observation form, and Bristol stool consistency scale were used for collecting the data. Results: The constipation frequency was 63.8% in the unit. The early constipation frequency was 18.9%, and the late constipation frequency was 6.8%. The hospitalization day in these groups was longer than those without constipation. Also, the patients receiving mechanical ventilator support, enteral tube feeding, and diuretic medication had a higher risk for constipation. The enema/laxative was applied to half of the patients who developed constipation in the unit, after which more than half developed diarrhea. Distension and enteral feeding were more frequent in late-type constipation patients. The levels of white blood cells, C-reactive protein levels, and body temperature between all groups were not statistically different (p>0.05). Conclusion: The frequency of constipation was higher in the intensive care unit, even when the defecation period was considered four days. Receiving mechanical ventilator support, enteral tube feeding, and diuretics increased the risk of constipation. Amaç: Bu çalışma erken, geç ve toplam konstipasyon sıklığı, ilişkili faktörler ve bunların hastaneye yatış günü, mide rezidüel hacmi, kusma, distansiyon, diyare, beslenme şekli, beyaz kan hücreleri, C-reaktif protein seviyeleri ve vücut sıcaklığı üzerine etkilerinin incelenmesini amaçladı. Yöntem: Bu gözlemsel kesitsel çalışmanın verileri, Türkiye'de Bolu ilinde bulunan bir devlet hastanesinin anestezi ve reanimasyon yoğun bakım ünitesinde toplandı. Örneklem, çalışmanın kriterlerini karşılayan 116 hastayı içerdi. Örneklem büyüklüğü, pilot çalışmanın sonuçlarına göre güç analizi kullanılarak belirlendi. Verilerin toplanmasında hasta bilgi formu, günlük gözlem formu ve Bristol dışkı kıvam ölçeği kullanıldı. Bulgular: Yoğun bakımda konstipasyon sıklığı %63,8 idi. Erken konstipasyon sıklığı %18,9, geç konstipasyon sıklığı ise %6,8 olarak belirlendi. Bu gruplarda hastanede kalış günü konstipasyonu olmayanlara göre daha uzundu. Ayrıca mekanik ventilatör desteği, enteral tüple beslenme ve diüretik ilaç kullanan hastalarda konstipasyon riski daha yüksekti. Yoğun bakımda konstipasyon gelişen hastaların yarısına lavman/laksatif uygulandı, sonrasında yarısından fazlasında diyare gelişti. Geç tip konstipasyon hastalarında distansiyon ve enteral beslenme daha sık görüldü. Beyaz kan hücreleri, C-reaktif protein seviyeleri ve vücut sıcaklığı tüm gruplar arasında istatistiksel olarak anlamlı değildi (p>0,05). Sonuç: Yoğun bakım ünitesinde dışkılama süresi dört gün olarak kabul edildiğinde bile konstipasyon sıklığının daha yüksek olduğu görüldü. Mekanik ventilatör desteği almak, enteral tüple beslenmek ve diüretik kullanmak konstipasyon riskini artırmaktadır. [ABSTRACT FROM AUTHOR]
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- 2024
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28. Artificial Intelligence in the Intensive Care Unit.
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Gutierrez, Guillermo
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This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2020. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2020. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901. [ABSTRACT FROM AUTHOR]
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- 2024
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29. Evaluating early lymphocyte-tomonocyte ratio as a predictive biomarker for delirium in older adult patients with sepsis: insights from a retrospective cohort analysis.
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Xiaopeng Shi, Lei Yang, Weimin Bai, Lijuan Jing, and Lijie Qin
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- 2024
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30. A nomogram for predicting mortality risk within 30 days in sepsis patients admitted in the emergency department: A retrospective analysis.
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Wang, Bin, Chen, Jianping, Pan, Xinling, Xu, Bingzheng, and Ouyang, Jian
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SEPSIS ,HOSPITAL emergency services ,NOMOGRAPHY (Mathematics) ,RECEIVER operating characteristic curves ,MORTALITY risk factors ,DECISION making - Abstract
Objective: To establish and validate an individualized nomogram to predict mortality risk within 30 days in patients with sepsis from the emergency department. Methods: Data of 1205 sepsis patients who were admitted to the emergency department in a tertiary hospital between Jun 2013 and Sep 2021 were collected and divided into a training group and a validation group at a ratio of 7:3. The independent risk factors related to 30-day mortality were identified by univariate and multivariate analysis in the training group and used to construct the nomogram. The model was evaluated by receiver operating characteristic (ROC) curve, calibration chart and decision curve analysis. The model was validated in patients of the validation group and its performance was confirmed by comparing to other models based on SOFA score and machine learning methods. Results: The independent risk factors of 30-day mortality of sepsis patients included pro-brain natriuretic peptide, lactic acid, oxygenation index (PaO2/FiO2), mean arterial pressure, and hematocrit. The AUCs of the nomogram in the training and verification groups were 0.820 (95% CI: 0.780–0.860) and 0.849 (95% CI: 0.783–0.915), respectively, and the respective P-values of the calibration chart were 0.996 and 0.955. The DCA curves of both groups were above the two extreme curves, indicating high clinical efficacy. The AUC values were 0.847 for the model established by the random forest method and 0.835 for the model established by the stacking method. The AUCs of SOFA model in the model and validation groups were 0.761 and 0.753, respectively. Conclusion: The sepsis nomogram can predict the risk of death within 30 days in sepsis patients with high accuracy, which will be helpful for clinical decision-making. [ABSTRACT FROM AUTHOR]
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- 2024
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31. Prognostic evaluation of quick sequential organ failure assessment score in ICU patients with sepsis across different income settings.
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Li, Andrew, Ling, Lowell, Qin, Hanyu, Arabi, Yaseen M., Myatra, Sheila Nainan, Egi, Moritoki, Kim, Je Hyeong, Nor, Mohd Basri Mat, Son, Do Ngoc, Fang, Wen-Feng, Wahyuprajitno, Bambang, Hashmi, Madiha, Faruq, Mohammad Omar, Patjanasoontorn, Boonsong, Al Bahrani, Maher Jaffer, Shrestha, Babu Raja, Shrestha, Ujma, Nafees, Khalid Mahmood Khan, Sann, Kyi Kyi, and Palo, Jose Emmanuel M.
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Background: There is conflicting evidence on association between quick sequential organ failure assessment (qSOFA) and sepsis mortality in ICU patients. The primary aim of this study was to determine the association between qSOFA and 28-day mortality in ICU patients admitted for sepsis. Association of qSOFA with early (3-day), medium (28-day), late (90-day) mortality was assessed in low and lower middle income (LLMIC), upper middle income (UMIC) and high income (HIC) countries/regions. Methods: This was a secondary analysis of the MOSAICS II study, an international prospective observational study on sepsis epidemiology in Asian ICUs. Associations between qSOFA at ICU admission and mortality were separately assessed in LLMIC, UMIC and HIC countries/regions. Modified Poisson regression was used to determine the adjusted relative risk (RR) of qSOFA score on mortality at 28 days with adjustments for confounders identified in the MOSAICS II study. Results: Among the MOSAICS II study cohort of 4980 patients, 4826 patients from 343 ICUs and 22 countries were included in this secondary analysis. Higher qSOFA was associated with increasing 28-day mortality, but this was only observed in LLMIC (p < 0.001) and UMIC (p < 0.001) and not HIC (p = 0.220) countries/regions. Similarly, higher 90-day mortality was associated with increased qSOFA in LLMIC (p < 0.001) and UMIC (p < 0.001) only. In contrast, higher 3-day mortality with increasing qSOFA score was observed across all income countries/regions (p < 0.001). Multivariate analysis showed that qSOFA remained associated with 28-day mortality (adjusted RR 1.09 (1.00–1.18), p = 0.038) even after adjustments for covariates including APACHE II, SOFA, income country/region and administration of antibiotics within 3 h. Conclusions: qSOFA was independently associated with 28-day mortality in ICU patients admitted for sepsis. In LLMIC and UMIC countries/regions, qSOFA was associated with early to late mortality but only early mortality in HIC countries/regions. [ABSTRACT FROM AUTHOR]
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- 2024
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32. Blended teaching mode based on small private online course and case-based learning in analgesia and sedation education in China: a comparison with an offline mode.
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Li, Shu, Su, Longxiang, Lou, Ran, Liu, Ying, Zhang, Hua, and Jiang, Li
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CASE-based reasoning ,ONLINE education ,PSYCHOLOGY of students ,SUMMATIVE tests ,ACADEMIC degrees - Abstract
Background: Standardized training for pain, agitation-sedation, and delirium (PAD) management is urgently needed for Chinese intensivists' continuing education. Since 2020, because of the COVID-19 pandemic, the Chinese Analgesia and Sedation Education and Research (CASER) group has used an online blended teaching mode based on a small private online course (SPOC) and case-based learning (CBL). This study evaluated whether an online blended teaching mode has similar effects on PAD management training when an offline mode cannot be used. Materials and methods: Since 2020, the CASER group has provided offline training and online SPOC&CBL training three times each, targeting intensivists and ICU nurses in China. All participants were divided into an offline group and SPOC&CBL group. A final examination was offered in each training session to assess the students' mastery of professional knowledge. Teachers' and students' perceptions regarding the online SPOC&CBL mode were evaluated through questionnaires. Results: Of all participants (n = 117), 106 completed all examinations and questionnaires. Most participants were aged 31–40 years (53, 50.0%), had an academic degree (60, 56.6%), and worked in a tertiary hospital (100, 94.34%). We assessed the learning effect on participants from two aspects: theory and clinical practice. There was no significant difference between the SPOC&CBL and offline groups in terms of theoretical, case analysis, and total scores (p > 0.05). In terms of the participants' perceptions regarding the SPOC&CBL mode, 91.5% considered the online mode to be a useful and accessible alternative to improve knowledge and skills. A total of 95.7% of the participants believed that they could interact well with group members, and 87.2% believed that they had a good degree of participation. Of these participants, 76.6% believed that they had received valuable learning resources. All instructors believed that the SPOC&CBL mode was more flexible than the offline mode in terms of teaching time and location, and they were all willing to carry out training with the SPOC&CBL mode. Conclusion: Compared to the offline mode, the SPOC&CBL mode can also enhance participants' knowledge and skills and meets their expectations. Therefore, an online mode can be considered a potential method in PAD management education in China. [ABSTRACT FROM AUTHOR]
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- 2024
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33. Naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation: A retrospective, single-center cohort study.
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Nishiyama, Seiya, Uchino, Shigehiko, Sasabuchi, Yusuke, Masuyama, Tomoyuki, Lefor, Alan Kawarai, and Sanui, Masamitsu
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DEFECATION ,CRITICALLY ill ,CONSTIPATION ,INTENSIVE care patients ,COHORT analysis - Abstract
Introduction: There are few reports describing the association of naldemedine with defecation in critically ill patients with opioid-induced constipation. The purpose of this study was to determine whether naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation. Methods: In this retrospective cohort study, patients admitted to the Intensive Care Unit (ICU) without defecation for 48 hours while receiving opioids were eligible for enrollment. The primary endpoint was the time of the first defecation within 96 hours after inclusion. Secondary endpoints included presence of diarrhea, duration of mechanical ventilation, ICU length of stay, ICU mortality, and in-hospital mortality. The Cox proportional hazard regression analysis with time-dependent covariates was used to evaluate the association naldemedine with earlier defecation. Results: A total of 875 patients were enrolled and were divided into 63 patients treated with naldemedine and 812 patients not treated. Defecation was observed in 58.7% of the naldemedine group and 48.8% of the no-naldemedine group during the study (p = 0.150). The naldemedine group had statistically significantly prolonged duration of mechanical ventilation (8.7 days vs 5.5 days, p < 0.001) and ICU length of stay (11.8 days vs 9.2 days, p = 0.001) compared to the no-naldemedine group. However, the administration of naldemedine was significantly associated with earlier defecation [hazard ratio:2.53; 95% confidence interval: 1.71–3.75, p < 0.001]. Conclusion: The present study shows that naldemedine is associated with earlier defecation in critically ill patients with opioid-induced constipation. [ABSTRACT FROM AUTHOR]
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- 2024
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34. Acute Kidney Injury in Patients Undergoing Extracorporeal Membrane Oxygenation: A Retrospective Cohort Study.
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Surjit, Aswin, Prasannan, Bipi, Abraham, Jobin, Balagopal, Anuroop, and Unni, Vavullipathy Narayanan
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HYPERTENSION ,NEPHROTOXICOLOGY ,THERAPEUTICS ,AGE distribution ,EXTRACORPOREAL membrane oxygenation ,RETROSPECTIVE studies ,DISEASE incidence ,APACHE (Disease classification system) ,RENAL replacement therapy ,RISK assessment ,HOSPITAL mortality ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,ACUTE kidney failure ,LONGITUDINAL method ,CARDIOTONIC agents ,DISEASE risk factors ,DISEASE complications - Abstract
Aims and background: Extracorporeal membrane oxygenation (ECMO) is a mode of extracorporeal therapy to support oxygenation of patients with severe cardiac or respiratory failure. Studies have shown that acute kidney injury (AKI) can worsen the outcome in these patients. This study aims to assess the incidence and outcome of AKI in patients on ECMO support. Materials and methods: This retrospective study included 64 patients who underwent ECMO for more than 24 hours. Patients who died within 48 hours of initiation of ECMO and patients with end-stage renal disease (ESRD) on maintenance hemodialysis were excluded. Acute kidney injury was diagnosed and categorized according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Results: Of the 64 patients studied, 38 patients (59.38%) developed AKI and 17 patients (44.73%) among them developed AKI within 24 hours of initiation of ECMO. Age, Acute Physiology and Chronic Health Evaluation (APACHE-II) score, hypertension, use of nephrotoxic agents, inotropic support, and poor cardiac function were the risk factors associated with the development of AKI. Diabetes mellitus, type of ECMO used, and duration of ECMO were not found to be risk factors for AKI. Renal replacement therapy was initiated in 31 patients (81.58%). The overall mortality in the whole group was 67.19%, while it was 81.58% among the patients with AKI. Conclusion: Acute kidney injury was found to be an independent risk factor for mortality in patients on ECMO. Early identification of the risk factors for AKI and management may help to improve the survival rate. Clinical significance: The occurrence of AKI among patients on ECMO support increases the risk of mortality significantly. Hence, measures to prevent AKI, as well as early detection and appropriate management of AKI, would improve patient outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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35. A Randomized, Open-Label, Non-inferiority Clinical Trial Assessing 7 Versus 14 Days of Antimicrobial Therapy for Severe Multidrug-Resistant Gram-Negative Bacterial Infections: The OPTIMISE Trial Protocol.
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Arns, Beatriz, Horvath, Jaqueline Driemeyer C., Rech, Gabriela Soares, Sesin, Guilhermo Prates, Agani, Crepin Aziz Jose Oluwafoumi, da Rosa, Bruna Silveira, dos Santos, Tiago Marcon, Brochier, Liliane Spencer Bittencourt, Cavalcanti, Alexandre Biasi, Tomazini, Bruno Martins, Pereira, Adriano Jose, Veiga, Viviane Cordeiro, Nascimento, Giovana Marssola, Kalil, Andre C., and Zavascki, Alexandre P.
- Abstract
Introduction: Shorter courses of antimicrobials have been shown to be non-inferior to longer, "traditional" duration of therapies, including for some severe healthcare-associated infections, with a few exceptions. However, evidence is lacking regarding shorter regimes against severe infections by multidrug-resistant Gram-negative bacteria (MDR-GNB), which are often caused by distinct strains and commonly treated with second-line antimicrobials. In the duratiOn of theraPy in severe infecTIons by MultIdrug-reSistant gram-nEgative bacteria (OPTIMISE) trial, we aim to assess the non-inferiority of 7-day versus 14-day antimicrobial therapy in critically ill patients with severe infections caused by MDR-GNB. Methods: This is a randomized, multicenter, open-label, parallel controlled trial to assess the non-inferiority of 7-day versus 14-day of adequate antimicrobial therapy for intensive care unit (ICU)-acquired severe infections by MDR-GNB. Adult patients with severe infections by MDR-GNB initiated after 48 h of ICU admission are screened for eligibility. Patients are eligible if they proved to be hemodynamically stable and without fever for at least 48 h on the 7th day of adequate antimicrobial therapy. After consenting, patients are 1:1 randomized to discontinue antimicrobial therapy on the 7th (± 1) day or to continue for a total of 14th (± 1) days. Planned Outcomes: The primary outcome is treatment failure, defined as death or relapse of infection within 28 days after randomization. Non-inferiority will be achieved if the upper edge of the two-tailed 95% confidence interval of the difference between the clinical failure rate in the 7-day and the 14-day group is not higher than 10%. Conclusion: The OPTIMISE trial is the first randomized controlled trial specifically designed to assess the duration of antimicrobial therapy in patients with severe infections by MDR-GNB. Trial Registration: ClinicalTrials.gov, NCT05210387. Registered on 27 January 2022. Seven Versus 14 Days of Antibiotic Therapy for Multidrug-resistant Gram-negative Bacilli Infections (OPTIMISE). [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
36. Investigation of Fluid- and Electrolyte Balance in Post Cardiac-surgery Patients (Clinibil)
- Author
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B. Braun Melsungen AG and Center for Biomarker Research in Medicine
- Published
- 2022
37. The use of checklists in the intensive care unit: a scoping review.
- Author
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Erikson, Ethan J., Edelman, Daniel A., Brewster, Fiona M., Marshall, Stuart D., Turner, Maryann C., Sarode, Vineet V., and Brewster, David J.
- Abstract
Background: Despite the extensive volume of research published on checklists in the intensive care unit (ICU), no review has been published on the broader role of checklists within the intensive care unit, their implementation and validation, and the recommended clinical context for their use. Accordingly, a scoping review was necessary to map the current literature and to guide future research on intensive care checklists. This review focuses on what checklists are currently used, how they are used, process of checklist development and implementation, and outcomes associated with checklist use. Methods: A systematic search of MEDLINE (Ovid), Embase, Scopus, and Google Scholar databases was conducted, followed by a grey literature search. The abstracts of the identified studies were screened. Full texts of relevant articles were reviewed, and the references of included studies were subsequently screened for additional relevant articles. Details of the study characteristics, study design, checklist intervention, and outcomes were extracted. Results: Our search yielded 2046 studies, of which 167 were selected for further analysis. Checklists identified in these studies were categorised into the following types: rounding checklists; delirium screening checklists; transfer and handover checklists; central line-associated bloodstream infection (CLABSI) prevention checklists; airway management checklists; and other. Of 72 significant clinical outcomes reported, 65 were positive, five were negative, and two were mixed. Of 122 significant process of care outcomes reported, 114 were positive and eight were negative. Conclusions: Checklists are commonly used in the intensive care unit and appear in many clinical guidelines. Delirium screening checklists and rounding checklists are well implemented and validated in the literature. Clinical and process of care outcomes associated with checklist use are predominantly positive. Future research on checklists in the intensive care unit should focus on establishing clinical guidelines for checklist types and processes for ongoing modification and improvements using post-intervention data. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
38. ICU Delirium in Cardiac Patients.
- Author
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FAISAL, HINA, FARHAT, SOUHA, GREWAL, NAVNEET K., and MASUD, FAISAL N.
- Subjects
CARDIAC patients ,DELIRIUM ,CRITICALLY ill patient care ,INTENSIVE care patients ,COGNITION disorders - Abstract
Delirium is a prevalent complication in critically ill medical and surgical cardiac patients. It is associated with increased morbidity and mortality, prolonged hospitalizations, cognitive impairments, functional decline, and hospital costs. The incidence of delirium in cardiac patients varies based on the criteria used for the diagnosis, the population studied, and the type of surgery (cardiac or not cardiac). Delirium experienced when cardiac patients are in the intensive care unit (ICU) is likely preventable in most cases. While there are many protocols for recognizing and managing ICU delirium in medical and surgical cardiac patients, there is no homogeneity, nor are there established clinical guidelines. This review provides a comprehensive overview of delirium in cardiac patients and highlights its presentation, course, risk factors, pathophysiology, and management. We define cardiac ICU patients as both medical and postoperative surgical patients with cardiac disease in the ICU. We also highlight current controversies and future considerations of innovative therapies and nonpharmacological and pharmacological management interventions. Clinicians caring for critically ill patients with cardiac disease must understand the complex syndrome of ICU delirium and recognize the impact of delirium in predicting long-term outcomes for ICU patients. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
39. Impact of gas humidification and nebulizer position under invasive ventilation: preclinical comparative study of regional aerosol deposition.
- Author
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Montigaud, Yoann, Georges, Quentin, Leclerc, Lara, Clotagatide, Anthony, Louf-Durier, Aurore, Pourchez, Jérémie, Prévôt, Nathalie, and Périnel-Ragey, Sophie
- Subjects
HUMIDITY control ,NEBULIZERS & vaporizers ,AEROSOLS ,MINE ventilation ,ARTIFICIAL respiration ,GASES ,MICROBIOLOGICAL aerosols - Abstract
Successful aerosol therapy in mechanically ventilated patients depends on multiple factors. Among these, position of nebulizer in ventilator circuit and humidification of inhaled gases can strongly influence the amount of drug deposited in airways. Indeed, the main objective was to preclinically evaluate impact of gas humidification and nebulizer position during invasive mechanical ventilation on whole lung and regional aerosol deposition and losses. Ex vivo porcine respiratory tracts were ventilated in controlled volumetric mode. Two conditions of relative humidity and temperature of inhaled gases were investigated. For each condition, four different positions of vibrating mesh nebulizer were studied: (i) next to the ventilator, (ii) right before humidifier, (iii) 15 cm to the Y-piece adapter and (iv) right after the Y-piece. Aerosol size distribution were calculated using cascade impactor. Nebulized dose, lung regional deposition and losses were assessed by scintigraphy using
99m technetium-labeled diethylene-triamine-penta-acetic acid. Mean nebulized dose was 95% ± 6%. For dry conditions, the mean respiratory tract deposited fractions reached 18% (± 4%) next to ventilator and 53% (± 4%) for proximal position. For humidified conditions, it reached 25% (± 3%) prior humidifier, 57% (± 8%) before Y-piece and 43% (± 11%) after this latter. Optimal nebulizer position is proximal before the Y-piece adapter showing a more than two-fold higher lung dose than positions next to the ventilator. Dry conditions are more likely to cause peripheral deposition of aerosols in the lungs. But gas humidification appears hard to interrupt efficiently and safely in clinical use. Considering the impact of optimized positioning, this study argues to maintain humidification. [ABSTRACT FROM AUTHOR]- Published
- 2023
- Full Text
- View/download PDF
40. THE PRESENTATION OF MEDICAL COMPLICATIONS IN THE ACUTE IN-HOSPITAL MANAGEMENT OF STROKE PATIENTS AND THEIR DETERMINANTS: A CROSS-SECTIONAL STUDY.
- Author
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Ikram, Muhammad Tabish, Azam, Hashim Uddin, Azam, Kamal Uddin, Arif, Amina, Rahman, Asad, Khan, Bakht Danyal, and Rahim, Adam khan
- Subjects
ASPIRATION pneumonia ,STROKE patients ,URINARY tract infections ,GLASGOW Coma Scale ,CROSS-sectional method ,STROKE ,HOSPITAL patients - Abstract
Objectives: To find the frequency of Acute Medical complications and their determinants in stroke patients admitted to a hospital in Peshawar. Materials and Methods: In this cross-sectional descriptive study in the Department of Medicine and Neurology at Hayat Abad Medical Complex, Peshawar, Pakistan from 1/10/2022 till 31/12/2022, a total of 180 patients who presented with Cerebrovascular events based on CT/MRI were included. Patients' data were collected through questionnaires, NIHSS and GCS scores were calculated at the presentation and patients were followed in the hospital to detect complications. Comparisons with p-values were then determined using SPSS. Results: The overall rate of stroke complications in 180 patients documented was 90%, the common being Aspiration Pneumonia (48.89%), Urinary Tract infections (30%), Bedsores (28.33%), Pyrexia illness (22.22%) and Seizures (12.78%). NIHSS scores had a direct relationship, with patients scoring >12 having a complications rate of 93% in contrast to 76.5% in patients with scores of =3 (p-value 0.032). GCS at presentation had similar predictive value with scores of 15/15 having 73% and =8 having a 91% complication rate. Duration of hospitalization (p-value 0.014) had a key impact as patients admitted for a month had higher percentages of complications primarily UTI (52.4%), Bedsores (71%), and Constipation (33.3%). Treatments like Dexamethasone (p-value 0.003) and antiplatelets (p-value 0.010) were found to increase the rate of complications. Conclusion: In-hospital post-stroke complications are common having a direct link with stroke severity, hospitalization duration, and treatment given. An active approach is needed to identify and treat any complications early, thereby, improving outcomes and decreasing morbidity. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
41. Constipation Bundle/Protocol and the Effect of Adherence in the Incidence of Constipation in Critically Ill Patients (motility)
- Author
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Eduardo Tobar, Associated Professor
- Published
- 2021
42. Efferon LPS Hemoperfusion for Treatment of Patients With Septic Shock
- Published
- 2021
43. The Effect of Naloxegol on Refractory Constipation in the Intensive Care Unit (NaRC-ICU)
- Author
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AstraZeneca
- Published
- 2021
44. Comparing inhaled colistin with inhaled fosfomycin/tobramycin as an adjunctive treatment for ventilator‐associated pneumonia: An open‐label randomized controlled trial.
- Author
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Hakamifard, Atousa, Torfeh Esfahani, Abbas Ali, Homayouni, Alireza, Khorvash, Farzin, Ataei, Behrooz, and Abbasi, Saeed
- Subjects
VENTILATOR-associated pneumonia ,TOBRAMYCIN ,RANDOMIZED controlled trials ,FOSFOMYCIN ,COLISTIN - Abstract
Purpose: Although investigations are limited, adjunctive aerosolized antibiotics have been advised in the setting of gram‐negative ventilator‐associated pneumonia (VAP). This study aimed to compare the efficiency of inhaled colistin with inhaled fosfomycin/tobramycin in treating VAP due to extensively drug‐resistant (XDR) Acinetobacter baumannii. Methods: This single center open‐label randomized controlled trial included 60 patients who developed XDR A. bumannii VAP. Eligible participants were randomly assigned to two groups (no. 30). Regardless of the assignment, all participants received meropenem (2 g as a 3‐h extended infusion every 8 h) plus intravenous colistin (a loading dose of 9 million IU and then 4.5 million IU every 12 h). The control group was given inhaled colistin (1 million IU every 8 h), and the case group received inhaled tobramycin/fosfomycin (300 mg every 12 h/80 mg every 12 h) as adjunctive therapy. The primary outcome was treatment duration, and the secondary outcomes were Clinical Pulmonary Infection Score (CPIS) trend and mortality rate in the groups. The decision to stop treatment was made by the treating physician. Results: The mean treatment duration was 13.73 ± 3.22 days in the colistin group and 10.85 ± 2.84 days in the tobramycin/fosfomycin group; the mean treatment duration in the latter group was lower significantly (P = 0.001). CPIS was decreased in the groups significantly (P < 0.001), but the mean changes of CPIS were significantly different between the groups, and in the inhaled tobramycin/fosfomycin group, a greater reduction (P = 0.005) was observed. Two (6.67%) patients in the control group and three (10%) patients in the case group died. Conclusion: The use of inhaled tobramycin/fosfomycin in cases with XDR A. bumannii VAP was associated with a shorter treatment duration in this open‐label trial. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
45. Mechanical Ventilation Epidemiology in Argentina. (EpVAr2019)
- Author
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Gustavo Plotnikow, Physical and Respiratory Therapist, Head of Physical and Respiratory Therapist Department, Sanatorio Anchorena, Buenos Aires, Argentina
- Published
- 2020
46. Coated Devices to Decrease Infection in the Intensive Care Unit (CRITIC)
- Author
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Bactiguard AB
- Published
- 2020
47. Changes in functional mobility of patients with solid tumors after discharge from intensive care unit.
- Author
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da Silva Tavares Costa, Carolina, Martins de Bessa, Camila, Leão Gutierrez, Ana Cristina Machado, dos Santos, Tiago Eduardo, Bergmann, Anke, and Telles da Silva, Gustavo
- Subjects
TUMOR surgery ,T-test (Statistics) ,SEX distribution ,FUNCTIONAL status ,DISCHARGE planning ,CANCER patients ,RETROSPECTIVE studies ,ONCOLOGY ,DESCRIPTIVE statistics ,AGE distribution ,LONGITUDINAL method ,KAPLAN-Meier estimator ,INTENSIVE care units ,CONVALESCENCE ,MEDICAL records ,ACQUISITION of data ,TUMORS ,LENGTH of stay in hospitals ,DATA analysis software ,SURVIVAL analysis (Biometry) ,PHYSICAL mobility ,HOSPITAL wards ,REGRESSION analysis ,OVERALL survival ,COMORBIDITY ,PROPORTIONAL hazards models - Abstract
Copyright of Fisioterapia e Pesquisa is the property of Universidade de Sao Paulo, Faculdade de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2023
- Full Text
- View/download PDF
48. Summer Dreams.
- Author
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ALEXANDER, PHILIP
- Subjects
WHITE House staff ,SYMPHONY orchestras ,ART ,SUMMER - Abstract
Philip Alexander, MD, is a native Texan, retired physician, and accomplished musician and artist. After 41 years as an internal medicine physician, Dr. Phil retired from his practice in College Station in 2016. A lifelong musician and former music professor, he often performs as an oboe soloist for the Brazos Valley Symphony Orchestra. He began exploring visual art in 1980, evolving from pencil sketches—including an official White House portrait of President Ronald Reagan—to the computer-generated drawings featured in this journal. His images, which first appeared in this journal in the spring of 2012, are his own original creations. If you would like to see your art published in the Methodist DeBakey Cardiovascular Journal, submit your creation online at journal.houstonmethodist.org as a “Humanities” entry. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
49. Comparison of mNUTRIC-S2 and mNUTRIC scores to assess nutritional risk and predict intensive care unit mortality.
- Author
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So Jeong Kim, Hong Yeul Lee, Sun Mi Choi, Sang-Min Lee, and Jinwoo Lee
- Subjects
INTENSIVE care units ,APACHE (Disease classification system) ,RECEIVER operating characteristic curves ,ELECTRONIC health records - Abstract
Background: Nutritional status is associated with mortality. The modified Nutrition Risk in the Critically Ill (mNUTRIC) score is one of the most commonly used nutritional risk assessment tools in intensive care units (ICUs). The purpose of this study was to compare the mortality predictive ability of the mNUTRIC score to that of the mNUTRIC-S2 score, which uses the Simplified Acute Physiology Score (SAPS) II instead of the Acute Physiology and Chronic Health Evaluation (APACHE) II. Methods: This retrospective cohort analysis included patients admitted to the ICU between January and September 2020. Each patient's electronic medical records were reviewed. The model discrimination for predicting ICU mortality was assessed by the area under the receiver operating characteristic (ROC) curve, and a Cox regression model was performed to confirm the relationship between the groups and mortality. Results: In total, 220 patients were enrolled. The ROC curve for predicting ICU mortality was 0.64 for the mNUTRIC score versus 0.67 for the mNUTRIC-S2 score. The difference between the areas was 0.03 (95% confidence interval [CI], -0.01 to 0.06; P=0.09). Patients with mNUTRIC-S2 score =5 had a greater risk of ICU mortality (hazard ratio [HR], 3.64; 95% CI, 1.85-7.14; P<0.001); however, no such relationship was observed with mNUTRIC score (HR, 1.69; 95% CI, 0.62-4.62; P=0.31). Conclusions: The mNUTRIC-S2 score was significantly associated with ICU mortality. A cutoff score of 5 was selected as most appropriate. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
50. Percepções e práticas sobre sedação superficial em pacientes sob ventilação mecânica: um inquérito sobre as atitudes de médicos intensivistas brasileiros.
- Author
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Cés de Souza-Dantas, Vicente, Sobreira Tanaka, Lilian Maria, Bernardo Serafim, Rodrigo, and Figueira Salluh, Jorge Ibrain
- Subjects
CRITICAL care medicine ,ARTIFICIAL respiration ,CONSCIOUS sedation - Abstract
Copyright of Revista Brasileira de Terapia Intensiva is the property of Associacao de Medicina Intensiva Brasileira and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2022
- Full Text
- View/download PDF
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