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Critical care/intensive care

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https://www.readbyqxmd.com/read/29356376/boosting-art-uptake-and-retention-among-hiv-infected-pregnant-and-breastfeeding-women-and-their-infants-the-promise-of-innovative-service-delivery-models
#1
Meena Srivastava, David Sullivan, B Ryan Phelps, Surbhi Modi, Laura N Broyles
INTRODUCTION: With the rapid scale-up of antiretroviral treatment (ART) in the "Treat All" era, there has been increasing emphasis on using differentiated models of HIV service delivery. The gaps within the clinical cascade for mothers and their infants suggest that current service delivery models are not meeting families' needs and prompt re-consideration of how services are provided. This article will explore considerations for differentiated care and encourage the ongoing increase of ART coverage through innovative strategies while also addressing the unique needs of mothers and infants...
January 2018: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/29355796/clinical-utility-of-serum-procalcitonin-level-and-infection-in-the-neurosurgical-intensive-care-unit
#2
Lauren E Rotman, Bonita S Agee, Gustavo Chagoya, Matthew C Davis, James M Markert
OBJECTIVE: Procalcitonin, a blood stream inflammatory biomarker, has shown to be useful in the diagnosis of sepsis in critically ill patients treated in medical and surgical intensive care units. This study aims to further our understanding of procalcitonin levels in Neuroscience Intensive Care Unit (NICU) patients. METHODS: Neurosurgical patients who underwent procalcitonin assay in the NICU over a two-year period were included. Procalcitonin equal to or above 0...
January 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29355141/an-observational-study-of-incidence-risk-factors-outcome-of-systemic-inflammatory-response-organ-dysfunction-following-major-trauma
#3
Satish Balkrishna Dharap, Sanket Vishnu Ekhande
BACKGROUND & OBJECTIVES: Trauma is known to lead to systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS), which is often a cause of late deaths after injury. SIRS and MODS have been objectively measured using scoring systems. This prospective observational study was carried out in a tertiary care hospital in India to evaluate SIRS and MODS following trauma in terms of their incidence, the associated risk factors and the effect on the outcome. METHODS: All adult patients with major life- and limb-threatening trauma were included...
September 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29354572/association-of-post-extubation-dysphagia-with-tongue-weakness-and-somatosensory-disturbance-in-non-neurologic-critically-ill-patients
#4
Hee Seon Park, Jung Hoi Koo, Sun Hong Song
Objective: To prospectively assess the association between impoverished sensorimotor integration of the tongue and lips and post-extubation dysphagia (PED). Methods: This cross-sectional study included non-neurologic critically ill adult patients who required endotracheal intubation and underwent videofluoroscopic swallowing study (VFSS) between October and December 2016. Participants underwent evaluation for tongue and lip performance, and oral somatosensory function...
December 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29353893/organ-dysfunctions-among-deaths-in-critically-ill-patients
#5
Leison Maharjan, Aarzoo Shah, Udaya Bajracharya, Gambhir Shrestha
BACKGROUND: Multiple organ failure is recognized as the final pathway preceding majority of deaths in intensive care unit. This study aims to find out the prevalence of organ dysfunctions/ failures in patients at the time of their demise irrespective of the underlying diseases in a tertiary care hospital. METHODS: This study was done in medical intensive care unit of Blue Cross Hospital. Medical records of all deceased patients in two years period were thoroughly reviewed retrospectively...
January 1, 2018: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29353710/prevalence-and-predictors-of-difficulty-accessing-the-mouths-of-intubated-critically-ill-adults-to-deliver-oral-care-an-observational-study
#6
Craig M Dale, Orla Smith, Lisa Burry, Louise Rose
BACKGROUND: Oral care of intubated patients is essential to the prevention of infection and patient discomfort. However, barriers to oral access and delivery of oral care have received little attention. OBJECTIVE: To determine prevalence and predictors of oral access difficulty. DESIGN: A prospective, observational, multi-center study. SETTINGS: Four intensive care units in Toronto, Canada. PARTICIPANTS: Adult patients orally intubated for ≥48 h...
December 28, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29353120/phase-angle-assessment-in-critically-ill-cancer-patients-relationship-with-the-nutritional-status-prognostic-factors-and-death
#7
Tatiana Cathoud do Amaral Paes, Kátia Cansanção Correa de Oliveira, Patrícia de Carvalho Padilha, Wilza Arantes Ferreira Peres
PURPOSE: To evaluate the relationship between phase angle (PA) and nutritional status and the prognostic significance of PA in critically ill cancer patients. METHODS: 31 patients that had been admitted to the intensive care unit (ICU) of a center on oncology were evaluated. Their PA was obtained from their bioelectrical impedance within 48 h of the ICU admission. The logistic regression analysis of Cox was used in order to identify the independent predictors of the outcomes...
January 10, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29353024/outcomes-and-mortality-prediction-model-of-critically-ill-adults-with-acute-respiratory-failure-and-interstitial-lung-disease
#8
Whitney Gannon, David J Lederer, Mauer Biscotti, Azka Javaid, Nina Patel, Daniel Brodie, Matthew Bacchetta, Matthew Baldwin
BACKGROUND: We aimed to examine short- and long-term mortality in a mixed population of interstitial lung disease (ILD) patients with acute respiratory failure, and to identify those at lower versus higher risk of in-hospital death. METHODS: We conducted a single-center retrospective cohort study of 126 consecutive adults with ILD admitted to an intensive care unit (ICU) for respiratory failure at a tertiary care hospital between 2010 and 2014 who did not undergo lung transplantation during their hospitalization...
January 15, 2018: Chest
https://www.readbyqxmd.com/read/29351759/tracheal-intubation-in-critically-ill-patients-a-comprehensive-systematic-review-of-randomized-trials
#9
Luca Cabrini, Giovanni Landoni, Martina Baiardo Radaelli, Omar Saleh, Carmine D Votta, Evgeny Fominskiy, Alessandro Putzu, Cézar Daniel Snak de Souza, Massimo Antonelli, Rinaldo Bellomo, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. METHODS: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years...
January 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29351128/fluid-removal-with-ultrasound-guided-protocol-improves-the-efficacy-and-safety-of-dehydration-in-post-resuscitated-critically-ill-patients-a-quasi-experimental-before-and-after-study
#10
Luhao Wang, Chunfang Qiu, Xiangdong Guan, Minying Chen, Juan Chen, Xiang Si, Zhicheng Du, Yanqiu Liu, Bin Ouyang
Fluid overload is associated with increased morbidity and mortality in critically ill patients. However, researches rarely study the precise start or end point of fluid removal and no protocol was developed to control the fluid removal process. We hypothesized that individualized fluid removal with ultrasound-guided protocol could improve the efficacy and safety of fluid removal in post-resuscitated critically ill patients. A quasi-experimental, before and after trial was conducted to identify the benefits of ultrasound-guided fluid removal...
January 18, 2018: Shock
https://www.readbyqxmd.com/read/29349777/in-bed-cycling-in-the-icu-patient-safety-and-recollections-with-motivational-effects
#11
M Ringdal, M Warren Stomberg, K Egnell, E Wennberg, R Zätterman, C Rylander
BACKGROUND: In-bed cycling (IBC) is gaining interest for implementation in intensive care units. Our main objective was to explore patient recollections and experiences of early mobilization, including IBC. Secondly, we aimed to examine if IBC was safe and feasible. METHODS: Eleven participants were interviewed about their experiences during their critical illnesses and active mobilization in the intensive care unit. The interviews were analyzed thematically. Six participants were also monitored for physiological reactions and adverse events during IBC while mechanically ventilated...
January 18, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29349709/the-host-response-in-critically-ill-sepsis-patients-on-statin-therapy-a-prospective-observational-study
#12
Maryse A Wiewel, Brendon P Scicluna, Lonneke A van Vught, Arie J Hoogendijk, Aeilko H Zwinderman, René Lutter, Janneke Horn, Olaf L Cremer, Marc J Bonten, Marcus J Schultz, Tom van der Poll
BACKGROUND: Statins can exert pleiotropic anti-inflammatory, vascular protective and anticoagulant effects, which in theory could improve the dysregulated host response during sepsis. We aimed to determine the association between prior statin use and host response characteristics in critically ill patients with sepsis. METHODS: We performed a prospective observational study in 1060 patients admitted with sepsis to the mixed intensive care units (ICUs) of two hospitals in the Netherlands between January 2011 and July 2013...
January 18, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29349705/stool-cultures-at-the-icu-get-rid-of-it
#13
Carolin F Manthey, Darja Dranova, Martin Christner, Laura Berneking, Stefan Kluge, Ansgar W Lohse, Valentin Fuhrmann
BACKGROUND: Stool cultures for Campylobacter, Salmonella and Shigella and/or Yersinia spp. are frequently ordered in critically ill patients with diarrhea. The aim of this study is to analyze the diagnostic yield in a large cohort of critically ill patients. Therefore, we performed a cohort study at the Department of Intensive Care Medicine of a University Hospital (11 ICUs). RESULTS: From all patients who were admitted to the ICU between 2010 and 2015, stool cultures were taken from 2...
January 18, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29348280/marked-cachexia-in-probable-invasive-pulmonary-aspergillosis-with-bronchopleural-fistula
#14
Christiana Page, Laura Blazy, Melanie Jenkins, Rosalba Spiritoso
A 49-year-old man with a medical history of diabetes and heavy smoking was admitted to intensive care with severe bilateral pneumonia associated with marked cachexia. He developed a complex right-sided bronchopleural fistula and was transferred to our tertiary centre for consideration of surgical intervention.Despite escalation of antibiotic therapy, he did not improve and further investigations led to a diagnosis of invasive pulmonary aspergillosis. Definitive treatment plans required a right pneumonectomy; however, given the severity of cachexia, he remained unable to undergo such a large operation...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29347982/emergency-department-hyperoxia-is-associated-with-increased-mortality-in-mechanically-ventilated-patients-a-cohort-study
#15
David Page, Enyo Ablordeppey, Brian T Wessman, Nicholas M Mohr, Stephen Trzeciak, Marin H Kollef, Brian W Roberts, Brian M Fuller
BACKGROUND: Providing supplemental oxygen is fundamental in the management of mechanically ventilated patients. Increasing amounts of data show worse clinical outcomes associated with hyperoxia. However, these previous data in the critically ill have not focused on outcomes associated with brief hyperoxia exposure immediately after endotracheal intubation. Therefore, the objectives of this study were to evaluate the impact of isolated early hyperoxia exposure in the emergency department (ED) on clinical outcomes among mechanically ventilated patients with subsequent normoxia in the intensive care unit (ICU)...
January 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29344048/the-impact-of-normal-saline-on-the-incidence-of-exposure-keratopathy-in-patients-hospitalized-in-intensive-care-units
#16
Zohreh Davoodabady, Korosh Rezaei, Reza Rezaei
Background: Patients in the intensive care unit (ICU) have impaired ocular protective mechanisms that lead to an increased risk of ocular surface diseases including exposure keratopathy (EK). This study was designed to evaluate the effect of normal saline (NS) on the incidence and severity of EK in critically ill patients. Materials and Methods: This single-blind randomized controlled trial was conducted on 50 patients admitted to ICUs. The participants were selected through purposive sampling...
January 2018: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/29343171/prognosis-of-acute-respiratory-distress-syndrome-in-patients-with-hematological-malignancies
#17
Gil Myeong Seong, Yunkyoung Lee, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Jin Won Huh
INTRODUCTION: The intensive care unit (ICU) admission of patients with hematologic malignancies is gradually increasing. Life-threatening events are common, and acute respiratory distress syndrome (ARDS) is one of the most critical conditions. The aim of this study was to investigate the clinical characteristics and outcomes of ARDS in patients with hematological malignancies admitted to the ICU. METHODS: A retrospective study was performed on all patients with ARDS with hematological malignancies in a single tertiary teaching hospital between 2008 and 2015...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29343041/forgoing-life-sustaining-treatments-in-the-icu-to-withhold-or-to-withdraw-is-that-the-question
#18
Giuseppe R Gristina, Francesca Baroncelli, Marco Vergano
In the last decades, mortality from severe acute illnesses has considerably declined thanks to the advances in intensive care medicine. Meanwhile, critical care physicians realized that lifesustaining treatments (LST) may not be appropriate for every patient, and end-of-life care in the Intensive Care Unit (ICU) started to receive growing attention. Most deaths occurring in the ICU now follow a decision to forgo life-sustaining treatments (DFLST), which can be implemented either by withdrawing (WDLST) or withholding (WHLST) life-sustaining treatments...
January 17, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29342996/-optimal-energy-supply-in-different-age-groups-of-critically-ill-children-on-mechanical-ventilation
#19
X H Li, J Ji, S Y Qian
Objective: To analyze the resting energy expenditure and optimal energy supply in different age groups of critically ill children on mechanical ventilation in pediatric intensive care unit (PICU). Methods: Patients on mechanical ventilation hospitalized in PICU of Beijing Children's Hospital from March 2015 to March 2016 were enrolled prospectively. Resting energy expenditure of patients was calculated by US Med Graphic company critical care management (CCM) energy metabolism test system after mechanical ventilation...
January 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29340541/safety-criteria-to-start-early-mobilization-in-intensive-care-units-systematic-review
#20
Thais Martins Albanaz da Conceição, Ana Inês Gonzáles, Fernanda Cabral Xavier Sarmento de Figueiredo, Danielle Soares Rocha Vieira, Daiana Cristine Bündchen
Mobilization of critically ill patients admitted to intensive care units should be performed based on safety criteria. The aim of the present review was to establish which safety criteria are most often used to start early mobilization for patients under mechanical ventilation admitted to intensive care units. Articles were searched in the PubMed, PEDro, LILACS, Cochrane and CINAHL databases; randomized and quasi-randomized clinical trials, cohort studies, comparative studies with or without simultaneous controls, case series with 10 or more consecutive cases and descriptive studies were included...
October 2017: Revista Brasileira de Terapia Intensiva
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