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volume status critical care patients

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https://www.readbyqxmd.com/read/29747662/progressive-mobility-program-and-technology-to-increase-the-level-of-physical-activity-and-its-benefits-in-respiratory-muscular-system-and-functionality-of-icu-patients-study-protocol-for-a-randomized-controlled-trial
#1
Debora Stripari Schujmann, Adriana Claudia Lunardi, Carolina Fu
BACKGROUND: Enhanced mobility in the Intensive Care Unit (ICU) could minimize the negative effects of critical illness, such as declines in cognitive, muscular, respiratory, and functional capacity. We aim to compare the functional status at ICU discharge of patients who underwent a progressive mobilization protocol versus patients who received conventional physiotherapy. We also examine the level of physical activity in the ICU, the degree of pulmonary and muscle function, and the length of stay to analyze correlations between these variables...
May 10, 2018: Trials
https://www.readbyqxmd.com/read/29741919/efficacy-of-acupuncture-treatment-for-improving-the-respiratory-status-in-patients-receiving-prolonged-mechanical-ventilation-in-intensive-care-units-a-retrospective-observational-study
#2
Jun Matsumoto-Miyazaki, Hiroaki Ushikoshi, Kodai Suzuki, Nagisa Miyazaki, Takahide Nawa, Hideshi Okada, Shozo Yoshida, Ichijiro Murata, Shinji Ogura, Shinya Minatoguchi
BACKGROUND AND OBJECTIVE: Patients in critical care settings often require prolonged mechanical ventilation (MV) therapy and, occasionally, they cannot be weaned from MV. The authors evaluated the efficacy of acupuncture treatment for improving the respiratory status and promoting successful weaning from prolonged MV in patients at intensive care units (ICUs). DESIGN: Retrospective observational study. SETTING: Gifu University Hospital, Gifu, Japan...
May 9, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29703214/ultrasound-assessed-diaphragmatic-impairment-is-a-predictor-of-outcomes-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-undergoing-noninvasive-ventilation
#3
Alessandro Marchioni, Ivana Castaniere, Roberto Tonelli, Riccardo Fantini, Matteo Fontana, Luca Tabbì, Andrea Viani, Francesco Giaroni, Valentina Ruggieri, Stefania Cerri, Enrico Clini
BACKGROUND: Ultrasound (US) evaluation of diaphragmatic dysfunction (DD) has proved to be a reliable technique in critical care. In this single-center prospective study, we investigated the impact of US-assessed DD on noninvasive ventilation (NIV) failure in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and its correlation with the transdiaphragmatic pressure assessed using the invasive sniff maneuver (Pdi sniff). METHODS: A population of 75 consecutive patients with AECOPD with hypercapnic acidosis admitted to our respiratory intensive care unit (RICU) were enrolled...
April 27, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29685123/the-pigeon-project-protocol-of-a-longitudinal-study-examining-psychosocial-and-ethical-issues-and-outcomes-in-germline-genomic-sequencing-for-cancer
#4
Megan Best, Ainsley J Newson, Bettina Meiser, Ilona Juraskova, David Goldstein, Kathy Tucker, Mandy L Ballinger, Dominique Hess, Timothy E Schlub, Barbara Biesecker, Richard Vines, Kate Vines, David Thomas, Mary-Anne Young, Jacqueline Savard, Chris Jacobs, Phyllis Butow
BACKGROUND: Advances in genomics offer promise for earlier detection or prevention of cancer, by personalisation of medical care tailored to an individual's genomic risk status. However genome sequencing can generate an unprecedented volume of results for the patient to process with potential implications for their families and reproductive choices. This paper describes a protocol for a study (PiGeOn) that aims to explore how patients and their blood relatives experience germline genomic sequencing, to help guide the appropriate future implementation of genome sequencing into routine clinical practice...
April 23, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29680878/quantitative-computed-tomography-in-comparison-with-transpulmonary-thermodilution-for-the-estimation-of-pulmonary-fluid-status-a-clinical-study-in-critically-ill-patients
#5
Bernd Saugel, Moritz Wildgruber, Albrecht Staudt, Michael Dieckmeyer, Konstantin Holzapfel, Georgios Kaissis, Mikhail Y Kirov, Vsevolod V Kuzkov, Roland M Schmid, Wolfgang Huber
Extravascular lung water (index) (EVLW(I)) can be estimated using transpulmonary thermodilution (TPTD). Computed tomography (CT) with quantitative analysis of lung tissue density has been proposed to quantify pulmonary edema. We compared variables of pulmonary fluid status assessed using quantitative CT and TPTD in critically ill patients. In 21 intensive care unit patients, we performed TPTD measurements directly before and after chest CT. Based on the density data of segmented CT images we calculated the tissue volume (TV), tissue volume index (TVI), and the mean weighted index of voxel aqueous density (VMWaq)...
April 21, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29549931/impairment-of-thyroid-function-in-critically-ill-patients-in-the-intensive-care-units
#6
Eashaa Kumar, Michael T McCurdy, Christian A Koch, Abdurrahman Hamadah, Tibor Fülöp, Kamel A Gharaibeh
Unexplained hypotension in the intensive care unit is commonly attributed to volume depletion, cardiorespiratory failure, sepsis, or relative adrenal insufficiency. In these acute conditions, thyroid hormone levels measured in blood, serum or plasma are often altered and solely attributed to critical illness. We report a series of 3 critically ill patients with prolonged respiratory failure, suppressed mental status and unexplained hypotension. Thyroid stimulating hormone levels ranged from normal to mildly elevated (2...
March 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29507845/stereotactic-radiosurgery-for-multiple-brain-metastases-two-cases-of-preserved-quality-of-life
#7
Anthony Pham, Becky Lee, Eric L Chang
Brain metastases are the most common intracranial tumors in the adult population and have been historically treated with whole brain radiation therapy (WBRT). However, as medical advances improve life expectancy, stereotactic radiosurgery (SRS) has replaced WBRT as the standard of care for limited (one to three) brain metastases due to the relative sparing of neurocognitive function (NCF) and therefore quality of life (QoL). The use of SRS has been less documented in the case of multiple (four or more) brain metastases, with literature limited to non-randomized studies showing comparable survival and local control...
December 28, 2017: Curēus
https://www.readbyqxmd.com/read/29430443/electrical-impedance-tomography
#8
REVIEW
Beatriz Lobo, Cecilia Hermosa, Ana Abella, Federico Gordo
Continuous assessment of respiratory status is one of the cornerstones of modern intensive care unit (ICU) monitoring systems. Electrical impedance tomography (EIT), although with some constraints, may play the lead as a new diagnostic and guiding tool for an adequate optimization of mechanical ventilation in critically ill patients. EIT may assist in defining mechanical ventilation settings, assess distribution of tidal volume and of end-expiratory lung volume (EELV) and contribute to titrate positive end-expiratory pressure (PEEP)/tidal volume combinations...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29324608/quality-assurance-practices-in-obstetric-care-a-survey-of-hospitals-in-california
#9
Lisbet S Lundsberg, Henry C Lee, Grace Villarin Dueñas, Kimberly D Gregory, Holly K Grossetta Nardini, Christian M Pettker, Jessica L Illuzzi, Xiao Xu
OBJECTIVE: To assess hospital practices in obstetric quality management activities and identify institutional characteristics associated with utilization of evidence-supported practices. METHODS: Data for this study came from a statewide survey of obstetric hospitals in California regarding their organization and delivery of perinatal care. We analyzed responses from 185 hospitals that completed quality assurance sections of the survey to assess their practices in a broad spectrum of quality enhancement activities...
February 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29202543/-experts-consensus-on-the-management-of-the-right-heart-function-in-critically-ill-patients
#10
X T Wang, D W Liu, H M Zhang, Y Long, X D Guan, H B Qiu, K J Yu, J Yan, H Zhao, Y Q Tang, X Ding, X C Ma, W Du, Y Kang, B Tang, Y H Ai, H W He, D C Chen, H Chen, W Z Chai, X Zhou, N Cui, H Wang, X Rui, Z J Hu, J G Li, Y Xu, Y Yang, B Ouyan, H Y Lin, Y M Li, X Y Wan, R L Yang, Y Z Qin, Y G Chao, Z Y Xie, R H Sun, Z Y He, D F Wang, Q Q Huang, D P Jiang, X Y Cao, R G Yu, X Wang, X K Chen, J F Wu, L N Zhang, M G Yin, L X Liu, S W Li, Z J Chen, Z Luo
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29182211/assessment-of-hypovolaemia-in-the-critically-ill
#11
Jan Van der Mullen, Robert Wise, Griet Vermeulen, Pieter-Jan Moonen, Manu L N G Malbrain
Assessment of the intravascular volume status of patients is one of the most challenging tasks for the intensive care clinician. It is also one of the most important skills in intensive care management as both hypervolaemia and hypovolaemia lead to increased morbidity and mortality. The assessment of hypovolaemic patients is aided by several clinical signs, laboratory investigations, and a multitude of haemodynamic monitoring systems. This review aims to outline the definitions, pathophysiology, and various assessment techniques (both old and new) employed by intensivists on the critically ill patient...
November 28, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29131347/critical-care-ultrasound-a-national-survey-across-specialties
#12
Jeffrey R Stowell, Ross Kessler, Resa E Lewiss, Igor Barjaktarevic, Bikash Bhattarai, Napatkamon Ayutyanont, John L Kendall
PURPOSE: Management of the critically ill patient requires rapid assessment and differentiation. Point-of-care ultrasound (POCUS) improves diagnostic accuracy and guides resuscitation. This study sought to describe the use of critical care related POCUS amongst different specialties. METHODS: This study was conducted as an online 18-question survey. Survey questions queried respondent demographics, preferences for POCUS use, and barriers to implementation. RESULTS: 2735 recipients received and viewed the survey with 416 (15...
March 2018: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28940546/measuring-emergency-department-acuity
#13
Maame Yaa A B Yiadom, Christopher W Baugh, Tyler W Barrett, Xulei Liu, Alan B Storrow, Timothy J Vogus, Vikram Tiwari, Corey M Slovis, Stephan Russ, Dandan Liu
BACKGROUND: Emergency department (ED) acuity is the general level of patient illness, urgency for clinical intervention, and intensity of resource use in an ED environment. The relative strength of commonly used measures of ED acuity is not well understood. METHODS: We performed a retrospective cross-sectional analysis of ED-level data to evaluate the relative strength of association between commonly used proxy measures with a full spectrum measure of ED acuity...
January 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28932401/practical-approach-to-detection-and-management-of-acute-kidney-injury-in-critically-ill-patient
#14
REVIEW
Vahid Mohsenin
BACKGROUND: Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with high morbidity and mortality. This paper provides a critical review of the etiologies of AKI and a systematic approach toward its diagnosis and management with emphasis on fluid volume assessment and the use of urine biochemical profile and microscopy in identifying the nature and the site of kidney injury. MATERIALS AND METHODS: The search of PubMed and selection of papers had employed observational designs or randomized control trials relevant to AKI...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28866972/comparison-of-continous-wave-doppler-ultrasound-monitor-and-echocardiography-to-assess-cardiac-output-in-intensive-care-patients
#15
COMPARATIVE STUDY
Ahmad Elgendy, Ian M Seppelt, Andrew S Lane
BACKGROUND: Continuous-wave Doppler (CWD) ultrasound through the left ventricular outflow tract is one modality used for non-invasive cardiac output measurement. The ultrasonic cardiac output monitor (USCOM) is a relatively new monitor which uses a small, transcutaneous ultrasound probe to measure cardiac output with CWD via the suprasternal window. It is faster and less complex to train new users than conventional echocardiography. In addition to stroke volume (SV), the USCOM can calculate stroke volume variation (SVV) and the Smith-Madigan inotropy index (SMII), which is an estimate of the pre-load independent contractility of the myocardium...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28828035/urine-flow-rate-monitoring-in-hypovolemic-multiple-trauma-patients
#16
Evgeni Brotfain, Yoram Klein, Ronen Toledano, Leonid Koyfman, Dmitry Frank, Micha Y Shamir, Moti Klein
BACKGROUND: The urine output is an important clinical parameter of renal function and blood volume status, especially in critically ill multiple trauma patients. In the present study, the minute-to-minute urine flow rate and its variability were analyzed in hypotensive multiple trauma patients during the first 6 h of their ICU (intensive care unit) stay. These parameters have not been previously reported. METHODS: The study was retrospective and observational. Demographic and clinical data were extracted from the computerized Register Information Systems...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28746899/hypertonic-saline-in-critical-illness-a-systematic-review
#17
REVIEW
Carmen Andrea Pfortmueller, Joerg C Schefold
INTRODUCTION: The optimal approach to fluid management in critically ill patients is highly debated. Fluid resuscitation using hypertonic saline was used in the past for more than thirty years, but has recently disappeared from clinical practice. Here we provide an overview on the currently available literature on effects of hypertonic saline infusion for fluid resuscitation in the critically ill. METHODS: Systematic analysis of reports of clinical trials comparing effects of hypertonic saline as resuscitation fluid to other available crystalloid solutions...
December 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28580340/a-system-for-continuous-estimating-and-monitoring-cardiac-output-via-arterial-waveform-analysis
#18
A Vakily, H Parsaei, M M Movahhedi, M A Sahmeddini
BACKGROUND: Cardiac output (CO) is the total volume of blood pumped by the heart per minute and is a function of heart rate and stroke volume. CO is one of the most important parameters for monitoring cardiac function, estimating global oxygen delivery and understanding the causes of high blood pressure. Hence, measuring CO has always been a matter of interest to researchers and clinicians. Several methods have been developed for this purpose, but a majority of them are either invasive, too expensive or need special expertise and experience...
June 2017: Journal of Biomedical Physics & Engineering
https://www.readbyqxmd.com/read/28567186/critical-evaluation-of-contemporary-management-in-a-new-pelvic-exenteration-unit-the-first-25-consecutive-cases
#19
Min Hoe Chew, Yu-Ting Yeh, Ee-Lin Toh, Stephen Aditya Sumarli, Ghee Kheng Chew, Lui Shiong Lee, Mann Hong Tan, Tiffany Priyanthi Hennedige, Shin Yi Ng, Say Kiat Lee, Tze Tec Chong, Hairil Rizal Abdullah, Terence Lin Hon Goh, Mohamed Zulfikar Rasheed, Kok Chai Tan, Choong Leong Tang
AIM: To critically appraise short-term outcomes in patients treated in a new Pelvic Exenteration (PE) Unit. METHODS: This retrospective observational study was conducted by analysing prospectively collected data for the first 25 patients (16 males, 9 females) who underwent PE for advanced pelvic tumours in our PE Unit between January 2012 and October 2016. Data evaluated included age, co-morbidities, American Society of Anesthesiologists (ASA) score, Eastern Cooperative Oncology Group (ECOG) status, preoperative adjuvant treatment, intra-operative blood loss, procedural duration, perioperative adverse event, lengths of intensive care unit (ICU) stay and hospital stay, and oncological outcome...
May 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28478875/assessment-of-volume-status-using-ultrasonography
#20
REVIEW
Brooke A Bailey, Sarah Davis, Briana Witherspoon
Ultrasonography is a first-line diagnostic tool when evaluating volume status in the critical care patient population. Ultrasonography leads to a prompt diagnosis and more appropriate management plan, while decreasing health care costs, time to diagnosis, hospital length of stay, time to definitive operation, and mortality. It is recommended that critical care providers treating critically ill patients be skilled and competent in critical care ultrasonography. As the critical care population and the shortage of critical care physicians increases, advanced practice providers are becoming more prevalent in critical care areas and should be competent in this skill as well...
June 2017: Nursing Clinics of North America
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