TY - JOUR AU - Csomós, Ákos AU - Klicsu, László AU - László, István AU - Bobek, Ilona AU - Sárkány, Ágnes AU - Gál, Béla TI - Klinikai táplálás az intenzív osztályon: az EuroPN-vizsgálat magyarországi eredményei JF - ORVOSI HETILAP J2 - ORV HETIL VL - 165 PY - 2024 IS - 14 SP - 531 EP - 537 PG - 7 SN - 0030-6002 DO - 10.1556/650.2024.33017 UR - https://m2.mtmt.hu/api/publication/34780699 ID - 34780699 AB - Bevezetés: A kritikus állapotú betegek mesterséges táplálásának jelentősége jól ismert, hiányában a folyamatos fehérjelebontás miatt romlik a sebgyógyulás, valamint emelkedik a lélegeztetőgépen töltött napok száma. Célkitűzés: A korábban publikált EuroPN nemzetközi vizsgálat célja az volt, hogy európai összehasonlításban felmérje a részt vevő intenzív osztályok aktuális táplálási gyakorlatát, és megvizsgálja a kalória-, illetve fehérjebevitel hatását a lélegeztetőgépről való leszoktatásban és a 90 napos halálozásban. A jelen kézirat a vizsgálatban részt vevő magyarországi osztályok eredményeit elemzi. Módszer: Vizsgálatunkba azokat a betegeket vontuk be, akiket legalább 5 napja kezeltek az intenzív osztályon. A klinikai és a táplálási adatokat napokra bontva gyűjtöttük az intenzív osztályos felvételt követő első 5 napban retrospektíven, majd azt követően maximum 15 napon át (vagy az elbocsátás/elhalálozás napjáig) prospektíven. A betegkimeneteli adatokat a 15., a 30. és a 90. napon rögzítettük. Eredmények: Magyarországról 6 intenzív osztályról összesen 111 beteget vontunk be a vizsgálatba. A kumulatív kalória- és fehérjebevitel tekintetében a magyarországi betegek nagyobb arányban kapták meg az ESPEN-célértékeket: kalória esetében az előírt kalória 92%-át (95% CI 68; 118) sikerült biztosítani ( vs. 83% Európában [95% CI 59; 107]); fehérje esetében pedig még jelentősebb a különbség: Magyarországon 83% (95%CI 57; 121), ezzel szemben Európában 65% (95% CI 41; 91) volt a bevitel és az ESPEN-célérték aránya. Megbeszélés és következtetés: A nemzetközi EuroPN-adatelemzésben a nagyobb kumulatív kalória- és fehérjebevitel csökkentette a lélegeztetőgépről való leszoktatás időtartamát. A magyarországi betegek esetében gyorsabban értük el ezeket a célértékeket, köszönhetően annak, hogy a kiegészítő parenteralis táplálást nagyobb arányban alkalmaztuk. Orv Hetil. 2024; 165(14): 531–537. LA - Hungarian DB - MTMT ER - TY - JOUR AU - Matejovic, Martin AU - Huet, Olivier AU - Dams, Karolien AU - Elke, Gunnar AU - Vaquerizo Alonso, Clara AU - Csomós, Ákos AU - Krzych, Łukasz J. AU - Tetamo, Romano AU - Puthucheary, Zudin AU - Rooyackers, Olav AU - Tjäder, Inga AU - Kuechenhoff, Helmut AU - Hartl, Wolfgang H. AU - Hiesmayr, Michael TI - Medical nutrition therapy and clinical outcomes in critically ill adults: a European multinational, prospective observational cohort study (EuroPN) JF - CRITICAL CARE J2 - CRIT CARE VL - 26 PY - 2022 IS - 1 SN - 1364-8535 DO - 10.1186/s13054-022-03997-z UR - https://m2.mtmt.hu/api/publication/33091847 ID - 33091847 LA - English DB - MTMT ER - TY - JOUR AU - Giugni, Aimone AU - Gamberini, Lorenzo AU - Carrara, Greta AU - Antiga, Luca AU - Brissy, Obou AU - Buldini, Virginia AU - Calamai, Italo AU - Csomós, Ákos AU - De Luca, Alessandra AU - Ferri, Enrico AU - Fleming, Joanne M. AU - Gradisek, Primoz AU - Kaps, Rafael AU - Kyprianou, Theodoros AU - Lagomarsino, Silvia AU - Lazar, Isaac AU - Martino, Costanza AU - Mikaszewska-Sokolewicz, Malgorzata AU - Montis, Andrea AU - Nardai, Gábor AU - Nattino, Giovanni AU - Nattino, Giuseppe AU - Paci, Giulia AU - Portolani, Laila AU - Xirouchaki, Nektaria AU - Chieregato, Arturo AU - Bertolini, Guido AU - Ágnes, Sárkány AU - Agostini, Fulvio AU - Ajmone-Cat, Claudio AU - Bassi, Giovanni AU - Bekos, Vasileios AU - Bellin, Marzia AU - Bocci, Maria Grazia AU - Bonato, Valeria AU - Bonato, Alfeo AU - Bonizzoli, Manuela AU - Bonucci, Paola AU - Bottazzi, Andrea AU - Calicchio, Giuseppe AU - Carlin, Fabrizia AU - Casagli, Sergio AU - Castioni, Carlo Alberto AU - Ciceri, Rita AU - Cocciolo, Francesco AU - Crestan, Ezio AU - Cseplo, Peter AU - Csomos, Akos AU - Curto, Francesco AU - Dąbrowski, Wojciech AU - De Cristofaro, Anna AU - De Luca, Alessandra AU - Duda, Izabela AU - Duek, Or AU - Bakó, Blanka Emoke AU - Fagoni, Nazzareno AU - Fassini, Paola AU - Ferri, Enrico AU - Filekovic, Suada AU - Fiore, Gilberto AU - Gamberini, Emiliano AU - Gattari, Diego AU - Gianni, Massimo AU - Dessena, Maria Giovanna AU - Giuntini, Romano AU - Guido, Stefania AU - Gyulai, Rita AU - Hadash, Amir AU - Hribar, Renata AU - Ilia, Stavroula AU - Jankovic, Vesna Novak AU - Jurekovic, Vlado AU - Jereb, Mateja AU - Kapias, Maciej AU - Karadzic, Dragica AU - Kasnik, Darja AU - Kioulpalis, Anastasios AU - Szaszi, Adrienn Kitti AU - Kompan, Janez AU - Kyriakides, Eraclis AU - Lamborghini, Sara AU - Livigni, Sergio AU - Malacarne, Paolo AU - Martelli, Maria AU - Martin, Marina Alessandra AU - Marudi, Andrea AU - Melis, Martina AU - Mengoli, Francesca AU - Mirkovic, Tomislav AU - Mizak, Wiktoria AU - Munari, Marina AU - Nascimben, Ennio AU - Natalini, Giuseppe AU - Negro, Giancarlo AU - Nemes, Csaba AU - Bernasconi, Mara Olga AU - Pagani, Michele AU - Parrini, Vieri AU - Partala, Panagio AU - Pastorelli, Mauro AU - Pellicioli, Isabella AU - Bert, Paolo Perino AU - Petrucci, Nicola AU - Piva, Simone AU - Poole, Daniele AU - Radrizzani, Danilo AU - Rekas, Anna AU - Robak, Paweł AU - Rosano, Antonio AU - Ruggeri, Patrizia AU - Sacchi, Marco AU - Skoti, Mara AU - Skrt, Alja AU - Spagarino, Ermanno AU - Sulkowski, Wiktor AU - Szedlák, Balázs AU - Terzitta, Marina AU - Tinturini, Rebecca AU - Tofani, Rossella AU - Tselioti, Paraskevi AU - Vecchiarelli, Ada AU - Venturini, Elisabetta AU - Visconti, Salvatore AU - Xirouchaki, Nektaria AU - Zompanti, Valeria AU - Zoppellari, Roberto TI - Hospitals with and without neurosurgery: a comparative study evaluating the outcome of patients with traumatic brain injury JF - SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION AND EMERGENCY MEDICINE J2 - SCAND J TRAUMA RESUS VL - 29 PY - 2021 IS - 1 PG - 15 SN - 1757-7241 DO - 10.1186/s13049-021-00959-2 UR - https://m2.mtmt.hu/api/publication/32764995 ID - 32764995 N1 - *Aimone Giugni and Lorenzo Gamberini are shared frst authorship. LA - English DB - MTMT ER - TY - JOUR AU - Hiesmayr, M. AU - Csomós, Ákos AU - Dams, K. AU - Elke, G. AU - Hartl, W. AU - Huet, O. AU - Krzych, L.J. AU - Kuechenhoff, H. AU - Matejovic, M. AU - Puthucheary, Z.A. AU - Rooyackers, O. AU - Tetamo, R. AU - Tjäder, I. AU - Vaquerizo, C. TI - Protocol for a prospective cohort study on the use of clinical nutrition and assessment of long-term clinical and functional outcomes in critically ill adult patients JF - CLINICAL NUTRITION ESPEN J2 - CLINICAL NUTRITION ESPEN VL - 43 PY - 2021 SP - 104 EP - 110 PG - 7 SN - 2405-4577 DO - 10.1016/j.clnesp.2021.01.048 UR - https://m2.mtmt.hu/api/publication/32236838 ID - 32236838 LA - English DB - MTMT ER - TY - JOUR AU - Gradisek, Primoz AU - Carrara, Greta AU - Antiga, Luca AU - Bottazzi, Barbara AU - Chieregato, Arturo AU - Csomós, Ákos AU - Fainardi, Enrico AU - Filekovic, Suada AU - Fleming, Joanne AU - Hadjisavvas, Andreas AU - Kaps, Rafael AU - Kyprianou, Theodoros AU - Latini, Roberto AU - Lazar, Isaac AU - Masson, Serge AU - Mikaszewska-Sokolewicz, Malgorzata AU - Novelli, Deborah AU - Paci, Giulia AU - Xirouchaki, Nektaria AU - Zanier, Elisa AU - Nattino, Giovanni AU - Bertolini, Guido TI - Prognostic Value of a Combination of Circulating Biomarkers in Critically Ill Patients with Traumatic Brain Injury: Results from the European CREACTIVE Study JF - JOURNAL OF NEUROTRAUMA J2 - J NEUROTRAUM VL - 38 PY - 2021 IS - 19 SP - 2667 EP - 2676 PG - 10 SN - 0897-7151 DO - 10.1089/neu.2021.0066 UR - https://m2.mtmt.hu/api/publication/32193801 ID - 32193801 N1 - Funding Agency and Grant Number: European UnionEuropean Commission [602714] Funding text: The research leading to these results has received funding from the European Union Seventh Framework Programme (FP7/2007-2013) under Grant Agreement number 602714. AB - Individualized patient care is essential to reduce the global burden of traumatic brain injury (TBI). This pilot study focused on TBI patients admitted to intensive care units (ICUs) and aimed at identifying patterns of circulating biomarkers associated with the disability level at 6 months from injury, measured by the extended Glasgow Outcome Scale (GOS-E). The concentration of 107 biomarkers, including proteins related to inflammation, innate immunity, TBI, and central nervous system, were quantified in blood samples collected on ICU admission from 80 patients. Patients were randomly selected among those prospectively enrolled in the Collaborative Research on Acute Traumatic Brain Injury in Intensive Care Medicine in Europe (CREACTIVE) observational study. Six biomarkers were selected to be associated with indicators of primary or secondary brain injury: three glial proteins (glial cell-derived neurotrophic factor, glial fibrillary acidic protein, and S100 calcium-binding protein B) and three cytokines (stem cell factor, fibroblast growth factor [FGF] 23 and FGF19). The subjects were grouped into three clusters according to the expression of these proteins. The distribution of the 6-month GOS-E was significantly different across clusters (p < 0.001). In two clusters, the number of 6-month deaths or vegetative states was significantly lower than expected, as calculated according to a customization of the corticosteroid randomization after significant head injury (CRASH) scores (observed/expected [O/E] events = 0.00, 95% confidence interval [CI]: 0.00-0.90 and 0.00, 95% CI: 0.00-0.94). In one cluster, less-than-expected unfavorable outcomes (O/E = 0.50, 95% CI: 0.05-0.95) and more-than-expected good recoveries (O/E = 1.55, 95% CI: 1.05-2.06) were observed. The improved prognostic accuracy of the pattern of these six circulating biomarkers at ICU admission upon established clinical parameters and computed tomography results needs validation in larger, independent cohorts. Nonetheless, the results of this pilot study are promising and will prompt further research in personalized medicine for TBI patients. LA - English DB - MTMT ER - TY - JOUR AU - Finazzi, Stefano AU - Paci, Giulia AU - Antiga, Luca AU - Brissy, Obou AU - Carrara, Greta AU - Crespi, Daniele AU - Csato, Gabor AU - Csomós, Ákos AU - Duek, Or AU - Facchinetti, Sara AU - Fleming, Joanne AU - Garbero, Elena AU - Gianni, Massimo AU - Gradisek, Primoz AU - Kaps, Rafael AU - Kyprianou, Theodoros AU - Lazar, Isaac AU - Mikaszewska-Sokolewicz, Malgorzata AU - Mondini, Matteo AU - Nattino, Giovanni AU - Olivieri, Carlo AU - Poole, Daniele AU - Previtali, Claudio AU - Radrizzani, Danilo AU - Rossi, Carlotta AU - Skurzak, Stefano AU - Tavola, Mario AU - Xirouchaki, Nektaria AU - Bertolini, Guido TI - PROSAFE: a European endeavor to improve quality of critical care medicine in seven countries JF - MINERVA ANESTESIOLOGICA J2 - MINERVA ANESTESIOL VL - 86 PY - 2020 IS - 12 SP - 1305 SN - 0375-9393 DO - 10.23736/S0375-9393.20.14112-9 UR - https://m2.mtmt.hu/api/publication/32236858 ID - 32236858 LA - English DB - MTMT ER - TY - JOUR AU - Szudi, László János AU - Szekely, László AU - Sápi, Erzsébet AU - Prodán, Zsolt AU - Szolnoky, Jenő AU - Csomós, Ákos AU - Nyolczas, Noémi AU - Paulovich, Erzsébet AU - Németh, Endre AU - Hartyánszky, István AU - Zima, Endre István AU - Sax, Balázs AU - Bertalan, Andrea AU - Hejjel, László AU - Bogáts, Gábor AU - Babik, Barna AU - Gombocz, K AU - Szerafin, Tamás AU - Koszta, György AU - Molnár, Andrea TI - A levoszimendán perioperatív alkalmazása a szívsebészetben. Magyar ajánlás TS - Magyar ajánlás JF - ORVOSI HETILAP J2 - ORV HETIL VL - 159 PY - 2018 IS - 22 SP - 870 EP - 877 PG - 8 SN - 0030-6002 DO - 10.1556/650.2018.31083 UR - https://m2.mtmt.hu/api/publication/3381212 ID - 3381212 AB - Low output syndrome significantly increases morbidity and mortality of cardiac surgery and lengthens the durations of intensive care unit and hospital stays. Its treatment by catecholamines can lead to undesirable systemic and cardiac complications. Levosimendan is a calcium sensitiser and adenosine triphosphate (ATP)-sensitive potassium channel (IK,ATP) opener agent. Due to these effects, it improves myocardium performance, does not influence adversely the balance between O2 supply and demand, and possesses cardioprotective and organ protective properties as well. Based on the scientific literature and experts' opinions, a European recommendation was published on the perioperative use of levosimendan in cardiac surgery in 2015. Along this line, and also taking into consideration cardiac surgeon, anaesthesiologist and cardiologist representatives of the seven Hungarian heart centres and the children heart centre, the Hungarian recommendation has been formulated that is based on two pillars: literature evidence and Hungarian expert opinions. The reviewed fields are: coronary and valvular surgery, assist device implantation, heart transplantation both in adult and pediatric cardiologic practice. Orv Hetil. 2018; 159(22): 870-877. LA - Hungarian DB - MTMT ER - TY - JOUR AU - Maas, AIR AU - Menon, DK AU - Adelson, PD AU - Andelic, N AU - Bell, MJ AU - Belli, A AU - Bragge, P AU - Brazinova, A AU - Büki, András AU - Chesnut, RM AU - Citerio, G AU - Coburn, M AU - Cooper, DJ AU - Crowder, AT AU - Czeiter, Endre AU - Czosnyka, M AU - Diaz-Arrastia, R AU - Dreier, JP AU - Duhaime, AC AU - Ercole, A AU - van Essen, TA AU - Feigin, VL AU - Gao, G AU - Giacino, J AU - Gonzalez-Lara, LE AU - Gruen, RL AU - Gupta, D AU - Hartings, JA AU - Hill, S AU - Jiang, JY AU - Ketharanathan, N AU - Kompanje, EJO AU - Lanyon, L AU - Laureys, S AU - Lecky, F AU - Levin, H AU - Lingsma, HF AU - Maegele, M AU - Majdan, M AU - Manley, G AU - Marsteller, J AU - Mascia, L AU - McFadyen, C AU - Mondello, S AU - Newcombe, V AU - Palotie, A AU - Parizel, PM AU - Peul, W AU - Piercy, J AU - Polinder, S AU - Puybasset, L AU - Rasmussen, TE AU - Rossaint, R AU - Smielewski, P AU - Soderberg, J AU - Stanworth, SJ AU - Stein, MB AU - von Steinbuchel, N AU - Stewart, W AU - Steyerberg, EW AU - Stocchetti, N AU - Synnot, A AU - Te, Ao B AU - Tenovuo, O AU - Theadom, A AU - Tibboel, D AU - Videtta, W AU - Wang, KKW AU - Williams, WH AU - Wilson, L AU - Yaffe, K ED - Adams, H / Collaborator ED - Agnoletti, V / Collaborator ED - Allanson, J / Collaborator ED - Amrein, K / Collaborator ED - Andaluz, N / Collaborator ED - Anke, A / Collaborator ED - Antoni, A / Collaborator ED - van As, AB / Collaborator ED - Audibert, G / Collaborator ED - Azaševac, A / Collaborator ED - Azouvi, P / Collaborator ED - Azzolini, ML / Collaborator ED - Baciu, C / Collaborator ED - Badenes, R / Collaborator ED - Barlow, KM / Collaborator ED - Bartels, R / Collaborator ED - Bauerfeind, U / Collaborator ED - Beauchamp, M / Collaborator ED - Beer, D / Collaborator ED - Beer, R / Collaborator ED - Belda, FJ / Collaborator ED - Bellander, BM / Collaborator ED - Bellier, R / Collaborator ED - Benali, H / Collaborator ED - Benard, T / Collaborator ED - Beqiri, V / Collaborator ED - Beretta, L / Collaborator ED - Bernard, F / Collaborator ED - Bertolini, G / Collaborator ED - Bilotta, F / Collaborator ED - Blaabjerg, M / Collaborator ED - den Boogert, H / Collaborator ED - Boutis, K / Collaborator ED - Bouzat, P / Collaborator ED - Brooks, B / Collaborator ED - Brorsson, C / Collaborator ED - Bullinger, M / Collaborator ED - Burns, E / Collaborator ED - Calappi, E / Collaborator ED - Cameron, P / Collaborator ED - Carise, E / Collaborator ED - Castaño-León, AM / Collaborator ED - Causin, F / Collaborator ED - Chevallard, G / Collaborator ED - Chieregato, A / Collaborator ED - Christie, B / Collaborator ED - Cnossen, M / Collaborator ED - Coles, J / Collaborator ED - Collett, J / Collaborator ED - Della Corte, F / Collaborator ED - Craig, W / Collaborator ED - Csato, G / Collaborator ED - Csomós, Ákos / Collaborator ED - Curry, N / Collaborator ED - Dahyot-Fizelier, C / Collaborator ED - Dawes, H / Collaborator ED - DeMatteo, C / Collaborator ED - Depreitere, B / Collaborator ED - Dewey, D / Collaborator ED - van Dijck, J / Collaborator ED - Đilvesi, Đ / Collaborator ED - Dippel, D / Collaborator ED - Dizdarevic, K / Collaborator ED - Donoghue, E / Collaborator ED - Duek, O / Collaborator ED - Dulière, GL / Collaborator ED - Dzeko, A / Collaborator ED - Eapen, G / Collaborator ED - Emery, CA / Collaborator ED - English, S / Collaborator ED - Esser, P / Collaborator ED - Ezer, E / Collaborator ED - Fabricius, M / Collaborator ED - Feng, J / Collaborator ED - Fergusson, D / Collaborator ED - Figaji, A / Collaborator ED - Fleming, J / Collaborator ED - Foks, K / Collaborator ED - Francony, G / Collaborator ED - Freedman, S / Collaborator ED - Freo, U / Collaborator ED - Frisvold, SK / Collaborator ED - Gagnon, I / Collaborator ED - Galanaud, D / Collaborator ED - Gantner, D / Collaborator ED - Giraud, B / Collaborator ED - Glocker, B / Collaborator ED - Golubovic, J / Collaborator ED - Gómez, López PA / Collaborator ED - Gordon, WA / Collaborator ED - Gradisek, P / Collaborator ED - Gravel, J / Collaborator ED - Griesdale, D / Collaborator ED - Grossi, F / Collaborator ED - Haagsma, JA / Collaborator ED - Håberg, AK / Collaborator ED - Haitsma, I / Collaborator ED - Van, Hecke W / Collaborator ED - Helbok, R / Collaborator ED - Helseth, E / Collaborator ED - van Heugten, C / Collaborator ED - Hoedemaekers, C / Collaborator ED - Höfer, S / Collaborator ED - Horton, L / Collaborator ED - Hui, J / Collaborator ED - Huijben, JA / Collaborator ED - Hutchinson, PJ / Collaborator ED - Jacobs, B / Collaborator ED - van der Jagt, M / Collaborator ED - Jankowski, S / Collaborator ED - Janssens, K / Collaborator ED - Jelaca, B / Collaborator ED - Jones, KM / Collaborator ED - Kamnitsas, K / Collaborator ED - Kaps, R / Collaborator ED - Karan, M / Collaborator ED - Katila, A / Collaborator ED - Kaukonen, KM / Collaborator ED - De Keyser, V / Collaborator ED - Kivisaari, R / Collaborator ED - Kolias, AG / Collaborator ED - Kolumbán, B / Collaborator ED - Kolundžija, K / Collaborator ED - Kondziella, D / Collaborator ED - Koskinen, LO / Collaborator ED - Kovács, N / Collaborator ED - Kramer, A / Collaborator ED - Kutsogiannis, D / Collaborator ED - Kyprianou, T / Collaborator ED - Lagares, A / Collaborator ED - Lamontagne, F / Collaborator ED - Latini, R / Collaborator ED - Lauzier, F / Collaborator ED - Lazar, I / Collaborator ED - Ledig, C / Collaborator ED - Lefering, R / Collaborator ED - Legrand, V / Collaborator ED - Levi, L / Collaborator ED - Lightfoot, R / Collaborator ED - Lozano, A / Collaborator ED - MacDonald, S / Collaborator ED - Major, S / Collaborator ED - Manara, A / Collaborator ED - Manhes, P / Collaborator ED - Maréchal, H / Collaborator ED - Martino, C / Collaborator ED - Masala, A / Collaborator ED - Masson, S / Collaborator ED - Mattern, J / Collaborator ED - McFadyen, B / Collaborator ED - McMahon, C / Collaborator ED - Meade, M / Collaborator ED - Melegh, Béla / Collaborator ED - Menovsky, T / Collaborator ED - Moore, L / Collaborator ED - Morgado, Correia M / Collaborator ED - Morganti-Kossmann, MC / Collaborator ED - Muehlan, H / Collaborator ED - Mukherjee, P / Collaborator ED - Murray, L / Collaborator ED - van der Naalt, J / Collaborator ED - Negru, A / Collaborator ED - Nelson, D / Collaborator ED - Nieboer, D / Collaborator ED - Noirhomme, Q / Collaborator ED - Nyirádi, J / Collaborator ED - Oddo, M / Collaborator ED - Okonkwo, DO / Collaborator ED - Oldenbeuving, AW / Collaborator ED - Ortolano, F / Collaborator ED - Osmond, M / Collaborator ED - Payen, JF / Collaborator ED - Perlbarg, V / Collaborator ED - Persona, P / Collaborator ED - Pichon, N / Collaborator ED - Piippo-Karjalainen, A / Collaborator ED - Pili-Floury, S / Collaborator ED - Pirinen, M / Collaborator ED - Ple, H / Collaborator ED - Poca, MA / Collaborator ED - Posti, J / Collaborator ED - Van, Praag D / Collaborator ED - Ptito, A / Collaborator ED - Radoi, A / Collaborator ED - Ragauskas, A / Collaborator ED - Raj, R / Collaborator ED - Real, RGL / Collaborator ED - Reed, N / Collaborator ED - Rhodes, J / Collaborator ED - Robertson, C / Collaborator ED - Rocka, S / Collaborator ED - Røe, C / Collaborator ED - Røise, O / Collaborator ED - Roks, G / Collaborator ED - Rosand, J / Collaborator ED - Rosenfeld, JV / Collaborator ED - Rosenlund, C / Collaborator ED - Rosenthal, G / Collaborator ED - Rossi, S / Collaborator ED - Rueckert, D / Collaborator ED - de Ruiter, GCW / Collaborator ED - Sacchi, M / Collaborator ED - Sahakian, BJ / Collaborator ED - Sahuquillo, J / Collaborator ED - Sakowitz, O / Collaborator ED - Salvato, G / Collaborator ED - Sánchez-Porras, R / Collaborator ED - Sándor, János / Collaborator ED - Sangha, G / Collaborator ED - Schäfer, N / Collaborator ED - Schmidt, S / Collaborator ED - Schneider, KJ / Collaborator ED - Schnyer, D / Collaborator ED - Schöhl, H / Collaborator ED - Schoonman, GG / Collaborator ED - Schou, RF / Collaborator ED - Sir, Ö / Collaborator ED - Skandsen, T / Collaborator ED - Smeets, D / Collaborator ED - Sorinola, A / Collaborator ED - Stamatakis, E / Collaborator ED - Stevanovic, A / Collaborator ED - Stevens, RD / Collaborator ED - Sundström, N / Collaborator ED - Taccone, FS / Collaborator ED - Takala, R / Collaborator ED - Tanskanen, P / Collaborator ED - Taylor, MS / Collaborator ED - Telgmann, R / Collaborator ED - Temkin, N / Collaborator ED - Teodorani, G / Collaborator ED - Thomas, M / Collaborator ED - Tolias, CM / Collaborator ED - Trapani, T / Collaborator ED - Turgeon, A / Collaborator ED - Vajkoczy, P / Collaborator ED - Valadka, AB / Collaborator ED - Valeinis, E / Collaborator ED - Vallance, S / Collaborator ED - Vámos, Z / Collaborator ED - Vargiolu, A / Collaborator ED - Vega, E / Collaborator ED - Verheyden, J / Collaborator ED - Vik, A / Collaborator ED - Vilcinis, R / Collaborator ED - Vleggeert-Lankamp, C / Collaborator ED - Vogt, L / Collaborator ED - Volovici, V / Collaborator ED - Voormolen, DC / Collaborator ED - Vulekovic, P / Collaborator ED - Vande, Vyvere T / Collaborator ED - Van, Waesberghe J / Collaborator ED - Wessels, L / Collaborator ED - Wildschut, E / Collaborator ED - Williams, G / Collaborator ED - Winkler, MKL / Collaborator ED - Wolf, S / Collaborator ED - Wood, G / Collaborator ED - Xirouchaki, N / Collaborator ED - Younsi, A / Collaborator ED - Zaaroor, M / Collaborator ED - Zelinkova, V / Collaborator ED - Zemek, R / Collaborator ED - Zumbo, F / Collaborator TI - Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. JF - LANCET NEUROLOGY J2 - LANCET NEUROL VL - 16 PY - 2017 IS - 12 SP - 987 EP - 1048 PG - 62 SN - 1474-4422 DO - 10.1016/S1474-4422(17)30371-X UR - https://m2.mtmt.hu/api/publication/3297422 ID - 3297422 N1 - CN: InTBIR Participants and Investigators AB - Executive summary A concerted effort to tackle the global health problem posed by traumatic brain injury (TBI) is long overdue. TBI is a public health challenge of vast, but insufficiently recognised, proportions. Worldwide, more than 50 million people have a TBI each year, and it is estimated that about half the world’s population will have one or more TBIs over their lifetime. TBI is the leading cause of mortality in young adults and a major cause of death and disability across all ages in all countries, with a disproportionate burden of disability and death occurring in low-income and middle-income countries (LMICs). It has been estimated that TBI costs the global economy approximately $US400 billion annually. Deficiencies in prevention, care, and research urgently need to be addressed to reduce the huge burden and societal costs of TBI. This Commission highlights priorities and provides expert recommendations for all stakeholders—policy makers, funders, health-care professionals, researchers, and patient representatives—on clinical and research strategies to reduce this growing public health problem and improve the lives of people with TBI. LA - English DB - MTMT ER - TY - JOUR AU - Guidet, B AU - van der Voort, PHJ AU - Csomós, Ákos TI - Intensive care in 2050: healthcare expenditure. JF - INTENSIVE CARE MEDICINE J2 - INTENS CARE MED VL - 43 PY - 2017 IS - 8 SP - 1141 EP - 1143 PG - 3 SN - 0342-4642 DO - 10.1007/s00134-017-4679-2 UR - https://m2.mtmt.hu/api/publication/3256264 ID - 3256264 N1 - Hiányzó Besorolás: 'Editorial',24 Hiányzó szerző: 'http' LA - English DB - MTMT ER - TY - JOUR AU - Morandi, A AU - Piva, S AU - Ely, EW AU - Myatra, SN AU - Salluh, JIF AU - Amare, D AU - Azoulay, E AU - Bellelli, G AU - Csomós, Ákos AU - Fan, E AU - Fagoni, N AU - Girard, TD AU - Heras, La Calle G AU - Inoue, S AU - Lim, CM AU - Kaps, R AU - Kotfis, K AU - Koh, Y AU - Misango, D AU - Pandharipande, PP AU - Permpikul, C AU - Cheng, Tan C AU - Wang, DX AU - Sharshar, T AU - Shehabi, Y AU - Skrobik, Y AU - Singh, JM AU - Slooter, A AU - Smith, M AU - Tsuruta, R AU - Latronico, N TI - Worldwide Survey of the "Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Drugs, Delirium Monitoring/Management, Early Exercise/Mobility, and Family Empowerment" (ABCDEF) Bundle. JF - CRITICAL CARE MEDICINE J2 - CRIT CARE MED VL - 45 PY - 2017 IS - 11 SP - e1111 EP - e1122 SN - 0090-3493 DO - 10.1097/CCM.0000000000002640 UR - https://m2.mtmt.hu/api/publication/3255774 ID - 3255774 AB - OBJECTIVES: To assess the knowledge and use of the Assessment, prevention, and management of pain; spontaneous awakening and breathing trials; Choice of analgesia and sedation; Delirium assessment; Early mobility and exercise; and Family engagement and empowerment (ABCDEF) bundle to implement the Pain, Agitation, Delirium guidelines. DESIGN: Worldwide online survey. SETTING: Intensive care. INTERVENTION: A cross-sectional online survey using the Delphi method was administered to intensivists worldwide, to assess the knowledge and use of all aspects of the ABCDEF bundle. MEASUREMENT AND MAIN RESULTS: There were 1,521 respondents from 47 countries, 57% had implemented the ABCDEF bundle, with varying degrees of compliance across continents. Most of the respondents (83%) used a scale to evaluate pain. Spontaneous awakening trials and spontaneous breathing trials are performed in 66% and 67% of the responder ICUs, respectively. Sedation scale was used in 89% of ICUs. Delirium monitoring was implemented in 70% of ICUs, but only 42% used a validated delirium tool. Likewise, early mobilization was "prescribed" by most, but 69% had no mobility team and 79% used no formal mobility scale. Only 36% of the respondents assessed ICU-acquired weakness. Family members were actively involved in 67% of ICUs; however, only 33% used dedicated staff to support families and only 35% reported that their unit was open 24 hr/d for family visits. CONCLUSIONS: The current implementation of the ABCDEF bundle varies across individual components and regions. We identified specific targets for quality improvement and adoption of the ABCDEF bundle. Our data reflect a significant but incomplete shift toward patient- and family-centered ICU care in accordance with the Pain, Agitation, Delirium guidelines. LA - English DB - MTMT ER -