scholarly journals Multiple-dose pharmacokinetics of amikacin and ceftazidime in critically ill patients with septic multiple-organ failure during intermittent hemofiltration.

1993 ◽  
Vol 37 (3) ◽  
pp. 464-473 ◽  
Author(s):  
J M Kinowski ◽  
J E de la Coussaye ◽  
F Bressolle ◽  
D Fabre ◽  
G Saissi ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multiple Dose ◽  
Multiple Organ ◽  
Multiple Dose Pharmacokinetics

Metabolic encephalopathy in critically ill patients suffering from septic or nonseptic multiple organ failure

2000 ◽  
Vol 28 (5) ◽  
pp. 1310-1315 ◽  
Author(s):  
Christian Zauner ◽  
Alexandra Gendo ◽  
Ludwig Kramer ◽  
Alexander Kranz ◽  
Georg Grimm ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multiple Organ ◽  
Metabolic Encephalopathy

ASSESSMENT OF CEREBRAL FUNCTION IN CRITICALLY ILL PATIENTS WITH MULTIPLE ORGAN FAILURE DUE TO SEPTIC AND NON-SEPTIC CONDITIONS

1999 ◽  
Vol 27 (Supplement) ◽  
pp. 125A
Author(s):  
Christian Zauner ◽  
Alexandra Gendo ◽  
Ludwig Kramer ◽  
Alexander Kranz ◽  
Christian Madl
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multiple Organ ◽  
Cerebral Function

Oncologists’ and Intensivists’ Attitudes Toward the Care of Critically Ill Patients with Cancer

2017 ◽  
Vol 34 (10) ◽  
pp. 811-817 ◽  
Author(s):  
Antonio Paulo Nassar ◽  
Aldo Lourenço Abadde Dettino ◽  
Cristina Prata Amendola ◽  
Rodrigo Alves dos Santos ◽  
Daniel Neves Forte ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pancreatic Cancer ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Life Support ◽  
Multiple Organ ◽  
Patients With Cancer ◽  
Support Measures

Background: Patients with cancer represent an important proportion of intensive care unit (ICU) admissions. Oncologists and intensivists have distinct knowledge backgrounds, and conflicts about the appropriate management of these patients may emerge. Methods: We surveyed oncologists and intensivists at 2 academic cancer centers regarding their management of 2 hypothetical patients with different cancer types (metastatic pancreatic cancer and metastatic breast cancer with positive receptors for estrogen, progesterone, and HER-2) who develop septic shock and multiple organ failure. Results: Sixty intensivists and 46 oncologists responded to the survey. Oncologists and intensivists similarly favored withdrawal of life support measures for the patient with pancreatic cancer (33/46 [72%] vs 48/60 [80%], P = .45). On the other hand, intensivists favored more withdrawal of life support measures for the patient with breast cancer compared to oncologists (32/59 [54%] vs 9/44 [21%], P < .001). In the multinomial logistic regression, the oncology specialists were more likely to advocate for a full-code status for the patient with breast cancer (OR = 5.931; CI 95%, 1.762-19.956; P = .004). Conclusions: Oncologists and intensivists share different views regarding life support measures in critically ill patients with cancer. Oncologists tend to focus on the cancer characteristics, whereas intensivists focus on multiple organ failure when weighing in on the same decisions. Regular meetings between oncologists and intensivists may reduce possible conflicts regarding the critical care of patients with cancer.

Derangements in mitochondrial metabolism in intercostal and leg muscle of critically ill patients with sepsis-induced multiple organ failure

2006 ◽  
Vol 291 (5) ◽  
pp. E1044-E1050 ◽  
Author(s):  
Katarina Fredriksson ◽  
Folke Hammarqvist ◽  
Karin Strigård ◽  
Kjell Hultenby ◽  
Olle Ljungqvist ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Citrate Synthase ◽  
Elective Surgery ◽  
Creatine Phosphate ◽  
Multiple Organ ◽  
Intercostal Muscle ◽  
Leg Muscle

Critically ill patients treated for multiple organ failure often develop muscle dysfunction. Here we test the hypothesis that mitochondrial and energy metabolism are deranged in leg and intercostal muscle of critically ill patients with sepsis-induced multiple organ failure. Ten critically ill patients suffering from sepsis-induced multiple organ failure and requiring mechanical ventilation were included in the study. A group ( n = 10) of metabolically healthy age- and sex-matched patients undergoing elective surgery were used as controls. Muscle biopsies were obtained from the vastus lateralis (leg) and intercostal muscle. The activities of citrate synthase and mitochondrial respiratory chain complexes I and IV and concentrations of ATP, creatine phosphate, and lactate were analyzed. Morphological evaluation of mitochondria was performed by electron microscopy. Activities of citrate synthase and complex I were 53 and 60% lower, respectively, in intercostal muscle of the patients but not in leg muscle compared with controls. The activity of complex IV was 30% lower in leg muscle but not in intercostal muscle. Concentrations of ATP and creatine phosphate were, respectively, 40 and 34% lower, and lactate concentrations were 43% higher in leg muscle but not in intercostal muscle. We conclude that both leg and intercostal muscle show a twofold decrease in mitochondrial content in intensive care unit patients with multiple organ failure, which is associated with lower concentrations of energy-rich phosphates and an increased anaerobic energy production in leg muscle but not in intercostal muscle.

Continuous Veno-Venous Hemofiltration in Critically Ill Patients with Multiple Organ Failure

1993 ◽  
Vol 16 (8) ◽  
pp. 592-598 ◽  
Author(s):  
S. Vesconi ◽  
A. Sicignano ◽  
P. De Pietri ◽  
C. Foroni ◽  
A. Minuto ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multiple Organ ◽  
Blood Levels ◽  
Intermittent Hemodialysis ◽  
Electrolyte Balance ◽  
High Flux ◽  
Urea Nitrogen

18 critically ill patients, with multiple organ failure (MOF) (from shock either septic, n = 15, or cardiogenic, n = 3), oliguria and increase in BUN and creatinine were treated with pump driven, high flux continuous veno-venous hemofiltration (CVVH). Replacement fluids were administered in predilution mode. All patients were under respiratory support and vasoactive drugs, and received early nutritional support (N input: 0.2–0.3 g/kg/day). Mean duration of treatment was 9.2 days and mean ultrafiltrate production was 21.4 l/day; treatment resulted in a significant reduction of both urea nitrogen and creatinine blood levels (-20 and -40% of initial values respectively) in spite of a very severe catabolism. The total amount of urea nitrogen removed through CVVH ranged from 15 to 73 g/day (mean 33.5), the median value of urea nitrogen clearance was 12.8 ml/min with a median ultrafiltration coefficient of 0.8. The mean duration of hemofilters was 69 hours (38–108); the efficacy of filters remained stable throughout the entire lifespan and changes were made in case of sudden decrease of ultrafiltration (< ml/min). No major complication was observed in over than 4000 hours of treatment. Pump driven, high flux CVVH proved effective in the control of water electrolyte balance and metabolic homeosthasis in a group of critically ill, hemodynamically unstable, catabolic patients with MOF and acute renal failure. In no case we had to add intermittent hemodialysis or to use hemodiafiltration. The constant extracorporeal blood flow and the stable efficacy of hemofilters allowed an easy control of the overall effectiveness of this technique.

Basal functional status predicts functional recovery in critically ill patients with multiple-organ failure

2015 ◽  
Vol 30 (3) ◽  
pp. 511-517 ◽  
Author(s):  
Sancho Rodríguez-Villar ◽  
Rocío Fernández-Méndez ◽  
Gary Adams ◽  
José L. Rodríguez-García ◽  
Juan Arévalo-Serrano ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Functional Status ◽  
Organ Failure ◽  
Critically Ill ◽  
Functional Recovery ◽  
Critically Ill Patients ◽  
Multiple Organ

The IN-PANCIA Study: Clinical Evaluation of Gastrointestinal Dysfunction and Failure, Multiple Organ Failure, and Levels of Citrulline in Critically Ill Patients

2017 ◽  
Vol 35 (3) ◽  
pp. 279-283 ◽  
Author(s):  
Nazzareno Fagoni ◽  
Simone Piva ◽  
Rosella Marino ◽  
Giovanni Chiarini ◽  
Daniela Ferrari ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Bowel Dysfunction ◽  
Multiple Organ ◽  
Abdominal Pressure ◽  
Gastrointestinal Dysfunction ◽  
Abdominal Hypertension ◽  
Patient Groups

Purpose: Gastrointestinal dysfunction and failure (GID and GIF) in critically ill patients are a common, relevant, and underestimated complications in ICU patients. The aims of this study were (1) to determine plasmatic levels of citrulline, glutamine, and arginine as markers of GID/GIF in critically ill patients with or without GID/GIF with or without multiple organ failure (MOF) and (2) to assess the role of intra-abdominal hypertension in these patient groups. Materials and Methods: This is a 1-year, monocentric (Italian hospital), prospective observational study. Inclusion criteria were adult patients with GID/GIF, with or without MOF. The GIF score was daily evaluated in 39 critically ill patients. Amino acids were measured at the time of GID or GIF. Results: We enrolled 39 patients. Nine patients developed GID and 7 GIF; 6 of patients with GID/GIF developed MOF. Citrulline was lower ( P < .001) in patients with GID/GIF (11.3 [4.4] µmol/L), compared to patients without GID/GIF (22.4 [6.8] µmol/L); likewise, glutamine was lower in patients with GID/GIF, whereas arginine was nonstatistically different between the 2 groups. Intra-abdominal pressure was higher in patients affected by MOF (13.0 [2.2] mm Hg) than in patients with GIF/GID without MOF (9.6 [2.6] mm Hg) and compared to patients without GID/GIF (7.2 [2.1] mm Hg). Conclusions: Both GID and GIF in critically ill patients are associated with low levels of citrulline and glutamine, which could be considered as markers of small bowel dysfunction. The higher the GIF score, the lower the citrulline levels. Patients affected by MOF had higher levels of intra-abdominal pressure.

scholarly journals A258 MULTIPLE ORGAN FAILURE AND PLATELET TRAPPING IN THE INTESTINE IN CRITICALLY ILL PATIENTS

1990 ◽  
Vol 73 (3A) ◽  
pp. NA-NA
Author(s):  
G H. Sigurdsson ◽  
J T. Christenson ◽  
M Bader ◽  
S Sadek
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multiple Organ
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