scholarly journals Vancomycin therapeutic monitoring by measured trough concentration versus Bayesian‐derived area under the curve in critically ill patients with cancer

2022 ◽  
Vol 10 (1) ◽  
Author(s):  
Aseel K. AbuSara ◽  
Deema H. Abdelrahman ◽  
Khader I. Habash ◽  
Mohammad H. Al‐Shaer ◽  
Jennifer Le ◽  
...  
Keyword(s):  
Critically Ill ◽  
Trough Concentration ◽  
Critically Ill Patients ◽  
Area Under The Curve ◽  
Therapeutic Monitoring ◽  
Patients With Cancer

scholarly journals Usefulness of sialic acid for diagnosis of sepsis in critically ill patients: a retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bo Yao ◽  
Wen-juan Liu ◽  
Di Liu ◽  
Jin-yan Xing ◽  
Li-juan Zhang
Keyword(s):  
Sialic Acid ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Incomplete Data ◽  
Acid Level ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Diagnostic Efficacy ◽  
Receiver Operating Characteristic Curves ◽  
Sensitivity Specificity

Abstract Background Early diagnosis of sepsis is very important. It is necessary to find effective and adequate biomarkers in order to diagnose sepsis. In this study, we compared the value of sialic acid and procalcitonin for diagnosing sepsis. Methods Newly admitted intensive care unit patients were enrolled from January 2019 to June 2019. We retrospectively collected patient data, including presence of sepsis or not, procalcitonin level and sialic acid level. Receiver operating characteristic curves for the ability of sialic acid, procalcitonin and combination of sialic acid and procalcitonin to diagnose sepsis were carried out. Results A total of 644 patients were admitted to our department from January 2019 to June 2019. The incomplete data were found in 147 patients. Finally, 497 patients data were analyzed. The sensitivity, specificity and area under the curve for the diagnosis of sepsis with sialic acid, procalcitonin and combination of sialic acid and procalcitonin were 64.2, 78.3%, 0.763; 67.9, 84.0%, 0.816 and 75.2, 84.6%, 0.854. Moreover, sialic acid had good values for diagnosing septic patients with viral infection, with 87.5% sensitivity, 82.2% specificity, and 0.882 the area under the curve. Conclusions Compared to procalcitonin, sialic acid had a lower diagnostic efficacy for diagnosing sepsis in critically ill patients. However, the combination of sialic acid and procalcitonin had a higher diagnostic efficacy for sepsis. Moreover, sialic acid had good value for diagnosing virus-induced sepsis.

Performance of Automated Telemetry in Diagnosing QT Prolongation in Critically Ill Patients

2021 ◽  
Vol 30 (6) ◽  
pp. 466-470
Author(s):  
Enrique Calvo-Ayala ◽  
Vince Procopio ◽  
Hayk Papukhyan ◽  
Girish B. Nair
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Demographic Data ◽  
Area Under The Curve ◽  
Qt Prolongation ◽  
Altman Analysis ◽  
Poor Agreement ◽  
Bland Altman Analysis ◽  
Prolonged Qt ◽  
Definition Of

Background QT prolongation increases the risk of ventricular arrhythmia and is common among critically ill patients. The gold standard for QT measurement is electrocardiography. Automated measurement of corrected QT (QTc) by cardiac telemetry has been developed, but this method has not been compared with electrocardiography in critically ill patients. Objective To compare the diagnostic performance of QTc values obtained with cardiac telemetry versus electrocardiography. Methods This prospective observational study included patients admitted to intensive care who had an electrocardiogram ordered simultaneously with cardiac telemetry. Demographic data and QTc determined by electrocardiography and telemetry were recorded. Bland-Altman analysis was done, and correlation coefficient and receiver operating characteristic (ROC) coefficient were calculated. Results Fifty-one data points were obtained from 43 patients (65% men). Bland-Altman analysis revealed poor agreement between telemetry and electrocardiography and evidence of fixed and proportional bias. Area under the ROC curve for QTc determined by telemetry was 0.9 (P < .001) for a definition of prolonged QT as QTc ≥ 450 milliseconds in electrocardiography (sensitivity, 88.89%; specificity, 83.33%; cutoff of 464 milliseconds used). Correlation between the 2 methods was only moderate (r = 0.6, P < .001). Conclusions QTc determination by telemetry has poor agreement and moderate correlation with electrocardiography. However, telemetry has an acceptable area under the curve in ROC analysis with tolerable sensitivity and specificity depending on the cutoff used to define prolonged QT. Cardiac telemetry should be used with caution in critically ill patients.

scholarly journals Lactate and base deficit are predictors of mortality in critically ill patients with cancer

Clinics ◽  
2011 ◽  
Vol 66 (12) ◽  
pp. 2037-2042 ◽  
Author(s):  
Ludhmila Abrahão Hajjar ◽  
Rosana Ely Nakamura ◽  
Juliano Pinheiro de Almeida ◽  
Julia T. Fukushima ◽  
Paulo Marcelo Gehm Hoff ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Base Deficit ◽  
Predictors Of Mortality ◽  
Patients With Cancer

scholarly journals Time-Limited Trials of Intensive Care for Critically Ill Patients With Cancer

JAMA Oncology ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 76 ◽  
Author(s):  
Mark G. Shrime ◽  
Bart S. Ferket ◽  
Daniel J. Scott ◽  
Joon Lee ◽  
Diana Barragan-Bradford ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Patients With Cancer

scholarly journals Galectin-3 in Critically Ill Patients with Sepsis and/or Trauma: A Good Predictor of Outcome or Not?

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Jasna Jevdjic ◽  
Maja Surbatovic ◽  
Snezana Milosavljevic ◽  
Goran Rondovic ◽  
Ivan Stanojevic ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Good Predictor ◽  
Injury Severity ◽  
Area Under The Curve ◽  
University Hospital ◽  
Youden Index ◽  
Lethal Outcome ◽  
Galectin 3

Abstract Severe sepsis and/or trauma complicated with multiple organ dysfunction syndrome are leading causes of death in critically ill patients. The aim of this prospective, observational, single centre study was to assess the prognostic value of galectin-3 regarding outcome in critically ill patients with severe trauma and/or severe sepsis. The outcome measure was hospital mortality. In total, 75 critically ill patients who were admitted to the intensive care unit of the tertiary university hospital were enrolled in a prospective observational study. Blood samples were collected upon fulfilling Sepsis-3 criteria and for a traumatized Injury Severity Score > 25 points. Levels of galectin-3 were significantly higher in nonsurvivors on the day of enrolment - Day 1 (p<0.05). On Day 1, the area under the curve (AUC) for the galectin-3 for lethal outcome was 0.602. At a cut-off level of 262.82 ng/mL, the sensitivity was 53%, and the specificity was 69.7%, which was objectively determined by a Youden index of 0.20. The discriminative power of galectin-3 in predicting outcome was statistically significant. Galectin-3 on Day 1 is a fairly good predictor of lethal outcome.

First‐Dose Vancomycin Pharmacokinetics Versus Empiric Dosing on Area‐Under‐the‐Curve Target Attainment in Critically Ill Patients

2020 ◽  
Vol 40 (12) ◽  
pp. 1210-1218
Author(s):  
Alexander H. Flannery ◽  
Natalie L. Delozier ◽  
Samuel A. Effoe ◽  
Katie L. Wallace ◽  
Aaron M. Cook ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Area Under The Curve ◽  
Target Attainment

Prognosis of Critically Ill Patients With Cancer and Acute Renal Dysfunction

2006 ◽  
Vol 24 (24) ◽  
pp. 4003-4010 ◽  
Author(s):  
Márcio Soares ◽  
Jorge I.F. Salluh ◽  
Marilia S. Carvalho ◽  
Michael Darmon ◽  
José R. Rocco ◽  
...  
Keyword(s):  
Renal Dysfunction ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Cox Model ◽  
Mortality Rates ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Acute Renal Dysfunction ◽  
Patients With Cancer ◽  
Organ Failures

Purpose To evaluate the outcomes of critically ill patients with cancer and acute renal dysfunction. Patients and Methods Prospective cohort study conducted at a 10-bed oncologic medical-surgical intensive care unit (ICU) over a 56-month period. Results Of 975 patients, 309 (32%) had renal dysfunction and were studied. Their mean age was 60.9 ± 15.9 years; 233 patients (75%) had solid tumors and 76 (25%) had hematologic malignancies. During the ICU stay, 98 patients (32%) received dialysis. Renal dysfunction was multifactorial in 56% of the patients, and the main associated factors were shock/ischemia (72%) and sepsis (63%). Overall hospital and 6-month mortality rates were 64% and 73%, respectively. Among patients who required dialysis, mortality rates were lower in patients who received dialysis on the first day of ICU in comparison with those who required it thereafter. In a multivariable Cox model, age more than 60 years, uncontrolled cancer, impaired performance status, and more than two associated organ failures were associated with increased 6-month mortality. Renal function was completely re-established in 82% and partially re-established in 12%, and only 6% of survivors required chronic dialysis. Conclusion Acute renal dysfunction is frequent in critically ill patients with cancer. Although mortality rates are high, selected patients can benefit from ICU care and advanced organ support. When evaluating prognosis and the appropriateness of dialysis in these patients, older age, functional capacity, cancer status and the severity of associated organ failures are important variables to take into consideration.

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