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1. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

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Pham, T, Heunks, L, Bellani, G, Madotto, F, Aragao, I, Beduneau, G, Goligher, E, Grasselli, G, Laake, J, Mancebo, J, Penuelas, O, Piquilloud, L, Pesenti, A, Wunsch, H, van Haren, F, Brochard, L, Laffey, J, Abrough, F, Acharya, S, Amin, P, Arabi, Y, Bauer, P, Beitler, J, Berkius, J, Bugedo, G, Camporota, L, Cerny, V, Cho, Y, Clarkson, K, Estenssoro, E, Gritsan, A, Hashemian, S, Hermans, G, Jovanovic, B, Kurahashi, K, Matamis, D, Moerer, O, Molnar, Z, Ozyilmaz, E, Panka, B, Papali, A, Perbet, S, Qiu, H, Razek, A, Rittayamai, N, Roldan, R, Serpa Neto, A, Szuldrzynski, K, Talmor, D, Tomescu, D, Villagomez, A, Zeggwagh, A, Abe, T, Aboshady, A, Acampo-de Jong, M, Adderley, J, Adiguzel, N, Agrawal, V, Aguilar, G, Aguirre, G, Aguirre-Bermeo, H, Ahlstrom, B, Akbas, T, Akker, M, Al Sadeh, G, Alamri, S, Algaba, A, Ali, M, Aliberti, A, Allegue, J, Alvarez, D, Amador, J, Andersen, F, Ansari, S, Apichatbutr, Y, Apostolopoulou, O, Arellano, D, Arica, M, Arikan, H, Arinaga, K, Arnal, J, Asano, K, Asin-Corrochano, M, Avalos Cabrera, J, Avila Fuentes, S, Aydemir, S, Aygencel, G, Azevedo, L, Bacakoglu, F, Badie, J, Baedorf Kassis, E, Bai, G, Balaraj, G, Ballico, B, Banner-Goodspeed, V, Banwarie, P, Barbieri, R, Baronia, A, Barrett, J, Barrot, L, Barrueco-Francioni, J, Barry, J, Bawangade, H, Beavis, S, Beck, E, Beehre, N, Belenguer Muncharaz, A, Belliato, M, Bellissima, A, Beltramelli, R, Ben Souissi, A, Benitez-Cano, A, Benlamin, M, Benslama, A, Bento, L, Benvenuti, D, Bernabe, L, Bersten, A, Berta, G, Bertini, P, Bertram-Ralph, E, Besbes, M, Bettini, L, Beuret, P, Bewley, J, Bezzi, M, Bhakhtiani, L, Bhandary, R, Bhowmick, K, Bihari, S, Bissett, B, Blythe, D, Bocher, S, Boedjawan, N, Bojanowski, C, Boni, E, Boraso, S, Borelli, M, Borello, S, Borislavova, M, Bosma, K, Bottiroli, M, Boyd, O, Bozbay, S, Briva, A, Bruel, C, Bruni, A, Buehner, U, Bulpa, P, Burt, K, Buscot, M, Buttera, S, Cabrera, J, Caccese, R, Caironi, P, Canchos Gutierrez, I, Canedo, N, Cani, A, Cappellini, I, Carazo, J, Cardonnet, L, Carpio, D, Carriedo, D, Carrillo, R, Carvalho, J, Caser, E, Castelli, A, Castillo Quintero, M, Castro, H, Catorze, N, Cengiz, M, Cereijo, E, Ceunen, H, Chaintoutis, C, Chang, Y, Chaparro, G, Chapman, C, Chau, S, Chavez, C, Chelazzi, C, Chelly, J, Chemouni, F, Chen, K, Chena, A, Chiarandini, P, Chilton, P, Chiumello, D, Chou-Lie, Y, Chudeau, N, Cinel, I, Cinnella, G, Clark, M, Clark, T, Clementi, S, Coaguila, L, Codecido, A, Collins, A, Colombo, R, Conde, J, Consales, G, Cook, T, Coppadoro, A, Cornejo, R, Cortegiani, A, Coxo, C, Cracchiolo, A, Crespo Ramirez, M, Crova, P, Cruz, J, Cubattoli, L, Cukurova, Z, Curto, F, Czempik, P, D'Andrea, R, da Silva Ramos, F, Dangers, L, Danguy des Deserts, M, Danin, P, Dantas, F, Daubin, C, Dawei, W, de Haro, C, de Jesus Montelongo, F, De Mendoza, D, de Pablo, R, De Pascale, G, De Rosa, S, Decavele, M, Declercq, P, Deicas, A, del Carmen Campos Moreno, M, Dellamonica, J, Delmas, B, Demirkiran, O, Demirkiran, H, Dendane, T, di Mussi, R, Diakaki, C, Diaz, A, Diaz, W, Dikmen, Y, Dimoula, A, Doble, P, Doha, N, Domingos, G, Dres, M, Dries, D, Duggal, A, Duke, G, Dunts, P, Dybwik, K, Dykyy, M, Eckert, P, Efe, S, Elatrous, S, Elay, G, Elmaryul, A, Elsaadany, M, Elsayed, H, Elsayed, S, Emery, M, Ena, S, Eng, K, Englert, J, Erdogan, E, Ergin Ozcan, P, Eroglu, E, Escobar, M, Esen, F, Esen Tekeli, A, Esquivel, A, Esquivel Gallegos, H, Ezzouine, H, Facchini, A, Faheem, M, Fanelli, V, Farina, M, Fartoukh, M, Fehrle, L, Feng, F, Feng, Y, Fernandez, I, Fernandez, B, Fernandez-Rodriguez, M, Ferrando, C, Ferreira da Silva, M, Ferreruela, M, Ferrier, J, Flamm Zamorano, M, Flood, L, Floris, L, Fluckiger, M, Forteza, C, Fortunato, A, Frans, E, Frattari, A, Fredes, S, Frenzel, T, Fumagalli, R, Furche, M, Fusari, M, Fysh, E, Galeas-Lopez, J, Galerneau, L, Garcia, A, Garcia, M, Garcia, E, Garcia Olivares, P, Garlicki, J, Garnero, A, Garofalo, E, Gautam, P, Gazenkampf, A, Gelinotte, S, Gelormini, D, Ghrenassia, E, Giacomucci, A, Giannoni, R, Gigante, A, Glober, N, Gnesin, P, Gollo, Y, Gomaa, D, Gomero Paredes, R, Gomes, R, Gomez, R, Gomez, O, Gomez, A, Gondim, L, Gonzalez, M, Gonzalez, I, Gonzalez-Castro, A, Gordillo Romero, O, Gordo, F, Gouin, P, Graf Santos, J, Grainne, R, Grando, M, Granov Grabovica, S, Grasso, S, Grasso, R, Grimmer, L, Grissom, C, Gu, Q, Guan, X, Guarracino, F, Guasch, N, Guatteri, L, Gueret, R, Guerin, C, Guerot, E, Guitard, P, Gul, F, Gumus, A, Gurjar, M, Gutierrez, P, Hachimi, A, Hadzibegovic, A, Hagan, S, Hammel, C, Han Song, J, Hanlon, G, Heines, S, Henriksson, J, Herbrecht, J, Heredia Orbegoso, G, Hermon, A, Hernandez, R, Hernandez, C, Herrera, L, Herrera-Gutierrez, M, Hidalgo, J, Hill, D, Holmquist, D, Homez, M, Hongtao, X, Hormis, A, Horner, D, Hornos, M, Hou, M, House, S, Housni, B, Hugill, K, Humphreys, S, Humbert, L, Hunter, S, Hwa Young, L, Iezzi, N, Ilutovich, S, Inal, V, Innes, R, Ioannides, P, Iotti, G, Ippolito, M, Irie, H, Iriyama, H, Itagaki, T, Izura, J, Izza, S, Jabeen, R, Jamaati, H, Jamadarkhana, S, Jamoussi, A, Jankowski, M, Jaramillo, L, Jeon, K, Jeong Lee, S, Jeswani, D, Jha, S, Jiang, L, Jing, C, Jochmans, S, Johnstad, B, Jongmin, L, Joret, A, Junhasavasdikul, D, Jurado, M, Kam, E, Kamohara, H, Kane, C, Kara, I, Karakurt, S, Karnjanarachata, C, Kataoka, J, Katayama, S, Kaushik, S, Kelebek Girgin, N, Kerr, K, Kerslake, I, Khairnar, P, Khalid, A, Khan, A, Khanna, A, Khorasanee, R, Kienhorst, D, Kirakli, C, Knafelj, R, Kol, M, Kongpolprom, N, Kopitko, C, Korkmaz Ekren, P, Kubisz-Pudelko, A, Kulcsar, Z, Kumasawa, J, Kuriyama, A, Kutchak, F, Labarca, E, Labat, F, Laborda, C, Laca Barrera, M, Lagache, L, Landaverde Lopez, A, Lanspa, M, Lascari, V, Le Meur, M, Lee, S, Lee, Y, Lee, J, Lee, W, Legernaes, T, Leiner, T, Lemiale, V, Leonor, T, Lepper, P, Li, D, Li, H, Li, O, Lima, A, Lind, D, Litton, E, Liu, N, Liu, L, Liu, J, Llitjos, J, Llorente, B, Lopez, R, Lopez, C, Lopez Nava, C, Lovazzano, P, Lu, M, Lucchese, F, Lugano, M, Lugo Goytia, G, Luo, H, Lynch, C, Macheda, S, Madrigal Robles, V, Maggiore, S, Magret Iglesias, M, Malaga, P, Mallapura Maheswarappa, H, Malpartida, G, Malyarchikov, A, Mansson, H, Manzano, A, Marey, I, Marin, N, Marin, M, Markman, E, Martin, F, Martin, A, Martin Dal Gesso, C, Martinez, F, Martinez-Fidalgo, C, Martin-Loeches, I, Mas, A, Masaaki, S, Maseda, E, Massa, E, Mattsson, A, Maugeri, J, Mccredie, V, Mccullough, J, Mcguinness, S, Mckown, A, Medve, L, Mei, C, Mellado Artigas, R, Mendes, V, Mervat, M, Michaux, I, Mikhaeil, M, Milagros, O, Milet, I, Millan, M, Minwei, Z, Mirabella, L, Mishra, S, Mistraletti, G, Mochizuki, K, Moghal, A, Mojoli, F, Molin, A, Montiel, R, Montini, L, Monza, G, Mora Aznar, M, Morakul, S, Morales, M, Moreno Torres, D, Morocho Tutillo, D, Motherway, C, Mouhssine, D, Mouloudi, E, Munoz, T, Munoz de Cabo, C, Mustafa, M, Muthuchellappan, R, Muthukrishnan, M, Muttini, S, Nagata, I, Nahar, D, Nakanishi, M, Nakayama, I, Namendys-Silva, S, Nanchal, R, Nandakumar, S, Nasi, A, Nasir, K, Navalesi, P, Naz Aslam, T, Nga Phan, T, Nichol, A, Niiyama, S, Nikolakopoulou, S, Nikolic, E, Nitta, K, Noc, M, Nonas, S, Nseir, S, Nur Soyturk, A, Obata, Y, Oeckler, R, Oguchi, M, Ohshimo, S, Oikonomou, M, Ojados, A, Oliveira, M, Oliveira Filho, W, Oliveri, C, Olmos, A, Omura, K, Orlandi, M, Orsenigo, F, Ortiz-Ruiz De Gordoa, L, Ota, K, Ovalle Olmos, R, Oveges, N, Oziemski, P, Ozkan Kuscu, O, Pachas Alvarado, F, Pagella, G, Palaniswamy, V, Palazon Sanchez, E, Palmese, S, Pan, G, Pan, W, Papanikolaou, M, Papavasilopoulou, T, Parekh, A, Parke, R, Parrilla, F, Parrilla, D, Pasha, T, Pasin, L, Patao, L, Patel, M, Patel, G, Pati, B, Patil, J, Pattnaik, S, Paul, D, Pavesi, M, Pavlotsky, V, Paz, G, Paz, E, Pecci, E, Pellegrini, C, Pena Padilla, A, Perchiazzi, G, Pereira, T, Pereira, V, Perez, M, Perez Calvo, C, Perez Cheng, M, Perez Maita, R, Perez-Araos, R, Perez-Teran, P, Perez-Torres, D, Perkins, G, Persona, P, Petnak, T, Petrova, M, Philippart, F, Picetti, E, Pierucci, E, Piervincenzi, E, Pinciroli, R, Pintado, M, Piraino, T, Piras, S, Piras, C, Pirompanich, P, Pisani, L, Platas, E, Plotnikow, G, Porras, W, Porta, V, Portilla, M, Portugal, J, Povoa, P, Prat, G, Pratto, R, Preda, G, Prieto, I, Prol-Silva, E, Pugh, R, Qi, Y, Qian, C, Qin, T, Qu, H, Quintana, T, Quispe Sierra, R, Quispe Soto, R, Rabbani, R, Rabee, M, Rabie, A, Rahe Pereira, M, Rai, A, Raj Ashok, S, Rajab, M, Ramdhani, N, Ramey, E, Ranieri, M, Rathod, D, Ray, B, Redwanul Huq, S, Regli, A, Reina, R, Resano Sarmiento, N, Reynaud, F, Rialp, G, Ricart, P, Rice, T, Richardson, A, Rieder, M, Rinket, M, Rios, F, Risso Vazquez, A, Riva, I, Rivette, M, Roca, O, Roche-Campo, F, Rodriguez, C, Rodriguez, G, Rodriguez Gonzalez, D, Rodriguez Tucto, X, Rogers, A, Romano, M, Rortveit, L, Rose, A, Roux, D, Rouze, A, Rubatto Birri, P, Ruilan, W, Ruiz Robledo, A, Ruiz-Aguilar, A, Sadahiro, T, Saez, I, Sagardia, J, Saha, R, Saiphoklang, N, Saito, S, Salem, M, Sales, G, Salgado, P, Samavedam, S, Sami Mebazaa, M, Samuelsson, L, San Juan Roman, N, Sanchez, P, Sanchez-Ballesteros, J, Sandoval, Y, Sani, E, Santos, M, Santos, C, Sanui, M, Saravanabavan, L, Sari, S, Sarkany, A, Sauneuf, B, Savioli, M, Sazak, H, Scano, R, Schneider, F, Schortgen, F, Schultz, M, Schwarz, G, Seckin Yucesoy, F, Seely, A, Seiler, F, Seker Tekdos, Y, Seok Chan, K, Serano, L, Serednicki, W, Setten, M, Shah, A, Shah, B, Shang, Y, Shanmugasundaram, P, Shapovalov, K, Shebl, E, Shiga, T, Shime, N, Shin, P, Short, J, Shuhua, C, Siddiqui, S, Silesky Jimenez, J, Silva, D, Silva Sales, B, Simons, K, Sjobo, B, Slessor, D, Smiechowicz, J, Smischney, N, Smith, P, Smith, T, Smith, M, Snape, S, Snyman, L, Soetens, F, Sook Hong, K, Sosa Medellin, M, Soto, G, Souloy, X, Sousa, E, Sovatzis, S, Sozutek, D, Spadaro, S, Spagnoli, M, Spangfors, M, Spittle, N, Spivey, M, Stapleton, A, Stefanovic, B, Stephenson, L, Stevenson, E, Strand, K, Strano, M, Straus, S, Sun, C, Sun, R, Sundaram, V, Sunpark, T, Surlemont, E, Sutherasan, Y, Szabo, Z, Tainter, C, Takaba, A, Tallott, M, Tamasato, T, Tang, Z, Tangsujaritvijit, V, Taniguchi, L, Taniguchi, D, Tarantino, F, Teerapuncharoen, K, Temprano, S, Terragni, P, Terzi, N, Thakur, A, Theerawit, P, Thille, A, Thomas, M, Thungtitigul, P, Thyrault, M, Tilouch, N, Timenetsky, K, Tirapu, J, Todeschini, M, Tomas, R, Tomaszewski, C, Tonetti, T, Tonnelier, A, Trinder, J, Trongtrakul, K, Truwit, J, Tsuei, B, Tulaimat, A, Turan, S, Turkoglu, M, Tyagi, S, Ubeda, A, Vagginelli, F, Valenti, M, Vallverdu, I, Van Axel, A, van den Hul, I, van der Hoeven, H, Van Der Meer, N, Vanhoof, M, Vargas-Ordonez, M, Vaschetto, R, Vascotto, E, Vatsik, M, Vaz, A, Vazquez-Sanchez, A, Ventura, S, Vermeijden, J, Vidal, A, Vieira, J, Vilela Costa Pinto, B, Villagra, A, Villegas Succar, C, Vinorum, O, Vitale, G, Vj, R, Vochin, A, Voiriot, G, Volta, C, von Seth, M, Wajdi, M, Walsh, D, Wang, S, Wardi, G, Ween-Velken, N, Wei, B, Weller, D, Welsh, D, Welters, I, Wert, M, Whiteley, S, Wilby, E, Williams, E, Williams, K, Wilson, A, Wojtas, J, Won Huh, J, Wrathall, D, Wright, C, Wu, J, Xi, G, Xing, Z, Xu, H, Yamamoto, K, Yan, J, Yanez, J, Yang, X, Yates, E, Yazicioglu Mocin, O, Ye, Z, Yildirim, F, Yoshida, N, Yoshido, H, Young Lee, B, Yu, R, Yu, G, Yu, T, Yuan, B, Yuangtrakul, N, Yumoto, T, Yun, X, Zakalik, G, Zaki, A, Zalba-Etayo, B, Zambon, M, Zang, B, Zani, G, Zarka, J, Zerbi, S, Zerman, A, Zetterquist, H, Zhang, J, Zhang, H, Zhang, W, Zhang, G, Zhao, H, Zheng, J, Zhu, B, Zumaran, R, Pham T., Heunks L., Bellani G., Madotto F., Aragao I., Beduneau G., Goligher E. C., Grasselli G., Laake J. H., Mancebo J., Penuelas O., Piquilloud L., Pesenti A., Wunsch H., van Haren F., Brochard L., Laffey J. G., Abrough F., Acharya S. P., Amin P., Arabi Y., Bauer P., Beitler J., Berkius J., Bugedo G., Camporota L., Cerny V., Cho Y. -J., Clarkson K., Estenssoro E., Goligher E., Gritsan A., Hashemian S. M., Hermans G., Heunks L. M., Jovanovic B., Kurahashi K., Matamis D., Moerer O., Molnar Z., Ozyilmaz E., Panka B., Papali A., Perbet S., Qiu H., Razek A. A., Rittayamai N., Roldan R., Serpa Neto A., Szuldrzynski K., Talmor D., Tomescu D., Villagomez A., Zeggwagh A. A., Abe T., Aboshady A., Acampo-de Jong M., Acharya S., Adderley J., Adiguzel N., Agrawal V. K., Aguilar G., Aguirre G., Aguirre-Bermeo H., Ahlstrom B., Akbas T., Akker M., Al Sadeh G., Alamri S., Algaba A., Ali M., Aliberti A., Allegue J. M., Alvarez D., Amador J., Andersen F. H., Ansari S., Apichatbutr Y., Apostolopoulou O., Arellano D., Arica M., Arikan H., Arinaga K., Arnal J. -M., Asano K., Asin-Corrochano M., Avalos Cabrera J. M., Avila Fuentes S., Aydemir S., Aygencel G., Azevedo L., Bacakoglu F., Badie J., Baedorf Kassis E., Bai G., Balaraj G., Ballico B., Banner-Goodspeed V., Banwarie P., Barbieri R., Baronia A., Barrett J., Barrot L., Barrueco-Francioni J. E., Barry J., Bawangade H., Beavis S., Beck E., Beehre N., Belenguer Muncharaz A., Belliato M., Bellissima A., Beltramelli R., Ben Souissi A., Benitez-Cano A., Benlamin M., Benslama A., Bento L., Benvenuti D., Bernabe L., Bersten A., Berta G., Bertini P., Bertram-Ralph E., Besbes M., Bettini L. R., Beuret P., Bewley J., Bezzi M., Bhakhtiani L., Bhandary R., Bhowmick K., Bihari S., Bissett B., Blythe D., Bocher S., Boedjawan N., Bojanowski C. M., Boni E., Boraso S., Borelli M., Borello S., Borislavova M., Bosma K. J., Bottiroli M., Boyd O., Bozbay S., Briva A., Bruel C., Bruni A., Buehner U., Bulpa P., Burt K., Buscot M., Buttera S., Cabrera J., Caccese R., Caironi P., Canchos Gutierrez I., Canedo N., Cani A., Cappellini I., Carazo J., Cardonnet L. P., Carpio D., Carriedo D., Carrillo R., Carvalho J., Caser E., Castelli A., Castillo Quintero M., Castro H., Catorze N., Cengiz M., Cereijo E., Ceunen H., Chaintoutis C., Chang Y., Chaparro G., Chapman C., Chau S., Chavez C. E., Chelazzi C., Chelly J., Chemouni F., Chen K., Chena A., Chiarandini P., Chilton P., Chiumello D., Chou-Lie Y., Chudeau N., Cinel I., Cinnella G., Clark M., Clark T., Clementi S., Coaguila L., Codecido A. J., Collins A., Colombo R., Conde J., Consales G., Cook T., Coppadoro A., Cornejo R., Cortegiani A., Coxo C., Cracchiolo A. N., Crespo Ramirez M., Crova P., Cruz J., Cubattoli L., Cukurova Z., Curto F., Czempik P., D'Andrea R., da Silva Ramos F., Dangers L., Danguy des Deserts M., Danin P. -E., Dantas F., Daubin C., Dawei W., de Haro C., de Jesus Montelongo F., De Mendoza D., de Pablo R., De Pascale G., De Rosa S., Decavele M., Declercq P. -L., Deicas A., del Carmen Campos Moreno M., Dellamonica J., Delmas B., Demirkiran O., Demirkiran H., Dendane T., di Mussi R., Diakaki C., Diaz A., Diaz W., Dikmen Y., Dimoula A., Doble P., Doha N., Domingos G., Dres M., Dries D., Duggal A., Duke G., Dunts P., Dybwik K., Dykyy M., Eckert P., Efe S., Elatrous S., Elay G., Elmaryul A. S., Elsaadany M., Elsayed H., Elsayed S., Emery M., Ena S., Eng K., Englert J. A., Erdogan E., Ergin Ozcan P., Eroglu E., Escobar M., Esen F., Esen Tekeli A., Esquivel A., Esquivel Gallegos H., Ezzouine H., Facchini A., Faheem M., Fanelli V., Farina M. F., Fartoukh M., Fehrle L., Feng F., Feng Y., Fernandez I., Fernandez B., Fernandez-Rodriguez M. L., Ferrando C., Ferreira da Silva M. J., Ferreruela M., Ferrier J., Flamm Zamorano M. J., Flood L., Floris L., Fluckiger M., Forteza C., Fortunato A., Frans E., Frattari A., Fredes S., Frenzel T., Fumagalli R., Furche M. A., Fusari M., Fysh E., Galeas-Lopez J. L., Galerneau L. -M., Garcia A., Garcia M. F., Garcia E., Garcia Olivares P., Garlicki J., Garnero A., Garofalo E., Gautam P., Gazenkampf A., Gelinotte S., Gelormini D., Ghrenassia E., Giacomucci A., Giannoni R., Gigante A., Glober N., Gnesin P., Gollo Y., Gomaa D., Gomero Paredes R., Gomes R., Gomez R. A., Gomez O., Gomez A., Gondim L., Gonzalez M., Gonzalez I., Gonzalez-Castro A., Gordillo Romero O., Gordo F., Gouin P., Graf Santos J., Grainne R., Grando M., Granov Grabovica S., Grasso S., Grasso R., Grimmer L., Grissom C., Gu Q., Guan X. -D., Guarracino F., Guasch N., Guatteri L., Gueret R., Guerin C., Guerot E., Guitard P. -G., Gul F., Gumus A., Gurjar M., Gutierrez P., Hachimi A., Hadzibegovic A., Hagan S., Hammel C., Han Song J., Hanlon G., Heines S., Henriksson J., Herbrecht J. -E., Heredia Orbegoso G. O., Hermon A., Hernandez R., Hernandez C., Herrera L., Herrera-Gutierrez M., Hidalgo J., Hill D., Holmquist D., Homez M., Hongtao X., Hormis A., Horner D., Hornos M. C., Hou M., House S., Housni B., Hugill K., Humphreys S., Humbert L., Hunter S., Hwa Young L., Iezzi N., Ilutovich S., Inal V., Innes R., Ioannides P., Iotti G. A., Ippolito M., Irie H., Iriyama H., Itagaki T., Izura J., Izza S., Jabeen R., Jamaati H., Jamadarkhana S., Jamoussi A., Jankowski M., Jaramillo L. A., Jeon K., Jeong Lee S., Jeswani D., Jha S., Jiang L., Jing C., Jochmans S., Johnstad B. A., Jongmin L., Joret A., Junhasavasdikul D., Jurado M. T., Kam E., Kamohara H., Kane C., Kara I., Karakurt S., Karnjanarachata C., Kataoka J., Katayama S., Kaushik S., Kelebek Girgin N., Kerr K., Kerslake I., Khairnar P., Khalid A., Khan A., Khanna A. K., Khorasanee R., Kienhorst D., Kirakli C., Knafelj R., Kol M. K., Kongpolprom N., Kopitko C., Korkmaz Ekren P., Kubisz-Pudelko A., Kulcsar Z., Kumasawa J., Kuriyama A., Kutchak F., Labarca E., Labat F., Laborda C., Laca Barrera M. A., Lagache L., Landaverde Lopez A., Lanspa M., Lascari V., Le Meur M., Lee S. H., Lee Y. J., Lee J., Lee W. -Y., Legernaes T., Leiner T., Lemiale V., Leonor T., Lepper P. M., Li D., Li H., Li O., Lima A. R., Lind D., Litton E., Liu N., Liu L., Liu J., Llitjos J. -F., Llorente B., Lopez R., Lopez C. E., Lopez Nava C., Lovazzano P., Lu M., Lucchese F., Lugano M., Lugo Goytia G., Luo H., Lynch C., Macheda S., Madrigal Robles V. H., Maggiore S. M., Magret Iglesias M., Malaga P., Mallapura Maheswarappa H., Malpartida G., Malyarchikov A., Mansson H., Manzano A., Marey I., Marin N., Marin M. D. C., Markman E., Martin F., Martin A., Martin Dal Gesso C., Martinez F., Martinez-Fidalgo C., Martin-Loeches I., Mas A., Masaaki S., Maseda E., Massa E., Mattsson A., Maugeri J., McCredie V., McCullough J., McGuinness S., McKown A., Medve L., Mei C., Mellado Artigas R., Mendes V., Mervat M. K. E., Michaux I., Mikhaeil M., Milagros O., Milet I., Millan M. T., Minwei Z., Mirabella L., Mishra S., Mistraletti G., Mochizuki K., Moghal A., Mojoli F., Molin A., Montiel R., Montini L., Monza G., Mora Aznar M., Morakul S., Morales M., Moreno Torres D., Morocho Tutillo D. R., Motherway C., Mouhssine D., Mouloudi E., Munoz T., Munoz de Cabo C., Mustafa M., Muthuchellappan R., Muthukrishnan M., Muttini S., Nagata I., Nahar D., Nakanishi M., Nakayama I., Namendys-Silva S. A., Nanchal R., Nandakumar S., Nasi A., Nasir K., Navalesi P., Naz Aslam T., Nga Phan T., Nichol A., Niiyama S., Nikolakopoulou S., Nikolic E., Nitta K., Noc M., Nonas S., Nseir S., Nur Soyturk A., Obata Y., Oeckler R., Oguchi M., Ohshimo S., Oikonomou M., Ojados A., Oliveira M. T., Oliveira Filho W., Oliveri C., Olmos A., Omura K., Orlandi M. C., Orsenigo F., Ortiz-Ruiz De Gordoa L., Ota K., Ovalle Olmos R., Oveges N., Oziemski P., Ozkan Kuscu O., Pachas Alvarado F., Pagella G., Palaniswamy V., Palazon Sanchez E. L., Palmese S., Pan G., Pan W., Papanikolaou M., Papavasilopoulou T., Parekh A., Parke R., Parrilla F. J., Parrilla D., Pasha T., Pasin L., Patao L., Patel M., Patel G., Pati B. K., Patil J., Pattnaik S., Paul D., Pavesi M., Pavlotsky V. 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M., Regli A., Reina R., Resano Sarmiento N., Reynaud F., Rialp G., Ricart P., Rice T., Richardson A., Rieder M., Rinket M., Rios F., Risso Vazquez A., Riva I., Rivette M., Roca O., Roche-Campo F., Rodriguez C., Rodriguez G., Rodriguez Gonzalez D., Rodriguez Tucto X. Y., Rogers A., Romano M. E., Rortveit L., Rose A., Roux D., Rouze A., Rubatto Birri P. N., Ruilan W., Ruiz Robledo A., Ruiz-Aguilar A. L., Sadahiro T., Saez I., Sagardia J., Saha R., Saiphoklang N., Saito S., Salem M., Sales G., Salgado P., Samavedam S., Sami Mebazaa M., Samuelsson L., San Juan Roman N., Sanchez P., Sanchez-Ballesteros J., Sandoval Y., Sani E., Santos M., Santos C., Sanui M., Saravanabavan L., Sari S., Sarkany A., Sauneuf B., Savioli M., Sazak H., Scano R., Schneider F., Schortgen F., Schultz M. J., Schwarz G. 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W., Thomas M., Thungtitigul P., Thyrault M., Tilouch N., Timenetsky K., Tirapu J., Todeschini M., Tomas R., Tomaszewski C., Tonetti T., Tonnelier A., Trinder J., Trongtrakul K., Truwit J., Tsuei B., Tulaimat A., Turan S., Turkoglu M., Tyagi S., Ubeda A., Vagginelli F., Valenti M. F., Vallverdu I., Van Axel A., van den Hul I., van der Hoeven H., Van Der Meer N., Vanhoof M., Vargas-Ordonez M., Vaschetto R., Vascotto E., Vatsik M., Vaz A., Vazquez-Sanchez A., Ventura S., Vermeijden J. W., Vidal A., Vieira J., Vilela Costa Pinto B., Villagra A., Villegas Succar C., Vinorum O. G., Vitale G., Vj R., Vochin A., Voiriot G., Volta C. A., von Seth M., Wajdi M., Walsh D., Wang S., Wardi G., Ween-Velken N. 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F., Fartoukh M., Fehrle L., Feng F., Feng Y., Fernandez I., Fernandez B., Fernandez-Rodriguez M. L., Ferrando C., Ferreira da Silva M. J., Ferreruela M., Ferrier J., Flamm Zamorano M. J., Flood L., Floris L., Fluckiger M., Forteza C., Fortunato A., Frans E., Frattari A., Fredes S., Frenzel T., Fumagalli R., Furche M. A., Fusari M., Fysh E., Galeas-Lopez J. L., Galerneau L. -M., Garcia A., Garcia M. F., Garcia E., Garcia Olivares P., Garlicki J., Garnero A., Garofalo E., Gautam P., Gazenkampf A., Gelinotte S., Gelormini D., Ghrenassia E., Giacomucci A., Giannoni R., Gigante A., Glober N., Gnesin P., Gollo Y., Gomaa D., Gomero Paredes R., Gomes R., Gomez R. A., Gomez O., Gomez A., Gondim L., Gonzalez M., Gonzalez I., Gonzalez-Castro A., Gordillo Romero O., Gordo F., Gouin P., Graf Santos J., Grainne R., Grando M., Granov Grabovica S., Grasso S., Grasso R., Grimmer L., Grissom C., Gu Q., Guan X. -D., Guarracino F., Guasch N., Guatteri L., Gueret R., Guerin C., Guerot E., Guitard P. -G., Gul F., Gumus A., Gurjar M., Gutierrez P., Hachimi A., Hadzibegovic A., Hagan S., Hammel C., Han Song J., Hanlon G., Heines S., Henriksson J., Herbrecht J. -E., Heredia Orbegoso G. O., Hermon A., Hernandez R., Hernandez C., Herrera L., Herrera-Gutierrez M., Hidalgo J., Hill D., Holmquist D., Homez M., Hongtao X., Hormis A., Horner D., Hornos M. C., Hou M., House S., Housni B., Hugill K., Humphreys S., Humbert L., Hunter S., Hwa Young L., Iezzi N., Ilutovich S., Inal V., Innes R., Ioannides P., Iotti G. A., Ippolito M., Irie H., Iriyama H., Itagaki T., Izura J., Izza S., Jabeen R., Jamaati H., Jamadarkhana S., Jamoussi A., Jankowski M., Jaramillo L. A., Jeon K., Jeong Lee S., Jeswani D., Jha S., Jiang L., Jing C., Jochmans S., Johnstad B. A., Jongmin L., Joret A., Junhasavasdikul D., Jurado M. T., Kam E., Kamohara H., Kane C., Kara I., Karakurt S., Karnjanarachata C., Kataoka J., Katayama S., Kaushik S., Kelebek Girgin N., Kerr K., Kerslake I., Khairnar P., Khalid A., Khan A., Khanna A. K., Khorasanee R., Kienhorst D., Kirakli C., Knafelj R., Kol M. K., Kongpolprom N., Kopitko C., Korkmaz Ekren P., Kubisz-Pudelko A., Kulcsar Z., Kumasawa J., Kuriyama A., Kutchak F., Labarca E., Labat F., Laborda C., Laca Barrera M. A., Lagache L., Landaverde Lopez A., Lanspa M., Lascari V., Le Meur M., Lee S. H., Lee Y. J., Lee J., Lee W. -Y., Legernaes T., Leiner T., Lemiale V., Leonor T., Lepper P. M., Li D., Li H., Li O., Lima A. R., Lind D., Litton E., Liu N., Liu L., Liu J., Llitjos J. -F., Llorente B., Lopez R., Lopez C. 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M., Regli A., Reina R., Resano Sarmiento N., Reynaud F., Rialp G., Ricart P., Rice T., Richardson A., Rieder M., Rinket M., Rios F., Risso Vazquez A., Riva I., Rivette M., Roca O., Roche-Campo F., Rodriguez C., Rodriguez G., Rodriguez Gonzalez D., Rodriguez Tucto X. Y., Rogers A., Romano M. E., Rortveit L., Rose A., Roux D., Rouze A., Rubatto Birri P. N., Ruilan W., Ruiz Robledo A., Ruiz-Aguilar A. L., Sadahiro T., Saez I., Sagardia J., Saha R., Saiphoklang N., Saito S., Salem M., Sales G., Salgado P., Samavedam S., Sami Mebazaa M., Samuelsson L., San Juan Roman N., Sanchez P., Sanchez-Ballesteros J., Sandoval Y., Sani E., Santos M., Santos C., Sanui M., Saravanabavan L., Sari S., Sarkany A., Sauneuf B., Savioli M., Sazak H., Scano R., Schneider F., Schortgen F., Schultz M. J., Schwarz G. 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C., Wei B. -L., Weller D., Welsh D., Welters I., Wert M., Whiteley S., Wilby E., Williams E., Williams K., Wilson A., Wojtas J., Won Huh J., Wrathall D., Wright C., Wu J. -F., Xi G., Xing Z. -J., Xu H., Yamamoto K., Yan J., Yanez J., Yang X., Yates E., Yazicioglu Mocin O., Ye Z., Yildirim F., Yoshida N., Yoshido H. H. L., Young Lee B., Yu R., Yu G., Yu T., Yuan B., Yuangtrakul N., Yumoto T., Yun X., Zakalik G., Zaki A., Zalba-Etayo B., Zambon M., Zang B., Zani G., Zarka J., Zerbi S. M., Zerman A., Zetterquist H., Zhang J., Zhang H., Zhang W., Zhang G., Zhao H., Zheng J., Zhu B., and Zumaran R.

Abstract

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 d

Published
2023

4. 36th International Symposium on Intensive Care and Emergency Medicine

Author

Bateman, R. M., Sharpe, M. D., Jagger, J. E., Ellis, C. G., Solé-Violán, J., López-Rodríguez, M., Herrera-Ramos, E., Ruíz-Hernández, J., Borderías, L., Horcajada, J., González-Quevedo, N., Rajas, O., Briones, M., Rodríguez de Castro, F., Rodríguez Gallego, C., Esen, F., Orhun, G., Ergin Ozcan, P., Senturk, E., Ugur Yilmaz, C., Orhan, N., Arican, N., Kaya, M., Kucukerden, M., Giris, M., Akcan, U., Bilgic Gazioglu, S., Tuzun, E., Riff, R., Naamani, O., Douvdevani, A., Takegawa, R., Yoshida, H., Hirose, T., Yamamoto, N., Hagiya, H., Ojima, M., Akeda, Y., Tasaki, O., Tomono, K., Shimazu, T., Ono, S., Kubo, T., Suda, S., Ueno, T., Ikeda, T., Ogura, H., Takahashi, H., Kang, J., Nakamura, Y., Kojima, T., Izutani, Y., Taniguchi, T., O, M., Dinter, C., Lotz, J., Eilers, B., Wissmann, C., Lott, R., Meili, M. M., Schuetz, P. S., Hawa, H., Sharshir, M., Aburageila, M., Salahuddin, N., Chantziara, V., Georgiou, S., Tsimogianni, A., Alexandropoulos, P., Vassi, A., Lagiou, F., Valta, M., Micha, G., Chinou, E., Michaloudis, G., Kodaira, A., Imaizumi, H., De la Torre-Prados, M. V., Garcia-De la Torre, A., Enguix-Armada, A., Puerto-Morlan, A., Perez-Valero, V., Garcia-Alcantara, A., Bolton, N., Dudziak, J., Bonney, S., Tridente, A., Nee, P., Nicolaes, G., Wiewel, M., Schultz, M., Wildhagen, K., Horn, J., Schrijver, R., Van der Poll, T., Reutelingsperger, C., Pillai, S., Davies, G., Mills, G., Aubrey, R., Morris, K., Williams, P., Evans, P., Gayat, E. G., Struck, J., Cariou, A., Deye, N., Guidet, B., Jabert, S., Launay, J., Legrand, M., Léone, M., Resche-Rigon, M., Vicaut, E., Vieillard-Baron, A., Mebazaa, A., Arnold, R., Capan, M., Linder, A., Akesson, P., Popescu, M., Tomescu, D., Sprung, C. L., Calderon Morales, R., Munteanu, G., Orenbuch-Harroch, E., Levin, P., Kasdan, H., Reiter, A., Volker, T., Himmel, Y., Cohen, Y., Meissonnier, J., Girard, L., Rebeaud, F., Herrmann, I., Delwarde, B., Peronnet, E., Cerrato, E., Venet, F., Lepape, A., Rimmelé, T., Monneret, G., Textoris, J., Beloborodova, N., Moroz, V., Osipov, A., Bedova, A., Sarshor, Y., Pautova, A., Sergeev, A., Chernevskaya, E., Odermatt, J., Bolliger, R., Hersberger, L., Ottiger, M., Christ-Crain, M., Mueller, B., Schuetz, P., Sharma, N. K., Tashima, A. K., Brunialti, M. K., Machado, F. R., Assuncao, M., Rigato, O., Salomao, R., Cajander, S. C., Rasmussen, G., Tina, E., Söderquist, B., Källman, J., Strålin, K., Lange, A. L., Sundén-Cullberg, J. S., Magnuson, A. M., Hultgren, O. H., Van der Geest, P., Mohseni, M., Linssen, J., De Jonge, R., Duran, S., Groeneveld, J., Miller, R., Lopansri, B. K., McHugh, L. C., Seldon, A., Burke, J. P., Johnston, J., Reece-Anthony, R., Bond, A., Molokhia, A., Mcgrath, C., Nsutebu, E., Bank Pedersen, P., Pilsgaard Henriksen, D., Mikkelsen, S., Touborg Lassen, A., Tincu, R., Cobilinschi, C., Ghiorghiu, Z., Macovei, R., Wiewel, M. A., Harmon, M. B., Van Vught, L. A., Scicluna, B. P., Hoogendijk, A. J., Zwinderman, A. H., Cremer, O. L., Bonten, M. J., Schultz, M. J., Juffermans, N. P., Wiersinga, W. 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R., Boutin, A., Moore, L., Lacroix, J., Lessard-Bonaventure, P., Turgeon, A. F., Green, R., Erdogan, M., Butler, M., Desjardins, P., Fergusson, D. A., Goncalves, B., Vidal, B., Valdez, C., Rodrigues, A. C., Miguez, L., Moralez, G., Hong, T., Kutz, A., Hausfater, P., Amin, D., Struja, T., Haubitz, S., Huber, A., Brown, T., Collinson, J., Pritchett, C., Slade, T., Le Guen, M., Hellings, S., Ramsaran, R., Alsheikhly, A., Abe, T., Kanapeckaite, L., Bahl, R., Russell, M. Q., Real, K. J., Lyon, R. M., Oveland, N. P., Penketh, J., Mcdonald, M., Kelly, F., Alfafi, M., Almutairi, W., Alotaibi, B., Van den Berg, A. E, Schriel, Y., Dawson, L., Meynaar, I. A., Silva, D., Fernandes, S., Gouveia, J., Santos Silva, J., Foley, J., Kaskovagheorgescu, A., Evoy, D., Cronin, J., Ryan, J., Huck, M., Hoffmann, C., Renner, J., Laitselart, P., Donat, N., Cirodde, A., Schaal, J. V., Masson, Y., Nau, A., Howarth, O., Davenport, K., Jeanrenaud, P., Raftery, S., MacTavish, P., Devine, H., McPeake, J., Daniel, M., Quasim, T., Alrabiee, S., Alrashid, A., Gundogan, O., Bor, C., Akýn Korhan, E., Demirag, K., Uyar, M., Frame, F., Ashton, C., Bergstrom Niska, L., Dilokpattanamongkol, P., Suansanae, T., Suthisisang, C., Morakul, S., Karnjanarachata, C., Tangsujaritvijit, V., Mahmood, S., Al Thani, H., Almenyar, A., Morton, S. E., Chiew, Y. S., Pretty, C., Chase, J. G., Shaw, G. M., Kordis, P., Grover, V., Kuchyn, I., Bielka, K., Aidoni, Z., Stavrou, G., Skourtis, C., Lee, S. D., Williams, K., Weltes, I. D., Berhane, S., Arrowsmith, C., Peters, C., Robert, S., Panerai, R. B., Robinson, T. G., Borg-Seng-Shu, E., De Lima Oliveira, M., Mian, N. C., Nogueira, R., Zeferino, S. P., Jacobsen Teixeira, M., Killeen, P., McPhail, M., Bernal, W., Maggs, J., Wendon, J., Hughes, T., Taniguchi, L. U., Siqueira, E. M., Vieira Jr, J. M., Azevedo, L. C., Ahmad, A. N., Helme, E., Hadfield, S., Shak, J., Senver, C., Howard-Griffin, R., Wacharasint, P., Fuengfoo, P., Sukcharoen, N., Rangsin, R., Sbiti-Rohr, D., Na, H., Song, S., Lee, S., Jeong, E., Lee, K., Zoumpelouli, E., Volakli, E. A, Chrysohoidou, V., Charisopoulou, K., Kotzapanagiotou, E., Manavidou, K., Stathi, Z., AlGhamdi, B., Marashly, Q., Zaza, K., Khurshid, M., Ali, Z., Malgapo, M., Jamil, M., Shafquat, A., Shoukri, M., Hijazi, M., Rocha, F. A., Ebecken, K., Rabello, L. S., Lima, M. F., Hatum, R., De Marco, F. V., Alves, A., Pinto, J. E., Godoy, M., Brasil, P. E., Bozza, F. A., Salluh, J. I., Soares, M., Krinsley, J., Kang, G., Perry, J., Hines, H., Wilkinson, K. M., Tordoff, C., Sloan, B., Bellamy, M. C., Moreira, E., Verga, F., Barbato, M., Burghi, G., Soares, M, Silva, U. V., Torelly, A. P., Kahn, J. M., Angus, D. C., Knibel, M. F., Marshall, R., Gilpin, T., Mota, D., Loureiro, B., Dias, J., Afonso, O., Coelho, F., Martins, A., Faria, F., Al Orainni, H., AlEid, F., Tlaygeh, H., Itani, A., Hejazi, A., Messika, J., Ricard, J. D., Guillo, S., Pasquet, B., Dubief, E., Tubach, F., James, K., Temblett, P., Davies, L., Lynch, C., Pereira, S., Cavaco, S., Fernandes, J., Moreira, I., Almeida, E., Seabra Pereira, F., Malheiro, M., Cardoso, F., Aragão, I., Cardoso, T., Fister, M., Muraray Govind, P., Brahmananda Reddy, N., Pratheema, R., Arul, E. D., Devachandran, J., Chin-Yee, N., D’Egidio, G., Thavorn, K., Kyeremanteng, K., Murchison, A. G., Swalwell, K., Mandeville, J., Stott, D., Guerreiro, I., Goossens, C., Marques, M. B., Derde, S., Vander Perre, S., Dufour, T., Thiessen, S. E., Güiza, F., Janssens, T., Hermans, G., Vanhorebeek, I., De Bock, K., Van den Berghe, G., Langouche, L., Miles, B., Madden, S., Weiler, M., Marques, P., Rodrigues, C., Boeira, M., Brenner, K., Leães, C., Machado, A., Townsend, R., Andrade, J., Kishore, R., Fenlon, C., Fiks, T., Ruijter, A., Te Raa, M., Spronk, P., Docherty, P., Dickson, J., Moltchanova, E., Scarrot, C., Hall, T., Ngu, W. C., Jack, J. M., Pavli, A., Gee, X., Akin Korhan, E., Shirazy, M., Fayed, A., Gupta, S., Kaushal, A., Dewan, S., Varma, A., Ghosh, E., Yang, L., Eshelman, L., Lord, B., Carlson, E., Broderick, R., Ramos, J., Forte, D., Yang, F., Feeney, J., Wilkinson, K., Shuker, K., Faulds, M., Bryden, D., England, L., Shuker, K, Tridente, A, Faulds, M, Matheson, A, Gaynor, J., Bryden, D, Peroni, B., Daglius-Dias, R., Miranda, L., Cohen, C., Carvalho, C., Velasco, I., Kelly, J. M., Neill, A., Rubenfeld, G., Masson, N., Min, A., Boezeman, E., Hofhuis, J., Hovingh, A., De Vries, R., Cabral-Campello, G., Van Mol, M., Nijkamp, M., Kompanje, E., Ostrowski, P., Kiss, K., Köves, B., Csernus, V., Molnár, Z., Hoydonckx, Y., Vanwing, S., Medo, V., Galvez, R., Miranda, J. P., Stone, C., Wigmore, T., Arunan, Y., Wheeler, A., Wong, Y., Poi, C., Gu, C., Molmy, P., Van Grunderbeeck, N., Nigeon, O., Lemyze, M., Thevenin, D., Mallat, J., Correa, M., Carvalho, R. T., Fernandez, A., McBride, C., Koonthalloor, E., Walsh, C., Webber, A., Ashe, M., Smith, K., Volakli, E. A., Dimitriadou, M., Mantzafleri, P., Vrani, O., Arbouti, A., Varsami, T., Bollen, J. A., Van Smaalen, T. C., De Jongh, W. C., Ten Hoopen, M. M., Ysebaert, D., Van Heurn, L. W., Van Mook, W. N., Roze des Ordons, A., Couillard, P., Doig, C., Van Keer, R. V., Deschepper, R. D., Francke, A. F., Huyghens, L. H., Bilsen, J. B., Nyamaizi, B., Dalrymple, C., Dobru, A., Marrinan, E., Ankuli, A., Struthers, R., Crawford, R., Mactavish, P., Morelli, P., Degiovanangelo, M., Lemos, F., MArtinez, V., Cabrera, J., Rutten, A., Van Ieperen, S., De Geer, S., Van Vugt, M., Der Kinderen, E., Giannini, A., Miccinesi, G, Marchesi, T, and Prandi, E

Subjects
Protocol (science), medicine.medical_specialty, business.industry, medicine.medical_treatment, French, 030208 emergency & critical care medicine, Compression (physics), Critical Care and Intensive Care Medicine, Meeting Abstracts, language.human_language, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Ventilation (architecture), Emergency medicine, language, Medicine, 030212 general & internal medicine, Cardiopulmonary resuscitation, business
Abstract

Table of contents P001 - Sepsis impairs the capillary response within hypoxic capillaries and decreases erythrocyte oxygen-dependent ATP efflux R. M. Bateman, M. D. Sharpe, J. E. Jagger, C. G. Ellis P002 - Lower serum immunoglobulin G2 level does not predispose to severe flu. J. Solé-Violán, M. López-Rodríguez, E. Herrera-Ramos, J. Ruíz-Hernández, L. Borderías, J. Horcajada, N. González-Quevedo, O. Rajas, M. Briones, F. Rodríguez de Castro, C. Rodríguez Gallego P003 - Brain protective effects of intravenous immunoglobulin through inhibition of complement activation and apoptosis in a rat model of sepsis F. Esen, G. Orhun, P. Ergin Ozcan, E. Senturk, C. Ugur Yilmaz, N. Orhan, N. Arican, M. Kaya, M. Kucukerden, M. Giris, U. Akcan, S. Bilgic Gazioglu, E. Tuzun P004 - Adenosine a1 receptor dysfunction is associated with leukopenia: A possible mechanism for sepsis-induced leukopenia R. Riff, O. Naamani, A. Douvdevani P005 - Analysis of neutrophil by hyper spectral imaging - A preliminary report R. Takegawa, H. Yoshida, T. Hirose, N. Yamamoto, H. Hagiya, M. Ojima, Y. Akeda, O. Tasaki, K. Tomono, T. Shimazu P006 - Chemiluminescent intensity assessed by eaa predicts the incidence of postoperative infectious complications following gastrointestinal surgery S. Ono, T. Kubo, S. Suda, T. Ueno, T. Ikeda P007 - Serial change of c1 inhibitor in patients with sepsis – A prospective observational study T. Hirose, H. Ogura, H. Takahashi, M. Ojima, J. Kang, Y. Nakamura, T. Kojima, T. Shimazu P008 - Comparison of bacteremia and sepsis on sepsis related biomarkers T. Ikeda, S. Suda, Y. Izutani, T. Ueno, S. Ono P009 - The changes of procalcitonin levels in critical patients with abdominal septic shock during blood purification T. Taniguchi, M. O P010 - Validation of a new sensitive point of care device for rapid measurement of procalcitonin C. Dinter, J. Lotz, B. Eilers, C. Wissmann, R. Lott P011 - Infection biomarkers in primary care patients with acute respiratory tract infections – Comparison of procalcitonin and C-reactive protein M. M. Meili, P. S. Schuetz P012 - Do we need a lower procalcitonin cut off? H. Hawa, M. Sharshir, M. Aburageila, N. Salahuddin P013 - The predictive role of C-reactive protein and procalcitonin biomarkers in central nervous system infections with extensively drug resistant bacteria V. Chantziara, S. Georgiou, A. Tsimogianni, P. Alexandropoulos, A. Vassi, F. Lagiou, M. Valta, G. Micha, E. Chinou, G. Michaloudis P014 - Changes in endotoxin activity assay and procalcitonin levels after direct hemoperfusion with polymyxin-b immobilized fiber A. Kodaira, T. Ikeda, S. Ono, T. Ueno, S. Suda, Y. Izutani, H. Imaizumi P015 - Diagnostic usefullness of combination biomarkers on ICU admission M. V. De la Torre-Prados, A. Garcia-De la Torre, A. Enguix-Armada, A. Puerto-Morlan, V. Perez-Valero, A. Garcia-Alcantara P016 - Platelet function analysis utilising the PFA-100 does not predict infection, bacteraemia, sepsis or outcome in critically ill patients N. Bolton, J. Dudziak, S. Bonney, A. Tridente, P. Nee P017 - Extracellular histone H3 levels are inversely correlated with antithrombin levels and platelet counts and are associated with mortality in sepsis patients G. Nicolaes, M. Wiewel, M. Schultz, K. Wildhagen, J. Horn, R. Schrijver, T. Van der Poll, C. Reutelingsperger P018 - Il-8: is this a more reliable biomarker for sepsis severity than CRP, Procalcitonin, E-selectin, IL-6 and TNF-[alpha] S. Pillai, G. Davies, G. Mills, R. Aubrey, K. Morris, P. Williams, P. Evans P019 - Relation between adrenomedullin and short-term outcome in ICU patients: Results from the frog ICU study E. G. Gayat, J. Struck, A. Cariou, N. Deye, B. Guidet, S. Jabert, J. Launay, M. Legrand, M. Léone, M. Resche-Rigon, E. Vicaut, A. Vieillard-Baron, A. Mebazaa P020 - Impact of disease severity assessment on performance of heparin-binding protein for the prediction of septic shock R. Arnold, M. Capan, A. Linder, P. Akesson P021 - Kinetics and prognostic value of presepsin (sCD14) in septic patients. A pilot study M. Popescu, D. Tomescu P022 - Comparison of CD64 levels performed by the facs and accellix systems C. L. Sprung, R. Calderon Morales, G. Munteanu, E. Orenbuch-Harroch, P. Levin, H. Kasdan, A. Reiter, T. Volker, Y. Himmel, Y. Cohen, J. Meissonnier P023 - Diagnosing sepsis in 5 minutes: Nanofluidic technology study with pancreatic-stone protein (PSP/ reg) L. Girard, F. Rebeaud P024 - How nanotechnology-based approaches could contribute to sepsis prevention, diagnosis and treatment I. Herrmann P025 - Il7r transcriptional expression analysis during septic shock B. Delwarde, E. Peronnet, E. Cerrato, F. Venet, A. Lepape, T. Rimmelé, G. Monneret, J. Textoris P026 - Disbalance of microbial metabolites of aromatic acids affects the severity in critically ill patients N. Beloborodova, V. Moroz, A. Osipov, A. Bedova, Y. Sarshor, A. Pautova, A. Sergeev, E. Chernevskaya P027 - Copeptin predicts 10-year all-cause mortality in community patients J. Odermatt, R. Bolliger, L. Hersberger, M. Ottiger, M. Christ-Crain, B. Mueller, P. Schuetz P028 - Identification of differential proteomic response in septic patients secondary to community and hospital acquired pneumonia N. K. Sharma, A. K. Tashima, M. K. Brunialti, F. R. Machado, M. Assuncao, O. Rigato, R. Salomao P029 - Monocyte HLA-DR expression in community-acquired bacteremic sepsis - dynamics associated to aetiology and prediction of secondary sepsis S. C. Cajander, G. Rasmussen, E. Tina, B. Söderquist, J. Källman, K. Strålin P030 - Soluble B- and T-lymphocyte attenuator: A possible prognostic marker in sepsis A. L. Lange, J. S. Sundén-Cullberg, A. M. Magnuson, O. H. Hultgren P031 - Fractal dimension: A new biomarker for quantifying clot microstructure in patients across the sepsis spectrum G. Davies, S. Pillai, G. Mills, R. Aubrey, K. Morris, P. Williams, P. Evans P032 - Comparison between the new biomarker for coagulation, clot microstructure (Df) with rotational thromboelastometry (ROTEM) in patients across the sepsis spectrum S. Pillai, G. Davies, G. Mills, R. Aubrey, K. Morris, P. Williams, P. Evans P033 - Changes in fibrinolysis across the sepsis spectrum: The use of rotational thromboelastometry (ROTEM) lysis index (LI60) and D-Dimer concentration S. Pillai, G. Davies, G. Mills, R. Aubrey, K. Morris, P. Williams, P. Evans P034 - The intensive care infection score – a promising marker for the prediction of infection and its severity. P. Van der Geest, M. Mohseni, J. Linssen, R. De Jonge, S. Duran, J. Groeneveld P035 - Challenges in the clinical diagnosis of sepsis R. Miller III, B. K. Lopansri, L. C. McHugh, A. Seldon, J. P. Burke P036 - Does zero heat flux thermometry more accurately identify sepsis on intensive care? J. Johnston, R. Reece-Anthony, A. Bond, A. Molokhia P037 - Advancing quality (AQ) sepsis programme: Improving early identification & treatment of sepsis in North West England. C. Mcgrath, E. Nsutebu P038 - Prehospital transport of acute septic patients P. Bank Pedersen, D. Pilsgaard Henriksen, S. Mikkelsen, A. Touborg Lassen P039 - Vasodilatory plant extracts gel as an alternative treatment for fever in critically ill patients R. Tincu, C. Cobilinschi, D. Tomescu, Z. Ghiorghiu, R. Macovei P040 - Host response and outcome of hypothermic sepsis M. A. Wiewel, M. B. Harmon, L. A. Van Vught, B. P. Scicluna, A. J. Hoogendijk, J. Horn, A. H. Zwinderman, O. L. Cremer, M. J. Bonten, M. J. Schultz, T. Van der Poll, N. P. Juffermans, W. J. Wiersinga P041 - Septic shock alert over SIRS criteria has an impact on outcome but needs to be revised G. Eren, Y Tekdos, M. Dogan, O. Acicbe, E. Kaya, O. Hergunsel P042 - Association between previous prescription of βblockers and mortality rate among septic patients: A retrospective observational study S. Alsolamy, G. Ghamdi, L. Alswaidan, S. Alharbi, F. Alenezi, Y. Arabi P043 - Recognition and treatment of sepsis on labour ward– teaching & information resources can improve knowledge J. Heaton, A. Boyce, L. Nolan, J. Johnston, A. Dukoff-Gordon, A. Dean, A. Molokhia P044 - Culture negative sepsis in the ICU – what is unique to this patient population? T. Mann Ben Yehudah P045 - Organ dysfunction in severe sepsis patients identified in administrative data in Germany, 2007-2013 C. Fleischmann, D. Thomas-Rueddel, C. Haas, U. Dennler, K. Reinhart P046 - A comparison of residents’ knowledge regarding; the Surviving Sepsis Campaign 2012 guideline O. Suntornlohanakul, B. Khwannimit P047 - Effectiveness of a septic shock bundle to improve outcomes in the ICU F. Breckenridge, A. Puxty P048 - Dose of norepinephrine in the first 24 hours as a parameter evaluating the effectiveness of treatment in patients with severe sepsis and septic shock P. Szturz, P. Folwarzcny, J. Svancara, R. Kula, P. Sevcik P049 - Norepinephrine or vasopressin + norepinephrine in septic shock. A retrospective series of 39 patients L. Caneva, A. Casazza, E. Bellazzi, S. Marra, L. Pagani, M. Vetere, R. Vanzino, D. Ciprandi, R. Preda, R. Boschi, L. Carnevale P050 - Methylene blue effectiveness as contributory treatment in patients with septic shock V. Lopez, M. Aguilar Arzapalo, L. Barradas, A. Escalante, J. Gongora, M. Cetina P051 - Coagulation disorders in patients with severe sepsis and DIC evaluated with thromboelastometry. B Adamik, D Jakubczyk, A Kübler P052 - Frequency and outcome of early sepsis-associated coagulopathy A. Radford, T. Lee, J. Singer, J. Boyd, D. Fineberg, M. Williams, J. Russell P053 - Assessment of coagulopathy in cancer patients with severe sepsis or septic shock. A case-control pilot study E. Scarlatescu, D. Tomescu, G. Droc, S. Arama P054 - Thromboelastometry in critically ill patients with disseminated intravascular coagulation M. Müller, M. Straat, S. S. Zeerleder, N. P. Juffermans P055 - Cessation of a preexisting chronic antiplatelet therapy is associated with increased mortality rates in severe sepsis and septic shock C. F. Fuchs, C. S. Scheer, S. W. Wauschkuhn, M. V. Vollmer, K. M. Meissner, S. K. Kuhn, K. H. Hahnenkamp, S. R. Rehberg, M. G. Gründling P056 - Neutrophil Extracellular Traps (NETs) production under hypoxic condition N. Yamamoto, M. Ojima, S. Hamaguchi, T. Hirose, Y. Akeda, R. Takegawa, O. Tasaki, T. Shimazu, K. Tomono P057 - Impact of ultraviolet air sterilizer in intensive care unit room, and clinical outcomes of patients E. Gómez-Sánchez, M. Heredia-Rodríguez, E. Álvarez-Fuente, M. Lorenzo-López, E. Gómez-Pesquera, M. Aragón-Camino, P. Liu-Zhu, A. Sánchez-López, A. Hernández-Lozano, M. T. Peláez-Jareño, E. Tamayo P058 - Focus of infection in severe sepsis - comparison of administrative data and prospective cohorts from Germany D. O. Thomas-Rüddel, C. Fleischmann, C. Haas, U. Dennler, K. Reinhart P059 - “Zero CLABSI” – can we get there? Obstacles on the 4 year journey and our strategies to overcome them – experience from an Indian ICU V. Adora, A. Kar, A. Chakraborty, S. Roy, A. Bandyopadhyay, M. Das P060 - Novel molecular techniques to identify central venous catheter (CVC) associated blood stream infections (BSIs) T. Mann Ben Yehudah, G. Ben Yehudah, M. Salim, N. Kumar, L. Arabi, T. Burger, P. Lephart, E. Toth-martin P061 - Zero clabsi” – can we get there? Obstacles on the 4 year journey and our strategies to overcome them – experience from an Indian ICU R. Rao, A. Kar, A. Chakraborty P062 - Prevention of central line-associated bloodstream infections in intensive care units: An international online survey C. Valencia, N. Hammami, S. Blot, J. L. Vincent, M. L. Lambert P063 - 30 days antimicrobial efficacy of non-leaching central venous catheters J. Brunke, T. Riemann, I. Roschke P064 - Efficacy of noble metal alloy-coated catheter in prevention of bacteriuria R. Tincu, C. Cobilinschi, D. Tomescu, Z. Ghiorghiu, R. Macovei P065 - Predicting bacteremic urinary tract infection in community setting: A prospective observational study S. Nimitvilai, K. Jintanapramote, S. Jarupongprapa P066 - Eight-year analysis of acinetobacter spp. monobacteremia in surgical and medical intensive care units at university hospital in Lithuania D. Adukauskiene, D. Valanciene P067 - Group A and group B streptococcal infections in intensive care unit – our experience in a tertiary centre G. Bose, V. Lostarakos, B. Carr P068 - Improved detection of spontaneous bacterial peritonitis by uritop + tm strip test and inoculation of blood culture bottles with ascitic fluid S. Khedher, A. Maaoui, A. Ezzamouri, M. Salem P069 - Increased risk of cellulitis in patients with congestive heart failure: a population based cohort study J. Chen P070 - Outcomes of severe cellulitis and necrotizing fasciitis in the critically ill D. R. Cranendonk, L. A. Van Vught, M. A. Wiewel, O. L. Cremer, J. Horn, M. J. Bonten, M. J. Schultz, T. Van der Poll, W. J. Wiersinga P071 - Botulism outbreak associated with people who inject drugs (PWIDs) in Scotland. M. Day, G. Penrice, K. Roy, P. Robertson, G. Godbole, B. Jones, M. Booth, L. Donaldson P072 - Surveillance of ESBL-producing enterobacteriaceae fecal carriers in the ICU Y. Kawano, H. Ishikura P073 - Prevalence of ESBL and carbapenemase producing uropathogens in a newly opened hospital in south India S. Sreevidya, N. Brahmananda Reddy, P. Muraray Govind, R. Pratheema, J. Devachandran Apollo Speciality Hospital - OMR, Chennai, India P074 - Prevalence, risk factors and outcomes of methicillin-resistant staphylococcus aureus nasal colonization in critically ill patients H. Al-Dorzi, M. Almutairi, B. Alhamadi, A. Crizaldo Toledo, R. Khan, B. Al Raiy, Y. Arabi P075 - Multidrug-resistant Acinetobacter baumannii infection in intensive care unit patients in a hospital with building construction: Is there an association? H. Talaie P076 - Multidrug-resistant organisms in a Dutch ICU J. A. Van Oers, A. Harts, E. Nieuwkoop, P. Vos P077 - Epidemiology and risk factors of ICU acquired infections caused by multidrug-resistant gram negative bacilli Y. Boussarsar, F. Boutouta, S. Kamoun, I. Mezghani, S. Koubaji, A. Ben Souissi, A. Riahi, M. S. Mebazaa P078 - Improving outcomes of severe infections by multidrug-resistant pathogens with polyclonal IgM-enriched immunoglobulins E. Giamarellos-Bourboulis, N. Tziolos, C. Routsi, C. Katsenos, I. Tsangaris, I. Pneumatikos, G. Vlachogiannis, V. Theodorou, A. Prekates, E. Antypa, V. Koulouras, N. Kapravelos, C. Gogos, E. Antoniadou, K. Mandragos, A. Armaganidis P079 - Must change the medical practice in ICU? A. R. Robles Caballero, B. Civantos, J. C. Figueira, J. López P080 - Mediterranean spotted fever in an infectious diseases intensive care unit A. Silva-Pinto, F. Ceia, A. Sarmento, L. Santos P081 - Clinical features and outcomes of patients with Middle East respiratory syndrome requiring admission to a saudi intensive care unit: A retrospective analysis of 31 cases G. Almekhlafi, Y. Sakr P082 - The ICU response to a hospital outbreak of Middle East respiratory syndrome coronavirus infection H. Al-Dorzi, R. Khan, S. Baharoon, A. Aldawood, A. Matroud, J. Alchin, S. Al Johani, H. Balkhy, Y. Arabi P083 - Middle East respiratory syndrome: Surveillance data analysis S. Alsolamy, S. Y. Yousif, B. O. Alotabi, A. S. Alsaawi P085 - Use of Taqman array card molecular diagnostics in severe pneumonia: A case series J. Ang, MD Curran, D. Enoch, V. Navapurkar, A. Conway Morris P086 - ‘BUNS’: An investigation protocol improves the ICU management of pneumonia R. Sharvill, J. Astin P087 - Pneumonia in patients following secondary peritonitis: epidemiological features and impact on mortality M. Heredia-Rodríguez, E. Gómez-Sánchez, M. T. Peláez-Jareño, E. Gómez-Pesquera, M. Lorenzo-López, P. Liu-Zhu, M. Aragón-Camino, A. Hernández-Lozano, A. Sánchez-López, E. Álvarez-Fuente, E. Tamayo P088 - The use of the “CURB-65 score” by emergency room clinicians in a large teaching hospital J. Patel, C. Kruger P089 - Incidence of community acquired pneumonia with viral infection in mechanically ventilated patients in the medical intensive care unit J. O’Neal, H. Rhodes, J. Jancik P090 - The SAATELLITE Study: Prevention of S aureus Nosocomial Pneumonia (NP) with MEDI4893, a Human Monoclonal Antibody (mAb) Against S aureus B. François, P. F. Laterre, P. Eggimann, A. Torres, M. Sánchez, P. F. Dequin, G. L. Bassi, J. Chastre, H. S. Jafri P091 - Risk factors and microbiological profile for nosocomial infections in trauma patients M. Ben Romdhane, Z. Douira, S. Kamoun, M. Bousselmi, A. Ben Souissi, Y. Boussarsar, A. Riahi, M.S. Mebazaa P092 - Correlation between percentages of ventilated patients developed vap and use of antimicrobial agents in ICU patients. A. Vakalos, V. Avramidis P093 - A comparison of two ventilator associated pneumonia surveillance techniques T. H. Craven, G. Wojcik, K. Kefala, J. McCoubrey, J. Reilly, R. Paterson, D. Inverarity, I. Laurenson, T. S. Walsh P094 - Lung ultrasound before and after fiberbronchoscopy - modifications may improve ventilator-associated pneumonia diagnosis S. Mongodi, B. Bouhemad, A. Orlando, A. Stella, G. Via, G. Iotti, A. Braschi, F. Mojoli P095 - Comparing the accuracy of predictors of mortality in ventilator-associated pneumonia M. Haliloglu, B. Bilgili, U. Kasapoglu, I. Sayan, M. Süzer Aslan, A. Yalcın, I. Cinel P096 - Impact of pRBCs transfusion on percentage of ventilated patients developed VAP in ICU patients A. Vakalos, V. Avramidis P097 - The impact of a series of interventions on the rate of ventilator associated pneumonia in a large teaching hospital H. E. Ellis, K. Bauchmuller, D. Miller, A Temple P098 - The EVADE study: Prevention of Nosocomial Pneumonia (NP) caused by P aeruginosa with MEDI3902, a Novel Bispecific Monoclonal Antibody, against P aeruginosa virulence factors J. Chastre, B. François, A. Torres, C. E. Luyt, M. Sánchez, M. Singer, H. S. Jafri P099 - Short-term inhaled colistin adjunctive therapy for ventilator-associated pneumonia Y. Nassar, M. S. Ayad P100 - Effect of aerosolised colistin on weaning from mechanical ventilation A. Trifi, S. Abdellatif, F. Daly, R. Nasri, S. Ben Lakhal P101 - Septic shock is an independent risk factor for colistin-induced severe acute kidney injury: a retrospective cohort study B. Bilgili, M. Haliloglu, F. Gul, I. Cinel P102 - Nosocomial pneumonia - emphasis on inhaled tobramycin A. Kuzovlev, A. Shabanov, S. Polovnikov, V. Moroz P103 - In vitro evaluation of amikacin inhale and commercial nebulizers in a mechanical ventilator N. Kadrichu, T. Dang, K. Corkery, P. Challoner P104 - The effects of nebulized amikacin/fosfomycin and systemic meropenem on severe amikacin-resistant meropenem-susceptible P.aeruginosa pneumonia G. Li Bassi, E. Aguilera, C. Chiurazzi, C. Travierso, A. Motos, L. Fernandez, R. Amaro, T. Senussi, F. Idone, J. Bobi, M. Rigol, A. Torres P105 - Optimization of gentamicin peak concentrations in critically ill patients C. J. Hodiamont, N. P. Juffermans, J. M. Janssen, C. S. Bouman, R. A. Mathôt, M. D. De Jong, R. M. Van Hest P106 - Systematic review of cefepime induced neurotoxicity L. Payne, G. L. Fraser P107 - Unasyn® causes QT prolongation during treatment of intensive care patients B. Tudor, M. Lahner, G. Roth, C. Krenn P108 - Comparative study between teicoplanin and vancomycin in methicillin-resistant staphylococcus aureus (mrsa) infectious of toxicological intensive care unit (ticu) patients – Tehran, Iran H. Talaie P109 - Phage therapy against antimicrobial resistance, design of the first clinical study phagoburn P. Jault, J. Gabard, T. Leclerc, S. Jennes, Y. Que, A. Rousseau, F. Ravat P110 - Antibiotic dosing errors in critically ill patients with severe sepsis or septic shock H. Al-Dorzi, A. Eissa, S. Al-Harbi, T. Aldabbagh, R. Khan, Y. Arabi P111 - Does empiric antifungal therapy improve survival in septic critically ill patients? (immunocompromised excluded) A. Trifi, S. Abdellatif, F. Daly, R. Nasri, S. Ben Lakhal P112 - Neurocysticercosis-Qatar experience F. Paramba, N. Purayil, V. Naushad, O. Mohammad, V. Negi, P. Chandra P113 - Early indicators in acute haemorrhagic shock A. Kleinsasser P114 - Filtering of red blood cells reduces the inflammatory response of pulmonary cells in an in vitro model of mechanical ventilation M. R. Witrz, J. F. Buchner-Doeven, A. M. Tuip-de Boer, J. C. Goslings, N. P. Juffermans P115 - Microparticles from red blood cell transfusion induce a pro-coagulant and pro-inflammatory endothelial cell response M. Van Hezel, M. Straat, A Boing, R Van Bruggen, N Juffermans P116 - The contribution of cytokines on thrombosis development during hospitalization in ICU D. Markopoulou, K. Venetsanou, V. Kaldis, D. Koutete, D. Chroni, I. Alamanos P117 - Prophylactic enoxaparin dosing and adjustment through anti-xa monitoring in an inpatient burn unit L. Koch, J. Jancik, H. Rhodes, E. Walter P118 - Determination of optimal cut-off values of haemoglobin, platelet count and fibrinogen at 24 hours after injury associated with mortality in trauma patients K. Maekawa, M. Hayakawa, S. Kushimoto, A. Shiraishi, H. Kato, J. Sasaki, H. Ogura, T. Matauoka, T. Uejima, N. Morimura, H. Ishikura, A. Hagiwara, M. Takeda P119 - Trauma-induced coagulopathy - prothrombin complex concentrate vs fresh frozen plasma O. Tarabrin, S. Shcherbakow, D. Gavrychenko, G. Mazurenko, V. Ivanova, O. Chystikov P120 - First study to prove the superiority of prothrombin complex concentrates on mortality rate over fresh frozen plasma in patients with acute bleeding C. Plourde, J. Lessard, J. Chauny, R. Daoust P121 - Prothrombin complex concentrate vs fresh frozen plasma in obstetric massive bleeding S. Shcherbakow, O. Tarabrin, D. Gavrychenko, G. Mazurenko, O. Chystikov P122 - Impact of FFP transfusion on VAP in ICU patients A. Vakalos, V. Avramidis P123 - Preoperative platelet function test and the thrombin generation assay are predictive for blood loss after cardiac surgery L. Kropman, L. In het Panhuis, J. Konings, D. Huskens, E. Schurgers, M. Roest, B. De Laat, M. Lance P124 - Rotational thromboelastometry versus standard coagulation tests before surgical interventions M. Durila, P. Lukas, M. Astraverkhava, J. Jonas P125 - Correction of impaired clot quality and stability by fibrinogen and activated prothrombin complex concentrate in a model of severe thrombocytopenia I. Budnik, B. Shenkman P126 - Assessment of point-of-care prothrombin time analyzer as a monitor after cardiopulmonary bypass H. Hayami, Y. Koide, T. Goto P127 - Disseminated intravascular coagulation (dic) is underdiagnosed in critically ill patients: do we need d-dimer measurements? R. Iqbal, Y. Alhamdi, N. Venugopal, S. Abrams, C. Downey, C. H. Toh, I. D. Welters P128 - Validity of the age-adjusted d-dimer cutoff in patients with COPD B. Bombay, J. M. Chauny, R. D. Daoust, J. L. Lessard, M. M. Marquis, J. P. Paquet P129 - A scoping review of strategies for prevention and management of bleeding following paediatric cardiopulmonary bypass surgery K. Siemens, D. Sangaran, B. J. Hunt, A. Durward, A. Nyman, I. A. Murdoch, S. M. Tibby P130 - Nadir hemoglobulin during cardiopulmonary bypass: impact on postoperative morbidity and mortality F. Ampatzidou, D. Moisidou, E. Dalampini, M. Nastou, E. Vasilarou, V. Kalaizi, H. Chatzikostenoglou, G. Drossos P131 - Red blood cell transfusion do not influence the prognostic value of RDW in critically ill patients S. Spadaro, A. Fogagnolo, T. Fiore, A. Schiavi, V. Fontana, F. Taccone, C. Volta P132 - Reasons for admission in the paediatric intensive care unit and the need for blood and blood products transfusions E. Chochliourou, E. Volakli, A. Violaki, E. Samkinidou, G. Evlavis, V. Panagiotidou, M. Sdougka P133 - The implementation of a massive haemorrhage protocol (mhp) for the management of major trauma: a ten year, single-centre study R. Mothukuri, C. Battle, K. Guy, G. Mills, P. Evans P134 - An integrated major haemorrhage protocol for pre-hospital and retrieval medical teams J. Wijesuriya, S. Keogh P135 - The impact of transfusion thresholds on mortality and cardiovascular events in patients with cardiovascular disease (non-cardiac surgery): a systematic review and meta-analysis A. Docherty, R. O’Donnell, S. Brunskill, M. Trivella, C. Doree, L. Holst, M. Parker, M. Gregersen, J. Almeida, T. Walsh, S. Stanworth P136 - The relationship between poor pre-operative immune status and outcome from cardiac surgery is specific to the peri-operative antigenic threat S. Moravcova, J. Mansell, A. Rogers, R. A. Smith, C. Hamilton-Davies P137 - Impact of simple clinical practice guidelines for reducing post-operative atrial fibrillation after cardiac surgery. A. Omar, M. Allam, O. Bilala, A. Kindawi, H. Ewila P138 - Dexamethasone administration during cardiopulmonary bypass has no beneficial effects on elective postoperative cardiac surgery patients F. Ampatzidou, D. Moisidou, M. Nastou, E. Dalampini, A. Malamas, E. Vasilarou, G. Drossos P139 - Intra-aortic balloon counterpulsation in patients undergoing cardiac surgery (IABCS): preliminary results G. Ferreira, J. Caldas, J. Fukushima, E. A. Osawa, E. Arita, L. Camara, S. Zeferino, J. Jardim, F. Gaioto, L. Dallan, F. B. Jatene, R. Kalil Filho, .F Galas, L. A. Hajjar P140 - Effects of low-dose atrial natriuretic peptide infusion on cardiac surgery-associated acute kidney injury C. Mitaka, T. Ohnuma, T. Murayama, F. Kunimoto, M. Nagashima, T. Takei, M. Tomita P141 - Acute kidney injury influence on high sensitive troponin measurements after cardiac surgery A. Omar, K. Mahmoud, S. Hanoura, S. Sudarsanan, P. Sivadasan, H. Othamn, Y. Shouman, R. Singh, A. Al Khulaifi P142 - Complex evaluation of endothelial dysfunction markers for prognosis of outcomes in patients undergoing cardiac surgery I. Mandel, S. Mikheev, I. Suhodolo, V. Kiselev, Y. Svirko, Y. Podoksenov P143 - New-onset atrial fibrillation in intensive care: incidence, management and outcome S. A. Jenkins, R. Griffin P144 - One single spot measurement of the sublingual microcirculation during acute pulmonary hypertension in a pig model of shock M. S. Tovar Doncel, A. Lima, C. Aldecoa, C. Ince P145 - Assessment of levosimendan as a therapeutic option to recruit the microcirculation in cardiogenic shock – initial experience in cardiac ICU A. Taha, A. Shafie, M. Mostafa, N. Syed, H. Hon P146 - Terlipressin vs. norepinephrine in the Potential Multiorgan Donor(PMD) F. Righetti, E. Colombaroli, G. Castellano P147 - Echocardiography in the potential heart donor exposed to substitution hormonotherapy F. Righetti, E. Colombaroli P148 - Machine learning can reduce rate of monitor alarms M. Hravnak, L. C. Chen, A. D. Dubrawski, G. C. Clermont, M. R. Pinsky P149 - Peripherally inserted central catheters placed in the ICU S. Gonzalez, D. Macias, J. Acosta, P. Jimenez, A. Loza, A. Lesmes, F. Lucena, C. 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Körner, M. Kubik, S. Kluge, D. Reuter, B. Saugel P155 - Hemodynamic monitoring in patients with septic shock (SS) – CPCCO (continuous pulse contour cardiac output) vs. TEE (transesophageal echocardiography) E. Colombaroli, F. Righetti, G. Castellano P156 - Cardiac output measurement with transthoracic echocardiography in critically ill patients: a pragmatic clinical study T. Tran, D. De Bels, A. Cudia, M. Strachinaru, P. Ghottignies, J. Devriendt, C. Pierrakos P157 - Left ventricular outflow tract velocity time integral correlates with stroke volume index in mechanically ventilated patients Ó. Martínez González, R. Blancas, J. Luján, D. Ballesteros, C. Martínez Díaz, A. Núñez, C. Martín Parra, B. López Matamala, M. Alonso Fernández, M. Chana P158 - Transpulmonary thermodilution (TPTD) derived from femoral vs. jugular central venous catheter: validation of a previously published correction formula and a proprietary correction formula for global end-diastolic volume index (GEDVI) W. Huber, M. Eckmann, F. Elkmann, A. Gruber, I. Klein, R. M. Schmid, T. Lahmer P160 - Dynamic arterial elastance calculated with lidcoplus monitor does not predict changes in arterial pressure after a fluid challenge in postsurgical patients D. Bastoni, H. Aya, L. Toscani, L. Pigozzi, A. Rhodes, M. Cecconi P159 - Venous return driving pressure and resistance in acute blood volume changes P. W. Moller, S. Sondergaard, S. M. Jakob, J. Takala, D. Berger P160 - Dynamic arterial elastance calculated with lidcoplus monitor does not predict changes in arterial pressure after a fluid challenge in postsurgical patients D. Bastoni, H. Aya, L. Toscani, L. Pigozzi, A. Rhodes, M. Cecconi P161 - Analysis of duration of post-operative goal-directed therapy protocol C. Ostrowska, H. Aya, A. Abbas, J. Mellinghoff, C. Ryan, D. Dawson, A. Rhodes, M. Cecconi P162 - Hemodynamic optimization – back to square one? M. Cronhjort, O. Wall, E. Nyberg, R. Zeng, C. Svensen, J. Mårtensson, E. Joelsson-Alm P163 - Effectiveness of fluid thoracic content measurement by bioimpedance guiding intravascular volume optimization in patients with septic shock M. Aguilar Arzapalo, L. Barradas, V. Lopez, M. Cetina P164 - A systematic review on the role of internal jugular vein ultrasound measurements in assessment of volume status in critical shock patients N. Parenti, C. Palazzi, L. A. Amidei, F. B. Borrelli, S. C. Campanale, F. T. Tagliazucchi, G. S. Sedoni, D. L. Lucchesi, E. C. Carella, A. L Luciani P165 - Importance of recognizing dehydration in medical Intensive Care Unit M. Mackovic, N. Maric, M. Bakula P166 - Effect of volume for a fluid challenge in septic patients H. Aya, A. Rhodes, R. M. Grounds, N. Fletcher, M. Cecconi P167 - Fluid bolus practices in a large Australian intensive care unit B. Avard, P. Zhang P168 - Liberal late fluid management is associated with longer ventilation duration and worst outcome in severe trauma patients: a retrospective cohort of 294 patients M. Mezidi, J. Charbit, M. Ould-Chikh, P. Deras, C. Maury, O. Martinez, X. Capdevila P169 - Association of fluids and outcomes in emergency department patients hospitalized with community-acquired pneumonia P. Hou, W. Z. Linde-Zwirble, I. D. Douglas, N. S. Shapiro P170 - Association of positive fluid balance with poor outcome in medicosurgical ICU patients A. Ben Souissi, I. Mezghani, Y. Ben Aicha, S. Kamoun, B. Laribi, B. Jeribi, A. Riahi, M. S. Mebazaa P171 - Impact of fluid balance to organ dysfunction in critically ill patients C. Pereira, R. Marinho, R. Antunes, A. Marinho P172 - Volume bolus in ICU patients: do we need to balance our crystalloids? M. Crivits, M. Raes, J. Decruyenaere, E. Hoste P173 - The use of 6 % HES solution do not reduce total fluid requirement in the therapy of patients with burn shock V. Bagin, V. Rudnov, A. Savitsky, M. Astafyeva, I. Korobko, V. Vein P174 - Electron microscopic assessment of acute kidney injury in septic sheep resuscitated with crystalloids or different colloids T. Kampmeier , P. Arnemann, M. Hessler, A. Wald, K. Bockbreder, A. Morelli, H. Van Aken, S. Rehberg, C. Ertmer P175 - Alterations of conjunctival microcirculation in a sheep model of haemorrhagic shock and resuscitation with 0.9 % saline or balanced tetrastarch P. Arnemann, M. Hessler, T. Kampmeier, S. Rehberg, H. Van Aken, C. Ince, C. Ertmer P176 - A single centre nested pilot study investigating the effect of using 0.9 % saline or Plasma-Lyte 148 ® as crystalloid fluid therapy on gastrointestinal feeding intolerance in mechanically ventilated patients receiving nasogastric enteral nutrition S. Reddy, M. Bailey, R. Beasley, R. Bellomo, D. Mackle, A. Psirides, P. 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Abisheganaden P182 - Plasma NGAL and urinary output: potential parameters for early initiation of renal replacement therapy K. Maas, H. De Geus P183 - Renal replacement therapy for critically ill patients: an intermittent continuity E. Lafuente, R. Marinho, J. Moura, R. Antunes, A. Marinho P184 - A survey of practices related to renal replacement therapy in critically ill patients in the north of England. T. E. Doris, D. Monkhouse, T. Shipley, S. Kardasz, I Gonzalez P185 - High initiation creatinine associated with lower 28-day mortality in critically ill patients necessitating continuous renal replacement therapy S. Stads, A. J. Groeneveld P186 - The impact of Karnofsky performance scale on outcomes in acute kidney injury patients receiving renal replacement therapy on the intensive care unit I. Elsayed, N. Ward, A. Tridente, A. Raithatha P187 - Severe hypophosphatemia during citrate-anticoagulated CRRT A. Steuber, C. Pelletier, S. Schroeder, E. Michael, T. Slowinski, D. Kindgen-Milles P188 - Citrate regional anticoagulation for post dilution continuous renal replacement therapy S. Ghabina P189 - Citrate 18 mmol/l improves anticoagulation during RRT with adsorbing filters F. Turani, A. Belli, S. Busatti, G. Barettin, F. Candidi, F. Gargano, R. Barchetta, M. Falco P190 - Calcium gluconate instead of calcium chloride in citrate-anticoagulated CVVHD O. Demirkiran, M. Kosuk, S. Bozbay P191 - Enhanced clearance of interleukin-6 with continuous veno-venous haemodialysis (CVVHD) using Ultraflux EMiC2 vs. Ultraflux AV1000S V. Weber, J. Hartmann, S. Harm, I. Linsberger, T. Eichhorn, G. Valicek, G. Miestinger, C. Hoermann P192 - Removal of bilirubin with a new adsorbent system: in vitro kinetics S. Faenza, D. Ricci, E. Mancini, C. Gemelli, A. Cuoghi, S. Magnani, M. Atti P193 - Case series of patients with severe sepsis and septic shock treated with a new extracorporeal sorbent T. Laddomada, A. Doronzio, B. Balicco P194 - In vitro adsorption of a broad spectrum of inflammatory mediators with CytoSorb® hemoadsorbent polymer beads M. C. Gruda, P. O’Sullivan, V. P. Dan, T. Guliashvili, A. Scheirer, T. D. Golobish, V. J. Capponi, P. P. Chan P195 - Observations in early vs. late use of cytosorb therapy in critically ill patients K. Kogelmann, M. Drüner, D. Jarczak P196 - Oxiris membrane decreases endotoxin during rrt in septic patients with basal EAA > 0,6 F. Turani, A. B. Belli, S. M. Martni, V. C. Cotticelli, F. Mounajergi, R. Barchetta P197 - An observational prospective study on the onset of augmented renal clearance: the first report S. Morimoto, H. Ishikura P198 - An ultrasound- guided algorithm for the management of oliguria in severe sepsis I. Hussain, N. Salahuddin, A. Nadeem, K. Ghorab, K. Maghrabi P199 - Ultrasound in acute kidney injury (aki). First findings of farius, an education-programme in structural ultrasonography S. K. Kloesel, C. Goldfuss, A. Stieglitz, A. S. 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Hana P205 - Early diagnosis of septic acute kidney injury in medical critical care patients with a urine cell cycle arrest marker: insulin like growth factor binding protein-7 (IGFBP-7) M. Aydogdu, N. Boyaci, S. Yuksel, G. Gursel, A. B. Cayci Sivri P206 - Urinary neutrophil gelatinase-associated lipocalin as early biomarker of severe acute kidney injury in intensive care J. Meza-Márquez, J. Nava-López, R. Carrillo-Esper P207 - Shrunken pore syndrome is associated with a sharp rise in mortality in patients undergoing elective coronary artery bypass grafting A. Dardashti, A. Grubb P208 - The biomarker nephrocheck™ can discriminate the septic shock patients with an akin 1 or 2 acute renal failure who will not progress toward the akin 3 level J. Maizel, M. Wetzstein, D. Titeca, L. Kontar, F. Brazier, B. De Cagny, A. Riviere, T. Soupison, M. Joris, M. Slama P209 - A worldwide multicentre evaluation of acute kidney injury in septic and non-septic critically ill patients: the intensive care over nations (icon) audit E. Peters, H. Njimi, P. Pickkers, J. L. Vincent P210 - Does enhanced recovery after surgery reduce the incidence of acute kidney injury in those undergoing major gynae-oncological surgery? M. Waraich , J. Doyle, T. Samuels, L. Forni P211 - Identification of risk factors for the development of acute kidney injury after lower limb arthroplasty N. Desai, R. Baumber, P. Gunning, A. Sell P212 - Incidences and associations of acute kidney injury after major trauma S. Lin, H. Torrence, M. O’Dwyer, C. Kirwan, J. Prowle P213 - Acute kidney injury of major trauma patients T Kim P214 - Trajectory of serum creatinine after major surgery and the diagnosis of acute kidney injury M. E. O’Connor, R. W. Hewson, C. J. Kirwan, R. M. Pearse, J. Prowle P215 - Epidemiology of acute kidney injury after cardiac surgery. 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Pavlovic, L. Lewerentz, A. Spassov, R. Schneider P227 - Long-term outcome and health-related quality of life in patients discharged from the intensive care unit with a tracheostomy and with or without prolonged mechanical ventilation S. De Smet, S. De Raedt, E. Derom, P Depuydt, S. Oeyen, D. Benoit, J. Decruyenaere P228 - Ultrasound-guided percutaneous dilational tracheostomy versus bronchoscopy-guided percutaneous dilational tracheostomy in critically ill patients (trachus): a randomized clinical trial A. Gobatto, B. Bese, P. Tierno, L. Melro, P. Mendes, F. Cadamuro, M. Park, L. M. Malbouisson P229 - Is it safe to discharge patients with tracheostomy from the ICU to the ward? B. C. Civanto, J. L. Lopez, A. Robles, J. Figueira, S. Yus, A. Garcia P230 - The application of tracheostomy in children in ICU A. Oglinda, G. Ciobanu, C. Oglinda, L. Schirca, T. Sertinean, V. Lupu P231 - The impact of passive humidifiers on aerosol drug delivery during mechanical ventilation P. Kelly, A. O’Sullivan, L. Sweeney, R. MacLoughlin P232 - Evaluation of vibrating mesh and jet nebuliser performance at two different attachment setups in line with a humidifier nebuliser system A. O’Sullivan, P. Kelly, L. Sweeney, E. Mukeria, M. Wolny , R. MacLoughlin P233 - Psv-niv versus cpap in the treatment of acute cardiogenic pulmonary edema A. Pagano, F. Numis, G. Vison, L. Saldamarco, T. Russo, G. Porta, F. Paladino P234 - Noninvasive ventilation in patients with haematologic malignancy: a retrospective review C. Bell, J. Liu, J. Debacker, C. Lee, E. Tamberg, V. Campbell, S. Mehta P235 - Use of non-invasive ventilation in infectious diseases besides classical indications A. Silva-Pinto, A. Sarmento, L. Santos P236 - The impact of fragility on noninvasive mechanical ventilation application and results in the ICU Ý. Kara, F. Yýldýrým, A. Zerman, Z. Güllü, N. Boyacý, B. Basarýk Aydogan, Ü. Gaygýsýz, K. Gönderen, G. Arýk, M. Turkoglu, M. Aydogdu, G. Aygencel, Z. Ülger, G. 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Diedrich P242 - A reduction in tidal volumes for ventilated patients on ICU calculated from IBW. can it minimise mortality in comparison to traditional strategies? A . Fuller, P. McLindon, K. Sim P243 - Predictive value of lung aeration scoring using lung ultrasound in weaning failure M. Shoaeir, K. Noeam, A. Mahrous, R. Matsa, A. Ali P244 - Conventional versus automated weaning from mechanical ventilation using SmartCare™ C. Dridi, S. Koubaji, S. Kamoun, F. Haddad, A. Ben Souissi, B. Laribi, A. Riahi, M. S. Mebazaa P245 - Ultrasonographic evaluation protocol for weaning from mechanichal ventilation A. Pérez-Calatayud, R. Carrillo-Esper, A. Zepeda-Mendoza, M. Diaz-Carrillo, E. Arch-Tirado P246 - Diaphragm ultrasonography: a method for weaning patients from mechanical ventilation S. Carbognin, L. Pelacani, F. Zannoni, A. Agnoli, G. Gagliardi P247 - Dorsal diaphragmatic excursion tracks transpulmonary pressure in ventilated ARDS patients: a potential non-invasive indicator of lung recruitment? R. Cho, A. Adams , S. Lunos, S. Ambur, R. Shapiro, M. Prekker P248 - Pulse oximetry in the icu patient: is the perfusion index of any value? M. Thijssen, L. Janssen, N. Foudraine P249 - Ventilation is a better assessment of respiratory status than EtCO2 C. J. Voscopoulos, J. Freeman P250 - Evaluation of the relationship between non-invasive minute ventilation and end-tidal CO2 in patients undergoing general vs spinal anesthesia C. J. Voscopoulos, J. Freeman, E. George P251 - Respiratory volume monitoring provides early warning of respiratory depression and can be used to reduce false alarms in non-intubated patients C. J. Voscopoulos, D. Eversole, J. Freeman, E. George P252 - P/i index: a predictive edi-derived weaning index during nava S. Muttini, R. Bigi, G. Villani, N. Patroniti P253 - Adequacy of ventilation in patients receiving opioids in the post anesthesia care unit: minute ventilation versus respiratory rate G. Williams, C. J. Voscopoulos, J. Freeman, E. George P254 - Comparison of regional and global expiratory time constants measured by electrical impedance tomography (EIT) A. Waldmann, S. Böhm, W. Windisch, S. Strassmann, C. Karagiannidis P255 - Electrical impedance tomography: robustness of a new pixel wise regional expiratory time constant calculation A. Waldmann, S. Böhm, W. Windisch, S. Strassmann, C. Karagiannidis P256 - Validation of regional and global expiratory time constant measurement by electrical impedance tomography in ards and obstructive pulmonary diseases C. K. Karagiannidis, A. W. Waldmann, S. B. Böhm, S. Strassmann, W. W. Windisch P257 - Transpulmonary pressure in a model with elastic recoiling lung and expanding chest wall P. Persson, S. Lundin, O. Stenqvist P258 - Lactate in pleural and abdominal effusion G. Porta, F. Numis, C. S. Serra, A. P. Pagano, M. M. Masarone, L. R. Rinaldi, A. A. Amelia, M. F. Fascione, L. A. Adinolfi, E. R. Ruggiero P259 - Outcome of patients admitted to the intensive care with pulmonary fibrosis F. Asota, K. O’Rourke, S. Ranjan, P. Morgan P260 - Sedation and analgesia practice in extra-corporeal membrane oxygenation (ECMO)-treated patients with acute respiratory distress syndrome (ARDS): a retrospective study J. W. DeBacker, E. Tamberg, L. O’Neill, L. Munshi, L. Burry, E. Fan, S. Mehta P261 - Characteristics and outcomes of patients deemed not eligible when referred for veno-venous extracorporeal membrane oxygenation (vv-ECMO) S. Poo, K. Mahendran, J. Fowles, C. Gerrard, A. Vuylsteke P262 - The SAVE SMR for veno-arterial ECMO R. Loveridge, C. Chaddock, S. Patel, V. Kakar, C. Willars, T. Hurst, C. Park, T. Best, A. Vercueil, G. Auzinger P263 - A simplified score to predict early (48 h) mortality in patients being considered for VA-ECMO A. Borgman, A. G. Proudfoot, E. Grins, K. E. Emiley, J. Schuitema, S. J. Fitch, G. Marco, J. Sturgill, M. G. Dickinson, M. Strueber, A. Khaghani, P. Wilton, S. M. Jovinge P264 - Lung function six months post extra corporeal membrane oxygenation (ECMO) for severe acute respiratory failure in adult survivors C. Sampson, S. Harris-Fox P265 - Bicarbonate dialysis removes carbon dioxide in hypoventilated rodents. M. E. Cove, L. H. Vu, A. Sen, W. J. Federspiel, J. A. Kellum P266 - Procalcitonin as predictor of primary graft dysfunction and mortality in post-lung transplantation C. Mazo Torre, J. Riera, S. Ramirez, B. Borgatta, L. Lagunes, J. Rello P267 - New molecular biomarkers of acute respiratory distress syndrome in abdominal sepsis A. K. Kuzovlev, V. Moroz, A. Goloubev, S. Polovnikov, S. Nenchuk P268 - Tight junction’s proteins claudin -5 and regulation by tnf in experimental murine lung injury model of ali/ards V. Karavana, C. Glynos, A. Asimakos, K. Pappas, C. Vrettou, M. Magkou, E. Ischaki, G. Stathopoulos, S. Zakynthinos P269 - Cell counts in endobronchial aspirate to assess airway inflammation in ARDS patients: a pilot study S. Spadaro, I. Kozhevnikova, F. Dalla Corte, S. Grasso, P. Casolari, G. Caramori, C. Volta P270 - Epidemiological and clinical profile of patients with acute respiratory distress syndrome in the surgical intensive care unit surgical, hospital JRA, Antananarivo T. Andrianjafiarinoa, T. Randriamandrato, T. Rajaonera P271 - Effect of high PEEP after recruitment maneuver on right ventricular function in ARDS. Is it good for the lung and for the heart? S. El-Dash, ELV Costa, MR Tucci, F Leleu, L Kontar, B. De Cagny, F. Brazier, D. Titeca, G. Bacari-Risal, J. Maizel, M. Amato, M. Slama P272 - Effect of recruitment maneuver on left ventricular systolic strain P. Mercado, J. Maizel, L. Kontar, D. Titeca, F. Brazier, A. Riviere, M. Joris, T. Soupison, B. De Cagny, S. El Dash, M. Slama P273 - Inhaled nitric oxide – is switching supplier cost effective? Remmington, A. Fischer, S. Squire, M. Boichat P274 - Epidemiological study of severe acute pancreatitis in Japan, comparison of the etiology and the patient outcomes on 1159 patients. H. Honzawa, H. Yasuda, T. Adati, S. Suzaki, M. Horibe, M. Sasaki, M. Sanui P275 - Extracorporeal liver support therapy. Experience in an intensive care unit R. Marinho, J. Daniel, H. Miranda, A. Marinho P276 - Accuracy of mortality prediction models in acute versus acute-on-chronic liver failure in the intensive care setting K. Milinis, M. Cooper, G. R. Williams, E. McCarron, S. Simants, I. Patanwala, I. Welters P277 - Risk of coronary artery disease in patients with chronic liver disease: a population based cohort study Y. Su P278 - 20 years of liver transplantation in Santiago de Compostela (Spain). Experience review J. Fernández Villanueva, R. Fernández Garda, A. López Lago, E. Rodríguez Ruíz, R. Hernández Vaquero, S. Tomé Martínez de Rituerto, E. Varo Pérez P279 - Diarrhea is a risk factor for liver injury and may lead to intestinal failure associated liver disease in critical illness N. Lefel, F. Schaap, D. Bergmans, S. Olde Damink, M. Van de Poll P280 - Bowel care on the intensive care unit: constipation guideline compliance and complications K. Tizard, C. Lister, L. Poole P281 - Malnutrition assessed by phase angle determines outcomes in low risk cardiac surgery patients D. Ringaitiene, D. Gineityte, V. Vicka, I. Norkiene, J. Sipylaite P282 - Preoperative fasting times in an irish hospital A. O’Loughlin, V. Maraj, J. Dowling P283 - Costs and final outcome of early x delayed feeding in a private Brazil ICU M. B. Velasco, D. M. Dalcomune, E. B. Dias, S. L. Fernandes P284 - Can ventilator derived energy expenditure measurements replace indirect calorimetry? T. Oshima, S. Graf, C. Heidegger, L. Genton, V. Karsegard, Y. Dupertuis, C. Pichard P285 - Revisiting the refeeding syndrome: results of a systematic review N. Friedli, Z. Stanga, B. Mueller, P. Schuetz P286 - Compliance with the new protocol for parenteral nutrition in our ICU L. Vandersteen, B. Stessel, S. Evers, A. Van Assche, L. Jamaer, J. Dubois P287 - Nutrition may be another treatment in the intensive care unit where less is more? R. Marinho, H. Castro, J. Moura, J. Valente, P. Martins, P. Casteloes, C. Magalhaes, S. Cabral, M. Santos, B. Oliveira, A. Salgueiro, A. Marinho P288 - Should we provide more protein to critically ill patients? R. Marinho, M. Santos, E. Lafuente, H. Castro, S. Cabral, J. Moura, P. Martins, B. Oliveira, A. Salgueiro, S. Duarte, S. Castro, M. Melo, P. Casteloes, A. Marinho P289 Protein provision in an adult intensive care unit S. Gray P290 - Prevalence and clinical outcomes of vitamin d deficiency in the medical critically ill patients in Songklanagarind hospital K. Maipang, R. Bhurayanontachai P291 - Vitamin d deficiency strongly predicts adverse medical outcome across different medical inpatient populations: results from a prospective study L. G. Grädel, P. Schütz P292 - Omega-3 fatty acids in patients undergoing cardiac surgery: a systematic review and meta-analysis P. Langlois, W. Manzanares P293 - Can 5-hydroxytriptophan prevent post-traumatic stress disorder in critically ill patients? R. Tincu, C. Cobilinschi, D. Tomescu, Z. Ghiorghiu, R. Macovei P294 - Parenteral selenium in the critically ill: an updated systematic review and meta-analysis W. Manzanares, P. Langlois, M. Lemieux, G. Elke, F. Bloos, K. Reinhart, D. Heyland P295 - Probiotics in the critically ill: an updated systematic review and meta-analysis P. Langlois, M. Lemieux, I. Aramendi, D. Heyland, W. Manzanares P296 - Diabetes with hyperglycemic crisis episodes may be associated with higher risk of pancreatic cancer: a population-based cohort study Y. 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Bertellini P318 Correlation between electroencephalographic findings and serum neuron specific enolase with outcome of post cardiac arrest patients A. Taha, T. Abdullah, S. Abdel Monem P319 Introduction of a targeted temperature management strategy following cardiac arrest in a district general hospital intensive care unit. S. Alcorn, S. McNeill, S. Russell P320 The evolution of cerebral oxygen saturation in post-cardiac arrest patients treated with therapeutic hypothermia W. Eertmans, C. Genbrugge, I. Meex, J. Dens, F. Jans, C. De Deyne P321 Prognostic factors and neurological outcomes of therapeutic hypothermia in comatose survivors from cardiac arrest: 8-year single center experience J. Cholkraisuwat, N. Kongpolprom P322 Adherence to targeted temperature management after out of hospital cardiac arrest B. Avard, R. Burns P323 Implementation of a therapeutic hypothermia protocol for comatose survivors of out-of-hospital cardiac arrest. A. Patarchi, T. 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Suchomel P343 - Evaluation of levetiracetam pharmacokinetics after severe traumatic brain injury in neurocritical care patients at a level one trauma center N. Ebert, J. Jancik, H. Rhodes P344 - Model based time series cluster analysis to determine unique patient states in traumatic brain injury T. Bylinski, C. Hawthorne, M. Shaw, I. Piper, J. Kinsella P345 - Brain compartment monitoring capabilities from ICP to BI (bioimpedance) during HS (hypertonic saline) administration. State of art simulation outcome depending on brain swelling type A. K. Kink , I. R. Rätsep P346 - Transfusion of red blood cells in patients with traumatic brain injury admitted to Canadian trauma health centers: a multicenter cohort study A. Boutin, L. Moore, M. Chasse, R. Zarychanski, F. Lauzier, S. English, L. McIntyre, J. Lacroix, D. Griesdale, P. Lessard-Bonaventure, A. F. 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Kelly P358 - Black widow envenomation in Saudi Arabia: a prospective observational case series M. Alfafi, S. Alsolamy, W. Almutairi, B. Alotaibi P359 - Mechanical ventilation in patients with overdose not yet intubated on icu admission A. E. Van den Berg, Y. Schriel, L. Dawson, I. A. Meynaar P360 - Central nervous system depressants poisoning and ventilator associated pneumonia: an underrated risk factor in toxicological intensive care unit H. Talaie P361 - Acute barium intoxication treated with hemodiafiltration D. Silva, S. Fernandes, J. Gouveia, J. Santos Silva P362 - Major trauma presenting to the emergency department. the spectrum of cycling injuries in Ireland J. Foley, A. Kaskovagheorgescu, D. Evoy, J. Cronin, J. Ryan P363 - Burns from French military operations: a 14-year retrospective observational analysis. M. Huck, C. Hoffmann, J. Renner, P. Laitselart, N. Donat, A. Cirodde, J. V. Schaal, Y. Masson, A. Nau, T. Leclerc P364 - A comparison of mortality scores in burns patients on the intensive care unit. O. Howarth, K. Davenport, P. Jeanrenaud, S. Raftery P365 - Clasification of pain and its treatment and an intensive care rehabiliation clinic P. MacTavish, H. Devine, J. McPeake, M. Daniel, J. Kinsella, T. Quasim P366 - Pain management adequacy in critical care areas ,the process and the barriers perceived by critical care nurses S. Alrabiee, A. Alrashid , S. Alsolamy P367 - Pain assessment in critically ill adult patients: validation of the Turkish version of the critical-care pain observation tool O. Gundogan, C. Bor, E. Akýn Korhan, K. Demirag , M. Uyar P368 - An audit of pain and sedation assessments in the intensive care unit: recommendations for clinical practice F. Frame, C. Ashton, L. Bergstrom Niska P369 - Impact of pharmaceutical care on treatment of pain and agitation in medical intensive care unit P. Dilokpattanamongkol, T. Suansanae, C. Suthisisang, S. Morakul, C. Karnjanarachata, V. Tangsujaritvijit P370 - Agitation in trauma ICU, prevention and outcome S. Mahmood, H. Al Thani, A. Almenyar P371 Correlation between percentages of ventilated patients developed vap and use of sedative agents in icu patients. A. Vakalos , V. Avramidis P372 - Improving recording of sedation events in the Emergency Department: The implementation of the SIVA International Taskforce adverse event reporting tool for procedural sedation R. Sharvill, J. Penketh P373 - Impact of sedative drug use on the length of mechanical ventilation S. E. Morton, Y. S. Chiew, C. Pretty, J. G. Chase, G. M. Shaw P374 - Co-administration of nitric oxide and sevoflurane using anaconda R. Knafelj, P. Kordis P375 - A retrospective study of the use of Dexmedetomidine in an oncological critical care setting S. Patel, V. Grover P376 - Dexmedetomidine and posttraumatic stress disorder incidence in alcohol withdrawal icu patients I. Kuchyn, K. Bielka P377 - Hemodynamic effects of dexmedetomidine in a porcine model of septic shock Z. Aidoni, V. Grosomanidis, K. Kotzampassi, G. Stavrou, B. Fyntanidou, S. Patsatzakis, C. Skourtis P378 - Ketamine for analgosedation in severe hypoxic respiratory failure S. D. Lee, K. Williams, I. D. Weltes P379 - Madness from the moon? lunar cycle and the incidence of delirium on the intensive care unit S. Berhane, C. Arrowsmith, C. Peters, S. Robert P380 - Impaired dynamic cerebral autoregulation after coronary artery bypass grafting and association with postoperative delirium J. Caldas, R. B. Panerai, T. G. Robinson, L. Camara, G. Ferreira, E. Borg-Seng-Shu, M. De Lima Oliveira, N. C. Mian, L. Santos, R. Nogueira, S. P. Zeferino, M. Jacobsen Teixeira, F. Galas, L. A. Hajjar P381 - Risk factors predicting prolonged intensive care unit length of stay after major elective surgery. P. Killeen, M. McPhail, W. Bernal, J. Maggs, J. Wendon, T. Hughes P382 - Systemic inflammatory response syndrome criteria and hospital mortality prediction in a brazilian cohort of critically ill patients L. U. Taniguchi, E. M. Siqueira, J. M. Vieira Jr, L. C. Azevedo P383 - Evaluating the efficacy of a risk predictor panel in identifying patients at elevated risk of morbidity following emergency admission A. N. Ahmad, M. Abu-Habsa, R. Bahl, E. Helme, S. Hadfield, R. Loveridge P384 - A retrospective comparison of outcomes for elective surgical patients admitted post-operatively to the critical care unit or general ward J. Shak, C. Senver, R. Howard-Griffin P385 - Effect of obesity on mortality in surgical critically ill patients. P. Wacharasint, P. Fuengfoo, N. Sukcharoen, R. Rangsin P386 - The national early warning score (news) reliably improves adverse clinical outcome prediction in community-acquired pneumonia - results from a 6 year follow-up D. Sbiti-Rohr, P. Schuetz P387 - Clinical usefulness of the charlson¡¯s weighted index of comorbidities _as prognostic factor in patients with prolonged acute mechanical ventilation H. Na, S. Song, S. Lee, E. Jeong, K. Lee P388 - Comparison of mortality prediction scoring systems in patients with cirrhosis admitted to general intensive care unit M. Cooper, K. Milinis, G. Williams, E. McCarron, S. Simants, I. Patanwala, I. D. Welters P389 - Impact of admission source and time of admission on outcome of pediatric intensive care patients: retrospective 15 years study E. Zoumpelouli, EA Volakli, V. Chrysohoidou, S. Georgiou, K. Charisopoulou, E. Kotzapanagiotou, V. Panagiotidou, K. Manavidou, Z. Stathi, M. Sdougka P390 - Heart rate variability and outcomes prediction in critical illness N. Salahuddin, B. AlGhamdi, Q. Marashly, K. Zaza, M. Sharshir, M. Khurshid, Z. Ali, M. Malgapo, M. Jamil, A. Shafquat, M. Shoukri, M. Hijazi P391 - The incidence and outcome of hyperlactatemia in the post anaesthesia care unit T. Abe, S. Uchino, M. Takinami P392 - Correlation between arterial blood gas disturbances and arterial lactate levels during hospitalization and outcome in critically septic patients N. R. Rangel Neto, S. Oliveira, F. Q. Reis, F. A. Rocha P393 - External validation of saps 3 and mpm iii scores in 48,816 patients from 72 brazilian icus G. Moralez, K. Ebecken, L. S. Rabello, M. F. Lima, R. Hatum, F. V. De Marco, A. Alves, J. E. Pinto, M. Godoy, P. E. Brasil, F. A. Bozza, J. I. Salluh, M. Soares P394 - The frailty penalty: pre-admission functional status confounds mortality prediction models in critically ill patients J. Krinsley, G. Kang P395 - ‘sooner rather than later”: how delayed discharge from critical care leads to increased out of hours discharges and subsequent increase in in-hospital mortality. J. Perry, H. Hines P396 - Identifying poor outcome patient groups in a resource-constrained critical care unit K. M. Wilkinson, C. Tordoff, B. Sloan, M. C. Bellamy P397 - Effects of icu weekend admission and discharge on mortality. E. Moreira, F. Verga, M. Barbato, G. Burghi P398 - Organizational factors, outcomes and resource use in 9,946 cancer patients admitted to 70 ICUs M Soares, U. V. Silva, L. C. Azevedo, A. P. Torelly, J. M. Kahn, D. C. Angus, M. F. Knibel, P. E. Brasil, F. A. Bozza, J. I. Salluh P399 - Evaluation of oncological critically ill patients, severity score and outcome compared to not oncological in a particular hospital cti. M. B. Velasco, D. M. Dalcomune P400 - Outcomes of patients admitted to a large uk critical care department with palliative oncological diagnoses R. Marshall, T. Gilpin, A. Tridente, A. Raithatha P401 - Predictors of mortality in febrile neutropenic patients with haematological malignancies admitted to an intensive care unit of a cancer center D. Mota, B. Loureiro, J. Dias, O. Afonso, F. Coelho, A. Martins, F. Faria P402 - Patients with hematologic malignancies requiring invasive mechanical ventilation: characteristics and predictors of mortality H. Al-Dorzi, H. Al Orainni , F. AlEid, H. Tlaygeh, A. Itani, A. Hejazi, Y. Arabi P403 - Patient-important outcomes in randomized controlled trials in critically ill patients: a systematic review S. Gaudry, J. Messika, J. D. Ricard, S. Guillo, B. Pasquet, E. Dubief, D. Dreyfuss, F. Tubach P404 - Alopecia in survivors of critical illness: a qualitative study C . Battle, K. James, P. Temblett P405 - The impact of mental health on icu admission L. Davies, C. Battle, C. Lynch P406 - Cognitive impairment 5 years after ICU discharge S. Pereira, S. Cavaco, J. Fernandes, I. Moreira, E. Almeida, F. Seabra Pereira, M. Malheiro, F. Cardoso, I. Aragão, T. Cardoso P407 - Apache ii versus apache iv for octagenerians in medical icu M. Fister, R. Knafelj P408 - Outcomes of octagenarians in an indian icu P. Muraray Govind, N. Brahmananda Reddy, R. Pratheema, E. D. Arul, J. Devachandran P409 - Mortality and outcomes in elderly patients 80 years of age or older admitted to the icu M. B. Velasco , D. M. Dalcomune P410 - Octagenerians in medical icu - adding days to life or life to days? R. Knafelj, M. Fister P411 - The very elderly admitted to intensive care unit: outcomes and economic evaluation N. Chin-Yee, G. D’Egidio, K. Thavorn, D. Heyland, K. Kyeremanteng P412 - The very elderly in intensive care: relationship between acuity of illness and long-term mortality A. G. Murchison, K. Swalwell, J. Mandeville, D. Stott P413 - Acquired weakness in an oncological intensive care unit I. Guerreiro P414 - Musculoskeletal problems in intensive care unit (ICU) patients post-discharge H. Devine, P. MacTavish, J. McPeake, T. Quasim, J. Kinsella, M. Daniel P415 - Premorbid obesity, but not nutrition, prevents critical illness-induced muscle wasting and weakness C. Goossens M. B. Marques, S. Derde, S. Vander Perre, T. Dufour, S. E. Thiessen, F. Güiza, T. Janssens, G. Hermans, I. Vanhorebeek, K. De Bock, G. Van den Berghe, L. Langouche P416 - Physical outcome measures for critical care patients following intensive care unit (icu) discharge H. Devine, P. MacTavish, T. Quasim, J. Kinsella, M. Daniel, J. McPeake P417 - Improving active mobilisation in a general intensive care unit B. Miles , S. Madden, H. Devine P418 - Mobilization in patients on vasoactive drugs use – a pilot study. M. Weiler, P. Marques, C. Rodrigues, M. Boeira, K. Brenner, C. Leães, A. Machado, R. Townsend, J. Andrade P419 - Pharmacy intervention at an intensive care rehabilitation clinic P. MacTavish, J. McPeake, H. Devine, J. Kinsella, M. Daniel, R. Kishore, C. Fenlon, T. Quasim P420 - Interactive gaming is feasible and potentially increases icu patients’ motivation to be engaged in rehabilitation programs T. Fiks, A. Ruijter, M. Te Raa, P. Spronk P421 - Simulation-based design of a robust stopping rule to ensure patient safety Y. S. Chiew, P. Docherty, J. Dickson, E. Moltchanova, C. Scarrot, C. Pretty, G. M. Shaw, J. G. Chase P422 - Are daily blood tests on the intensive care unit necessary? T. Hall, W. C. Ngu, J. M. Jack, P. Morgan P423 - Measuring urine output in ward patients: is it helpful? B. Avard, A. Pavli, X. Gee P424 - The incidence of pressure ulcers in an adult mixed intensive care unit in turkey C . Bor, E. Akin Korhan, K. Demirag, M. Uyar P425 - Intensivist/patient ratios in closed ICUs in Alexandria, Egypt; an overview M. Shirazy, A. Fayed P426 - Eicu (electronic intensive care unit): impact on ALOS (average length of stay) in a developing country like India S. Gupta, A. Kaushal, S. Dewan, A. Varma P427 - Predicting deterioration in general ward using early deterioration indicator E. Ghosh, L. Yang, L. Eshelman, B. Lord, E. Carlson P428 - High impact enhanced critical care outreach - the imobile service: making a difference E. Helme, R. Broderick, S. Hadfield, R. Loveridge P429 - Impact of bed availability and cognitive load on intensive care unit (ICU) bed allocation: a vignette-based trial J. Ramos, D. Forte P430 - Characteristics of critically ill patients admitted through the emergency department F. Yang, P. Hou P431 - Admission to critical care: the quantification of functional reserve J. Dudziak, J. Feeney, K. Wilkinson, K. Bauchmuller, K. Shuker, M. Faulds, A. Raithatha, D. Bryden, L. England, N. Bolton, A. Tridente P432 - Admission to critical care: the importance of frailty K. Bauchmuller, K Shuker, A Tridente, M Faulds, A Matheson, J. Gaynor, D Bryden, S South Yorkshire Hospitals Research Collaboration P433 - Development of an instrument to aid triage decisions for intensive care unit admission J. Ramos, B. Peroni, R. Daglius-Dias, L. Miranda, C. Cohen, C. Carvalho, I . Velasco, D. Forte P434 - Using selective serotonin re-uptake inhibitors and serotonin-norepinephrine re-uptake inhibitors in critical care: a systematic review of the evidence for benefit or harm J. M. Kelly, A. Neill, G. Rubenfeld, N. Masson, A. Min P435 - Measuring adaptive coping of hospitalized patients with a severe medical condition:the sickness insight in coping questionnaire (sicq) E. Boezeman, J. Hofhuis , A. Hovingh, R. De Vries, P. Spronk P436 - Results of a national survey regarding intensive care medicine training G. Cabral-Campello, I. Aragão, T. Cardoso P437 - Work engagement among healthcare professionals in the intensive care unit M. Van Mol, M. Nijkamp, E . Kompanje P438 - Empowering the intensive care practitioners. is it a burnout ameliorating intervention? P. Ostrowski, A. Omar P439 - Icu patients suffer from circadian rhythm desynchronisation K. Kiss , B. Köves, V. Csernus, Z. Molnár P440 - Noise reduction in the ICU: feasible ? Y. Hoydonckx, S. Vanwing, B. Stessel, A. Van Assche, L. Jamaer, J. Dubois P441 - Accidental removal of invasive devices in the critical patient into the bed-washing. does the presence of professional nurse modify his incidence? V. Medo, R. Galvez, J. P. Miranda P442 - Deprivation of liberty safeguards (dols): audit of compliance in a of a 16-bed specialist cancer critical care unit. C. Stone, T. Wigmore P443 - Use of a modified cristal score to predict futility of critical care in the elderly Y. Arunan, A. Wheeler, K. Bauchmuller, D. Bryden P444 - Improvement of Referral Rate to Palliative Care for Patients with Poor Prognosis in Neurosurgical Intensive Care Unit Y. Wong, C. Poi, C. Gu P445 - Factors associated with limitation of life supporting care (lsc) in a medico-surgical intermediate care unit, and outcome of patients with lsc limitation: a monocentric, six-month study. P. Molmy, N. Van Grunderbeeck, O. Nigeon, M. Lemyze, D. Thevenin, J. Mallat P446 - Palliative care consultation and intensive care unit admission request: a cohort study J. Ramos, M. Correa, R. T. Carvalho, D. Forte P447 - Nursing and medicine together in postsurgical intensive care unit: situations of prognostic conflict at the end of life. our critical care nurses suffer with our medical activism? A. Fernandez, C. McBride P448 - End of life who may decide E. Koonthalloor, C. Walsh P449 - Correctly diagnosing death A. Webber, M. Ashe, K. Smith, P. Jeanrenaud P450 - Skin procurement performed by intensive care physicians: yes, we can. A. Marudi , S. Baroni, F. Ragusa, E. Bertellini P451 - Death analysis in pediatric intensive care patients E. A. Volakli , E. Chochliourou, M. Dimitriadou, A. Violaki, P. Mantzafleri, E. Samkinidou, O. Vrani, A. Arbouti, T. Varsami, M. Sdougka P452 - The potential impact of euthanasia on organ donation: analysis of data from belgium J. A. Bollen, T. C. Van Smaalen, W. C. De Jongh, M. M. Ten Hoopen, D. Ysebaert, L. W. Van Heurn, W. N. Van Mook P453 - Communication within an intensive care setting K. Sim, A. Fuller P454 - Development and implementation of a longitudinal communication curriculum for critical care medicine fellows A. Roze des Ordons, P. Couillard, C. Doig P455 - Staff-family conflict in a multi-ethnic intensive care unit R. V. Van Keer, R. D. Deschepper, A. F. Francke, L. H. Huyghens, J. B. Bilsen P456 - Does the source of admission to critical care affect family satisfaction? B. Nyamaizi, C. Dalrymple, A. Molokhia, A. Dobru P457 - A simple alternative to the family satisfaction survey (fs-icu) E. Marrinan, A. Ankuli, A. Molokhia P458 - A study to explore the experiences of patient and family volunteers in a critical care environment: a phenomenological analysis J. McPeake, R. Struthers, R. Crawford , H. Devine , P. Mactavish , T. Quasim P459 - Prevalence and risk factors of anxiety and depression in relatives of burn patients. P. Morelli, M. Degiovanangelo, F. Lemos, V. MArtinez, F. Verga, J. Cabrera, G. Burghi P460 - Guidance of visiting children at an adult intensive care unit (icu) A. Rutten , S. Van Ieperen, S. De Geer, M. Van Vugt, E. Der Kinderen P461 - Visiting policies in Italian pediatric ICUs: an update A. Giannini, G Miccinesi, T Marchesi, E Prandi

Published
2016

5. The Perioperative and Anesthetic Adverse Events in Thailand (PAAd Thai) Study: 58 Case Reports of Obesity Patients.

Author

Rodanant O., Chau-in W., Charuluxananan S., Morakul S., Pongruekdee S., Tanyong U., Chanthawong S., and Punjasawadwong Y.

Subjects
OVERWEIGHT persons, ADVERSE health care events, BODY mass index, ARRHYTHMIA, SURGICAL emergencies, ELECTIVE surgery
Abstract

Background: The Royal College of Anesthesiologists of Thailand (RCAT) contributed to a multicenter study, the Perioperative and Anesthetic Adverse Events in Thailand study (PAAd Thai) in 22 hospitals across Thailand. In the past two decades, the number of obese patients increased at an alarming rate. Objective: To investigate natural history of anesthesia or surgical related complications, contributing factor and corrective strategies in patients whose body mass index (BMI) was equal or higher than 35 kg/m². Materials and Methods: The present study was prospective descriptive study. After being approved by each Institutional Ethical Committee, written informed consents were waived. Each hospital was asked to anonymously report incidence of anesthesia related adverse events. Two thousand two hundred six incidence reports were provided. Patient with a BMI equal or over 35 kg/m² that underwent surgery were selected from the incident reports. Data were discussed and analyzed by three senior anesthesiologists for contributing factors, clinical courses, factors minimizing incident, and suggested corrective strategies. Results: Fifty-eight cases (2.63%) from the 2,206 reports of the PAAd Thai Study met the inclusion definition and were reviewed. Seventy-eight incidents occurred from 3,028 critical incidents reports (2.57%), one-third was male and the rest were female. The average age was 39.96±6.72 year and BMI was 39.8±5.1 kg/m². The highest incidence occurred in patients with BMI 35 to 39.9 kg/m² (65.52%). Half was classified as the ASA physical status 3. The adverse events were found more frequent in elective surgery (40 incidents or 68.96%) than emergency surgery. General surgery such as laparotomy had higher incidence compared to other surgical specialties. Oxygen desaturation was the most common incident (51.7%). Severe arrhythmia, difficult intubation, and cardiac arrest in 24 hours post-operatively were found in the same frequency (12.1%). Contributing factors from the present report were inadequate preanesthetic evaluation and preparation, inexperience, inappropriate decision, and urgency. Having experiences, more vigilance, and experienced assistant or effective supervision were factors for minimizing outcomes. Conclusion: Improvement of supervision, additional training, and clinical practice guidelines were suggested for corrective strategies. [ABSTRACT FROM AUTHOR]

Published
2019

9. Thai-shock survey 2013: Survey of shock management in Thailand

Author

Chittawatanarat, K., Patjanasoontorn, B., Rungruanghiranya, S., Permpikul, C., Chaiwat, O., Kongsayreepong, S., Vorrakitpokatorn, P., Wilaichone, W., Bunburaphong, T., Saengchote, W., Morakul, S., Tangsujaritvijit, V., Thawitsri, T., Sitthipan, C., Sombunvibul, W., Chatrkaw, P., Poonyathawon, S., Watanathum, A., Fuengfoo, P., Sataworn, D., Wongsa, A., Piyavechviratana, K., Pothirat, C., Deesomchok, A., Panitchote, A., Rungsun Bhurayanontachai, Champunut, R., and Chuachamsai, N.

10. Cardiopulmonary monitoring in Thai ICUs (ICU-RESOURCE I Study)

Author

Chittawatanarat, K., Wattanathum, A., Chaiwat, O., Permpikul, C., Kongsayreepong, S., Vorrakitpokatorn, P., Wilaichone, W., Bunburaphong, T., Saengchote, W., Morakul, S., Thawitsri, T., Sitthipan, C., Sombunvibul, W., Chatrkaw, P., Poonyathawon, S., Watanathum, A., Fuengfoo, P., Sataworn, D., Wongsa, A., Piyavechviratana, K., Rungruanghiranya, S., Pothirat, C., Deesomchok, A., Patjanasoontorn, B., Rungsun Bhurayanontachai, Champunut, R., Chuachamsai, N., and Thongchai, C.

11. Non-cardiopulmonary monitoring in thai-ICU (ICU-RESOURCE I study)

Author

Chittawatanarat, K., Morakul, S., Thawitsri, T., Permpikul, C., Chaiwat, O., Kongsayreepong, S., Vorrakitpokatorn, P., Wilaichone, W., Bunburaphong, T., Saengchote, W., Sitthipan, C., Sombunvibul, W., Chatrkaw, P., Poonyathawon, S., Watanathum, A., Fuengfoo, P., Sataworn, D., Wongsa, A., Piyavechviratana, K., Rungruanghiranya, S., Pothirat, C., Deesomchok, A., Patjanasoontorn, B., Rungsun Bhurayanontachai, Champunut, R., Chuachamsai, N., and Thongchai, C.

14. Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

Author

Author et al, Bateman, R. M., Sharpe, M. D., Jagger, J. E., Ellis, C. G., Solé-Violán, J., López-Rodríguez, M., Herrera-Ramos, E., Ruíz-Hernández, J., Borderías, L., Horcajada, J., González-Quevedo, N., Rajas, O., Briones, M., Rodríguez de Castro, F., Rodríguez Gallego, C., Esen, F., Orhun, G., Ergin Ozcan, P., Senturk, E., Ugur Yilmaz, C., Orhan, N., Arican, N., Kaya, M., Kucukerden, M., Giris, M., Akcan, U., Bilgic Gazioglu, S., Tuzun, E., Riff, R., Naamani, O., Douvdevani, A., Takegawa, R., Yoshida, H., Hirose, T., Yamamoto, N., Hagiya, H., Ojima, M., Akeda, Y., Tasaki, O., Tomono, K., Shimazu, T., Ono, S., Kubo, T., Suda, S., Ueno, T., Ikeda, T., Ogura, H., Takahashi, H., Kang, J., Nakamura, Y., Kojima, T., Izutani, Y., Taniguchi, T., O, M., Dinter, C., Lotz, J., Eilers, B., Wissmann, C., Lott, R., Meili, M. M., Schuetz, P. S., Hawa, H., Sharshir, M., Aburageila, M., Salahuddin, N., Chantziara, V., Georgiou, S., Tsimogianni, A., Alexandropoulos, P., Vassi, A., Lagiou, F., Valta, M., Micha, G., Chinou, E., Michaloudis, G., Kodaira, A., Imaizumi, H., De la Torre-Prados, M. V., Garcia-De la Torre, A., Enguix-Armada, A., Puerto-Morlan, A., Perez-Valero, V., Garcia-Alcantara, A., Bolton, N., Dudziak, J., Bonney, S., Tridente, A., Nee, P., Nicolaes, G., Wiewel, M., Schultz, M., Wildhagen, K., Horn, J., Schrijver, R., Van der Poll, T., Reutelingsperger, C., Pillai, S., Davies, G., Mills, G., Aubrey, R., Morris, K., Williams, P., Evans, P., Gayat, E. G., Struck, J., Cariou, A., Deye, N., Guidet, B., Jabert, S., Launay, J., Legrand, M., Léone, M., Resche-Rigon, M., Vicaut, E., Vieillard-Baron, A., Mebazaa, A., Arnold, R., Capan, M., Linder, A., Akesson, P., Popescu, M., Tomescu, D., Sprung, C. L., Calderon Morales, R., Munteanu, G., Orenbuch-Harroch, E., Levin, P., Kasdan, H., Reiter, A., Volker, T., Himmel, Y., Cohen, Y., Meissonnier, J., Girard, L., Rebeaud, F., Herrmann, I., Delwarde, B., Peronnet, E., Cerrato, E., Venet, F., Lepape, A., Rimmelé, T., Monneret, G., Textoris, J., Beloborodova, N., Moroz, V., Osipov, A., Bedova, A., Sarshor, Y., Pautova, A., Sergeev, A., Chernevskaya, E., Odermatt, J., Bolliger, R., Hersberger, L., Ottiger, M., Christ-Crain, M., Mueller, B., Schuetz, P., Sharma, N. K., Tashima, A. K., Brunialti, M. K., Machado, F. R., Assuncao, M., Rigato, O., Salomao, R., Cajander, S. C., Rasmussen, G., Tina, E., Söderquist, B., Källman, J., Strålin, K., Lange, A. L., Sundén-Cullberg, J. S., Magnuson, A. M., Hultgren, O. H., Van der Geest, P., Mohseni, M., Linssen, J., De Jonge, R., Duran, S., Groeneveld, J., Miller, R., Lopansri, B. K., McHugh, L. C., Seldon, A., Burke, J. 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health care facilities, manpower, and services, education, Erratum, Critical Care and Intensive Care Medicine, reproductive and urinary physiology, humanities, health care economics and organizations
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15. Effects of ICU characters, human resources and workload to outcome indicators in thai ICUs: The results of ICU-RESOURCE i study

Author

Kaweesak Chittawatanarat, Sataworn, D., Thongchai, C., Permpikul, C., Chaiwat, O., Kongsayreepong, S., Vorrakitpokatorn, P., Wilaichone, W., Bunburaphong, T., Saengchote, W., Morakul, S., Thawitsri, T., Sitthipan, C., Sombunvibul, W., Chatrkaw, P., Poonyathawon, S., Watanathum, A., Fuengfoo, P., Wongsa, A., Piyavechviratana, K., Rungruanghiranya, S., Pothirat, C., Deesomchok, A., Patjanasoontorn, B., Bhurayanontachai, R., Champunut, R., and Chuachamsai, N.

16. Survey of respiratory support for intensive care patients in 10 tertiary hospital of Thailand

Author

Chittawatanarat, K., Jaikriengkrai, K., Permpikul, C., Chaiwat, O., Kongsayreepong, S., Vorrakitpokatorn, P., Wilaichone, W., Bunburaphong, T., Saengchote, W., Morakul, S., Thawitsri, T., Sitthipan, C., Sombunvibul, W., Chatrkaw, P., Poonyathawon, S., Watanathum, A., Fuengfoo, P., Sataworn, D., Wongsa, A., Piyavechviratana, K., Rungruanghiranya, S., Pothirat, C., Athavudh Deesomchok, Patjanasoontorn, B., Bhurayanontachai, R., Champunut, R., Chuachamsai, N., and Thongchai, C.

18. Characters of physician and nurse staffing in thai intensive care units (ICU-RESOURCE I study)

Author

Chittawatanarat, K., Rungsun Bhurayanontachai, Thongchai, C., Permpikul, C., Chaiwat, O., Kongsayreepong, S., Vorrakitpokatorn, P., Wilaichone, W., Bunburaphong, T., Saengchote, W., Morakul, S., Thawitsri, T., Sitthipan, C., Sombunvibul, W., Chatrkaw, P., Poonyathawon, S., Watanathum, A., Fuengfoo, P., Sataworn, D., Wongsa, A., Piyavechviratana, K., Rungruanghiranya, S., Pothirat, C., Deesomchok, A., Patjanasoontorn, B., Bhurayanontachai, R., Champunut, R., and Chuachamsai, N.

19. Mechanical ventilators availability survey in Thai ICUs (ICU-RESOURCE I study)

Author

Chittawatanarat, K., Bunburaphong, T., Champunot, R., Permpikul, C., Chaiwat, O., Kongsayreepong, S., Vorrakitpokatorn, P., Wilaichone, W., Saengchote, W., Morakul, S., Thawitsri, T., Sitthipan, C., Sombunvibul, W., Chatrkaw, P., Poonyathawon, S., Watanathum, A., Fuengfoo, P., Sataworn, D., Wongsa, A., Piyavechviratana, K., Rungruanghiranya, S., Pothirat, C., Athavudh Deesomchok, Patjanasoontorn, B., Bhurayanontachai, R., Champunut, R., Chuachamsai, N., and Thongchai, C.

20. Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Author

Labeau, Sonia O, Afonso, Elsa, Benbenishty, Julie, Blackwood, Bronagh, Boulanger, Carole, Brett, Stephen J, Calvino-Gunther, Silvia, Chaboyer, Wendy, Coyer, Fiona, Deschepper, Mieke, François, Guy, Honore, Patrick M, Jankovic, Radmilo, Khanna, Ashish K, Llaurado-Serra, Mireia, Lin, Frances, Rose, Louise, Rubulotta, Francesca, Saager, Leif, Williams, Ged, Blot, Stijn I, Dritan, Muzha, Antoni Margarit Ribas, Fernando, Lipovesty, Cecilia, Loudet, Fiona, Coyer, Philipp, Eller, Nafseen, Mostafa, Patrick, M Honoré, Vanesa Mercado Telleria, Jasmina, Smajic, Paula Cristina Nogueira, Khalid Mahmood Khan Nafees, Romuald, Hentchoya, Louise, Rose, Javiera, Soledad, Frances, Lin, Yenny, Cardenas, Amylkar Garay Reyes, Alan, Sustic, Meropi, Mpouzika, Tamas, Vymazal, Hanne Irene Jensen, Hernan, Aguirre-Bermeo, Liivi, Maddison, Maija, Valta, Silvia, Calvino-Gunther, Frank, Bloos, Faustina Excel Adipa, Vasilios, Koulouras, Judy, Enamorado, Zsuzsann, Ágoston, Hrönn, Birgisdóttir, Amit, Gupta, Mohan, Gurjar, Bram, Kilapong, Seyed Mohammadreza Hashemian, Ignacio, Martin-Loeches, Julie, Benbenishty, Andrea, Cortegiani, Kelly, Fletcher, Yoshiro, Hayashi, Wangari, Waweru-Siika, Khalid, Abidi, Sang-Min, Lee, Burhan, Hadri, Mihails, Dolgusevs, Fayez François Abillama, Tomas, Jovaisa, Cyril, Thix, Muhammed, Elhadi, Basri Mat Nor, Shanti, Ratnam, Mohd Zulfakar Mazlan, Sundaresan, Maiyalagan, Luis, Sánchez-Hurtado, Adrian, Belii, Mendsaikhan, Naranpurev, Prabha, Gautam, Dylan De Lange, Rachael, Parke, Rose Ekama Ilesanmi, Mirjana, Shosholcheva, Antonija, Petosic, Ranveig, Lind, Madiha Hashmi Ffarcsi, Javier, Bogarin, Aaron Mark Hernandez, Malgorzata, Mikaszewska-Sokolewicz, Bruno, Sousa, Dana, Tomescu, Dorel, Sandesc, Theogene, Twagirumugabe, Vitaly, Gusarov, Maie, Ebaid, Radmilo, Jankovic, Gari, Slobodianiuk, Andrea, Martonova, Rihard, Knafelj, Mervyn, Mer, Emilio, Maseda, Bernardo, Panka, Joerg, C Schefold, Eva, Joelsson-Alm, Konlawij, Trongtrakul, Lorna, Merritt-Charles, Lamia Ouanes Besbes, Yalım, Dikmen, Lesia, Zgrzheblovska, Mark, Fielding, Francesca, Rubulotta, Ashish, K Khanna, Leif, Saager, Ingrid von der Osten, Alban, Greca, Alma, Cani, Nordian, Xhindi, Genci, Hyska, Antonio Margarit Ribas, Susana, Pinto, Paulo, Alves, Romina, Esposito, Emanuel, Valgolio, John Thomas Sanchez Minope, Antonio, Abdala, Maria, Ayala, Silvina, Bravo, Ana, Bantar, Patricia, Delgado, Gustavo, Badariotti, Fernando, Lipovestky, Ana, Diaz, Pablo, Saul, Mariano, Setten, Alejandra, Aucapina, Ysica, Acosta, Victor, Gonzalez, Luis, Camputaro, Fernando, Baccaro, Robert, Villa, Marcela, Mastantuono, Emiliano, Dean, Oscar Fernández Rostello, Patricia, Brizuela, Julio Ricardo Bartoli, Matias, Guereschi, Cristian, Quiroga, Sofia, Putruele, Paula, Villegas, Veronica, Curilen, Ruben, Fernandez, Mariangeles Gabriela Nocheretti, Rosana Gabriela Escalante, Cecilia Inés Loudet, Silvia, Fernandez, Ana Laura Gonzalez, Gustavo Andres Alvarez, Federico, Iglesias, Silvia, Chaparro, Graciela, Zakalik, Gonzalo, Pagella, Matías, Baini, Pierina Arias Campos, Ignacio, Sabbag, Armando, Schmukler, Imelda Perdomo Fonseca, Gonzalo Martín Alvarez, Mario, Ramirez, Fernando, Tapia, Carlos Alejandro Bascary, Graciela Del Valle Gimenez, Fernando Pablo Bertoletti, Esteban, Milioto, Pablo Julio Maldonaldo Bonsignore, Maria Alejandra Fernandez, Julie, Smith, Tim, Chimunda, Lorraine, Thompson, Teena, Maguire, Wendy, Chaboyer, Stacey, Watts, Marion, Mitchell, Madeleine, Powell, India, Lye, Leanne, Parsons, Nerilee, Baker, Claire, Reynolds, Amy, Thompson, Kristy, Masters, Kellie, Sosnowski, Lynette, Morrison, Gavin, D Leslie, Ramanathan, Lakshmanan, Alexis, Tabah, Wendy, Brown, Sharon, McDowell-Skaines, Andrea, Mclucas, Chris, Smith, Mandy, Tallot, Sarah, Jones, Michelle, Barakat-Johnson, Thomas, Leong, Rand, Butcher, Kerrie, Martin, Philipp, Douschan, Dirk von Lewinski, René, Schmutz, Uta, Kolussi, Fatema, Salman, Zainab, Ateya, Koen De Decker, Niels Van Regenmortel, Anita, Jans, Patricia, Wijnands, Stefano, Coremans, Patrick, M Honore, David De Bels, Tanja, Depuydt, Caroline, Paillet, Luc-Marie, Jacquet, Walter, Swinnen, Francis, Hannes, Matthia, Mergeay, Stijn Van de Velde, Silvie, Allaert, Pieter, Hoste, Christophe, Borin, Sandrine, Balon, Vincent, Fraipont, Patrick, Biston, Nicolas De Schryver, Thierry, Dugernier, Ilse Van Cotthem, Angelica Olivetto de Almeida, Silvia Angelica Jorge, Delmiro, Becker, Raysa Cristina Schmidt, Evellyn, Oliveira, Aline, Ramalho, Eliane, Mazocoli, Audrey, Fioretti, Elaine, Barros, Leticia, Serpa, Suzana, Bianchini, Ticiane, Campanili, Taís, Pantaleao, Paulo Carlos Garcia, Ana Lucia Vitti Ronchini, Rayanne, Santos, Nurulhuda Binti, A Manap, Sean, Bagshaw, Dominic, Carney, Jon, Davidow, Ella, Rokosh, Andréa Maria Laizner, Samantha, Smith, Megan, Mcquirter, Betty Star Kampayana, René, Favre, Martin, Sills, Julie, Dallaire, Cathy, Becker, Sherissa, Microys, Bonnie, Bowes, Jennifer, Lajeunesse, Rishi, Ghosh, Jacqueline, Baptiste-Savoie, Rose, Raizman, Gabriel, Suen, Noushin, Taghavi, Orla, Smith, Clare, Fielding, Julieta, Canales, Pia, Molina, Javiera, Chaparro, Maria Idalia Sepulveda, Matias Jesús Flamm Zamorano, Pamela, Rocha, Ximena, Villanueva, Paola, Araya, Meneses, Dayan, Fernando, Avalos, Xiaohan, Li, Liu, Yu, Xinxia, Li, Xiaoyan, Chen, Zhixia, Jiang, Jing, Yang, Jingfang, Chen, Lei, Yang, Kefang, Wang, Jie, Gao, Xiuhua, Fang, Ronghua, Zhao, Xinhua, Xia, Hongmei, Liu, Jing, Li, Haiyan, Wang, Gen, Meng, Yanhong, Di, Damei, Wang, Rong Hua Zhao, Li Ping Hu, Peipei, Xu, Qing Feng Jiao, Hai Yun Wang, Chun Jie Xia, Yan, Liu, Mei, Ye, Yan, Wan, Wenmei, Wang, Yajun, Ding, Aiua, Ren, Yan, Gao, Qi, Li, Guifang, Du, Yanling, Shen, Yanming, Ding, Ning, Li, Cui, Yuan, Lei, Tan, Qiang, Lin, Hailing, Guo, Howe, Yan, Xiao, Xu, Wei, Zhang, Jinxian, Liang, Libing, Zhang, Eryun, Tian, Qian, Zhao, Lin, Insu, Jingwen, Dong, Yanmei, Gu, Ying, Liu, Lina, Zhao, Wei, Wang, Hongmei, Qiao, Lili, Tuo, Mengmeng, Lv, Jin Yu Zhu, Jifen, Zhu, Ying, Wei, Man, Liu, Yin, He, Jiyin, Cheng, Jin, Liu, Jia, Na, Dongfang, Wei, Qing, Li, Xiaoying, Wu, Huan, Duan, Dongliang, Lin, Qiong, Liang, Xiaofang, Luo, Yunfeng, Xiong, Rong Fen Huang, Jing, Fu, Tao, Zan, Man, Ye, Zeya, Shi, Yanfei, Long, Yang, Lei, Xiaodi, Liu, Chen, Yumei, Lingling, Wang, Yali, Zhang, Yan, Xu, Cheng, Wang, Zhijuan, Chengxia, Sun, Jinhui, Song, Yingli, Wang, Xiumei, Liu, Yupeng, Liu, Yuxia, Yuan, Qingping, Huang, Fengling, Yang, Yun, Wu, Xianping, Luo, Xiaowu, Bai, Hong, Zheng, Min, Song, Yue, Sun, Zhangshuangzi, Li, Feifei, Luo, Miao, Liu, Li Chuntang Li, Xinjian, Li, Guiping, Zhang, Lina, Xiao, Tingting, Yu, Guangyuan, Gao, Wei, Wei, Fanglan, Wang, Ting, Han, Tingting, Li, Zeng, Qi, Jing Mei Zeng, Yan, Long, Fuqun, Pan, Jing, Wang, Guoxue, He, Haiyan, Chen, Feifei, Zhang, Chao, Yu, Gao, Chunhua, Xiuying, Yao, Dongmei, Bai, Liu, Lu, Xuelian, Xu, Yan, Wang, Xuejuan, Liang, Zhang, Na, Aizhi, Zhang, Xiaochun, Hu, Hui, Zhang, Ruixia, Wang, Poon Shing Tak, Sung Wai Ho, Qun Xia 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Guillén, Josep Trenado Alvarez, Mercedes Del Cotillo, Jesus Emilio Barrueco-Francioni, Belen Burgos Conde, Maria Pilar Sogues Blanco, Maria Luisa Blasco, Ana Isabel Clement, Clara, Hurtado, Luz Coronado Sanz, David, Perez-Torres, Estefanía, Prol-Silva, Jorge, Pereira, Iván Areán González, Anastasio Espejo Cano, Cesar Rodriguez Nuñez, Inmaculada Lorenzo Fernadez, Alejandra Azahara Marguello Fernandez, Rosa Del Bosque Diez, Badiola, Hilario, Begoña, Zalba-Etayo, Ana, Pascual-Bielsa, Preveen, Banwarie, Dick, Nahar, Alisha van Axel, Naraindath, N Boedjawan, Erika Backlund Jansson, Ann-Sofie, Malvemyr, Lotta, Johansson, Ulla, Sandberg, Catarina, Tingsvik, Gunilla, Mattsson, Gun, Löf, Martin, Spångfors, Mona, Ringdal, Sebastian, Geijer, Lotti, Orvelius, Mia, Hylen, Caroline, Lagerhäll, Eva, Åkerman, Viveca Hamback Hellkvist, Ulrica, Mickelsson, Ewa, Wahlbom, Ing-Marie, Larsson, Ewa, Wallin, Filippo, Boroli, Solenne, Ory, Margaret Lynn Jong, Alexander, Dullenkopf, Martin, Lang, Yvan, Fleury, Marianne, Maus, Nawfel, Ben-Hamouda, Anne, Fishman, Mei Yu Hsu, Shu Chuan Chang, Konlawij, Trongtratul, Chaiwut, Sawawiboon, Sunthiti, Morakul, Bodin, Khwannimit, Keevan, Singh, Dale, Ventour, Dianne, Figaro-Barclay, Sasha, Sankar-Maharaj, Mhamed Sami Mebazaa, Salma, Kamoun, Souheil, Elatrous, Lamia, Besbes, Fekri, Abroug, Walid, Naija, Youssef Zied Elhechmi, Walid, Sellami, Zied, Hajjej, Takoua, Merhabene, Imen, Talik, Ozlem Ozkan Kuscu, Ozcengiz, Dilek, Avşar, Zerman, Hayriye Cankar Dal, Sema, Turan, Semih, Aydemir, Hakan, Yilmaz, Duygu Kayar Calili, Seval, İzdes, Melike, Cengiz, Ayça, Gümüş, Banu, Taşdemir, Ali, Kağnıcı, Mustafa, Ay, Serap Avcı Ay, Gulbahar, Caliskan, Turkay, Akbas, Abidin Oner Balbay, Serdar, Efe, Volkan, Inal, Gülseren, Elay, Pınar, Karabacak, Boğaç, Özserezli, Evren, Şentürk, Oktay, Demirkiran, Suha, Bozbay, Elif, Erdogan, Mustafa, Akker, Nebia, Peker, Asu, Ozgultekin, Sibel Ocak Serin, Can, Turan, Gulsah, Karaoren, Senay, Goksu, Sait, Karakurt, Huseyin, Arikan, Fethi, Gül, İsmail, Cinel, Iskender, Kara, Hasan Nabi Undar, Yesim Serife Bayraktar, Jale Bengi Çelik, Murat Emre Tokur, Demet Tok Aydin, İsmail, Yildiz, Beysim, Özcan, Başar, Erdivanli, Ahmet, Eroglu, Devrim, Akdağ, Nurdan, Ünlü, Adonis, Dungca, Ashwaq, Ali, Bindu, Thankamma, Paul Eric Reyes, Sini, John, Ajitha, Rajendran, Fatima Kasem El Ahmad, Kathleen Ann Smiley, Susanna, Hojden, Mia Thorning Miller, Vishnu Das Sasidharan Nair, Maria Gracia San Antonio, Khaled Al Qawasmeh, Sabah Abu Shawish, Hilary, Twiggs, Ines, Rosado, Volodymyr, Babych, Faye, Morren, Charlotte, Young, Nicola, Vaughan-Jones, Stephanie, Harris, Karen, Burns, Carmel, Georgiev, Rosina, Shayamano, Ian, Kerslake, Peter, Creber, Ana, Vochin, Catherine, O'Brien, Paul, Caddell, Samantha, Hagan, Mandy, Hughes, Tomasz, Torlinski, James, Sherwin, Santhana, Kannan, Amber, Markham, Richard, Lebon, Jason, Cupitt, Julius, Cranshaw, Nigel, White, Victoria, Marriott, Wendy, Milner, Casiano Barrera Groba, Joao, Azoia, Petra, Polgarova, Shaly, George, Ritoo, Kapoor, Ceri, Lynch, Nathalie, Fox, Karen, Cranmer, Natalie, Fox, Thomas, Llewellym, Kelly, Matthews, Louise, Maltby, Jowena, Ibao, Karen, Boulton, Rachel, Jarman, Karen, Baxter, Ashok Sundai Raj, Arif, Moghal, Joanne, White, Suzanne, Barrowcliffe, Mark, Pulletz, Vaarisan, Ganeshalingam, Rosaleen, Baruah, Carole, Boulanger, Helen, Baker, Justin, Woods, Poe Poe Ei, Vongayi, Ogbeide, Paul, Hayden, Jennifer, Hughes, Madhu, Balasubramanian, Armorel, Salberg, Rajnish, Saha, Dagmar, Holmquist, Claire, Derbyshire, Neil, Smith, Elizabeth, Stones, Jane, Ademokun, Monica, Popescu, Maria Schofield Legorburo, Samantha, North, Carole, Brett, Helen, Jaundoo, Jayne, Craig, Simon, Whiteley, Clare, Howcroft, Liz, Wilby, Peter, Delve, David, Shaw, Karen, Williams, Ingeborg, D Welters, Jane, Mcmullen, Stephen, Brett, Leah, Flores, Treiza, Trueman-Dawkins, Mae, Templeton, John, Adams, Catherine, Smith, John, Prowle, Heather, Byers, Andrea, Mcdonnell, Bernd Oliver Rose, Rosie, Reece-Anthony, Luis, Mendes, Marcela, Vizcaychipi, Rhian, Bull, Grace, Lacaden, Eleanor, Santiago, Carlos Castro Delgado, Sarah, Farnell-Ward, Elaine, Thorpe, Justine, Somerville, Anne, Williams, Donna, Cummings, Helen, Derrick, Sarah, Brumwell, Claire, Randell, Nicola, Mccann, Emma, Aves, Gillian, Berry, Tamas, Szakmany, Una, Gunter, Paul, Pulak, Nikki, Sarkar, Kerry, Wright, Vitor, Gomes, Jones, Jo, Ruth, Palfrey, Julie, Camsooksai, Abby, Lewis, Antony, Eneas, Ascanio, Tridente, Louise, Barr, Beverley, Thomas, Emma, Parkin, Daniel, Horner, Christian, Frey, Suzanne, Bench, Rachel, Baumber, Phil, Broadhurst, Matthew, Jackson, Lynne, Williams, Michele, Clark, Jonathan, Paddle, Sarah, Bean, Sarah, Buckley, Christopher, Palfreeman, Sophie, Liu, Nicola, Allison, Ben, Attwood, Penny, Parsons, Victoria, Houghton, Sarah Jane Turner, David, Higgins, Egidija, Bielskute, Nicola, Horrigan, Reni, Jacob, Karen, Habgood, Ahmed, Zaki, Amy, Collins, Jenny, Lord, Charalice, Ramiro, Agnieszka, 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European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators, Muzha, D., Ribas, A.M., Lipovesty, F., Loudet, C., Coyer, F., Eller, P., Mostafa, N., Honoré, P.M., Telleria, V.M., Smajic, J., Nogueira, P.C., Nafees, KMK, Hentchoya, R., Rose, L., Soledad, J., Lin, F., Cardenas, Y., Reyes, A.G., Sustic, A., Mpouzika, M., Vymazal, T., Jensen, H.I., Aguirre-Bermeo, H., Maddison, L., Valta, M., Calvino-Gunther, S., Bloos, F., Adipa, F.E., Koulouras, V., Enamorado, J., Ágoston, Z., Birgisdóttir, H., Gupta, A., Gurjar, M., Kilapong, B., Hashemian, S.M., Martin-Loeches, I., Benbenishty, J., Cortegiani, A., Fletcher, K., Hayashi, Y., Waweru-Siika, W., Abidi, K., Lee, S.M., Hadri, B., Dolgusevs, M., Abillama, F.F., Jovaisa, T., Thix, C., Elhadi, M., Nor, B.M., Ratnam, S., Mazlan, M.Z., Maiyalagan, S., Sánchez-Hurtado, L., Belii, A., Naranpurev, M., Gautam, P., De Lange, D., Parke, R., Ilesanmi, R.E., Shosholcheva, M., Petosic, A., Lind, R., Ffarcsi, M.H., Bogarin, J., Hernandez, 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A.S., Goller, S., Afonso, E., Larina, E., Labeau, Sonia O. 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X.L., Chen W., Li Y., Zhigang Z., Yuchen W., Mu C., Zhu G., Bo Q., Li L., Chen M., Jiang J.H., Yin H., Pang X., Gong Y.Y., Yang S., Yan X., Zheng X., Lei D.H., Lei L., Guo Y., Yu J., Sun W., Bi A.P., Li W., Ni D., Wu Z., Song B., Fei Q., Xiaoyan Y., Ran Q., Xixi L., Jiao X., Ji H., Zhiping S., Hong M., Jianhong M., Hao Y., Yin L., Hui C., Ju W., Huo Y., Chen L., Yan Y., Bao G., Cao Y., Xu L., Guixiang J., Zhao H.M., Huang X., Dai Z., Jian Y., Tian Z., Cao Z.Q., Li M., Ouyang F., Ma F., Jin W., Ge L., Wu S.F., Yuan W., Chen T., Shi G., Chen Z., Liu K., Lin X., Yuemen L., Lijuan S., Tian X.F., Feng Z.X., Liu X.Z., Dong Y., Bocui N., Jiang Z.X., Wang G.X., Zhao Y., Yang Q., Hu R.L., Li X.Q., Yu Z.J., Yao Y., Deng X., Xiao Y., Xie Y., Yang Y., Yang H., Zhou Y., Li Z., Xiao M., Yang Y.X., Tian Y., Gama L.M.S., Hernandez J.S., Caicedo N., Marin J., Ochoa M.-E., Gomez M., Rojas-Suarez J., Gonzalez J., Reyes A.J.G., Chapeta E., Orozco E., Filipovic-Grcic I., Vukovic A., Pecenkovic S., Suput 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Y., Xia, C. J., Insu, L., Zhu, J. Y., Zhu, J. F., Huang, R. F., Wang, L. L., Song, J. H., Liu, X. M., Li, Z. S., Li, L. C., Zeng, J. M., Hu, X. C., Wang, R. X., Tak, P. S., Ho, S. W., Jiang, Q. X., Huang, L. P., Liu, X. L., Jiang, J. H., Gong, Y. Y., Lei, D. H., Bi, A. P., Zhao, H. M., Cao, Z. Q., Wu, S. F., Tian, X. F., Feng, Z. X., Liu, X. Z., Jiang, Z. X., Wang, G. X., Hu, R. L., Li, X. Q., Yu, Z. J., Yang, Y. X., Gama, L. M. S., Hernandez, J. S., Ochoa, M. -E., Reyes, A. J. G., Filipovic-Grcic, I., Vukovic, A., Pecenkovic, S., Suput, A., Radivojevic, R. C., Culjak, H., Adam, V. N., Pedersen, K. R., Kjaergard, I. E., Kodal, A. M., Hansen, T. C. B., Pedersen, A. S. B., Thomsen, T. D., Frandsen, T. M., Bliksted, I. A., Tamayo, L. M., Tutillo, D. R. M., Hurtado, C. V., Garcia, M. F., Kutimets, M., Lofqvist, C., Sakki, J. -K., Valta, M. A., Plantefeve, G., Deserts, M. D., Gunther, S. C., Timsit, J. -F., Farkas, J. -C., Bosl, K., Schuppel, S., Stubner, A., Osei, I. P., Kusi-Appiah, A. -C., Yakubu, Y. H., Patsiou, E. -C., Stalika, K. M. M., Enamorado, J. E., Jonasdottir, R. J., Lestari, M. I., Finn, D. O. C. R., Mcpherson, S., Ghioldi, D. M., Bruno, A. V., Maggiore, S. M., Volta, C. A., Taibi, M. R., Tranello, F. P., Giusti, G. D., Martin, M. A., Correia, M. C., Kim, J. H., Kim, K. C., Bae, J. -M., Park, S. Y., Park, T. S., Lee, H. B., Kim, S. C., Chee, H. K., Huh, J. W., Sim, Y. S., Ahn, J. -J., Kang, B. J., Lee, W. -Y., Lee, S. J., Feghaly, M. E., Belkhair, W. A., Tababa, O. W. E., Alkhumsi, S. I. R., Alshrif, A. I., Aboufray, A. A., Triki, A. R., Zahra, H. B., Al-Alawi, M. M. S., Ghula, M. A. A., Bahrin, L. K. K., Deva, S. R., Rahim, A. H. A., Hassan, W. N. W., Ismail, W. N. W., Ali, M. N., Khoo, T. M., Samat, N. M., Tong, J. M. G., Adib, N. A. N., Nor, M. B. M., Sulaiman, S. R., Foong, K. W., Hua, N. P., Zermeno, J. M., Nava, C. L. L., Nandyelly, S. J. R., Sanchez-Hurtado, L. A., Nava, L. P. A., Herrera, J. G., de Anda, G. F. V., Namendys-Silva, S. A., Romero-Gonzalez, J. P., Sosa, M. A., de Molina Serrano, J. I. R., Iburrigarro, S. R., Padilla, N. R. C., Pineda, A. A. V., Villafuerte, M. V. E., Herrera, M. O. G., Subedi, N. B., Pathak, S. D., Vermeijden, J. W., Gerritsen, R. T., Fijen, J. -W., Adejumo, P. O., Sankey, B. J., Olsen, B. F., Jensen, K. D., Johansen, B. F., Finnstrom, I. J., Skorstad, E. M., Lunde, G. A., Akselsen, G. R., Monstad, K. R., Hogvall, L., Malmin, S. K., Andersen, M. H., Hargott, R. F., de Jesus Ortiz, A., Cabral, D. M. B., Rivas, J. C., Moreira, M. L., Ellazar, C. G., Cerezo, F. D., Palo, J. E., Aperocho, C. A. J., Figueiredo, M. F., Pinheiro, C. M., Rita, C. S., Feranandes, A. M., Pinto, V. M. V., Bispo, B. M., Lima, A., Alsheikhly, A. S., Guran, C. T., Filipescu, D. C., Scutariu, M. A., Ebaid, M. S., Velickovic, D., Rajkovic, M., Stanojevic, M., Turcan, A., Lancaricova, D., Yeni, N. P., Syed, M. R., Navarro, J. A., De Pablo, A. M., Llinas, A. A., Lajara, M. A. G., Nieto, M. V., Pena, J. M. G., Gorgolas, M. C., Isasi, M. A., Salva-Costa, V., Garzon-Tovar, C., Olivares, P. G., de Ceballos, J. P. G., Polo, A. B. C., del Mar Diaz Salcedo, M., Alvarez, J. D., Arcas, M. L. B., Gonzalez, J. I. T., de la Ventana, A. B. S., Calleja, P. L. -A., Alvarez, R. G., Zamora, P. S., Guerrero, A. O., Barreiro, E. M., Sanchez, L. C., Diaz, M. G., Muriel, D. S., Alonso, H. F., Fernandez, A. W., Pinan, I. S., Albaiceta, G. M., Fernandez, M. C. I., Abos, F. J. S., Chueca, R. M., Aguirre, L. G., Manosa, S. C., Luque, C. P., Losilla, M. R., Fores, M. T., del Rosario Villar Redondo, M., Arteta Arteta, D. S., Sanchez, M. A. H., Espinosa, C. P., Reyes, L. M., Domenech, L. C., Guillen, C. V., Alvarez, J. T., del Cotillo, M., Barrueco-Francioni, J. E., Conde, B. B., Blanco, M. P. S., Blasco, M. L., Clement, A. I., Sanz, L. C., Gonzalez, I. A., Cano, A. E., Nunez, C. R., Fernadez, I. L., Fernandez, A. A. M., Boedjawan, N. N., Jansson, E. B., Malvemyr, A. -S., Lof, G., Spangfors, M., Lagerhall, C., Akerman, E., Hellkvist, V. H., Larsson, I. -M., Jong, M. L., Hsu, M. Y., Chang, S. C., Mebazaa, M. S., Elhechmi, Y. Z., Kuscu, O. O., Dal, H. C., Calili, D. K., Izdes, S., Gumus, A., Tasdemir, B., Kagnici, A., Ay, S. A., Balbay, A. O., Ozserezli, B., Senturk, E., Serin, S. O., Gul, F., Cinel, I., Undar, H. N., Bayraktar, Y. S., Celik, J. B., Tokur, M. E., Aydin, D. T., Yildiz, I., Ozcan, B., Akdag, D., Unlu, N., Reyes, P. E., Ahmad, F. K. E., Smiley, K. A., Miller, M. T., Antonio, M. G. S., Qawasmeh, K. A., Shawish, S. A., Groba, C. B., Raj, A. S., Ei, P. P., Legorburo, M. S., Welters, I. D., Mcmullen, J., Mcdonnell, A., Rose, B. O., Delgado, C. C., Mccann, N., Turner, S. J., Rodriguez, G. E., Eltorai, A. S., Pastores, S. M., Demarre, L., and Debue, A. -S.

Subjects
Male, Original, medicine.medical_treatment, artificial, Critical Care and Intensive Care Medicine, Medical and Health Sciences, Pressure ulcer, law.invention, Decubitus epidemiology, ICU, Morbidity, Mortality, Outcome, Pressure injury, Risk factors, Adult, Aged, Hospital Mortality, Humans, Patient Discharge, Prevalence, Risk Factors, Intensive Care Units, Respiration, Artificial, 0302 clinical medicine, decubitus epidemiology, pressure injury, pressure ulcer, outcome, risk factors, morbidity, mortality, law, Medicine and Health Sciences, adults, Medicine, Simplified Acute Physiology Score, icu, ziekenhuissterfte, Immunodeficiency, intensive care, European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators, mannen, volwassenen, COST, Intensive care unit, STATE, ULCERS, Underweight, medicine.symptom, Life Sciences & Biomedicine, Human, medicine.medical_specialty, risicofactoren, Decubitus epidemiology, ICU, Pressure injury, Pressure ulcer, Outcome, Risk factors, Morbidity, Mortality, pressure injuries, Intensive Care Unit, prevalentie, NO, 1117 Public Health and Health Services, DecubICUs Study Team, 03 medical and health sciences, Critical Care Medicine, Anesthesiology, General & Internal Medicine, Health Sciences, ouderen, Mechanical ventilation, Science & Technology, business.industry, decubitus, Risk Factor, 030208 emergency & critical care medicine, 1103 Clinical Sciences, Odds ratio, medicine.disease, Emergency & Critical Care Medicine, Confidence interval, 030228 respiratory system, Emergency medicine, kunstmatige ademhaling, RISK-FACTORS, business, respiration
Abstract

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347, Funder: Flemish Society for Critical Care Nurses, Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score < 19, ICU stay > 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat.

Published
2021
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21. Implementing pain, agitation, delirium, and sleep deprivation protocol in critically ill patients: A pilot study on pharmacological interventions.

Author

Luetrakool P, Taesotikul S, Susantitapong K, Suthisisang C, Morakul S, Sutherasan Y, Tangsujaritvijit V, and Dilokpattanamongkol P

Subjects
Humans, Pilot Projects, Prospective Studies, Retrospective Studies, Sleep Deprivation drug therapy, Pain diagnosis, Pain drug therapy, Observational Studies as Topic, Critical Illness therapy, Delirium drug therapy, Delirium etiology
Abstract

Critically ill patients frequently experience pain, agitation, delirium, and sleep deprivation, which have been linked to increased mortality and unfavorable clinical outcomes. To address these challenges, the Pain, Agitation, Delirium, and Sleep Deprivation (PADS) protocol was developed, aiming to mitigate mortality and improve clinical outcomes. This study focuses on assessing the protocol's impact using a robust before-and-after study design in the medical and surgical intensive care units (ICUs) at Ramathibodi Hospital. Using an observational approach, this study compares clinical outcomes before and after implementing the PADS protocol in the ICUs. Two patient cohorts were identified: the "before" group, comprising 254 patients with retrospective data collected between May 2018 and September 2019, and the "after" group, consisting of 255 patients for whom prospective data was collected from May to September 2020. Analysis reveals improvements in the after group. Specifically, there was a significant increase in 14-day ICU-free days (9.95 days vs. 10.40 days, p value = 0.014), a decrease in delirium incidence (18.1% vs. 16.1%, p value < 0.001), and a significant reduction in benzodiazepine usage (38.6% vs. 24.6%, p value = 0.001) within the after group. This study emphasizes the protocol's potential to improve patient care and highlights its significance in the ICU context., (© 2024 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.)

Published
2024
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22. Effect of Temperatures on Cyclic Fatigue Resistance of 3 Different Ni-Ti Alloy Files.

Author

Hiran-Us S and Morakul S

Subjects
Humans, Temperature, Nickel, Root Canal Preparation, Materials Testing, Equipment Failure, Gold, Equipment Design, Stress, Mechanical, Alloys, Titanium
Abstract

Objective: The aim of this study was to investigate and compare the effect of temperature on the cyclic fatigue resistance of conventional (ProTaper Universal [PTU]), Gold-Wire (ProTaper Gold [PTG]), and Fire-Wire (EdgeTaper Platinum [ETP]) nickel-titanium alloy files., Method: Twenty files from each system were tested for cyclic fatigue resistance in an artificial canal model. The experiments were performed at room temperature and body temperature in controlled temperature water. Magnified videos were recorded using a dental operating microscope integrated camera during testing to detect file fracture. The number of cycles to failure (NCF) was calculated. The type of failure was investigated macroscopically and microscopically with a dental operating microscope and scanning electron microscope, respectively., Result: The NCF at room temperature was significantly higher compared with body temperature in each system (P < .001). Compared at the same temperature, the ETP group demonstrated the highest NCF, followed by the PTG and PTU groups (P < .001). All files demonstrated cyclic fatigue failure macroscopically and microscopically., Conclusions: The 3 alloy files were affected by temperature. The cyclic fatigue resistance was reduced at the higher temperature and increased at the lower temperature. If the files are geometrically identical, files made of Fire-Wire are preferred compared with Gold-Wire and conventional nickel-titanium alloys based on cyclic fatigue resistance., Competing Interests: Conflict of interest The authors have no competing interests related to this article., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2023
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23. Long-term outcomes of delirium in critically ill surgical patients: A multicenter prospective cohort study.

Author

To-Adithep P, Chittawatanarat K, Mueankwan S, Morakul S, Luetrakool P, Dilokpattanamongkol P, Thanakiattiwibun C, and Chaiwat O

Subjects
Humans, Aged, Prospective Studies, Critical Illness, Intensive Care Units, Risk Factors, Emergence Delirium, Dementia
Abstract

Objective: To identify the mortality rates and dependency rate (functional outcomes) of delirious patients at 12-months after surgical intensive care unit (SICU) admission and to determine the independent risk factors of 12-months mortality and dependency rate in a cohort of SICU patients., Methods: A prospective, multi-center study was conducted in 3 university-based hospitals. Critically-ill surgical patients who were admitted to SICU and followed-up at 12-months after ICU admission were enrolled., Results: A total of 630 eligible patients were recruited. 170 patients (27%) had postoperative delirium (POD). The overall 12-months mortality rate in this cohort was 25.2%. Delirium group showed significantly higher mortality rates than non-delirium group at 12-months after ICU admission (44.1% vs 18.3%, P < 0.001). Independent risk factors of 12-months mortality were age, diabetes mellitus, preoperative dementia, high Sequential Organ Failure Assessment (SOFA) score and POD. POD was associated with 12-months mortality (adjusted hazard ratio, 1.49; 95% confidence interval 1.04-2.15; P = 0.032). The dependency rate defined as the Basic Activities Daily Living (B-ADL) ≤70 was 52%. Independent risk factors of B-ADL were age ≥ 75 years, cardiac disease, preoperative dementia, intraoperative hypotension, on mechanical ventilator and POD. POD was associated with dependency rate at 12-months. (adjusted risk ratio, 1.26; 95%CI 1.04-1.53; P = 0.018)., Conclusions: Postoperative delirium was an independent risk factor of death and was also associated with dependent state at 12 months after a surgical intensive care unit admission in critically ill surgical patients., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to disclose., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Published
2023
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24. Validation of a delirium predictive model in patients admitted to surgical intensive care units: a multicentre prospective observational cohort study.

Author

Chaiwat O, Chittawatanarat K, Mueankwan S, Morakul S, Dilokpattanamongkol P, Thanakiattiwibun C, and Siriussawakul A

Subjects
Adult, Aged, Aged, 80 and over, Critical Care, Critical Illness, Humans, Middle Aged, Prospective Studies, Delirium diagnosis, Delirium epidemiology, Delirium etiology, Intensive Care Units
Abstract

Objective: To internally and externally validate a delirium predictive model for adult patients admitted to intensive care units (ICUs) following surgery., Design: A prospective, observational, multicentre study., Setting: Three university-affiliated teaching hospitals in Thailand., Participants: Adults aged over 18 years were enrolled if they were admitted to a surgical ICU (SICU) and had the surgery within 7 days before SICU admission., Main Outcome Measures: Postoperative delirium was assessed using the Thai version of the Confusion Assessment Method for the ICU. The assessments commenced on the first day after the patient's operation and continued for 7 days, or until either discharge from the ICU or the death of the patient. Validation was performed of the previously developed delirium predictive model: age+(5×SOFA)+(15×benzodiazepine use)+(20×DM)+(20×mechanical ventilation)+(20×modified IQCODE>3.42)., Results: In all, 380 SICU patients were recruited. Internal validation on 150 patients with the mean age of 75±7.5 years resulted in an area under a receiver operating characteristic curve (AUROC) of 0.76 (0.683 to 0.837). External validation on 230 patients with the mean age of 57±17.3 years resulted in an AUROC of 0.85 (0.789 to 0.906). The AUROC of all validation cohorts was 0.83 (0.785 to 0.872). The optimum cut-off value to discriminate between a high and low probability of postoperative delirium in SICU patients was 115. This cut-off offered the highest value for Youden's index (0.50), the best AUROC, and the optimum values for sensitivity (78.9%) and specificity (70.9%)., Conclusions: The model developed by the previous study was able to predict the occurrence of postoperative delirium in critically ill surgical patients admitted to SICUs., Trial Registration Number: Thai Clinical Trail Registry (TCTR20180105001)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2022
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25. Prediction of Fluid Responsiveness by the Effect of the Lung Recruitment Maneuver on the Perfusion Index in Mechanically Ventilated Patients During Surgery.

Author

Morakul S, Prachanpanich N, Permsakmesub P, Pinsem P, Mongkolpun W, and Trongtrakul K

Abstract

Introduction: Excessive or inadequate fluid administration during perioperative period affects outcomes. Adjustment of volume expansion (VE) by performing fluid responsiveness (FR) test plays an important role in optimizing fluid infusion. Since changes in stroke volume (SV) during lung recruitment maneuver (LRM) can predict FR, and peripheral perfusion index (PI) is related to SV; therefore, we hypothesized that the changes in PI during LRM (ΔPI LRM ) could predict FR during perioperative period., Methods: Patients who were scheduled for elective non-laparoscopic surgery under general anesthesia with a mechanical ventilator and who required VE (250 mL of crystalloid solution infusion over 10 min) were included. Before VE, LRM was performed by a continuous positive airway pressure of 30 cm H 2 O for 30 sec; hemodynamic variables with their changes (PI, obtained by pulse oximetry; and ΔPI LRM , calculated by using [(PI before LRM-PI after LRM)/PI before LRM] * 100) were obtained before and after LRM. After SV (measured by esophageal doppler) and PI had returned to the baseline values, VE was infused, and the values of these variables were recorded again, before and after VE. Fluid responders (Fluid-Res) were defined by an increase in SV ≥10% after VE. Receiver operating characteristic curves of the baseline values and ΔPI LRM were constructed and reported as areas under the curve (AUC) with 95% confidence intervals, to predict FR., Results: Of 32 mechanically ventilated adult patients included, 13 (41%) were in the Fluid-Res group. Before VE and LRM, there were no differences in the mean arterial pressure (MAP), heart rate, SV, and PI between patients in the Fluid-Res and fluid non-responders (Fluid-NonRes) groups. After LRM, SV, MAP, and, PI decreased in both groups, ΔPI LRM was greater in the Fluid-Res group than in Fluid-NonRes group (55.2 ± 17.8% vs. 35.3 ± 17.3%, p < 0.001, respectively). After VE, only SV and cardiac index increased in the Fluid-Res group. ΔPI LRM had the highest AUC [0.81 (0.66-0.97)] to predict FR with a cut-off value of 40% (sensitivity 92.3%, specificity 73.7%)., Conclusions: ΔPI LRM can be applied to predict FR in mechanical ventilated patients during the perioperative period., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Morakul, Prachanpanich, Permsakmesub, Pinsem, Mongkolpun and Trongtrakul.)

Published
2022
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26. Fatal Air Embolism after Choroidal Melanoma Endoresection without Air Infusion: A Case Report.

Author

Rojanaporn D, Tipsuriyaporn B, Chulalaksiriboon P, Virankabutra T, Morakul S, and Damato B

Abstract

Background: The aim of this study was to report 2 cases of pulmonary air embolism developing several hours after choroidal melanoma endoresection without the use of air infusion during the surgery, with fatality in 1 patient., Methods: The method of this study was case report., Participants: Two patients with large choroidal melanomas who collapsed several hours after endoresection without air infusion as a result of pulmonary air embolism., Results: A 72-year-old man collapsed 4 h and 30 min after endoresection without air infusion. Computerized tomography angiography confirmed air embolism. The patient died after 86 min of cardiopulmonary resuscitation. A 41-year-old woman collapsed 5 h and 30 min after endoresection, performed without air infusion and with close monitoring, which included right internal jugular vein catheterization intraoperatively. Transthoracic and transesophageal echography, performed preoperatively, intraoperatively, and postoperatively, revealed air embolism only after collapse occurred. Imaging showed the embolism to be biventricular because of patent foramen ovale. The patient was treated promptly with extracorporeal membrane oxygenation and mechanical ventilation, which resulted in a full recovery., Conclusions: Air embolism can develop after endoresection for choroidal melanoma, despite avoiding air infusion. Further studies are needed to understand how this occurs. Special measures are indicated to detect this complication and to treat it promptly and effectively., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2021 by S. Karger AG, Basel.)

Published
2021
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27. Effectiveness of securing central venous catheters with topical tissue adhesive in patients undergoing cardiac surgery: a randomized controlled pilot study.

Author

Prachanpanich N, Morakul S, and Kiatmongkolkul N

Subjects
Administration, Topical, Female, Humans, Jugular Veins, Male, Middle Aged, Pilot Projects, Cardiac Surgical Procedures, Central Venous Catheters, Hemorrhage prevention & control, Postoperative Complications prevention & control, Tissue Adhesives administration & dosage
Abstract

Background: Central venous catheters (CVCs) play an important role during cardiac surgery. Topical tissue adhesives form a thin film of coating that becomes bound to keratin in the epidermis. The advantage of this "super glue" lies in its antimicrobial activity. This study aimed to evaluate fixation of CVCs with topical tissue adhesive in patients (prone to bleed) undergoing cardiac surgery regarding its ability to reduce the incidence of pericatheter leakage., Methods: This randomized controlled trial included 150 patients > 15 years of age who were (1) scheduled to undergo elective cardiac surgery, (2) required CVC insertion at the internal jugular vein, and (3) scheduled for transfer postoperatively to the cardiac intensive care unit. We randomly assigned patients to a topical tissue adhesive group (TA) or a standard control group (SC). The primary outcome was a change in dressing immediately postoperatively due to pericatheter blood oozing. Secondary outcomes were the number of dressings, total dressings per catheter day, and composite outcome of catheter failure within 3 days. Both intention-to-treat and per-protocol analyses were performed. Seven patients violated the protocol (three TA patients and four SC patients)., Results: Regarding the primary outcome, the SC group exhibited a significantly increased incidence of dressing change immediately postoperatively due to pericatheter leakage compared with the TA group in both the intention-to-treat analysis (5.33% vs 18.67%, RR 0.25 [95% CI 0.08 to 0.79], P = 0.012) and the per-protocol analysis (5.56% vs 16.90%, RR 0.289 [95% CI 0.09 to 0.95], P = 0.031). No significant differences were noted in the number of dressings, total dressings per catheter day, or composite outcome of catheter failure within 3 days between the two groups. Multiple logistic regression analysis was performed to adjust baseline characteristics that were different in the per-protocol analysis. The results showed that the risk ratio of immediate postoperative dressing change in TA patients was 0.25 compared to the SC group ([95% CI 0.07 to 0.87], P = 0.029) in the per-protocol analysis., Conclusion: The use of a topical tissue adhesive can reduce the incidence of immediate postoperative pericatheter blood oozing., Trial Registration: TCTR20180608004 , retrospectively registered on June 06, 2018.

Published
2021
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28. Effects of thiamine on vasopressor requirements in patients with septic shock: a prospective randomized controlled trial.

Author

Petsakul S, Morakul S, Tangsujaritvijit V, Kunawut P, Singhatas P, and Sanguanwit P

Subjects
Adult, Aged, Aged, 80 and over, Double-Blind Method, Female, Humans, Male, Middle Aged, Organ Dysfunction Scores, Prospective Studies, Shock, Septic mortality, Shock, Septic drug therapy, Thiamine pharmacology, Vasoconstrictor Agents therapeutic use
Abstract

Background: Thiamine, an essential vitamin for aerobic metabolism and glutathione cycling, may decrease the effects of critical illnesses. The objective of this study was to determine whether intravenous thiamine administration can reduce vasopressor requirements in patients with septic shock., Methods: This study was a prospective randomized double-blind placebo-controlled trial. We included adult patients with septic shock who required a vasopressor within 1-24 h after admission between March 2018 and January 2019 at a tertiary hospital in Thailand. Patients were divided into two groups: those who received 200 mg thiamine or those receiving a placebo every 12 h for 7 days or until hospital discharge. The primary outcome was the number of vasopressor-free days over 7 days. The pre-defined sample size was 31 patients per group, and the study was terminated early due to difficult recruitment., Results: Sixty-two patients were screened and 50 patients were finally enrolled in the study, 25 in each group. There was no difference in the primary outcome of vasopressor-free days within the 7-day period between the thiamine and placebo groups (mean: 4.9 days (1.9) vs. 4.0 days (2.7), p = 0.197, mean difference - 0.9, 95% CI (- 2.9 to 0.5)). However, the reductions in lactate (p = 0.024) and in the vasopressor dependency index (p = 0.02) at 24 h were greater among subjects who received thiamine repletion vs. the placebo. No statistically significant difference was observed in SOFA scores within 7 days, vasopressor dependency index within 4 days and 7 days, or 28-day mortality., Conclusions: Thiamine was not associated to a significant reduction in vasopressor-free days over 7-days in comparison to placebo in patients with septic shock. Administration of thiamine could be associated with a reduction in vasopressor dependency index and lactate level within 24 h. The study is limited by early stopping and low sample size., Trial Registration: TCTR, TCTR20180310001. Registered 8 March 2018, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=3330 .

Published
2020
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29. Induction of mutation in Monascus purpureus isolated from Thai fermented food to develop low citrinin-producing strain for application in the red koji industry.

Author

Ketkaeo S, Sanpamongkolchai W, Morakul S, Baba S, Kobayashi G, and Goto M

Subjects
Fermentation, Lipase metabolism, Monascus enzymology, Monascus metabolism, Mutagenesis, Peptide Hydrolases metabolism, Pigments, Biological biosynthesis, Thailand, alpha-Amylases metabolism, Citrinin biosynthesis, Fermented Foods microbiology, Monascus genetics, Oryza microbiology
Abstract

Red koji is produced from cultivating rice with Monascus strains that contain various types of fungal secondary metabolites, such as red pigments and monacolin K. Monascus strain also produces citrinin-a mycotoxin. In this study, Monascus purpureus KUPM5 isolated from the Thai fermented food, sufu, was mutagenized to reduce its citrinin production using UV irradiation, NTG treatment, and a combination of UV and NTG. Screening of the mutants using plate bioassay based on the inhibitory effect against Bacillus subtilis enables the selection of 10 mutants. The mutant strains KS301U and KS302U showed an 80% reduction in citrinin production in red koji compared with the wild type (wt), and maintained the ability to produce red pigments similar to the wild type. Activities of enzymes, α-amylase, protease, and lipase, from red koji extract produced by the mutant strain KS302U, were higher than those of the wt, whereas those of the mutant strain KS301U were similar to those of the wt. Consequently, strains KS301U and KS302U were successfully selected as strains suitable for producing red koji and fermented food.

Published
2020
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30. Relationship between Abdominal Circumference and Incidence of Hypotension during Cesarean Section under Spinal Anesthesia.

Author

Thomard P, Morakul S, Wirachpisit N, Ittichaikulthol W, and Pisitsak C

Abstract

Background: Enlarged uterus can compress the inferior vena cava and cause hypotension when lying supine. Previous studies have shown a positive association between the abdominal circumference and size of the uterus. Therefore, the aim of this study was to evaluate the relationship between abdominal circumference and incidence of hypotension during cesarean section under spinal anesthesia., Methods: The study cohort comprised women undergoing cesarean section under spinal anesthesia. Patients were divided into two groups according to the median abdominal circumference (<101 cm and ≥101 cm). Hypotension was defined as a systolic blood pressure of <90 mmHg or mean arterial pressure of <65 mmHg. The primary outcome of this study was the relationship between the incidence of hypotension and the abdominal circumference after spinal anesthesia in term pregnant women., Results: The study cohort comprised 100 women. The incidence of hypotension did not differ between the groups (71.42% in the smaller vs. 78.43% in the larger abdominal circumference group, p =0.419). However, the decrease in mean arterial pressure and its percentage decrease from baseline were greater in the larger than in the smaller abdominal circumference group (change in mean arterial pressure: 28.33 mmHg (18.66-33.67) in the smaller vs. 36.67 mmHg (23.34-43.34) in the larger abdominal circumference group, p =0.004; percentage decrease: 31.41% (22.74-39.22) in the smaller vs. 38.47% (28.00-44.81) in the larger abdominal circumference group, p =0.022)., Conclusions: Large abdominal circumference in pregnancy is associated with greater decreases in mean arterial pressure from baseline. However, the incidence of hypotension defined by standard criteria did not differ between larger and smaller abdominal circumference groups., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Pattaraleeya Thomard et al.)

Published
2020
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31. Acute kidney injury risk prediction score for critically-ill surgical patients.

Author

Trongtrakul K, Patumanond J, Kongsayreepong S, Morakul S, Pipanmekaporn T, Akaraborworn O, and Poopipatpab S

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Intensive Care Units, Logistic Models, Male, Middle Aged, Organ Dysfunction Scores, Risk, Acute Kidney Injury etiology, Critical Illness
Abstract

Background: There has been a global increase in the incidence of acute kidney injury (AKI), including among critically-ill surgical patients. AKI prediction score provides an opportunity for early detection of patients who are at risk of AKI; however, most of the AKI prediction scores were derived from cardiothoracic surgery. Therefore, we aimed to develop an AKI prediction score for major non-cardiothoracic surgery patients who were admitted to the intensive care unit (ICU)., Methods: The data of critically-ill patients from non-cardiothoracic operations in the Thai Surgical Intensive Care Unit (THAI-SICU) study were used to develop an AKI prediction score. Independent prognostic factors from regression analysis were included as predictors in the model. The outcome of interest was AKI within 7 days after the ICU admission. The AKI diagnosis was made according to the Kidney Disease Improving Global Outcomes (KDIGO)-2012 serum creatinine criteria. Diagnostic function of the model was determined by area under the Receiver Operating Curve (AuROC). Risk scores were categorized into four risk probability levels: low (0-2.5), moderate (3.0-8.5), high (9.0-11.5), and very high (12.0-16.5) risk. Risk of AKI was presented as likelihood ratios of positive (LH+)., Results: A total of 3474 critically-ill surgical patients were included in the model; 333 (9.6%) developed AKI. Using multivariable logistic regression analysis, older age, high Sequential Organ Failure Assessment (SOFA) non-renal score, emergency surgery, large volume of perioperative blood loss, less urine output, and sepsis were identified as independent predictors for AKI. Then AKI prediction score was created from these predictors. The summation of the score was 16.5 and had a discriminative ability for predicting AKI at AuROC = 0.839 (95% CI 0.825-0.852). LH+ for AKI were: low risk = 0.117 (0.063-0.200); moderate risk = 0.927 (0.745-1.148); high risk = 5.190 (3.881-6.910); and very high risk = 9.892 (6.230-15.695), respectively., Conclusions: The function of AKI prediction score to predict AKI among critically ill patients who underwent non-cardiothoracic surgery was good. It can aid in early recognition of critically-ill surgical patients who are at risk from ICU admission. The scores could guide decision making for aggressive strategies to prevent AKI during the perioperative period or at ICU admission., Trial Registration: TCTR20190408004, registered on April 4, 2019.

Published
2020
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32. Nutritional improvement of copra meal using mannanase and Saccharomyces cerevisiae .

Author

Kraikaew J, Morakul S, and Keawsompong S

Abstract

Copra meal is a by-product of coconut milk extraction, contained 4.60 ± 0.01 g/100 g DM and 62.19 ± 0.53% of protein and fiber, respectively. The optimal condition for quality improvement of copra meal was investigated using Box-Behnken design combined with response surface methodology (RSM). The simultaneous saccharification and fermentation (SSF) of Copra meal was performed by mannanase enzyme and yeast, Saccharomyces cerevisiae . The concentration of mannanase was determined as the most important factor to increase protein content in copra meal. The protein content was increased by 64% when 0.7% of enzyme per copra meal dry weight, the ratio of copra meal to water at 1:4.56 and fermentation time of 90.25 h at 30 °C were used. The program predicted an increase of 3.06 g of protein/100 g dry matter; however, the experimental result showed an increase of 3.35 g/100 g DM of protein in copra meal. The 10 kg of copra meal SSF in Koji reactor, the protein content increased to 4.18 g/100 g DM, while fiber content decreased 49%. Moreover, amino acids were increased by 64.05% and oligosaccharides, especially mannohexaose, were increased to 0.708 g/g DM. Results showed that fermentation of copra meal with mannanase and yeast offers a potential method to improve the nutrition of copra meal as animal feed., Competing Interests: Conflict of interestOn behalf of all authors, the corresponding author states that there is no conflict of interest., (© King Abdulaziz City for Science and Technology 2020.)

Published
2020
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33. Enhancement effect on antibacterial property of gray titania coating by plasma-sprayed hydroxyapatite-amino acid complexes during irradiation with visible light.

Author

Morakul S, Otsuka Y, Ohnuma K, Tagaya M, Motozuka S, Miyashita Y, and Mutoh Y

Abstract

The aim of this study was to reveal the mechanism of enhancement of antibacterial properties of gray titania by plasma-sprayed hydroxyapatite (HAp)-amino acid fluorescent complexes under irradiation with visible light. Although visible-light-sensitive photocatalysts are applied safely to oral cavities, their efficacy is not high because of the low energy of irradiating light. This study proposed a composite coating containing HAp and gray titania. HAp itself functioned as bacteria catchers and gray titania released antibacterial radicals by visible-light irradiation. HAp-amino acid fluorescent complexes were formed on the surface of the composite coating in order to increase light intensity to gray titania by fluorescence, based on an idea bioinspired by deep-sea fluorescent coral reefs. A cytotoxicity assay on murine osteoblastlike cells revealed that biocompatibility of the HAp-amino acid fluorescent complexes was identical with the that of HAp. Antibacterial assays involving Escherichia coli showed that the three types of HAp-amino acid fluorescent complexes and irradiation with three types of light-emitting diodes (blue, green, and red) significantly decreased colony-forming units. Furthermore, kelvin probe force microscopy revealed that the HAp-amino acid fluorescent complexes preserved the surface potentials even after irradiation with visible light, whereas those of HAp were significantly decreased by the irradiation. Such a preservative effect of the HAp-amino acid fluorescent complexes maintained the bacterial-adhesion performance of HAp and consequently enhanced the antibacterial action of gray titania.

Published
2019
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34. Prediction of massive transfusion in trauma patients in the surgical intensive care units (THAI-SICU study).

Author

Akaraborworn O, Chaiwat O, Chatmongkolchart S, Kitsiripant C, Chittawatanarat K, Morakul S, Thawitsri T, Wacharasint P, Poopipatpab S, Chau-In W, and Kusumaphanyo C

Subjects
Adult, Aged, Blood Loss, Surgical statistics & numerical data, Female, Forecasting, Humans, Intraoperative Care statistics & numerical data, Male, Middle Aged, Prospective Studies, Thailand, Blood Transfusion statistics & numerical data, Critical Care, Intensive Care Units, Wounds and Injuries therapy
Abstract

Purpose: After damage control surgery, trauma patients are transferred to intensive care units to restore the physiology. During this period, massive transfusion might be required for ongoing bleeding and coagulopathy. This research aimed to identify predictors of massive blood transfusion in the surgical intensive care units (SICUs)., Methods: This is an analysis of the THAI-SICU study which was a prospective cohort that was done in the 9-university-based SICUs in Thailand. The study included only patients admitted due to trauma mechanisms. Massive transfusion was defined as received ≥10 units of packed red blood cells on the first day of admission. Patient characteristics and physiologic data were analyzed to identify the potential factors. A multivariable regression was then performed to identify the significant model., Results: Three hundred and seventy patients were enrolled. Sixteen patients (5%) received massive transfusion in the SICUs. The factors that significantly predicted massive transfusion were an initial sequential organ failure assessment (SOFA) ≥9 (risk difference (RD) 0.13, 95% confidence interval (CI): 0.03-0.22, p = 0.01); intra-operative blood loss ≥ 4900 mL (RD 0.33, 95% CI: 0.04-0.62, p = 0.02) and intra-operative blood transfusion ≥ 10 units (RD 0.45, 95% CI: 0.06 to 0.84, p = 0.02). The probability to have massive transfusion was 0.976 in patients who had these 3 factors., Conclusion: Massive blood transfusion in the SICUs occurred in 5%. An initial SOFA ≥9, intra-operative blood loss ≥4900 mL, and intra-operative blood transfusion ≥10 units were the significant factors to predict massive transfusion in the SICUs., (Copyright © 2019 Chinese Medical Association. Production and hosting by Elsevier B.V. All rights reserved.)

Published
2019
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35. Effects of nutrition factors on mortality and sepsis occurrence in a multicenter university-based surgical intensive care unit in Thailand (THAI-SICU study).

Author

Auiwattanakul S, Chittawatanarat K, Chaiwat O, Morakul S, Kongsayreepong S, Ungpinitpong W, Yutthakasemsunt S, and Buranapin S

Subjects
APACHE, Aged, Body Mass Index, Critical Care, Female, Hospitals, University, Humans, Male, Middle Aged, Thailand epidemiology, Critical Illness epidemiology, Hospital Mortality, Intensive Care Units, Nutritional Status, Sepsis epidemiology
Abstract

Objectives: The aim of this study was to demonstrate the role of nutrition factors on a 28-d mortality outcome and sepsis occurrence in surgical intensive care unit., Methods: The data was extracted from a THAI-SICU study that prospectively recruited participants (≥18 y of age) from three Thai surgical intensive care units (SICUs) of university-based hospitals. The demographic data and nutrition factors at SICU admission included energy delivery deficit, weight loss severity, route of energy delivery, and albumin and nutrition risk screening (NRS-2002). The outcomes were 28-d hospital mortality and sepsis occurrence. The statistical analysis was performed using Cox regression., Results: The study included 1503 eligible patients with a predominantly male population. The 28-d mortality and sepsis occurrences were 211 (14%) and 452 (30%), respectively. Regarding multivariable analysis, for mortality outcome, the protective effects of nutrition variables were higher body mass index (BMI; hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.68-0.99; P = 0.039), tube feeding (HR, 0.46; 95% CI, 0.26-0.83; P = 0.010), and a combination of enteral and parenteral nutrition (HR, 0.24; 95% CI, 0.07-0.77; P = 0.016). The harmful effects were severe weight loss (HR, 1.61; 95% CI, 1.16-2.22; P = 0.004), albumin ≤2.5 (HR, 2.15; 95% CI, 1.20-3.84; P = 0.010), and at risk according to NRS-2002 (HR, 1.34; 95% CI, 0.98-1.85; P = 0.071). For the sepsis occurrence, only tube feeding had a protective effect (HR, 0.58; 95% CI, 0.39-0.88; P = 0.009), and only albumin ≤2.5 had a harmful effect (HR, 1.71; 95% CI, 1.20-2.45; P = 0.003)., Conclusion: Nutrition factors affecting the mortality or sepsis occurrence in this study were BMI, enteral feeding or combination with parenteral nutrition, severe weight loss, preadmission albumin ≤2.5, and at risk according to NRS-2002., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Published
2019
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36. Effects of compression on orientation of ligands in fluorescent complexes between hydroxyapatite with amino acids and their optical properties.

Author

Morakul S, Otsuka Y, Nararya A, Tagaya M, Motozuka S, Ohnuma K, Miyashita Y, and Mutoh Y

Subjects
Ligands, Pressure, Surface Properties, Amino Acids chemistry, Compressive Strength, Durapatite chemistry, Fluorescent Dyes chemistry, Optical Phenomena
Abstract

This study aims to reveal the effects of pressure during cold isostatic pressing (CIP) on the microstructure and optical properties of fluorescent HAp complexes. Although the microsturucture-dependent properties of fluorescent HAp complexes have been reported to improve the antibacterial properties of photocatalyst coating layers, the mechanism behind the changes in the fluorescence properties of highly compressed HAp complexes has not yet been unveiled. CIP was successfully used to fabricate fluorescent HAp - amino acid complexes, and their fluorescence intensities increased with increasing fabrication pressure. Peak wavelength of fluorescence emitted by the HAp - amino acid complexes exhibited yellow to red shift. Although the thickness of the amino acid layer was saturated in higher pressure cases, the concentration of amino acids increased proportionally with pressure, which suggests changes in the packing structures of the ligands in the HAp- amino acid complexes. Polarized Raman spectroscopy measurements clearly detected ligands normally arranged to the HAp layer under high pressure fabrication conditions, which can provide the tightly packed ligand structure in the HAp- amino acid complexes. These tightly packed ligand structure in the HAp- amino acid complexes could emit stronger fluorescence owing to the increased density of complexations. This newly found pressure dependency in the optical properties of HAp-amino acid complexes is beneficial for developing biocompatible fluorescence materials or enhancement agents for antibacterial coating layers., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Published
2018
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37. Characters of Nutrition Status and Energy-delivery Patterns of the University-based Surgical Intensive Care Units in Thailand (Multi-center THAI-SICU Study).

Author

Auiwattanakul S, Chittawatanarat K, Chaiwat O, Morakul S, Kongsayreepong S, Ungpinitpong W, Yutthakasemsunt S, and Buranapin S

Subjects
Aged, Female, Humans, Male, Middle Aged, Thailand, Critical Care Nursing methods, Critical Care Nursing statistics & numerical data, Energy Intake, Hospitals, University statistics & numerical data, Intensive Care Units statistics & numerical data, Nutritional Status, Parenteral Nutrition methods
Abstract

Aim: The authors aimed to describe nutrition status and energy-delivery characters in multi-center THAI-SICU study., Material and Methods: Eligible patients admitted in SICU were 1,686 after excluding 563 of 2,249 participants owing to very short stay or non-alive within 24 hours after admission and missing data. The study was a posthoc analysis and multicenter descriptive design. The analytic methods described categorical data in percentage and the continuous data in the median with interquartile range. Variables divided into baseline characteristics and nutrition data before SICU admission, and the pattern of energy delivery in SICU. Statistical significance accepted as a p-value less than 0.05., Results: The average age was 64 (52-76) years with 57% male. The median of serum albumin level at admission (interquartile range, IQR) was 2.8 (2.2-3.4). There was 46 -47 percent of nutrition risk patient. Less than 10 percent of the patient had enteral (EN), parenteral (PN) or their combination before admission. History of weight loss and appetite loss was 27-31 percent. However, seventy percent of the patient could not define the duration of the symptom. EN was initiated early, but the tendency of full feeding was 7-10 days. At that period, supplemental PN was added around 30 percent of total calories. The composition of PN was quite low in these study which contains only 15-16 percent of total calories. The average energy delivery was 20 kcal/kg/day (the recommendation is 25-30 kcal/kg/day)., Conclusion: The patient's nutrition status before SICU admission was at risk of 46-47% and weight loss and appetite loss might unreliable in ICU setting. EN is started early with gradually increase up to 7-10 days. The average total calories requirement is lower than a recommendation.

Published
2018
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38. Outcomes of Nutrition Status Assessment by Bhumibol Nutrition Triage/Nutrition Triage (BNT/NT) in Multicenter THAI-SICU Study.

Author

Chittawatanarat K, Chaiwat O, Morakul S, and Kongsayreepong S

Subjects
Adult, Aged, Female, Hospital Mortality, Hospitals, University, Humans, Intensive Care Units, Male, Middle Aged, Postoperative Care, Prospective Studies, Sepsis epidemiology, Thailand epidemiology, Nutritional Status, Triage
Abstract

Objective: The objective of the study is to evaluate the nutrition assessment tool used by Bhumibol Nutrition Triage/Nutrition Triage (BNT/NT) for patient outcomes in a surgical intensive care unit (SICU)., Material and Method: All data were retrieved from the THAI-SICU database. A total of 1,685 patients from three medical centers were participants in the nutrition project and were enrolled onto this study. The parameters needed for BNT/NT scoring were recorded including body mass index (BMI), weight change, energy delivery, age, and disease severity. The BNT/NT calculation was classified into 4 groups as BNT/NT I to IV. An adjusted odds ratio (OR) with 95% confidence interval (CI) of mortality and sepsis occurrence were reported. Results were classed as being statistically significant at p<0.05., Results: Regarding the nutrition assessment classification, the patients admitted to SICU were classified as BNT/NT class I48.6%, class II 30.0%, class III 9.3%, and class IV 12.1%. There were statistically significant differences between classes in terms of BMI, weight change, energy delivery and disease severity. In addition, the BNT/NT classification was also significantly associated with ICU mortality [OR (95% CI): 1.51 (1.25-1.83); p<0.001], 28 day mortality [1.47 (1.23-1.74); p<0.001], and sepsis occurrence [1.41 (1.25-1.60); p<0.001]., Conclusion: Most of the patients admitted to SICU had a low nutrition risk BNT/NT class I and II. The higher BNT/NT scores were associated with mortality and sepsis occurrence in SICU.

Published
2016

39. Pain Management in Surgical Intensive Care Units: A Multi-Center Prospective Observational Study (THAI-SICU Study).

Author

Nimmaanrat S, Chittawatanarat K, Kongsayreepong S, and Morakul S

Subjects
Adult, Drug Utilization, Female, Hospitals, University, Humans, Male, Middle Aged, Postoperative Care, Prospective Studies, Thailand, Analgesics therapeutic use, Intensive Care Units, Pain Management
Abstract

Objective: This study is a part of the multi-center Thai university-based Surgical Intensive Care Unit Study (THAI-SICU Study). It aimed to evaluate the patterns of pain management in patients admitted to surgical intensive care units., Material and Method: Case record forms (CRFs) were created by the working group. Data regarding pain management in the ICUs were documented on the daily record form. These included types of analgesics used (opioids and non-opioids), routes of administration (oral, intravenous, intramuscular, epidural and intrathecal) and methods of administration (continuous infusion, regular intermittent, as needed, patient-controlled analgesia and patient-controlled epidural analgesia)., Results: Data were gathered from 4,652 patients. The majority of the patients received analgesics (85.2%). The main stay analgesics were morphine (52.3%) and fentanyl (27%). Analgesics were frequently administered via the intravenous route (76.5%) on an as needed basis (48.6%)., Conclusion: Analgesics were commonly given to patients in the surgical intensive care units. The analgesics of choice were strong opioids, and the most preferred route and method of administration was the intravenous route and the as needed basis, respectively.

Published
2016

40. The Differences of Nutrition Status, Energy Delivery and Outcomes between Metropolis and Regional University-Based Thai Surgical Intensive Care Units.

Author

Chittawatanarat K, Chaiwat O, Morakul S, and Kongsayreepong S

Subjects
Aged, Energy Intake, Enteral Nutrition statistics & numerical data, Female, Humans, Male, Middle Aged, Postoperative Care, Registries, Thailand epidemiology, Hospitals, University, Hospitals, Urban, Intensive Care Units, Nutritional Status
Abstract

Objective: The objective of this study was to compare the differences of nutrition status, nutrition delivery, and the outcomes between the metropolis (MUH) and regional university based hospitals (RUH) in Thailand., Material and Method: The nutrition data were retrieved from the THAI-SICU database. A total of 1,686 patients (MUH 927 patients vs. RUH 759 patients) with completion of nutrition status and nutrition delivery data were included in this analysis. The enrolled patients from study centers located in Bangkok were defined as MUH, and the patients from Chiang Mai were defined as RUH. Patient characteristics, nutrition status using the subjective global assessment (SGA) and nutrition risk screening (NRS), nutrition delivery, and outcomes of treatment were recorded. The outcome associations were analyzed by a multivariable regression model., Results: At admission, there were significant differences of age, gender, body mass index, disease severity, albumin level, and diagnosis. RUH had significantly poorer nutritional status than MUH (RUH vs. MUH: SGA class B and C, 57.7% vs. 37.1%, p<0.001; NRS at risk, 56.3% vs. 38.4%, p<0.001). The tendency of total calories and enteral nutrition delivery per day of RUH was significantly lower than MUH especially in the first three weeks of hospitalization. Carbohydrates were the main resource for parenteral nutrition. Although there was no difference of protein delivery, MUH had a significantly higher prescription of fat emulsion especially in the 1st-2nd weeks. Even though there were higher occurrences of intensive care unit (ICU) mortality, 28-day mortality, sepsis occurrence, ICU length of stay (LOS), and hospital LOS in RUH, the multivariable analysis did not demonstrate the statistical value of these outcomes., Conclusion: RUH had a poorer nutritional status. MUH had more total caloric intake and enteral nutrition delivery per day especially during the first three weeks. However, the treatment outcomes showed no differences in multivariable analysis.

Published
2016

41. Prevalence and Impact of Overweight and Obesity in Critically Ill Surgical Patients: Analysis of THAI-SICU Study.

Author

Wacharasint P, Fuengfoo P, Rangsin R, Morakul S, Chittawattanarat K, and Chaiwat O

Subjects
Adult, Aged, Female, Hospitals, University, Humans, Hypertension epidemiology, Male, Middle Aged, Postoperative Care, Prevalence, Registries, Respiratory Distress Syndrome epidemiology, Thailand epidemiology, Critical Illness, Intensive Care Units, Obesity epidemiology, Overweight epidemiology
Abstract

Objective: To investigate the prevalence of overweight and obesity, and their impacts in patients admitted to a surgical intensive care unit (SICU) in Thailand., Material and Method: We conducted an analysis using the THAI-SICU database. All 4,579 patients who had weight and height measured were classified into four groups using body mass index (BMI) based on the World Health Organization criteria, which were 1) underweight (BMI <18.5 kg/m2), 2) normal BMI (BMI 18.5-24.9 kg/m2), 3) overweight (BMI 25-29.9 kg/m2), and 4) obese (BMI >30 kg/m2) groups. Primary outcome was prevalence of overweight and obesity. Secondary outcomes were 28-day survival, and SICU outcomes between four patient groups., Results: There were 768 (16.8%) of underweight, 2,624 (57.3%) of normal BMI, 858 (18.7%) of overweight, and 329 (7.2%) of obese patients. Compared to other three patient groups, obese had the highest 28-day survival (log-rank, p<0.001), lowest incidence of systemic inflammatory response syndrome (SIRS) (underweight 41.1%, normal BMI 35.6%, overweight 34.5%, and obese 29.5%; p = 0.001), and lowest incidence of new infection (underweight 27.3%, normal BMI 23.3%, overweight 24.5%, and obese 20.4%; p = 0.047). After adjustment for related confounding factors, we found that every one unit increasing of BMI associated with lower risk of hospital mortality [odds ratio, OR, 0.97(95% confidence interval, CI, 0.94-0.99); p = 0.04], higher risk of acute respiratory distress syndrome (ARDS) [OR 1.06 (95% CI 1.03-1.08); p<0.001], and higher risk of intra-abdominal hypertension (IAH) [OR 1.06 (95% CI 1.03-1.09); p<0.001]., Conclusion: The prevalence of overweight and obesity in Thai critically ill surgical patients were 18.7% and 7.2%, respectively. Compared to patients with lower BMI, patients with higher BMI had significantly lower mortality but greater risk of ARDS and IAH.

Published
2016

42. Acute Kidney Injury in Elderly Patients in Thai-Surgical Intensive Care Units (THAI-SICU) Study.

Author

Trongtrakul K, Poopipatpab S, Pisitsak C, Chittawatanarat K, and Morakul S

Subjects
APACHE, Age Factors, Aged, Delirium epidemiology, Emergencies, Female, Hospital Mortality, Hospitals, University, Humans, Male, Organ Dysfunction Scores, Postoperative Care, Prospective Studies, Respiration, Artificial, Sepsis mortality, Smoking adverse effects, Thailand epidemiology, Acute Kidney Injury mortality, Intensive Care Units
Abstract

Objective: To demonstrate prevalence, characteristics and outcomes of the elderly patients who were diagnosed with acute kidney injury (AKI) in surgical intensive care units (ICUs)., Material and Method: AKI data were extracted from multicenter prospective cohort study conducted in 9 university-affiliated surgical ICUs in Thailand (THAI-SICU study) from April 2011 to January 2013. The elderly group was defined as those over 65 years old. Statistical analysis was done comparing baseline characteristics and outcomes between the elderly with AKI and those without., Results: A total of 2,310 elderly patients (49.7%) were identified in our surgical ICUs from a total 4,652 cases. Of this elderly group, AKI was diagnosed in 445 cases (19.3%). The differences in the baseline characteristics of the elderly with AKI group were: older, higher number of males, greater number of smokers, and greater disease severity evaluated with APACHE-II and SOFA score than the elderly without AKI. The ICU mortality and 28-day hospital mortality were higher in the elderly with AKI than those without (28.1% vs. 5.2%, p<0.001 with RR = 5.401, 95% CI 4.231-6.895 and 35.7% vs. 9.4%, p<0.001 with RR = 3.786, 95% CI 3.138-4.569, respectively). Using multivariable logistic regression analysis and after adjustment of covariates, independent potential risk factors of developing AKI in the SICU included: older age, higher APACHE-II and SOFA score, smoking history, emergency surgery, concurrent sepsis, cardiac complications, delirium, and requiring respiratory support during ICU stay., Conclusion: Geriatric patients made up almost half of our surgical ICU population and nearly one-fifth of them suffered AKI. Once they had AKI, ICU mortality and 28-day hospital mortality were higher than those without AKI.

Published
2016

43. Hazards and Intensive Care Unit Economic Burden of Cigarette Smoking on Critically Ill Surgical Patients: Analysis of the THAI-SICU Study.

Author

Wacharasint P, Fuengfoo P, Rangsin R, Morakul S, Chittawattanarat K, and Chaiwat O

Subjects
Acute Kidney Injury epidemiology, Adult, Aged, Cigarette Smoking epidemiology, Critical Illness, Female, Hospitals, University, Humans, Male, Middle Aged, Postoperative Care, Prospective Studies, Respiratory Distress Syndrome epidemiology, Systemic Inflammatory Response Syndrome epidemiology, Thailand epidemiology, Cigarette Smoking adverse effects, Intensive Care Units
Abstract

Objective: Cigarette smoking is not only has detrimental effects on the respiratory system but also contributes to development of atherosclerosis and inflammatory vascular reactions. We hypothesized whether smoking is associated with increased risk of acute respiratory distress syndrome (ARDS), systemic inflammatory response syndrome (SIRS), sepsis, distant organ dysfunctions, and the increase of total cost of surgical intensive care unit (SICU) in critically ill surgical patients., Material and Method: We performed analysis using the THAI-SICU data, a prospective, observational, multicenter study in patients who admitted to SICU in nine university-based hospitals in Thailand. The patients were categorized into 3 groups based on their smoking histories, which were 1) never smoked, 2) former smoker, and 3) current smoker. The primary outcome was probability of ARDS and the secondary outcomes included incidences of SIRS, sepsis, distant organ dysfunction (included acute kidney injury (AKI) and acute myocardial infarction (AMI)), total SICU cost, and 28-day mortality, Results: A total of 4,652 patients had complete data of smoking and were analyzed. The smoking status was never smoked (2,947 patients), former smokers (1,148 patients), and current smokers (557 patients). Compared to current smokers and former smokers, patients who had never smoked had significantly lower proportion of patients with chronic obstructive pulmonary disease (p<0.01) and had significantly higher PaO2/FiO2 ratio on SICU admission (p = 0.02). Compared to patients who had never smoked and former smokers, current smokers had significantly higher probability of ARDS (p = 0.003), higher incidence of SIRS (p = 0.006), and AKI (p<0.001), after adjustment for age, gender, APACHE II score, and patients’ pre-existing diseases. We found that every 1-pack year of cigarette smoking increased risk of ARDS with a hazard ratio of 1.02 (95% CI 1.01-1.03, p = 0.001). There was no difference in incidence of sepsis, AMI, and 28-day mortality among three groups of patients. Current smokers had significantly higher SICU cost, followed by former smokers, and patients who had never smoked (p = 0.02)., Conclusion: In critically ill surgical patients, we found dose-response association between smoking pack year and risk of ARDS. Compared to patients who had never smoked and former smokers, current smokers had significantly higher probability of ARDS, higher incidence of SIRS, AKI, and higher total SICU cost. Our findings demonstrated harm of cigarette smoking in critically ill surgical patients who admitted to SICU.

Published
2016

44. Prevalence, Outcomes and Risk factors of Acute Kidney Injury in Surgical Intensive Care Unit: A Multi-Center Thai University-Based Surgical Intensive Care Units Study (THAI-SICU Study).

Author

Pisitsak C, Chittawatanarat K, Wacharasint P, Chaiwat O, Komonhirun R, and Morakul S

Subjects
APACHE, Adult, Aged, Female, Hospitals, University, Humans, Male, Middle Aged, Multiple Organ Failure epidemiology, Postoperative Care, Prevalence, Prospective Studies, Risk Factors, Serum Albumin, Thailand epidemiology, Acute Kidney Injury epidemiology, Intensive Care Units
Abstract

Objective: Acute kidney injury (AKI) is one of the most common problems in critically ill patients. AKI associates with poor outcome in ICU. The recognition of the prevalence and risk factors of AKI is important. This could lead to the prevention of AKI and improve patient’s outcome. This study aims to identify the prevalence, outcomes and independent risk factors of AKI in Thai surgical intensive care units., Material and Method: We conducted the prospective cohort study from nine university-based SICUs. The patients were diagnosed AKI by Acute Kidney Injury Network (AKIN) classification. The types of RRT and outcomes including mortality were collected. The risk factors of AKI were identified., Results: A total cohort of 4,652 patients was included for the present study. AKI was diagnosed in 786 (16.89%) patients. The ICU mortality was higher in patients with AKI (29.90% vs. 5.48%, p-value <0.001). Among patients with AKI staging, we found that those with AKIN III had higher ICU mortality compared to patients with AKIN II and AKIN I respectively (47.66% vs. 26.67% vs. 14.69%, p-value <0.001). Patients with AKI had higher 28 day-mortality compared with those without AKI (37.53% vs. 8.98%, p-value <0.001). The independent risk factors of AKI were higher APACHE II scores (OR 1.04, 95% CI 1.01-1.06, p-value = 0.001), lower serum albumin (OR 0.82, 95% CI 0.70-0.97, p-value = 0.020), organ failures which were in the gastrointestinal system (OR 1.53, 95% CI 1.13-2.08, p-value = 0.007), cardiovascular system (OR 1.95, 95% CI 1.34-2.83, p-value <0.001), neurological system (OR 1.37, 95% CI 1.02-1.85, p-value = 0.038) and urinary system (OR 7.00, 95% CI 5.21-9.40, p-value <0.001)., Conclusion: Acute kidney injury associates with poor outcomes including increased ICU and 28-day mortality. Independent risk factors of AKI in the present study were higher APACHE II scores, lower serum albumin and organ failures on admission.

Published
2016

45. A Multi-Center Thai University-Based Surgical Intensive Care Units Study (THAI-SICU Study): Outcome of ICU Care and Adverse Events.

Author

Kongsayreepong S, Chittawatanarat K, Thawitsri T, Chatmongkolchart S, Morakul S, Wacharasint P, Chau-In W, Poopipatpab S, and Kusumaphanyo C

Subjects
Acute Kidney Injury epidemiology, Aged, Arrhythmias, Cardiac epidemiology, Delirium epidemiology, Female, Heart Arrest epidemiology, Hospital Mortality, Hospitals, University, Humans, Length of Stay statistics & numerical data, Male, Postoperative Care, Prospective Studies, Respiratory Distress Syndrome epidemiology, Sepsis epidemiology, Thailand epidemiology, Intensive Care Units, Outcome and Process Assessment, Health Care
Abstract

Objective: Surgical intensive care units (SICUs) are special units for critically ill surgical patients both in the pre and postoperative period. There is little aggregated information about surgical patients who are admitted to the Thai surgical ICU. The objective of this report was to describe patient characteristics, outcomes of ICU care, incidence and outcomes of adverse events in the SICU in the participating SICUs., Material and Method: This multi-center, prospective, observational study of nine university-based SICUs was done. All admitted patients with ages >18 years old were included. Information about patient characteristics, underlying medical problems, indication and type of ICU admission, severity score as ASA physical status in operative patients, APACHE II score and SOFA score, adverse events of interest, ventilator days, ICU and 28 days mortality. The association of outcome and predictors was reported by relative risk (RR) with 95% confidence interval (95% CI). Statistical significant difference was defined by p<0.05., Results: During April 2011-January 2013 of total cohort time, a total of 4,652 patients from nine university-based SICUs were included in this study. Mode of patient age was 71-75 year old for both sexes. Median (IQR) of APACHE II scores and SOFA scores were 10 (7-10) and 2 (1-5), respectively. Seventy eight percent of patients were postoperative patients and 50% of them were ASA physical status III. The median of ICU stay was 2 (IQR 1-4) days. Each day of ICU increment was associated with increased 1.4 days of a hospital stay. Three percent of survived at discharge were clinically inappropriate discharge resulting in ICU readmission. Sixty-five percent were discharged home after ICU admission. ICU and 28 days mortality was 9.6% and 13.8%. The seven most common adverse events were sepsis (19.5%), acute kidney injury (AKI) (16.9%), new cardiac arrhythmias (6.2%), acute respiratory distress syndrome (ARDS) (5.8%), cardiac arrest (4.9%), delirium (3.5%) and reintubation within 72 hours (3.0%), respectively. Most of the adverse events occurred in the first five days, significantly less occurred after 15 days of ICU admission. The association between adverse events and 28 days mortality were significant for cardiac arrest (RR, 9.5; 95% CI, 8.6-10.4), respiratory failure [acute respiratory distress syndrome (ARDS) (RR, 4.6; 95% CI, 3.9-5.3), acute lung injury (ALI) (RR, 2.7; 95% CI, 2.1-3.6)], acute kidney injury (AKI) (RR, 4.2; 95% CI, 3.7-4.8), sepsis (RR, 3.6; 95% CI, 3.2-4.2), iatrogenic pneumothorax (RR, 3.2; 95% CI, 2.1-5.1), new seizure (RR, 3.1, 95% CI, 2.2-4.4), upper GI hemorrhage (RR, 3.0, 95% CI, 2.1-4.1), new cardiac arrhythmias (RR, 2.9; 95% CI, 2.4-3.5), delirium (RR, 2.1; 95% CI, 1.7-2.8), acute myocardial infarction (RR, 2.1; 95% CI, 1.4-3.1), unplanned extubation (RR, 2.1; 95% CI, 1.4-3.1), intra-abdominal hypertension (RR, 1.8; 95% CI, 1.2-2.7) and reintubation within 72 hours (RR, 1.5; 95% CI, 1.1-2.1)., Conclusion: This is the first large study of surgical critical care in Thailand, which had a systematic patient follow-up program. Most of the patients were elderly. Adverse events were most frequent during the first 5 days of admission and were associated with ICU and 28 days mortality.

Published
2016

46. Non-cardiopulmonary monitoring in Thai-ICU (ICU-RESOURCE I study).

Author

Chittawatanarat K, Morakul S, and Thawitsri T

Subjects
Cross-Sectional Studies, Health Care Surveys, Humans, Monitoring, Physiologic instrumentation, Thailand, Critical Care, Monitoring, Physiologic statistics & numerical data, Practice Patterns, Physicians' statistics & numerical data
Abstract

Objective: In addition to cardiopulmonary monitoring, non-cardiopulmonary monitoring (non-CPM) is considered to be an important parameter in intensive care units (ICUs). However no data on this subject has been reported for Thai ICUs. The objective of the present study is to describe the non-CPM situation in Thai ICUs., Materials and Method: ICU RESOURCE I survey database released during the year 2012 was used for the present study. Non-CPMo refers to neurological monitoring, renal function monitoring, metabolic monitoring, perfusion monitoring and identifying biomarkers. Academic hospital (ACAD), availability grading (AG), numeric frequency grading scale (FGS) and device availability per bed (DPB) were used for categorization of non-CPM collected data. Significant differences between the groups are defined as p < 0.05., Results: Advanced monitoring, including; indirect calorimetry, near infrared spectroscopy, peripheral nerve stimulation, gut mucosal tonometry and sublingual side stream darkfield imaging are currently unavailable in participating Thai ICUs. All ICUs have devices to measure the levels of capillary glucose, creatinine kinase MB, troponin T and albumin. Bispectral index, ultrasound, continuous renal replacement therapy devices, continuous enteral feeding pumps, intra-abdominal pressure monitoring devices and rectal temperature measuring devices are available in ACAD facilities in greater instances than in other institutions. Similarly; for biomarker and drug level monitoring; procalcitonin, interleukin, brain natriuretic peptide, total creatinine kinase, neutrophilgelatinase-associated lipocalin (NGAL), lactate, central venous oxygen saturation/mixed venous oxygen saturation (ScvO2/SvO2), phenytoin, vancomycin and pre-albumin are used more frequently in ACADs. Gap analysis demonstrating warmer cabins, NGAL, lactate and ScvO2/SvO2 show less availability but are frequently used when they have been made available. Intra-abdominal pressure and core temperatures are used less in general ICU practices and are scarcely found., Conclusion: Some of the more advanced non-CPM devices are not found in Thai ICUs. Basic non-CPM devices are available in all ICUs. Some new devices for measurements and for biomarkers are used with greater prevalence in ACAD ICUs. Some measurements including IAP core temperature, lactate and ScvO2/SvO) are monitored less frequently in Thai ICUs (Thai Clinical Trial Registry: TCTR-201200005).

Published
2014

47. A multi-center Thai university-based surgical intensive care units study (THAI-SICU study): methodology and ICU characteristics.

Author

Chittawatanarat K, Chaiwat O, Morakul S, Pipanmekaporn T, Thawitsri T, Wacharasint P, Fuengfoo P, Chatmongkolchart S, Akaraborworn O, Pathonsamit C, Poopipatpab S, Chanthawong S, Chau-In W, Kusumaphanyo C, Buppha P, Somrat C, and Kongsayreepong S

Subjects
Humans, Patient Selection, Personnel Management, Prospective Studies, Thailand, Academic Medical Centers, Critical Care organization & administration, Intensive Care Units organization & administration, Outcome and Process Assessment, Health Care
Abstract

Objective: Although there were two large intra-operative observational studies on Thai surgical patients (THAI and THAI-AIMS), there has been no available study on critically ill surgical patients regarding their adverse events and outcomes. A THAI-Surgical Intensive Care Unit (SICU) study has been established for monitoring the occurrence of these adverse events and outcomes in the SICU. The objective of this report is to describe the methodology of the THAI-SICU study and participating SICUs' characteristics as well as the early recruitment results on patients enrolled in the present study., Material and Method: The present study is designed as a multi-center, prospective, observational study. This report describes the method of case record form development and summarizes their collected parameters as well as the adverse event surveillance variables. All of nine SICU characteristics are described regarding their management systems, physicians' and nurses' work patterns. The final group of enrolled patients is reported., Results: A total of nine university-based SICUs were included in the present study. All participating hospitals are residency training centers. Four of the SICUs, fulltime directors are anesthesiologists. Only one hospital's SICU is directed by a surgeon. Two SICUs were closed ICUs, three were mandatory consulting units, one was an elective consultation unit and the remaining three ICUs had no directors. Most of the participating SICUs had heterogeneity of surgical specialty patients. Six SICUs had regular resident rotations and only two of the SICUs had critical care fellowship training. There were significant differences regarding the nursing workload among the ICUs. The patient to registered nurse ratio ranged from 0.9-2.0. After a total of 19.7 months of a recruitment period, the total number of patient admissions was 6,548 (1,894 patients were excluded). A total cohort of 4,654 patients was included for further analytical processes., Conclusion: There were differences in ICU management systems, physician and specialist coverage, nurse burdens, nurse sparing, and types of patients admitted in the university based SICUs. This presentation is the pioneer multi-center study on Thai SICUs in which adverse events and outcomes are reported.

Published
2014

48. The role of the hospitalists in the workforce to address the shortages of intensivists in hospitals here in Thailand.

Author

Pisitsak C, Champunot R, and Morakul S

Subjects
Humans, Thailand, Workforce, Critical Care, Hospitalists organization & administration
Abstract

The problem of a shortage of intensivists in Thailand is increasing annually. As stated in The Thai Society of Critical Care Medicine Database, 2013, the number of qualified intensivists currently is 163, working in 76 provinces in Thailand. This disproportion in the ratio of intensivists has affected patient outcomes. In an attempt to solve this problem, there has been an increased number of hospitalists working in place of the intensivists. Medical specialties are not available in many hospitals of Thailand. Thus, the hospitalists, who care for Intensive Care Unit (ICU) patients, are not trained to care for the acutely ill, hospitalized patients. Their competencies vary depending on their experience and training. In other countries, there has been evidence that properly trained hospitalists can work effectively in the ICU. This awareness of the importance of intensivists in Thailand is one of the stifling factors; the improvement of the hospitalists, determining the hospitalists' workforce and increasing the number of the intensivists to match future demands are needed.

Published
2014

49. Comprehensive study of the evolution of gas-liquid partitioning of aroma compounds during wine alcoholic fermentation.

Author

Morakul S, Athes V, Mouret JR, and Sablayrolles JM

Subjects
Carbon Dioxide chemistry, Food Handling methods, Kinetics, Phase Transition, Quality Control, Fermentation, Hydrocarbons, Aromatic chemistry, Wine analysis
Abstract

Calculating the gas-liquid partitioning of aromatic molecules during winemaking fermentation is essential to minimize the loss of aroma and to optimize the fermentation conditions. In this study, the effect of the main fermentation parameters on the partition coefficients (ki) of higher alcohols (2-methylpropan-1-ol and 3-methyl butan-1-ol) and esters (ethyl acetate, 3-methyl-1-butyl acetate, and 2-ethyl hexanoate) was assessed. The values of ki were first determined in synthetic media simulating must and wine. They varied considerably with both the hydrophobicity of the compound and the composition of the medium. Then, the effect of temperature on ki was quantified. The absence of any effect of gas composition was also established by replacing air with CO2. Finally, the impact of CO2 stripping was assessed by running specific fermentations in which the rate of CO2 production was kept constant by perfusion with assimilable nitrogen. These fermentations showed that in contrast to temperature and must composition, CO2 stripping did not change the gas-liquid partitioning of higher alcohols and esters.

Published
2010
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