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https://www.readbyqxmd.com/read/28829210/an-update-on-the-recognition-and-treatment-of-non-convulsive-status-epilepticus-in-the-intensive-care-unit
#1
Michael O Kinney, Peter W Kaplan
Non-convulsive status epilepticus (NCSE) is a complex and diverse condition which is often an under-recognised entity in the intensive care unit. When NCSE is identified the optimal treatment strategy is not always clear. Areas covered: This review is based on a literature review of the key literature in the field over the last 5-10 years. The articles were selected based on their importance to the field by the authors. Expert commentary: This review discusses the complex situations when a neurological consultation may occur in a critical care setting and provides an update on the latest evidence regarding the recognition of NCSE and the decision making around determining the aggressiveness of treatment...
August 22, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28828357/definition-and-epidemiology-of-acute-respiratory-distress-syndrome
#2
REVIEW
Emanuele Rezoagli, Roberto Fumagalli, Giacomo Bellani
Fifty years ago, Ashbaugh and colleagues defined for the first time the acute respiratory distress syndrome (ARDS), one among the most challenging clinical condition of the critical care medicine. The scientific community worked over the years to generate a unified definition of ARDS, which saw its revisited version in the Berlin definition, in 2014. Epidemiologic information about ARDS is limited in the era of the new Berlin definition, and wide differences are reported among countries all over the world. Despite decades of study in the field of lung injury, ARDS is still so far under-recognized, with 2 out of 5 cases missed by clinicians...
July 2017: Annals of Translational Medicine
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
#3
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/28828176/erratum-to-pediatric-intensive-care-stress-ulcer-prevention-pic-up-a-protocol-for-a-pilot-randomized-trial
#4
Mark Duffett, Karen Choong, Jennifer Foster, Elaine Gilfoyle, Jacques Lacroix, Nikhil Pai, Lehana Thabane, Deborah J Cook
[This corrects the article DOI: 10.1186/s40814-017-0142-y.].
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28822384/clinical-characteristics-of-trauma-patients-requiring-hydrocortisone-treatment-for-refractory-hypotension
#5
Gina Kim, Jeffrey Young
Corticosteroids play an important role in responding to physiologic stress in the human body. However, its application in critical care remains heavily debated. The purpose of this study was to identify patient characteristics associated with receiving stress-dose steroids during the intensive care unit stay after traumatic injury and its effect on in-hospital mortality. Patients admitted to the University of Virginia trauma center between January 1, 2011, and December 31, 2015, were identified using our Trauma Registry...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28820650/critical-care-nutrition-support-best-practices-key-differences-between-canadian-and-american-guidelines
#6
Jayshil J Patel, Margot Lemieux, Stephen A McClave, Robert G Martindale, Ryan T Hurt, Daren K Heyland
Since 2015, Society of Critical Care Medicine/American Society for Parenteral and Enteral Nutrition and Canadian critical care nutrition support guidelines have both been updated. Despite a similar evidentiary basis, there remain key differences between guideline recommendations. These differences in recommendations may pose confusion for the clinician and may encumber widespread applicability. The aim of this review was to enhance practitioner confidence in applying critical care nutrition support guidelines to patient care in their settings by outlining the similarities and differences between the American and Canadian methods for guideline development and describing the key differences and reasons behind the differences...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28820608/skeletal-muscle-ultrasound-in-critical-care-a-tool-in-need-of-translation
#7
Marina Mourtzakis, Selina Parry, Bronwen Connolly, Zudin Puthucheary
With the emerging interest in documenting and understanding muscle atrophy and function in critically ill patients and survivors, ultrasonography has transformational potential in measuring muscle quantity and quality. Here, we discuss the importance of quantifying skeletal muscle in the ICU setting. We also identify the merits and limitations of various modalities that are capable of accurately and precisely measuring muscularity. Ultrasound is emerging as a potentially powerful tool for skeletal muscle quantification; however, there are key challenges that need to be addressed in future work to ensure useful interpretation and comparability of results across diverse observational and interventional studies...
August 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28820040/effect-of-interhospital-icu-relocation-on-patient-physiology-and-clinical-outcomes
#8
David R Janz, Yasin A Khan, Jennifer L Mooney, Matthew W Semler, Todd W Rice, Jessica L Johnson, Bennett P deBoisblanc
Relocation of large numbers of critically ill patients between hospitals is sometimes necessary and the risks associated with relocation may be high. In the setting of adherence to an interhospital intensive care unit (ICU) relocation protocol, we aimed to determine whether the interhospital relocation of all ICU patients in a single day is associated with changes in vital signs, device removal, and worse clinical outcomes. We conducted a prospective, observational, cohort study of all critically ill adults admitted to a tertiary medical center's ICUs on the day of a planned hospital relocation and exposed to interhospital ICU relocation compared with unexposed critically ill adults...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28818522/reduced-critical-care-utilization-another-victory-for-effective-bystander-interventions-in-cardiac-arrest
#9
EDITORIAL
Christopher B Fordyce
No abstract text is available yet for this article.
August 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28818344/the-2016-espen-arvid-wretlind-lecture-the-gut-in-stress
#10
REVIEW
Stephen A McClave, Cynthia C Lowen, Robert G Martindale
The gut has a major influence on the course of the human stress response in critical illness for several reasons; the quantity of its immune tissue, the extent of interface with the external environment, the expanse of the microbiome, and its access to the systemic circulation. In critical illness, it is not uncommon to lose mucosal barrier function, which exposes the host to the downside effects of luminal contents and epithelial cell regulation. In that setting, the microbiome is converted to a pathobiome, upregulation of metabolic and immune responses occurs, and homeostatic defense systems are compromised...
July 29, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28817531/bias-confounding-and-interaction-lions-and-tigers-and-bears-oh-my
#11
Thomas R Vetter, Edward J Mascha
Epidemiologists seek to make a valid inference about the causal effect between an exposure and a disease in a specific population, using representative sample data from a specific population. Clinical researchers likewise seek to make a valid inference about the association between an intervention and outcome(s) in a specific population, based upon their randomly collected, representative sample data. Both do so by using the available data about the sample variable to make a valid estimate about its corresponding or underlying, but unknown population parameter...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28817507/comparison-of-consent-models-in-a-randomized-trial-of-corticosteroids-in-pediatric-septic-shock
#12
Kusum Menon, Katharine O'Hearn, James Dayre McNally, Anand Acharya, Hector R Wong, Margaret Lawson, Tim Ramsay, Lauralyn McIntyre, Elaine Gilfoyle, Marisa Tucci, David Wensley, Ronald Gottesman, Gavin Morrison, Karen Choong
OBJECTIVES: To describe the use of deferred and prior informed consent models in the context of a low additional risk to standard of care, placebo-controlled randomized controlled trial of corticosteroids in pediatric septic shock. DESIGN: An observational substudy of consent processes in a randomized controlled trial of hydrocortisone versus placebo. SETTING: Seven tertiary level PICUs in Canada. PATIENTS: Children newborn to 17 years inclusive admitted to PICU with suspected septic shock between July 2014 and March 2016...
August 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28817482/american-college-of-critical-care-medicine-clinical-practice-parameters-for-hemodynamic-support-of-pediatric-and-neonatal-septic-shock-erratum
#13
(no author information available yet)
No abstract text is available yet for this article.
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28817424/impact-of-simulator-based-training-in-focused-transesophageal-echocardiography-a-randomized-controlled-trial
#14
Andreas Bloch, Robert von Arx, Reto Etter, David Berger, Heiko Kaiser, Armando Lenz, Tobias M Merz
BACKGROUND: The aim of the study was to determine if training in transesophageal echocardiography (TEE) using a TEE simulator improves the ability of novice operators to perform and interpret a focused critical care TEE. METHODS: In this prospective, randomized, controlled study with blinded outcome assessment, 44 intensive care unit trainees were randomly assigned to a control group receiving 4 hours of lecture-based training only, or an intervention group which was additionally trained for 4 hours using a TEE simulator...
August 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28816858/meta-analysis-of-bowel-protocols-in-critical-care-patients-a-word-of-caution
#15
Dominique Prat, Jonathan Messika, Jean Damien Ricard, Benjamin Sztrymf
No abstract text is available yet for this article.
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28816799/successful-extracorporeal-life-support-in-a-pediatric-hematopoietic-stem-cell-transplant-recipient-with-periengraftment-respiratory-failure
#16
Jenny Potratz, Martina Ahlmann, Claudia Rössig, Heymut Omran, Katja Masjosthusmann
The use of extracorporeal life support (ECLS) as ultimate salvage therapy for hematopoietic stem cell transplant recipients remains controversial among oncologists and critical care specialists. Prognosis is poor, particularly after allogeneic transplantation, and literature to guide clinical decision-making is scarce. Our report describes successful ECLS in a pediatric patient undergoing allogeneic hematopoietic stem cell transplantation, who developed acute respiratory failure during severe neutropenia, followed by immediate neutrophil engraftment...
August 14, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28816031/do-you-see-what-i-see-a-mother-s-plea
#17
Kees Nydam, Rebecca Soole
There is sometimes dissonance between the medical services that the general public expects an ED to provide and the acute critical care that emergency clinicians hope to provide. One explanation for this is that the ED is both a territory and a meeting place for a cornucopia of clinicians, some of whom are not ED clinicians themselves. Roles are sometimes ambiguous and location-specific. Recently, one Queensland mother believed that her son's suicide could have been prevented had emergency staff been better educated...
August 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28814943/comparison-of-different-laboratory-tests-in-the-evaluation-of-hemorrhagic-risk-of-patients-using-rivaroxaban-in-the-critical-care-setting-diagnostic-accuracy-study
#18
Marjorie Paris Colombini, Priscilla Bento Matos Cruz Derogis, Valdir Fernandes de Aranda, João Carlos de Campos Guerra, Nelson Hamerschlak, Cristóvão Luis Pitangueiras Mangueira
BACKGROUND: Rivaroxaban is a direct oral anticoagulant designed to dispense with the necessity of laboratory monitoring. However, monitoring rivaroxaban levels is necessary in certain clinical conditions, especially in the critical care setting. METHODS: This is a diagnostic accuracy study evaluating sensitivity and specificity of prothrombin time (PT), activated partial thromboplastin time (aPTT), and Dilute Russell viper venom time (dRVVT), to evaluate the hemorrhagic risk in patients taking rivaroxaban...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28814577/physician-nurse-interactions-in-critical-care
#19
Sumaira Khowaja-Punjwani, Charlotte Smardo, Monica Rita Hendricks, John D Lantos
Nearly 20% of nurses leave their first job within a year of being hired. Many do so because they perceive the work environment to be unhealthy or nonsupportive. Nurse turnover is costly. When new nurses leave within 3 years of being hired, it costs the hospital $64 000, over and above salaries, to replace them. One of the hallmarks of an unhealthy work environment is poor communication between doctors and nurses. We present a case in which a nurse advocates for a young mother by questioning the doctor. She is reprimanded for doing so...
August 16, 2017: Pediatrics
https://www.readbyqxmd.com/read/28813205/combining-2-commonly-adopted-nutrition-instruments-in-the-critical-care-setting-is-superior-to-administering-either-one-alone
#20
Charles Chin Han Lew, Ka Po Cheung, Mary Foong Fong Chong, Ai Ping Chua, Robert J L Fraser, Michelle Miller
BACKGROUND: This study aimed to determine the agreement between the modified Nutrition Risk in Critically ill Score (mNUTRIC) and the Subjective Global Assessment (SGA) and compare their ability in discriminating and quantifying mortality risk independently and in combination. METHODS: Between August 2015 and October 2016, all patients in a Singaporean hospital received the SGA within 48 hours of intensive care unit admission. Nutrition status was dichotomized into presence or absence of malnutrition...
August 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
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