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Critical Care Research and Practice

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https://www.readbyqxmd.com/read/29973987/combination-of-apache-scoring-systems-with-adductor-pollicis-muscle-thickness-for-the-prediction-of-mortality-in-patients-who-spend-more-than-one-day-in-the-intensive-care-unit
#1
Elahe Nematifard, Seyed Hossein Ardehali, Shaahin Shahbazi, Hassan Eini-Zinab, Zahra Vahdat Shariatpanahi
Background: The objective of the present study was to compare the ability of Acute Physiology and Chronic Health Evaluation (APACHE) scoring systems with the combination of an anthropometric variable score "adductor pollicis muscle (APM) thickness" to the APACHE systems in predicting mortality in the intensive care unit. Methods: A prospective observational study was conducted with the APM thickness in the dominant hand, and APACHE II and III scores were measured for each patient upon admission...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29888001/exploring-factors-affecting-the-emergency-specialists-decision-making-in-case-of-emergencies-in-patients
#2
Abbasali Ebrahimian, Seyed-Hossein Hashemi-Amrei, Mohammadreza Monesan
Introduction: Appropriate decision-making is essential in emergency situations; however, little information is available on how emergency decision-makers decide on the emergency status of the patients shifted to the emergency department of the hospital. This study aimed at explaining the factors that influence the emergency specialists' decision-making in case of emergency conditions in patients. Methods: This study was carried out with a qualitative content analysis approach...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29854452/updates-in-refractory-status-epilepticus
#3
REVIEW
Rohit Marawar, Maysaa Basha, Advait Mahulikar, Aaron Desai, Kushak Suchdev, Aashit Shah
Refractory status epilepticus is defined as persistent seizures despite appropriate use of two intravenous medications, one of which is a benzodiazepine. It can be seen in up to 40% of cases of status epilepticus with an acute symptomatic etiology as the most likely cause. New-onset refractory status epilepticus (NORSE) is a recently coined term for refractory status epilepticus where no apparent cause is found after initial testing. A large proportion of NORSE cases are eventually found to have an autoimmune etiology needing immunomodulatory treatment...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29854451/design-and-deployment-of-a-pediatric-cardiac-arrest-surveillance-system
#4
Jordan Michel Duval-Arnould, Heather Marie Newton, Leann McNamara, Branden Michael Engorn, Kareen Jones, Meghan Bernier, Pamela Dodge, Cheryl Salamone, Utpal Bhalala, Justin M Jeffers, Lilly Engineer, Marie Diener-West, Elizabeth Anne Hunt
Objective: We aimed to increase detection of pediatric cardiopulmonary resuscitation (CPR) events and collection of physiologic and performance data for use in quality improvement (QI) efforts. Materials and Methods: We developed a workflow-driven surveillance system that leveraged organizational information technology systems to trigger CPR detection and analysis processes. We characterized detection by notification source, type, location, and year, and compared it to previous methods of detection...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29854450/child-psychiatry-engagement-in-the-management-of-delirium-in-critically-ill-children
#5
Sean S Barnes, Marco A Grados, Sapna R Kudchadkar
Objectives: To characterize the engagement of child psychiatry by pediatric intensivists in cases of suspected delirium in a pediatric intensive care unit (PICU) prior to implementation of a delirium management algorithm with regards to recommendations, antipsychotic prescribing, and follow-up after PICU discharge. Design: Retrospective chart review. Setting: Single-center tertiary PICU. Subjects: Sixteen patients who received child psychiatry consultation for suspected delirium while in the PICU...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29854449/clinical-utility-of-a-structured-program-to-reduce-the-risk-of-health-related-quality-of-life-impairment-after-discharge-from-intensive-care-unit-a-real-world-experience
#6
Angelica Venni, Francesca Ioia, Silvia Laviola, Francesca Frigieri, Alessandra Pieri, Simona Marilli, Daniela Balzi, Piercarlo Ballo, Stefano Gori, Diletta Guarducci
Background: Postdischarge deterioration in health-related quality of life (HRQoL) is a major clinical issue for patients after an intensive care unit (ICU) hospitalization. A significant proportion of these patients is known to develop a progressive worsening of mental and physical performance-the so-called post-intensive care syndrome (PICS). Aim: We aimed at exploring the effects of a structured program for the management of ICU patients, aimed at improving postdischarge HRQoL and reducing the risk of PICS...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29854448/new-optic-nerve-sonography-quality-criteria-in-the-diagnostic-evaluation-of-traumatic-brain-injury
#7
Ibrahim Soliman, Garrett G R J Johnson, Lawrence M Gillman, Frederick A Zeiler, Fahad Faqihi, Waleed Tharwat Aletreby, Abdullah Balhamar, Nasir Nasim Mahmood, Shahzad Ahmad Mumtaz, Abdulrahman Alharthy, Christos Lazaridis, Dimitrios Karakitsos
Background: New sonographic quality criteria to optimize optic nerve sheath diameter (ONSD) measurements were suggested. The latter were correlated to elevated intracranial pressure (ICP) in traumatic brain injury (TBI). Aim: We investigated whether ONSD measurements were correlated to simultaneous ICP measurements in severe TBI. Methods: Forty patients with severe TBI (Marshall Scale ≥II and GCS ≤8) participated in the study. All patients had an intraparenchymal ICP catheter inserted, while ONSD was measured bilaterally, upon admission and over the next 48 hours, based on the new sonographic criteria...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29808117/can-diaphragm-dysfunction-be-reliably-evaluated-with-pocket-sized-ultrasound-devices-in-intensive-care-unit
#8
Gul Gursel, Kamil Inci, Zenfira Alasgarova
Background: Diaphragm dysfunction (DD) is frequently seen in critically ill patients, and ultrasound could be a useful tool to detect it and to predict extubation success or failure in mechanically ventilated patients. Besides, it would also be useful in differential diagnosis of dyspnea and respiratory failure. The aim of this study is to evaluate usefulness and accuracy of pocket-sized ultrasound devices (PSDs) in assessment of DD in intensive care unit (ICU) patients in comparison with standard ultrasound devices (SD)...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29744226/cerebral-pathophysiology-in-extracorporeal-membrane-oxygenation-pitfalls-in-daily-clinical-management
#9
REVIEW
Syed Omar Kazmi, Sanjeev Sivakumar, Dimitrios Karakitsos, Abdulrahman Alharthy, Christos Lazaridis
Extracorporeal membrane oxygenation (ECMO) is a life-saving technique that is widely being used in centers throughout the world. However, there is a paucity of literature surrounding the mechanisms affecting cerebral physiology while on ECMO. Studies have shown alterations in cerebral blood flow characteristics and subsequently autoregulation. Furthermore, the mechanical aspects of the ECMO circuit itself may affect cerebral circulation. The nature of these physiological/pathophysiological changes can lead to profound neurological complications...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29692932/intensive-care-unit-rotations-and-predictors-of-career-choice-in-pulmonary-critical-care-medicine-a-survey-of-internal-medicine-residency-directors
#10
Daniel J Minter, Sean D Levy, Sowmya R Rao, Paul F Currier
Background: The United States (US) is experiencing a growing shortage of critical care medicine (CCM) trained physicians. Little is known about the exposures to CCM experienced by internal medicine (IM) residents or factors that may influence their decision to pursue a career in pulmonary/critical care medicine (PCCM). Methods: We conducted a survey of US IM residency program directors (PDs) and then used multivariable logistic regression to identify factors that were predictive of residency programs with a higher percentage of graduates pursuing careers in PCCM...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29623221/efficacy-of-dexmedetomidine-versus-ketofol-for-sedation-of-postoperative-mechanically-ventilated-patients-with-obstructive-sleep-apnea
#11
Hatem Elmoutaz Mahmoud, Doaa Abou Elkassim Rashwan
Patients with sleep apnea are prone to postoperative respiratory complications, requiring restriction of sedatives during perioperative care. We performed a prospective randomized study on 24 patients with obstructive sleep apnea (OSA) who underwent elective surgery under general anesthesia. The patients were equally divided into two groups: Group Dex : received dexmedetomidine loading dose 1 mcg/kg IV over 10 min followed by infusion of 0.2-0.7 mcg/kg/hr; Group KFL : received ketofol as an initial bolus dose 500 mcg/kg IV (ketamine/propofol 1 : 1) and maintenance dose of 5-10 mcg/kg/min...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29181195/survey-of-extent-of-translation-of-oral-healthcare-guidelines-for-icu-patients-into-clinical-practice-by-nursing-staff
#12
Vivek Agarwal, Rameshwari Singhal, Richa Khanna, Pavitra Rastogi, Avinash Agarwal, Shuchi Tripathi
Nosocomial infections in critically ill/ventilated patients result from bacterial load in oropharyngeal regions. Oral decontamination serves as the easiest effective means of controlling infections. Knowledge, attitude, and practices followed by healthcare personnel in intensive care settings need to be assessed to implement concrete measures in health-care. Survey questionnaire was constructed and implemented following its validation on seventy nursing and paramedical staff working in government and private intensive care units throughout Lucknow city...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29158918/challenges-with-surveillance-of-healthcare-associated-infections-in-intensive-care-units-in-south-africa
#13
Saajida Mahomed, Ozayr Mahomed, A Willem Sturm, Stephen Knight, Prashini Moodley
Background: The incidence of healthcare-associated infections (HAIs) in the public health sector in South Africa is not known due to the lack of a surveillance system. We report on the challenges experienced in the implementation of a surveillance system for HAIs in intensive care units (ICUs). Methods: A passive, paper-based surveillance system was piloted in eight ICUs to measure the incidence of ventilator-associated pneumonia, catheter-associated urinary tract infection, and central line-associated bloodstream infection...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29119023/improvement-in-quality-metrics-outcomes-and-patient-and-family-satisfaction-in-a-neurosciences-intensive-care-unit-after-creation-of-a-dedicated-neurocritical-care-team
#14
Yaw Sarpong, Premkumar Nattanmai, Ginger Schelp, Robert Bell, Keerthivaas Premkumar, Erin Stapleton, Ashley McCormick, Christopher R Newey
Introduction: Dedicated neurointensivists have been shown to improve outcome measurements in the neurosciences intensive care unit (NSICU). Quality outcome data in relation to patient and family satisfaction is lacking. This study evaluated the impact of newly appointed neurointensivists and creation of a neurocritical care team on quality outcome measures including patient satisfaction in a NSICU. Methods: This is a retrospective study of data over 36 months from a 14-bed NSICU evaluating quality outcome measures and anonymous patient satisfaction questionnaires before and after neurointensivists appointment...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29104806/a-retrospective-pilot-study-of-de-novo-antidepressant-medication-initiation-in-intensive-care-unit-patients-and-post-icu-depression
#15
Daniel Haines, Johanna Hild, Jianghua He, Lucy Stun, Angie Ballew, Justin L Green, Lewis Satterwhite, Brigid C Flynn
Post-ICU Syndromes (PICS) remain a devastating problem for intensive care unit (ICU) survivors. It is currently unknown if de novo initiation of an antidepressant medication during ICU stay decreases the prevalence of post-ICU depression. We performed a retrospective, pilot study evaluating patients who had not previously been on an antidepressant medication and who were started on an antidepressant while in the trauma surgical, cardiothoracic, or medical intensive care unit (ICU). The PHQ-2 depression scale was used to ascertain the presence of depression after ICU discharge and compared this to historical controls...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29075530/variability-in-glycemic-control-with-temperature-transitions-during-therapeutic-hypothermia
#16
Krystal K Haase, Jennifer L Grelle, Faisal A Khasawneh, Chiamaka Ike
PURPOSE: Patients treated with therapeutic hypothermia (TH) and continuous insulin may be at increased risk of hyperglycemia or hypoglycemia, particularly during temperature transitions. This study aimed to evaluate frequency of glucose excursions during each phase of TH and to characterize glycemic control patterns in relation to survival. METHODS: Patients admitted to a tertiary care hospital for circulatory arrest and treated with both therapeutic hypothermia and protocol-based continuous insulin between January 2010 and June 2013 were included...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29062574/analysis-of-adverse-events-during-intrahospital-transportation-of-critically-ill-patients
#17
Francielli Mary Pereira Gimenez, Wesley Henrique Bueno de Camargo, Ana Clara Beraldo Gomes, Thaylla Sumyre Nihei, Monique Walicheki Maria Andrade, Maria Laura de A F Sé Valverde, Larissa D' Epiro de Souza Campos, Debora Carvalho Grion, Josiane Festti, Cintia Magalhães Carvalho Grion
PURPOSE: To describe adverse events occurring during intrahospital transportation of adult patients hospitalized in an Intensive Care Unit (ICU) and to evaluate the association with morbidity and mortality. METHOD: Prospective cohort study from July 2014 to July 2015. Data collection comprised clinical data, prognostic scores, length of stay, and outcome at hospital discharge. Data was collected on transport and adverse events. Adverse events were classified according to the World Health Organization following the degree of damage...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29057120/ivc-measurements-in-critically-ill-patients-with-acute-renal-failure
#18
Rami Jambeih, Jean I Keddissi, Houssein A Youness
OBJECTIVE: To determine whether the inferior vena cava (IVC) measurement by bedside ultrasound (US-IVC) predicts improvement in renal function in patients with acute kidney injury (AKI). DESIGN: Prospective observational study. SETTING: Medical intensive care unit. PATIENTS: 33 patients with AKI were included. INTERVENTION: US-IVC was done on admission. The patients' management was done by the primary teams, who were unaware of the US-IVC findings...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/28828185/clinical-characteristics-and-outcomes-of-surgical-patients-with-intensive-care-unit-lengths-of-stay-of-90-days-and-greater
#19
Verena Martini, Ann-Kathrin Lederer, Claudia Laessle, Frank Makowiec, Stefan Utzolino, Stefan Fichtner-Feigl, Lampros Kousoulas
BACKGROUND: The aim of this study was to evaluate the influence of prolonged length of stay in an intensive care unit (ICU) on the mortality and morbidity of surgical patients. METHODS: We performed a monocentric and retrospective observational study in the surgical critical care unit of the department of surgery at the Medical Center of the University of Freiburg, Germany. Clinical data was collected from patients assigned to the ICU with a length of stay (LOS) of 90 days and greater...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/28761764/resurgence-of-polymyxin-b-for-mdr-xdr-gram-negative-infections-an-overview-of-current-evidence
#20
REVIEW
Suneel Kumar Garg, Omender Singh, Deven Juneja, Niraj Tyagi, Amandeep Singh Khurana, Amit Qamra, Salman Motlekar, Hanmant Barkate
Polymyxin B has resurged in recent years as a last resort therapy for Gram-negative multidrug-resistant (MDR) and extremely drug resistant (XDR) infections. Understanding newer evidence on polymyxin B is necessary to guide clinical decision making. Here, we present a literature review of polymyxin B in Gram-negative infections with update on its pharmacology.
2017: Critical Care Research and Practice
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