red cell transfusion in perioperative and critically ill patients pdf

... and lipoproteins to bind to and neutralize bacterial endotoxin (lipopolysaccharide [LPS]) [4] It has been noted that LPS in blood binds to LPS binding protein [5], activating the cell surface ... cholesterol and lipoprotein levels also predicted a poor clinical outcome Those investigators suggested that hypolipidemia (hypocholesterolemia) is an independent predictor of clinical outcome in critically ... in critically ill patients They also implied that a vicious cycle is initiated in many critically ill patients with acute sepsis with an increased production of inflammatory cytokines, which then...

Ngày tải lên: 12/08/2014, 20:20

... for diagnosing bacterial infection versus standard care in critically ill newborns and children During a 16-week period in 2003 we conducted a pilot study, which tested the intervention and data ... nosocomial infection In this study we will test the hypothesis that routine surveillance by determination of cytokine levels in plasma and tracheal aspirates will allow safe discontinuation of ... hypothesis we will test is whether early diagnosis reduces the morbidity and costs associated with hospital acquired infection Ascertaining relevant indicators of morbidity and costs in all patients...

Ngày tải lên: 12/08/2014, 20:20

... Johnston AJ, Steiner LA, O'Connell M, Chatfield DA, Gupta AK, Menon DK: Pharmacokinetics and pharmacodynamics of dopamine and norepinephrine in critically ill head-injured patients Intensive Care ... the rate of norepinephrine infusion during steady-state conditions of the norepinephrine infusion period The average norepinephrine dose infused in the presently investigated patients ranged from ... mobilization, increased formation of cyclic AMP, inhibition of increases in intracellular pH, and attenuated protein kinase C activation [32] Adaptive intracellular processes upon initial midazolam-induced...

Ngày tải lên: 13/08/2014, 11:22

... care, including financial support, professional training, research, prioritizing pain control, and global awareness of palliative medicine[14-16] Palliative care is becoming increasingly valued in ... liaisons with individuals and organizations in order to help patients and families honor EOL cultural and religious traditions Develop skill at communicating sensitive information, including poor ... dialogue and inform individuals of their rights as patients Even brief educational interventions can prove to be beneficial in improving patient understanding[69] Only a minority of patients...

Ngày tải lên: 13/08/2014, 23:20

... microorganism as that cultured from the sinus occurred in 12 patients; in five patients the microorganism causing bacteraemia was cultured only from the blood and the sinus, making sinusitis the most ... marked reduction in the incidence of sinusitis in our ICU Conclusion Hospital-acquired sinusitis is a frequent cause of FUO in orotracheally intubated and mechanically ventilated critically ill patients ... hospital-acquired infection in mechanically ventilated and orotracheally intubated patients admitted to our ICU, in a prospective study using a rigorous protocol with predefined criteria for suspecting sinusitis...

Ngày tải lên: 12/08/2014, 22:22

... identified and requiring open intervention Esophageal injury/fistula Identified and repaired intraoperatively Tracheal stenosis Revision and reconstruction Thyroid injury Requiring lobe or gland removal ... leading respiratory arrest or to severe hypoxemia requiring reintubation Severe stoma infection Systemic infection requiring treatment for sepsis or surgical debridements Major bleeding Hemoglobin ... continuity correc- Table Definitions of tracheostomy complications Minor complications Definition Cuff leak Failure of tracheal cuff to remain inflated at recommended pressure Minor bleeding...

Ngày tải lên: 13/08/2014, 03:20

... were involved in drafting the manuscript or revising it critically for important intellectual content ABl, MF, JAA, and JCM participated in the design of the study and they coordinated the meetings ... nutrition-related gastrointestinal complications in critically ill patients: a multicenter study The Nutritional and Metabolic Working Group of the Spanish Society of Intensive Care Medicine and Coronary ... thousand four hundred and nine patients were admitted during the study Seven hundred and fifty-six patients received nutrition in some form, whether TPN or EN, but 31 were excluded and 725 were studied...

Ngày tải lên: 13/08/2014, 03:20

... baseline ± days baseline ± days Change in mitochondrial DNA (mtDNA)/nuclear DNA (nDNA) ratio between baseline and day (± 1) in the intensive care unit Of the 28 critically ill between baseline and ... survivors and non-survivors after adjusting for platelet counts, white blood cell count, and antioxidant dosing group In addition, a linear mixed model with random patient intercepts and slopes ... while the cells and tissues remain apparently alive yet dysfunctional, up to a point of no return The aim of this study was to describe blood cell mtDNA levels in critically ill patients and evaluate...

Ngày tải lên: 13/08/2014, 08:20

... bacterial infection, offers intensivists a golden opportunity to rethink our approach to therapy in patients with suspected infections in the ICU, and in particular the blind and often inappropriate ... reported a 50% reduction in antibiotic usage in patients with lower respiratory tract infection [12] A similar study in suspected community-acquired pneumonia (procalcitonin in patients with community-acquired ... guidance and address the more critical questions of integrating PCT into effective clinical decision making and assess the full potential of its use in large-scale clinical trials [19] Müller and...

Ngày tải lên: 13/08/2014, 10:20

... http://ccforum.com/content/14/5/183 increase appetite and promote gastric emptying, which appears to be rather desirable in critically ill patients In light of the potential reductions in GLP-1 concentrations in critically ill ... examined in initial proof-of-concept studies in critically ill patients after abdominal surgery [13], after cardiac surgery [14], during parenteral nutrition [10] as well as during enteral feeding ... role for GLP-1 treatment in critically ill patients When considering the exogenous administration of GLP-1 in such patients, however, it is still important to bear in mind that the gut also produces...

Ngày tải lên: 13/08/2014, 20:22

... when to reinitiate sedation, the timing of extubation, and ICU and hospital discharge that may have accounted for differences in outcomes Finally, despite reduction in days with delirium no information ... Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation N Engl J Med 2000, 342:1471-1477 De Jonghe B, Lacherade JC, Durand MC, Sharshar T: Critical illness ... only patients with independent functional status Page of prior to illness were included in the study It is unclear whether the findings of this study could be generalized to other critically ill...

Ngày tải lên: 13/08/2014, 21:21

... Belgian Isepamycin Multicentre Group: Comparative in vitro activity of isepamycin and other antibiotics against gram-negative bacilli from intensive care units (ICU) in Belgium Acta Clin Belg 2001, ... Anzueto A, Martin CD, Moreno R, Lipman J, Gomersall C, Sakr Y, Reinhart K for the EPIC II Group of Investigators: International study of the prevalence and outcomes of infection in intensive care ... Antimicrobial Susceptibility Testing; ICU, intensive care unit; MIC, minimal inhibitory concentration; PD, pharmacodynamics; PK, pharmacokinetics Competing interests FST, FJ, and J-LV have received lecture...

Ngày tải lên: 13/08/2014, 21:21

... Enoxaparin, effective dosage for intensive care patients: double-blinded, randomised clinical trial Crit Care 2010, 14:R41 Moyen E, Camiré E, Stelfox H: Clinical review: medication errors in critical ... Understanding%20Human%20Behaviour%2 0and% 20Error .pdf ] Ostini R, Hegney D, Jackson C, Williamson M, Mackson JM, Gurman K, Hall W, Tett SE: Systematic review of interventions to improve prescribing ... default doses for aminoglycosides Drug Safety 2006, 29:803-809 doi:10.1186/cc9366 Cite this article as: Carson-Stevens A, et al.: Minimising drug errors in critically ill patients Critical Care...

Ngày tải lên: 14/08/2014, 07:21

... the fingers and 3/5 for wrist in both patients The Fugl-Meyer Motor Score for the upper limb (FM, 0–66) [18], was and respectively Pain, touch and position sensation, and two-point discrimination ... extension in healthy subjects [23] While passive movements caused some increase in activation, active training led to more prominent increases in fMRI activation, recruitment curves (TMS) and intracortical ... evidence in cats [29] and humans [30] that sensory stimulation induces long-term potentiation in the motor cortex, and increases corticospinal excitability In clinical studies of stroke patients, ...

Ngày tải lên: 19/06/2014, 08:20

... epoetin alfa in critically ill patients N Engl J Med 2007, 357:965-976 89 Tinmouth AT, McIntyre LA, Fowler RA: Blood conservation strategies to reduce the need for red blood cell transfusion in critically ... McIntyre L, Martin C, Doucette S, Blajchman M, Graham ID: Revisiting transfusion practices in critically ill patients Crit Care Med 2005, 33:7-12 Vincent JL, Piagnerelli M: Transfusion in the intensive ... cells and red blood cell transfusion in Canada Transfusion 2004, 44:1479-1486 87 Zarychanski R, Turgeon AF, McIntyre L, Fergusson DA: Erythropoietinreceptor agonists in critically ill patients: ...

Ngày tải lên: 20/06/2014, 23:20

... Barz D, Reinhart K: Anemia and blood transfusion in a surgical intensive care unit Crit Care 2010, 14:R92 Marik PE, Corwin HL: Efficacy of red blood cell transfusion in the critically ill: a systematic ... ventilation These uncertainties are acknowledged in recent guidelines and systematic reviews [11,12], and it is perhaps not surprising that surveys indicate continued variation in clinical practice [11,13] ... risk reduction) but significant ICU mortality reduction in Canada, and may be particularly important with prolonged red cell storage [14,15] Should we use blood more liberally in critically ill patients...

Ngày tải lên: 13/08/2014, 20:22

... of volume administered in group A but only 50% in group B, with the rest being crystalloid (not including saline for drug dialyses) Fluid administered in the period before CPB differed significantly ... restriction on red blood cell transfusions not only in cardiac surgery patients in general, but also in the subset of patients who are considered transfusion- prone Methods Patient selection and anesthesia ... this study show that intraoperative IV fluid restriction combined with red cell salvage and a well-defined PRC transfusion protocol reduces intraoperative PRC transfusion in cardiac surgery without...

Ngày tải lên: 10/08/2014, 10:20

... baseline hemoglobin, and erythropoietin treatment ICU LOS, baseline hemoglobin, and phlebotomy volumes are intuitive predictors of transfusion requirement, and have been found to be predictors in ... Hemoglobin (g/dl) aExcludes 25 patients with active bleeding bBMI unavailable for three bleeding patients and 12 nonbleeding patients (five nontransfused patients and seven transfused patients) ... iron and erythropoietin, and weekly hemoglobin indices to day 21 Patients admitted with pre-existing diagnoses of hypothyroidism (13 patients) or vitamin B12 deficiency (four patients) were continued...

Ngày tải lên: 13/08/2014, 03:20

... Kramer and Zygun Table Clinical studies assessing the impact of anemia or RBC transfusions on PbtO2 and other physiologic parameters in brain-injured patients Study Patients Design Baseline Intervention ... difference in the incidence of stroke and coma In summary, there remains uncertainty concerning optimum Hb levels for neuroprotection of patients undergoing cardiac surgery Many intensivists routinely ... usually restored within 24 to 72 hours after transfusion, the transiently increased binding affinity of Hb interferes with the release of O2 for use by tissues [74] Risks of red blood cell transfusion...

Ngày tải lên: 13/08/2014, 16:21

... Whereas colistin is mainly administered i.v in critically ill patients, it can be safely be administered by inhalation in patients with pneumonia/VAP or intrathecally in patients with meningitis due ... topical administration of colistin is noted in approximately 15% of patients Colistin’s clinical efficacy in critically ill patients In a recently published study, 258 adult critically ill patients ... CMS should be considered in critically ill patients [13] CMS and colistin PKs have been recently examined in 18 adult critically ill patients who received i.v colistin for infections caused by...

Ngày tải lên: 21/06/2014, 01:20