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https://www.readbyqxmd.com/read/29036464/the-mimic-code-repository-enabling-reproducibility-in-critical-care-research
#1
Alistair E W Johnson, David J Stone, Leo A Celi, Tom J Pollard
Objective: Lack of reproducibility in medical studies is a barrier to the generation of a robust knowledge base to support clinical decision-making. In this paper we outline the Medical Information Mart for Intensive Care (MIMIC) Code Repository, a centralized code base for generating reproducible studies on an openly available critical care dataset. Materials and Methods: Code is provided to load the data into a relational structure, create extractions of the data, and reproduce entire analysis plans including research studies...
September 27, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29034711/electromagnetically-guided-bedside-placement-of-post-pyloric-feeding-tubes-in-critical-care
#2
Danielle E Bear, Alice Champion, Katie Lei, Luigi Camporota, Nicholas A Barrett
Post-pyloric feeding is recommended in critically ill patients with gastro-intestinal intolerance. However, traditional placement methods are logistically difficult and carry potential risks. The authors retrospectively compared the position of post-pyloric feeding tubes (PPFTs) using an electromagnetic device that demonstrated by X-ray and analysed the complication rates, proportion of lung placements avoided and the time taken to establish enteral feeding. Forty placements in 37 mechanically ventilated patients were analysed; there was a success rate of 87...
October 12, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29033272/graduating-surgical-residents-lack-competence-in-critical-care-ultrasound
#3
Renuka Tripu, Margaret H Lauerman, Daniel Haase, Syeda Fatima, Jacob Glaser, Cassandra Cardarelli, Thomas M Scalea, Sarah Murthi
OBJECTIVE: Ultrasound provides accessible imaging for bedside diagnostics and procedural guidance, but may lead to misdiagnosis in untrained users. The main objective of this study was to determine observed and self-perceived competence with critical care ultrasound in graduated general surgery residents. DESIGN: The design of this study was a retrospective review. Ultrasound training program records were reviewed for number of prior ultrasound examinations performed, self-perceived competence, observed competence on faculty examinations, and intended future use of individual critical care ultrasound examinations...
October 13, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29033265/universal-coverage-for-palliative-care-in-respiratory-disease-and-critical-care
#4
Matthew Maddocks, Irene J Higginson
No abstract text is available yet for this article.
October 12, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29033047/effect-of-hemodialysis-on-levels-of-high-sensitivity-cardiac-troponin-t
#5
Michael Chen, Howard Gerson, Shaun Eintracht, Sharon J Nessim, Elizabeth MacNamara
Cardiac troponin (cTn) is essential for the diagnosis of an acute coronary syndrome (ACS). However, in end-stage renal disease (ESRD) baseline cTn levels are often elevated, and it is unknown whether the hemodialysis (HD) procedure affects cTn levels. This leaves clinicians unsure of how to interpret cTn in HD patients with cardiac ischemia. We therefore sought to determine if plasma levels of high-sensitivity cardiac troponin T (hs-cTnT) vary during or after HD treatment. We prospectively enrolled 10 chronic HD patients who were admitted to our institution...
September 4, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29030027/comparison-of-right-ventricular-measurements-by-perioperative-transesophageal-echocardiography-as-a-predictor-of-hemodynamic-instability-following-cardiac-surgery
#6
Pei-Chi Ting, An-Hsun Chou, Chia-Chih Liao, Victor Chien-Chia Wu, Feng-Chun Tsai, Jaw-Ji Chu, Min-Wen Yang, Shi-Chuan Chang
BACKGROUND: The relationship between perioperative right ventricular (RV) performance and hemodynamic instability after cardiac surgery seemed less portrayed. Therefore, we sought to elucidate this relationship and compare the accuracy of different RV systolic indices in predicting outcome of cardiac surgery. METHODS: This study enrolled consecutive patients referred for cardiac surgeries. Exclusion criteria were non-sinus rhythm or contraindications to transesophageal echocardiography (TEE)...
October 10, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29029855/improving-mortality-outcomes-of-stevens-johnson-syndrome-toxic-epidermal-necrolysis-a-regional-burns-centre-experience
#7
M Nizamoglu, J A Ward, Q Frew, H Gerrish, N Martin, A Shaw, D Barnes, O Shelly, B Philp, N El-Muttardi, P Dziewulski
INTRODUCTION: Stevens Johnson Syndrome/toxic epidermal necrolysis (SJS/TEN) are rare, potentially fatal desquamative disorders characterised by large areas of partial thickness skin and mucosal loss. The degree of epidermal detachment that occurs has led to SJS/TEN being described as a burn-like condition. These patients benefit from judicious critical care, early debridement and meticulous wound care. This is best undertaken within a multidisciplinary setting led by clinicians experienced in the management of massive skin loss and its sequelae...
October 10, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29029712/advanced-cardiopulmonary-support-for-pulmonary-embolism
#8
Oren Friedman, James M Horowitz, Danny Ramzy
Management of high-risk pulmonary embolism (PE) requires an understanding of the pathophysiology of PE, options for rapid clot reduction, critical care interventions, and advanced cardiopulmonary support. PE can lead to rapid respiratory and hemodynamic collapse via a complex sequence of events leading to acute right ventricular failure. Importantly, reduction in pulmonary vascular resistance must be accomplished either by systemic thrombolytics, catheter directed thrombolytics, endovascular clot extraction, or surgical embolectomy...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029709/medical-management-of-pulmonary-embolism-beyond-anticoagulation
#9
Nancy Hsu, Tisha Wang, Oren Friedman, Igor Barjaktarevic
Pulmonary embolism (PE) is a common medical condition that carries significant morbidity and mortality. Although diagnosis, anticoagulation, and interventional clot-burden reduction strategies represent the focus of clinical research and care in PE, appropriate risk stratification and supportive care are crucial to ensure good outcomes. In this chapter, we will discuss the medical management of PE from the time of presentation to discharge, focusing on the critical care of acute right ventricular failure, anticoagulation of special patient populations, and appropriate follow-up testing after acute PE...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029541/cancer-and-the-kidney-dangereoux-liasons-or-price-paid-for-the-progress-in-medicine
#10
REVIEW
Jolanta Małyszko, Leszek Kozlowski, Klaudia Kozłowska, Maciej Małyszko, Jacek Małyszko
A long time ago, the links between renal disease and malignancy were observed, however, quite recently, their importance was recognized and 'new' subspecialty in nephrology, namely 'onconephrology' was established. In the XXI century, patients with malignancy make up the most growing number of the subjects seen for nephrology consult and/or critical care nephrology services. A plethora of renal problems may be found in patients with malignancy. They may influence not only their short-term outcomes but also the adequate therapy of the underlying oncological problem...
September 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29029170/use-of-a-structured-panel-process-to-define-antimicrobial-prescribing-appropriateness-in-critical-care
#11
Linda D Dresser, Chaim M Bell, Marilyn Steinberg, Niall D Ferguson, Stephen Lapinsky, Neil Lazar, Patricia Murphy, Jeffrey M Singh, Andrew M Morris
Background: Antimicrobial prescribing is frequently reported as appropriate or inappropriate, particularly in the ICU. However, the definitions used are non-standardized and lack validity and reliability. Objectives: To develop standardized definitions of appropriateness for antimicrobial prescribing in the critical care setting. Methods: We used consensus-based modified Delphi and RAND appropriateness methodology to develop criteria to define appropriateness of antimicrobial prescribing...
September 26, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29028774/seeking-humanizing-care-in-patient-centered-care-process-a-grounded-theory-study
#12
Mohammad Ali Cheraghi, Maryam Esmaeili, Mahvash Salsali
Patient-centered care is both a goal in itself and a tool for enhancing health outcomes. The application of patient-centered care in health care services globally however is diverse. This article reports on a study that sought to introduce patient-centered care. The aim of this study is to explore the process of providing patient-centered care in critical care units. The study used a grounded theory method. Data were collected on 5 critical care units in Tehran University of Medical Sciences. Purposive and theoretical sampling directed the collection of data using 29 semistructured interviews with 27 participants (nurses, patients, and physician)...
November 2017: Holistic Nursing Practice
https://www.readbyqxmd.com/read/29028695/national-certification-in-critical-care-echocardiography-its-time-has-come
#13
José L Díaz-Gómez, Heidi L Frankel, Antonio Hernandez
No abstract text is available yet for this article.
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29027776/lung-ultrasonography-and-echocardiography-in-the-icu-a-combined-and-practical-approach
#14
Antoine Vieillard-Baron, Paul Mayo
This article describes some practical applications of critical care ultrasonography that are of interest to the frontline intensivist. Instead of presenting a standard state of the art review article, we present 3 typical clinical cases where combined echocardiography, lung ultrasonography, and other ultrasonography techniques were helpful to the critical care team. The manuscript includes a variety figures and video clips that illustrate the utility of critical care ultrasonography in guiding diagnosis and management of the critically ill patient...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29026930/-burnout-a%C3%A2-call-for-action
#15
REVIEW
C S Hartog
BACKGROUND: Burnout is an emerging topic and has recently been the subject of a position paper of the US American Society of Critical Care Medicine. OBJECTIVES: To give an overview over prevalence, causes, and relevance of burnout in intensive care unit (ICU) clinicians and point to potential prevention strategies MATERIALS AND METHODS: Narrative review. RESULTS AND CONCLUSION: Burnout is a job-related state which results from long-lasting, permanent work overload when short spells of recreation, for instance during the weekend, are not effective to reduce exhaustion, vegetative symptoms, loss of efficiency, and depersonalization...
October 12, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29026526/recent-advances-in-cerebral-oximetry-assessment-of-cerebral-autoregulation-with-near-infrared-spectroscopy-myth-or-reality
#16
REVIEW
Anneliese Moerman, Stefan De Hert
In recent years, the feasibility of near-infrared spectroscopy to continuously assess cerebral autoregulation has gained increasing interest. By plotting cerebral oxygen saturation over blood pressure, clinicians can generate an index of autoregulation: the cerebral oximetry index (COx). Successful integration of this monitoring ability in daily critical care may allow clinicians to tailor blood pressure management to the individual patient's need and might prove to be a major step forward in terms of patient outcome...
2017: F1000Research
https://www.readbyqxmd.com/read/29025454/an-audit-of-traumatic-brain-injury-tbi-in-a-busy-developing-world-trauma-service-exposes-a-significant-deficit-in-resources-available-to-manage-severe-tbi
#17
Ellen Jerome, Grant L Laing, John L Bruce, Ben Sartorius, Petra Brysiewicz, Damian L Clarke
BACKGROUND: Traumatic brain injury (TBI) affects large numbers of patients, both adults and children, and significant resources are needed to manage it. OBJECTIVE: To determine the burden of TBI and the adequacy of available resources to manage in the Pietermaritzburg Metropolitan Trauma Service (PMTS). METHODS: All patients with a TBI were identified from the hybrid electronic medical registry at Grey's and Edendale hospitals in Pietermaritzburg (PMB), KwaZulu-Natal, South Africa...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29024878/impact-of-outlier-status-on-critical-care-patient-outcomes-does-boarding-medical-intensive-care-unit-patients-make-a-difference
#18
Danish Ahmad, Katherine Moeller, Jared Chowdhury, Vishal Patel, Erika J Yoo
PURPOSE: To evaluate the impact of outlier status, or the practice of boarding ICU patients in distant critical care units, on clinical and utilization outcomes. MATERIALS AND METHODS: Retrospective observational study of all consecutive admissions to the MICU service between April 1, 2014-January 3, 2016, at an urban university hospital. RESULTS: Of 1931 patients, 117 were outliers (6.1%) for the entire duration of their ICU stay. In adjusted analyses, there was no association between outlier status and hospital (OR 1...
October 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29024808/critical-care-nurses-experiences-of-withdrawal-of-treatment-a-systematic-review-of-qualitative-evidence
#19
REVIEW
Brandi Vanderspank-Wright, Nikolaos Efstathiou, Amanda D Vandyk
BACKGROUND: Death and dying is a reality of the clinical context of the intensive care unit. Death often follows a decision to withdraw life-sustaining treatments. Critical care nurses, are the primary care providers to patients and families at the end-of-life in the intensive care unit. OBJECTIVE: To synthesize qualitative evidence on the experiences of critical care nurses who have cared for patients and families throughout the process of withdrawal of life-sustaining treatment...
September 28, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29024199/critical-care-pharmacy-workforce-uk-deployment-and-characteristics-in-2015
#20
Mark Borthwick, Greg Barton, Richard S Bourne, Catherine McKenzie
OBJECTIVE: Clinical pharmacists reduce medication errors and optimize the use of medication in critically ill patients, although actual staffing level and deployment of UK pharmacists is unknown. The primary aim was to investigate the UK deployment of the clinical pharmacy workforce in critical care and compare this with published standards. METHODS: An electronic data entry tool was created and distributed for UK critical care pharmacy services to record their critical care workforce deployment data...
October 11, 2017: International Journal of Pharmacy Practice
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