Intensive care medicine
-
Intensive care medicine · May 2019
Randomized Controlled Trial Multicenter StudyA multicenter, randomized, double-blind study of ulimorelin and metoclopramide in the treatment of critically ill patients with enteral feeding intolerance: PROMOTE trial.
Enteral feeding intolerance (EFI) is a frequent problem in the intensive care unit (ICU), but current prokinetic agents have uncertain efficacy and safety profiles. The current study compared the efficacy and safety of ulimorelin, a ghrelin agonist, with metoclopramide in the treatment of EFI. ⋯ Both prokinetic agents achieved similar rates of feeding success, and no safety differences between the two treatment groups were observed.
-
Intensive care medicine · May 2019
ReviewDiagnostic and therapeutic approach to infectious diseases in solid organ transplant recipients.
Prognosis of solid organ transplant (SOT) recipients has improved, mainly because of better prevention of rejection by immunosuppressive therapies. However, SOT recipients are highly susceptible to conventional and opportunistic infections, which represent a major cause of morbidity, graft dysfunction and mortality. ⋯ We provide state-of the art review of available knowledge of critically ill SOT patients with infections.
-
Intensive care medicine · May 2019
Multicenter Study Observational StudyCardiovascular clusters in septic shock combining clinical and echocardiographic parameters: a post hoc analysis.
Mechanisms of circulatory failure are complex and frequently intricate in septic shock. Better characterization could help to optimize hemodynamic support. ⋯ Our clustering approach on a large population of septic shock patients, based on clinical and echocardiographic parameters, was able to characterize five different cardiovascular phenotypes. How this could help physicians to optimize hemodynamic support should be evaluated in the future.
-
Intensive care medicine · May 2019
Whole genome sequencing reveals that genetic conditions are frequent in intensively ill children.
With growing evidence that rare single gene disorders present in the neonatal period, there is a need for rapid, systematic, and comprehensive genomic diagnoses in ICUs to assist acute and long-term clinical decisions. This study aimed to identify genetic conditions in neonatal (NICU) and paediatric (PICU) intensive care populations. ⋯ The use of WGS in intensively ill children is acceptable and trio analysis facilitates diagnoses. A gene agnostic approach was effective in identifying an underlying genetic condition, with phenotypes and symptomatology being primarily used for data interpretation rather than gene selection. WGS analysis has the potential to be a first-line diagnostic tool for a subset of intensively ill children.