Objectives: During critical illness, impaired endothelial vascular reactivity predicts prolonged acute brain dysfunction, but relationships between endothelial activation, blood-brain barrier/neurological injury, and acute brain dysfunction, including delirium, remain unexamined. We tested the hypothesis that elevated plasma markers of endothelial activation and blood-brain barrier/neurological injury are associated with delirium duration during critical illness. Design: Prospective cohort study. Setting: Medical and surgical ICUs in an academic medical center. Patients: Adults in acute respiratory failure and/or shock. Interventions: None. Measurements and Main Results: We enrolled subjects within 72 hours of organ failure diagnosis in the ICU. We measured plasma concentrations of plasminogen activator inhibitor-1, E-selectin, and angiopoietin-2 as markers of endothelial activation and S100B as a marker of blood-brain barrier/neurological injury in blood collected at enrollment. We assessed patients for delirium and coma twice daily after enrollment using the Confusion Assessment Method for the ICU and the Richmond Agitation-Sedation Scale. Among 134 patients with a median (interquartile) age of 57 years (46-66 yr) and Acute Physiology and Chronic Health Evaluation II of 26 (19-31), delirium occurred in 94 patients (70%) with a median duration of 2 days (0-4 d). Higher plasminogen activator inhibitor-1 (p = 0.002), E-selectin (p = 0.02), and S100B (p
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Academic Emergency Medicine, EarlyView. from Emergency Medicine via xlomafota13 on Inoreader https://ift.tt/2JxJINK
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This feed no longer exists. Cambridge Journals Online and Cambridge Books Online have been replaced by Cambridge University Press’s new acad...
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Objectives: Opioids and benzodiazepines are commonly used to provide analgesia and sedation for critically ill children with cardiac disease...
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Objective: Inotropic and vasopressor drugs are routinely used in critically ill patients to maintain adequate blood pressure and cardiac ou...
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Academic Emergency Medicine, EarlyView. from Emergency Medicine via xlomafota13 on Inoreader https://ift.tt/2Lq7OXW
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Abstract This paper proposes a novel system to protect the fingerprint database based on compressed binary fingerprint images. In this sys...
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Abstract Background and Significance Adverse drug events (ADEs) occur in approximately 2–5% of hospitalized patients, often resulting in...
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Steve Whitehead, host of Remember 2 Things, talks about why you should read your glucometer manual to get an accurate sample and how you can...
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