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Abdominal Aortic Calcifications Predict Survival in Peritoneal Dialysis Patients.

https://arctichealth.org/en/permalink/ahliterature298110
Source
Perit Dial Int. 2018 Sep-Oct; 38(5):366-373
Publication Type
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Author
Satu Mäkelä
Markku Asola
Henrik Hadimeri
James Heaf
Maija Heiro
Leena Kauppila
Susanne Ljungman
Mai Ots-Rosenberg
Johan V Povlsen
Björn Rogland
Petra Roessel
Jana Uhlinova
Maarit Vainiotalo
Maria K Svensson
Heini Huhtala
Heikki Saha
Author Affiliation
Tampere University Hospital, Tampere, Finland satu.m.makela@pshp.fi.
Source
Perit Dial Int. 2018 Sep-Oct; 38(5):366-373
Language
English
Publication Type
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Ankle Brachial Index
Aorta, Abdominal - diagnostic imaging
Aortic Diseases - diagnosis - epidemiology - etiology
Cause of Death - trends
Critical Illness - mortality - therapy
Denmark - epidemiology
Estonia - epidemiology
Female
Finland - epidemiology
Humans
Incidence
Male
Middle Aged
Peritoneal Dialysis - adverse effects - mortality
Prognosis
Prospective Studies
Renal Dialysis
Risk factors
Survival Rate - trends
Sweden - epidemiology
Ultrasonography, Doppler
Vascular Calcification - diagnosis - epidemiology - etiology
Abstract
Peripheral arterial disease and vascular calcifications contribute significantly to the outcome of dialysis patients. The aim of this study was to evaluate the prognostic role of severity of abdominal aortic calcifications and peripheral arterial disease on outcome of peritoneal dialysis (PD) patients using methods easily available in everyday clinical practice.
We enrolled 249 PD patients (mean age 61 years, 67% male) in this prospective, observational, multicenter study from 2009 to 2013. The abdominal aortic calcification score (AACS) was assessed using lateral lumbar X ray, and the ankle-brachial index (ABI) using a Doppler device.
The median AACS was 11 (range 0 - 24). In 58% of the patients, all 4 segments of the abdominal aorta showed deposits, while 19% of patients had no visible deposits (AACS 0). Ankle-brachial index was normal in 49%, low ( 1.3) in 34% of patients. Altogether 91 patients (37%) died during the median follow-up of 46 months. Only 2 patients (5%) with AACS 0 died compared with 50% of the patients with AACS = 7 (p
PubMed ID
29386304 View in PubMed
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[Abnormal coagulation in critical care patients].

https://arctichealth.org/en/permalink/ahliterature177817
Source
Duodecim. 2004;120(14):1745-52
Publication Type
Article
Date
2004

ABO-incompatible liver transplantation for critically ill adult patients.

https://arctichealth.org/en/permalink/ahliterature163388
Source
Transpl Int. 2007 Aug;20(8):675-81
Publication Type
Article
Date
Aug-2007
Author
Christian Toso
Mohammed Al-Qahtani
Faisal A Alsaif
David L Bigam
Glenda A Meeberg
A M James Shapiro
Vincent G Bain
Norman M Kneteman
Author Affiliation
Department of Surgery, Section of Hepatobiliary, Pancreatic and Transplant Surgery, University of Alberta, Edmonton, Canada.
Source
Transpl Int. 2007 Aug;20(8):675-81
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
ABO Blood-Group System - immunology
Adolescent
Adult
Aged
Alberta - epidemiology
Critical Illness
Female
Follow-Up Studies
Graft Rejection - blood - epidemiology - prevention & control
Graft Survival
Humans
Immunosuppressive Agents - therapeutic use
Incidence
Liver Failure - blood - surgery
Liver Transplantation - adverse effects
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate
Abstract
ABO incompatible (ABO-In) liver transplant remains a controversial solution to acute liver failure in adults. Adult liver recipients with acute liver failure or severely decompensated end-stage disease, intubated and/or in the intensive care unit, were grouped as ABO-In (n = 14), ABO-compatible (n = 29, ABO-C) and ABO-identical (n = 65, ABO-Id). ABO-In received quadruple immunosuppression with antibody-depleting induction agents (except two), calcineurin inhibitors, antimetabolites and steroids. No significant difference of patient and graft survivals was observed among ABO-In, ABO-C and ABO-Id: graft survivals were 64%, 62% and 67%, respectively, in 1 year and 56%, 54% and 60%, respectively, in 5 years; patient survivals 86%, 69% and 67%, respectively, in 1 year and 77%, 61% and 62%, respectively, in 5 years. Three ABO-In grafts were lost (one hyper-acute rejection and two hepatic artery thrombosis). Surgical and infectious complications were similarly distributed between groups, except the hepatic artery thrombosis, more frequent in ABO-In (2, 14%) than ABO-I (1, 1.5%, P
PubMed ID
17521384 View in PubMed
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Acute acalculous cholecystitis in critically ill patients.

https://arctichealth.org/en/permalink/ahliterature9411
Source
Acta Anaesthesiol Scand. 2004 Sep;48(8):986-91
Publication Type
Article
Date
Sep-2004
Author
J. Laurila
H. Syrjälä
P A Laurila
J. Saarnio
T I Ala-Kokko
Author Affiliation
Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Finland. jouko.laurila@pp_fimnet.fi
Source
Acta Anaesthesiol Scand. 2004 Sep;48(8):986-91
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
APACHE
Adult
Aged
Bacterial Infections - complications - microbiology
Cardiac Surgical Procedures
Cholecystectomy
Cholecystitis - diagnosis - etiology - microbiology
Critical Illness
Female
Humans
Intensive Care Units
Male
Middle Aged
Multiple Organ Failure - etiology
Norepinephrine - administration & dosage - therapeutic use
Palpation
Vasoconstrictor Agents - administration & dosage - therapeutic use
Abstract
BACKGROUND: Acute acalculous cholecystitis (AAC) is a serious complication of critical illness. We evaluated the underlying diseases, clinical and diagnostic features, severity of associated organ failures, and outcome of operatively treated AAC in a mixed ICU patient population. METHODS: The data of all ICU patients who had operatively confirmed AAC during their ICU stay between 1 January 2000 and 31 December 2001 were collected from the hospital records and the intensive care unit's data management system for predetermined variables. RESULTS: Thirty-nine (1%) out of 3984 patients underwent open cholecystectomy for AAC during the two-year period. Infection was the most common admission diagnosis, followed by cardiovascular surgery. The mean APACHE II score on admission was 25, and 64% of the patients had three or more failing organs on the day of cholecystectomy. The mean length of ICU stay before cholecystectomy was 8 days, and the mean total length of ICU stay was 19 days. Most patients (85%) received norepinephrine infusion, and 90% suffered respiratory failure before cholecystectomy. Hospital mortality was 44%. The non-survivors had higher Sequential Organ Failure Assessment (SOFA) scores on the day of cholecystectomy compared to the survivors (12.9 vs. 9.5, P = 0.007). CONCLUSION: Acute acalculous cholecystitis was associated with severe illness, infection, long ICU stay, and multiple organ failure. Mortality was related to the degree of organ failure. Prompt diagnosis and active treatment of AAC can be life-saving in these patients.
PubMed ID
15315616 View in PubMed
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Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study.

https://arctichealth.org/en/permalink/ahliterature113108
Source
BMC Nephrol. 2013;14:123
Publication Type
Article
Date
2013
Author
Sean M Bagshaw
Manish M Sood
Jennifer Long
Robert A Fowler
Neill K J Adhikari
Author Affiliation
Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 3C1.12 Walter C Mackenzie Centre, 8440-112 St NW, Edmonton, AB T6G 2B7, Canada.
Source
BMC Nephrol. 2013;14:123
Date
2013
Language
English
Publication Type
Article
Keywords
Acute Kidney Injury - diagnosis - epidemiology
Adult
Canada - epidemiology
Cohort Studies
Critical Illness - epidemiology
Female
Humans
Influenza A Virus, H1N1 Subtype
Influenza, Human - diagnosis - epidemiology
Male
Middle Aged
Pandemics
Prospective Studies
Abstract
Canada's pandemic H1N1 influenza A (pH1N1) outbreak led to a high burden of critical illness. Our objective was to describe the incidence of AKI (acute kidney injury) in these patients and risk factors for AKI, renal replacement therapy (RRT), and mortality.
From a prospective cohort of critically ill adults with confirmed or probable pH1N1 (16 April 2009-12 April 2010), we abstracted data on demographics, co-morbidities, acute physiology, AKI (defined by RIFLE criteria for Injury or Failure), treatments in the intensive care unit, and clinical outcomes. Univariable and multivariable logistic regression analyses were used to evaluate the associations between clinical characteristics and the outcomes of AKI, RRT, and hospital mortality.
We included 562 patients with pH1N1-related critical illness (479 [85.2%] confirmed, 83 [14.8%] probable]: mean age 48.0 years, 53.4% female, and 13.3% aboriginal. Common co-morbidities included obesity, diabetes, and chronic obstructive pulmonary disease. AKI occurred in 60.9%, with RIFLE categories of Injury (23.0%) and Failure (37.9%). Independent predictors of AKI included obesity (OR 2.94; 95%CI, 1.75-4.91), chronic kidney disease (OR 4.50; 95%CI, 1.46-13.82), APACHE II score (OR per 1-unit increase 1.06; 95%CI, 1.03-1.09), and P(a)O2/F(i)O2 ratio (OR per 10-unit increase 0.98; 95%CI, 0.95-1.00). Of patients with AKI, 24.9% (85/342) received RRT and 25.8% (85/329) died. Independent predictors of RRT were obesity (OR 2.25; 95% CI, 1.14-4.44), day 1 mechanical ventilation (OR 4.09; 95% CI, 1.21-13.84), APACHE II score (OR per 1-unit increase 1.07; 95% CI, 1.03-1.12), and day 1 creatinine (OR per 10 µmol/L increase, 1.06; 95%CI, 1.03-1.10). Development of AKI was not independently associated with hospital mortality.
The incidence of AKI and RRT utilization were high among Canadian patients with critical illness due to pH1N1.
Notes
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PubMed ID
23763900 View in PubMed
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Acute kidney injury in critically ill patients infected with 2009 pandemic influenza A(H1N1): report from a Canadian Province.

https://arctichealth.org/en/permalink/ahliterature144768
Source
Am J Kidney Dis. 2010 May;55(5):848-55
Publication Type
Article
Date
May-2010
Author
Manish M Sood
Claudio Rigatto
Ryan Zarychanski
Paul Komenda
Amy R Sood
Joe Bueti
Martina Reslerova
Dan Roberts
Julie Mojica
Anand Kumar
Author Affiliation
St Boniface General Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.
Source
Am J Kidney Dis. 2010 May;55(5):848-55
Date
May-2010
Language
English
Publication Type
Article
Keywords
Acute Kidney Injury - epidemiology - etiology - therapy - virology
Adult
Comorbidity
Critical Illness
Female
Humans
Influenza A Virus, H1N1 Subtype
Influenza, Human - complications - epidemiology
Length of Stay
Male
Manitoba
Middle Aged
Renal Dialysis - statistics & numerical data
Young Adult
Abstract
2009 pandemic influenza A(H1N1) has led to a global increase in severe respiratory illness. Little is known about kidney outcomes and dialytic requirements in critically ill patients infected with pandemic H1N1.
Prospective observational study.
50 patients with pandemic H1N1 admitted to any of 7 intensive care units in Manitoba, Canada, were prospectively followed.
Outcomes were kidney injury and kidney failure defined using RIFLE (risk, injury, failure, loss, end-stage disease) criteria or need for dialysis therapy.
The pandemic H1N1 group was composed of 50 critically ill patients with pandemic H1N1 with severe respiratory syndrome (47 confirmed cases, 3 probable). Kidney injury, kidney failure, and need for dialysis occurred in 66.7%, 66%, and 11% of patients, respectively. Mortality was 16%. Kidney failure was associated with increased death (OR, 11.29; 95% CI, 1.29-98.9), whereas the need for dialysis was associated with an increase in length of stay (RR, 2.38; 95% CI, 2.13-25.75).
Small population studied from single Canadian province; thus, limited generalizability.
In critically ill patients with pandemic H1N1, kidney injury, kidney failure, and the need for dialysis are common and associated with an increase in mortality and length of intensive care unit stay.
PubMed ID
20303633 View in PubMed
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[Acute splenic sequestration in children with sickle cell disease--an overview].

https://arctichealth.org/en/permalink/ahliterature282445
Source
Lakartidningen. 2016 Dec 20;113
Publication Type
Article
Date
Dec-20-2016
Author
Fredrik Larsson
Anders Åhlin
Mats Marshall Heyman
Jonas Abrahamsson
Source
Lakartidningen. 2016 Dec 20;113
Date
Dec-20-2016
Language
Swedish
Geographic Location
Sweden
Publication Type
Article
Keywords
Acute Disease
Anemia, Sickle Cell - complications - epidemiology - physiopathology - surgery
Child
Child, Preschool
Critical Illness
Hematopoietic Stem Cell Transplantation
Humans
Infant
Male
Recurrence
Risk
Splenectomy
Splenic Diseases - etiology - pathology - surgery
Sweden
Abstract
Acute splenic sequestration in children with sickle cell disease - an overview Acute splenic sequestration (ASS) is a life-threatening complication of sickle cell disease (SCD). The condition is important to recognize due to the fact that it can occur with previously unknown disease. ASS is one of the most common causes of death in children with SCD and is the result of blood suddenly getting congested in the spleen, resulting in splenomegaly, acute anemia, and hypovolemic shock. Timely and appropriate treatment is essential in preventing death. Episodes of ASS before one year of age are associated with a higher risk of recurrence. There is no established effective treatment for recurrent ASS; however, there is evidence that all children with SCD should be treated with hydroxyurea. In Sweden, our recommendation is to evaluate the indications for splenectomy after the first episode of ASS. Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative treatment, and all children with SCD should be evaluated with regard to the potential success of HSCT. This article presents an overview of the condition with Swedish recommendations.
PubMed ID
28026839 View in PubMed
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[Admission, initial examination and care of severely injured in Denmark].

https://arctichealth.org/en/permalink/ahliterature192618
Source
Ugeskr Laeger. 2001 Oct 22;163(43):5963-6
Publication Type
Article
Date
Oct-22-2001
Author
M P Boesen
C F Larsen
F K Lippert
M S Larsen
N D Röck
T. Lang-Jensen
Author Affiliation
H:S Rigshospitalet, HovedOrtoCentret, TraumeCenter.
Source
Ugeskr Laeger. 2001 Oct 22;163(43):5963-6
Date
Oct-22-2001
Language
Danish
Publication Type
Article
Keywords
Clinical Competence
Critical Illness
Denmark
Emergency Service, Hospital - organization & administration - standards - statistics & numerical data
Humans
Monitoring, Physiologic
Patient Admission - statistics & numerical data
Practice Guidelines as Topic
Questionnaires
Trauma Centers - organization & administration - standards - statistics & numerical data
Traumatology - education - organization & administration - standards
Triage
Wounds and Injuries - diagnosis - therapy
Abstract
The aim of this study was to describe the initial care and management of trauma patients in Denmark.
A questionnaire was sent to all 64 hospitals in Denmark in July 1999. All responded. The questionnaire covered 81 questions.
The number of severely injured patients received by the hospitals was evenly distributed. Nine hospitals received more than 50 severely injured patients/year. Protocols for trauma care were available in 46 hospitals. Monitoring with ECG and pulse oximetry in the emergency room was possible in most hospitals. Most hospitals were also equipped to perform endotracheal intubation, chest tube drainage, surgical airway, and peritoneal lavage. Radiological and clinical laboratory services were available round the clock in most hospitals. Ultrasonography could be performed in 41 and CT in 36 hospitals. Three hospitals did not transfer patients to other facilities. An estimated quarter of the severely traumatised patients are transferred to a hospital with a higher level of trauma treatment.
Many Danish hospitals receive trauma patients. However, a number of hospitals do not have the necessary organisation, clinical capabilities, or resources for trauma care. There is a need for regional and national guidelines for trauma care with recommendations ensuring early recognition of patients who may be sufficiently cared for in the local hospital, and those who require transfer to trauma centres for definitive care.
PubMed ID
11699270 View in PubMed
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Adverse events during treatment of critical limb ischemia with autologous peripheral blood mononuclear cell implant.

https://arctichealth.org/en/permalink/ahliterature127035
Source
Int Angiol. 2012 Feb;31(1):77-84
Publication Type
Article
Date
Feb-2012
Author
T B Jonsson
T. Larzon
B. Arfvidsson
U. Tidefelt
C G Axelsson
M. Jurstrand
L. Norgren
Author Affiliation
Department of Surgery, University Hospital, Örebro, Sweden. thomas.jonsson@surgsci.uu.se
Source
Int Angiol. 2012 Feb;31(1):77-84
Date
Feb-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Amputation
Angiography, Digital Subtraction
Ankle Brachial Index
Critical Illness
Cytokines - blood
Drug Administration Schedule
Female
Granulocyte Colony-Stimulating Factor - administration & dosage
Heart Failure - etiology - mortality
Hematopoietic Stem Cell Mobilization
Humans
Intercellular Signaling Peptides and Proteins - blood
Ischemia - blood - complications - diagnosis - mortality - physiopathology - surgery
Limb Salvage
Lower Extremity - blood supply
Male
Mesenteric Vascular Occlusion - etiology - mortality
Middle Aged
Myocardial Infarction - etiology
Pain - etiology - prevention & control
Pain Measurement
Peripheral Blood Stem Cell Transplantation - adverse effects - mortality
Pilot Projects
Predictive value of tests
Recombinant Proteins - administration & dosage
Reoperation
Risk assessment
Risk factors
Sweden
Thrombosis - etiology - mortality
Time Factors
Transplantation, Autologous
Treatment Outcome
Wound Healing
Abstract
Trials have reported clinical improvement and reduced need for amputation in critical limb ischemia (CLI) patients receiving therapeutic angiogenesis with stem cells. Our objective was to test peripheral stem cell therapy efficacy and safety to gain experiences for further work.
We included nine CLI patients (mean age 76.7 ±9.7). Stem cells were mobilized to the peripheral blood by administration of G-CSF (Filgrastim) for 4 days, and were collected on day five, when 30 mL of a stem cell suspension was injected into 40 points of the limb. The clinical efficacy was evaluated by assessing pain relief, wound healing and changes in ankle-brachial pressure index (ABI). Local metabolic and inflammatory changes were measured with microdialysis, growth factors and cytokine level determination. Patients were followed for 24 weeks.
Four patients experienced some degree of improvement with pain relief and/or improved wound healing and ABI increase. One patient was lost to follow up due to chronic psychiatric illness; one was amputated after two weeks. Two patients had a myocardial infarction (MI), one died. One patient died from a massive mesenteric thrombosis after two weeks and one died from heart failure at week 11. Improved patients showed variable effects in cytokine-, growth factor- and local metabolic response.
Even with some improvement in four patients, severe complications in four out of nine patients, and two in relation to the bone marrow stimulation, made us terminate the study prematurely. We conclude that with the increased risk and the reduced potential of the treatment, peripheral blood stem cell treatment in the older age group is less appropriate. Metabolic and inflammatory response may be of value to gain insight into mechanisms and possibly to evaluate effects of therapeutic angiogenesis.
PubMed ID
22330628 View in PubMed
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Age of red blood cells and outcome in acute kidney injury.

https://arctichealth.org/en/permalink/ahliterature263080
Source
Crit Care. 2013;17(5):R222
Publication Type
Article
Date
2013
Author
Kirsi-Maija Kaukonen
Suvi T Vaara
Ville Pettilä
Rinaldo Bellomo
Jarno Tuimala
David J Cooper
Tom Krusius
Anne Kuitunen
Matti Reinikainen
Juha Koskenkari
Ari Uusaro
Source
Crit Care. 2013;17(5):R222
Date
2013
Language
English
Publication Type
Article
Keywords
Acute Kidney Injury - blood - mortality - therapy
Aged
Critical Illness
Erythrocyte Aging
Erythrocyte Transfusion - mortality
Female
Finland - epidemiology
Hospital Mortality
Humans
Intensive Care Units - statistics & numerical data
Male
Middle Aged
Prospective Studies
Risk assessment
Risk factors
Abstract
Transfusion of red blood cells (RBCs) and, in particular, older RBCs has been associated with increased short-term mortality in critically ill patients. We evaluated the association between age of transfused RBCs and acute kidney injury (AKI), hospital, and 90-day mortality in critically ill patients.
We conducted a prospective, observational, predefined sub-study within the FINNish Acute Kidney Injury (FINNAKI) study. This study included all elective ICU admissions with expected ICU stay of more than 24 hours and all emergency admissions from September to November 2011. To study the age of RBCs, we classified transfused patients into quartiles according to the age of oldest transfused RBC unit in the ICU. AKI was defined according to KDIGO (Kidney Disease: Improving Global Outcomes) criteria.
Out of 1798 patients, 652 received at least one RBC unit. The median [interquartile range] age of the oldest RBC unit transfused was 12 [11-13] days in the freshest quartile and 21 [17-27] days in the quartiles 2 to 4. On logistic regression, RBC age was not associated with the development of KDIGO stage 3 AKI. Patients in the quartile of freshest RBCs had lower crude hospital and 90-day mortality rates compared to those in the quartiles of older blood. After adjustments, older RBC age was associated with significantly increased risk for hospital mortality. Age, Simplified Acute Physiology Score II (SAPS II)-score without age points, maximum Sequental Organ Failure Assessment (SOFA) score and the total number of transfused RBC units were independently associated with 90-day mortality.
The age of transfused RBC units was independently associated with hospital mortality but not with 90-day mortality or KDIGO stage 3 AKI. The number of transfused RBC units was an independent risk factor for 90-day mortality.
Notes
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PubMed ID
24093554 View in PubMed
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417 records – page 1 of 42.