Icu research points 2015 1

1. ICU
RESEARCH POINTS
2014-2015
1
SAMIR EL ANSARY

2. Global Critical Care
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9555/
Wellcome in our new group ..... Dr.SAMIR EL ANSARY

3. Propofolmay prevent or limit reparative
processes in the early-phase postinjury.
The results therefore indicate that anesthetics may
be potentially harmful not only in very young
mammalians but also in adult animals following acute
cerebral injuries.
The results provide first evidence for an altered
sensitivity for anesthesia-related negative effects on
neurogenesis, functional outcome, and survival in
adult rats with brain lesions.

4. Preliminary Report on Cardiac
Dysfunction After Isolated
Traumatic Brain Injury
cardiac dysfunction during the first 2 weeks after
isolated traumatic brain injury and its association
with in-hospital mortality.
Cardiac dysfunction was defined as left ventricular ejection
fraction less than 50% or presence of regional wall motion
abnormality.

5. Preliminary Report on Cardiac
Dysfunction After Isolated
Traumatic Brain Injury
Cardiac dysfunction in the setting of isolated traumatic brain
injury occurs and is associated with increased in-hospital
mortality. This finding raises the question as to whether
there are uncharted opportunities for a more timely
recognition of cardiac dysfunction and subsequent
optimization of the hemodynamic management of these
patients.

6. Association of Low Serum 25-Hydroxyvitamin D Levels
and Sepsis in the Critically Ill
25-hydroxyvitamin D deficiency prior to hospital
admission is a significant predictor of sepsis in the
critically ill. Additionally, patients with sepsis who are
not vitamin D sufficient have an increased risk of
mortality following critical care initiation.

7. Treatment With Neuromuscular Blocking
Agents and the Risk of In-Hospital
Mortality Among Mechanically
Ventilated Patients With Severe Sepsis*
Recent trials suggest that treatment with neuromuscular
blocking agents may improve survival in patients requiring
mechanical ventilation for acute respiratory distress
syndrome. We examined the association between receipt of a
neuromuscular blocking agent and in-hospital mortality
among mechanically ventilated patients with severe sepsis.

8. Treatment With Neuromuscular Blocking
Agents and the Risk of In-Hospital
Mortality Among Mechanically
Ventilated Patients With Severe Sepsis*
Among mechanically ventilated patients with
severe sepsis and respiratory infection, early
treatment with a neuromuscular blocking agent is
associated with lower in-hospital mortality.

9. Effects of Propofol on Patient-Ventilator
Synchrony and Interaction During Pressure
Support Ventilation and Neurally Adjusted
Ventilatory Assist
With neurally adjusted ventilatory assist, ineffective
triggering index fell to 0%, regardless of the depth of
sedation.
With both modes, deep sedation caused a significant
increase in PaCO2, which resulted, however, from
different breathing patterns and patient-ventilator
interactions.

10. Effects of Propofol on Patient-Ventilator
Synchrony and Interaction During Pressure
Support Ventilation and Neurally Adjusted
Ventilatory Assist
In pressure support ventilation, deep propofol
sedation increased asynchronies, while light sedation
did not.
Propofol reduced the respiratory drive, while
breathing timing was not significantly affected.
Gas exchange and breathing pattern were also
influenced by propofol infusion to an extent that
varied with the depth of sedation and the mode of
ventilation.

11. Bundle of Measures for External Cerebral Ventricular
Drainage-Associated Ventriculitis
the prevalence and outcome of external cerebral
ventricular drainage-associated ventriculitis in
neurocritical patients before and after the
implementation of a bundle of external cerebral
ventricular drainage-associated ventriculitis control
measures.

12. Bundle of Measures for External Cerebral Ventricular
Drainage-Associated Ventriculitis
The bundle of external cerebral ventricular drainage-
associated ventriculitis control measures included
1) reeducation of ICU personnel on issues of infection control
related to external cerebral ventricular drainage,
2) meticulous intraventricular catheter handling,
3) cerebrospinal fluid sampling only when clinically
necessary, and
4) routine replacement of the drainage catheter on the
seventh drainage day if the catheter was still necessary.

13. Bundle of Measures for External Cerebral Ventricular
Drainage-Associated Ventriculitis
Measurements: External cerebral ventricular
drainage-associated ventriculitis prevalence, external
cerebral ventricular drainage-associated ventriculitis
events per 1,000 drainage days (drain-associated
infection rate), length of ICU stay, Glasgow Outcome
Scale at 6 months, and risk factors for external
cerebral ventricular drainage-associated ventriculitis.

14. Bundle of Measures for External Cerebral Ventricular
Drainage-Associated Ventriculitis
The implementation of a bundle of
measures for external cerebral ventricular
drainage-associated ventriculitis control
was associated with significantly decreased
postintervention prevalence of the
infection.

15. Providing effective enteral nutrition is important during critical
illness.
In health, glucose is absorbed from the small intestine via
sodium-dependent glucose transporter-1 and glucose
transporter-2,
which may both be regulated by intestinal sweet taste
receptors.
The effect of critical illness on glucose absorption and
expression of intestinal sodium-dependent glucose
transporter-1, glucose transporter-2, and sweet taste
receptors in humans
The Effects of Critical Illness on Intestinal
Glucose Sensing, Transporters, and
Absorption

16. The Effects of Critical Illness on Intestinal
Glucose Sensing, Transporters, and
Absorption
Critical illness is characterized by markedly
diminished glucose absorption, associated with
reduced intestinal expression of glucose
transporters (sodium-dependent glucose
transporter-1 and glucose transporter-2) and
sweet taste receptor transcripts.

17. Global Critical Care
https://www.facebook.com/groups/1451610115129555/#!/groups/145161011512
9555/
Wellcome in our new group ..... Dr.SAMIR EL ANSARY

18. GOOD LUCK
SAMIR EL ANSARY
ICU PROFESSOR
AIN SHAMS
CAIRO
elansarysamir@yahoo.com