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Critical care/intensive care

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https://www.readbyqxmd.com/read/29786568/nutritive-support-for-newborns-in-critical-conditions-semi-elemental-formilas-as-a-means-of-enteral-nutrition
#1
Dmytro Shkurupii
OBJECTIVE: Introduction: The goal is to increase the efficiency of nutritional support in intensive care of newborns by substantiating the choice of the enteral blend. PATIENTS AND METHODS: Materials and methods: A prospective cohort study was conducted, which included 173 newborns. The main group consisted of 143 patients of intensive care units. The comparison group - 30 virtually healthy newborns. Physical parameters, changes in protein metabolism, serum immunoglobulins, functioning of the gastrointestinal tract and hepatobiliary system in the development of critical conditions and depending on the type of enteric urine formula were determined...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29785938/decision-making-in-end-of-life-care-are-we-really-playing-together-in-the-same-team
#2
M M Lomero-Martínez, M F Jiménez-Herrera, M A Bodí-Saera, M Llauradó-Serra, N Masnou-Burrallo, E Oliver-Juan, A Sandiumenge-Camps
BACKGROUND: Limitation of life-sustaining treatment is increasingly common in critical care units, and controlled donation after circulatory death is starting to be included as an option within patient care plans. Lack of knowledge and misunderstandings can place a barrier between healthcare professionals. OBJECTIVE: To determine the perceptions, knowledge and attitudes of physicians and nurses working in intensive care units regarding Limitation of life-sustaining treatment and controlled donation after circulatory death...
May 18, 2018: Enfermería Intensiva
https://www.readbyqxmd.com/read/29784539/revisiting-antithrombin-in-health-and-disease-congenital-deficiencies-and-genetic-variants-and-laboratory-studies-on-%C3%AE-and-%C3%AE-forms
#3
REVIEW
Jean Amiral, Jerard Seghatchian
Antithrombin [AT] is the main inhibitor for activated plasma coagulation serine esterases, inhibiting thrombin, Factors Xa and IXa, but also Factors XIIa, XIa, VIIa, kallicrein, and plasmin. Its activity is highly enhanced by heparin, through binding to the pentasaccharide sequences, for inhibition of all coagulation proteases, except thrombin, which inhibition requires its additional binding to the heparin polysaccharide chain. However, AT is the major inhibitor of thrombin in the blood circulation. Congenital or acquired deficiencies of AT expose affected patients to an increased risk of developing unprovoked and recurrent thrombo-embolic diseases...
April 19, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29783252/the-analytical-prognosis-of-the-susceptibility-to-aminoglycosides-and-doxycycline-inacinetobacter-baumanniiisoolated-from-burns-of-intensive-care-unit-patients
#4
Vasyl I Nahaichuk, Oleksandr A Nazarchuk, Neonila I Osadchuk, Dmytro V Dmytriiev, Halyna H Nazarchuk
OBJECTIVE: Introduction: Clinical strains of A.baumannii are becoming highly important in hospital-acquired infections, especially because of their association with low susceptibility to antibiotics, which requires in-depth study with a prognostic determination of the dynamics of antimicrobial efficacy of antibiotics. The aim was to investigate of prognostic models of aminoglycoside antibiotics effectiveness on the basis of the mathematical analysis of real susceptibility of A.baumannii clinical strains, isolated from patients in BICU...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#5
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29779927/patent-ductus-arteriosus-the-physiology-of-transition
#6
REVIEW
Poorva Deshpande, Michelle Baczynski, Patrick J McNamara, Amish Jain
The transition from intrauterine to extrauterine life represents a critical phase of physiological adaptation which impacts many organ systems, most notably the heart and the lungs. The majority of term neonates complete this transition without complications; however, dysregulation of normal postnatal adaptation may lead to acute cardiopulmonary instability, necessitating advanced intensive care support. Although not as well appreciated as changes in vascular resistances, the shunt across the DA plays a crucial physiologic role in the adaptive processes related to normal transitional circulation...
May 5, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29779912/how-often-do-we-perform-painful-and-stressful-procedures-in-the-paediatric-intensive-care-unit-a-prospective-observational-study
#7
Manuel A Baarslag, Sharan Jhingoer, Erwin Ista, Karel Allegaert, Dick Tibboel, Monique van Dijk
BACKGROUND: Adequate analgesia and sedation is crucial in critical care. There is little knowledge on the extent of painful and stressful procedures on children admitted to a paediatric intensive care unit (PICU) and its analgesic and/or sedative management. OBJECTIVE: The primary objective was to determine the number of painful and stressful procedures per patient per day in our PICU patients, including the numbers of attempts. A secondary objective was to map PICU nurses' perceptions of the painfulness of the included procedures...
May 17, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29779827/zika-virus-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#8
Gisele Sampaio Silva, Guy A Richards, Tim Baker, Jorge Hidalgo, Juan Ignacio Silesky Jiménez, Pravin Amin
Zika fever is an acute infectious disease caused by the Zika virus (ZIKV), an RNA virus belonging to the genus Flavivirus. ZIKV can be transmitted by bites from Aedes aegypti and Aedes albopictus species, sexual activity, blood transfusion and from mother to fetus during pregnancy and delivery. A total of 50 territories and countries in the Americas had reported ZIKV infections. For those with symptoms, the presentation is similar to dengue fever with body aches, joint pain, fatigue, malaise, fever and conjunctivitis lasting up to seven days...
April 5, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29779815/use-of-standard-enteral-formula-versus-enteric-formula-with-prebiotic-content-in-nutrition-therapy-a-randomized-controlled-study-among-neuro-critical-care-patients
#9
Piril Tuncay, Fatma Arpaci, Mutlu Doganay, Deniz Erdem, Arzu Sahna, Hulya Ergun, Dilek Atabey
OBJECTIVE: To compare use of standard enteral formula versus enteric formula with prebiotic content in terms of nutrition therapy related outcomes among neurocritical care patients. METHODS: A total of 46 adult neurocritical care patients who received nutrition therapy with standard enteral formula (SEF group; n = 23) or enteral formula with prebiotic content (EFPC group; n = 23) during their hospitalization in intensive care unit (ICU) were included in this prospective randomized controlled study...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29779805/the-use-of-computed-tomography-images-as-a-prognostic-marker-in-critically-ill-cancer-patients
#10
Diogo O Toledo, Amanda M Carvalho, Amanda M R R Oliveira, Jerusa M Toloi, Aline C Silva, José Francisco de Mattos Farah, Carla M Prado, Joao M Silva
BACKGROUND & AIMS: In the intensive care unit (ICU) setting, body composition is typically estimated through anthropometry, which does not specifically quantify skeletal muscle (SM). Recent findings have shown that computed tomography (CT) is a useful tool to identify low SM in critically ill patients, which in turn is associated with poor clinical outcomes. So, the present study aims at comparing low SM assessed by CT to BMI anthropometric data and its association with outcomes in critically ill patients...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29778659/sepsis-3-septic-shock-criteria-and-associated-mortality-among-infected-hospitalized-patients-assessed-by-a-rapid-response-team
#11
Shannon M Fernando, Peter M Reardon, Bram Rochwerg, Nathan I Shapiro, Donald M Yealy, Andrew J E Seely, Jeffrey J Perry, Douglas P Barnaby, Kyle Murphy, Peter Tanuseputro, Kwadwo Kyeremanteng
BACKGROUND: Rapid Response Teams (RRTs) respond to deteriorating hospitalized patients, and help determine subsequent management, including Intensive Care Unit (ICU) admission. In such patients with sepsis and septic shock, the Sepsis-3 clinical criteria have a potential role in detection, risk-stratification, and prognostication, though their accuracy in comparison to the Systemic Inflammatory Response Syndrome (SIRS)-based septic shock criteria are unknown. We sought to evaluate prognostic accuracy of the Sepsis-3 criteria for in-hospital mortality among infected hospitalized patients with acute deterioration...
May 17, 2018: Chest
https://www.readbyqxmd.com/read/29777555/impact-of-nicu-oral-feeding-on-neuropsychomotor-outcomes-at-9-months-of-corrected-age-in-chinese-low-birth-weight-preterm-infants-a-retrospective-study
#12
Wenwen Ding, Lijin Zhao, Nan Sheng, Jiali Ma, Ying Zhang
AIMS AND OBJECTIVES: To examine the changes in neuropsychomotor development and investigate the effect of feeding progression in Neonatal Intensive Care Unit (NICU) on neuropsychomotor outcomes in low-birth-weight preterm infants within 9 months of corrected age. BACKGROUND: Low-birth-weight (LBW) preterm infants (<37 weeks of gestation and birth weight < 2500 g) are at a high risk for neuropsychomotor development delay. Therefore, exploring NICU practices related to neuropsychomotor development is important...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29777534/is-it-necessary-to-have-a-dentist-within-an-intensive-care-unit-team-report-of-a-randomised-clinical-trial
#13
Wanessa Teixeira Bellissimo-Rodrigues, Mayra Gonçalves Menegueti, Gilberto Gambero Gaspar, Hayala Cristina Cavenague de Souza, Maria Auxiliadora-Martins, Anibal Basile-Filho, Roberto Martinez, Fernando Bellissimo-Rodrigues
OBJECTIVE: To evaluate the effectiveness of dental treatment in improving oral health in critical patients. METHODS: This randomised clinical trial was conducted in a general intensive care unit (ICU) at a tertiary care public facility from 1 January 2011 to 8 August 2013. Data from 254 adult patients staying in the ICU for 48 hours or more were analysed. The experimental group (n = 127) had access to dental treatment provided by a dentist four to five times a week, in addition to routine oral hygiene, whereas the control group (n = 127) had access only to routine oral hygiene, including topical application of chlorhexidine, provided by the ICU nursing staff...
May 18, 2018: International Dental Journal
https://www.readbyqxmd.com/read/29777262/intensive-care-medicine-in-2050-towards-critical-care-without-central-lines
#14
Jean-Louis Vincent, Frederic Michard, Bernd Saugel
No abstract text is available yet for this article.
May 18, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29776707/unplanned-extubations-in-an-intensive-care-unit-findings-from-a-critical-incident-technique
#15
Matteo Danielis, Simona Chiaruttini, Alvisa Palese
BACKGROUND: Patients on mechanical ventilation are at risk of experiencing a potentially life-threatening unplanned extubation in the intensive care unit, which can lead to arrhythmias, bronchial aspiration, difficulty in reintubation or even sudden cardiac arrest. Although incidence and outcomes of the phenomenon have been documented in several quantitative studies, no studies have investigated the antecedents as experienced by critical care nurses. OBJECTIVES: To gain a greater understanding of the antecedents of unplanned extubations...
May 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29776706/gaps-in-pain-agitation-and-delirium-management-in-intensive-care-outputs-from-a-nurse-workshop
#16
REVIEW
Carsten Hermes, Maria Acevedo-Nuevo, Andrea Berry, Thomas Kjellgren, Alessandra Negro, Paola Massarotto
Significant improvements in our understanding of pain, agitation, and delirium management within the Intensive Care Unit have been made in recent years. International guidelines and implementation bundles have become more evidence-based, patient-centred, and provide clear recommendations on the best-practice management of critically ill patients. However, the intensive care community has highlighted the need for higher-order evidence in several areas of pain, agitation and delirium research and studies suggest that a significant number of intensive care patients still receive outdated treatment as a consequence of inadequate guideline implementation...
May 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29775080/mindfulness-meditation-and-interprofessional-cardiopulmonary-resuscitation-a-mixed-methods-pilot-study
#17
Diana J Kelm, Jennifer L Ridgeway, Becca L Gas, Monali Mohan, David A Cook, Darlene R Nelson, Roberto P Benzo
PROBLEM: Mindfulness training includes mindfulness meditation, which has been shown to improve both attention and self-awareness. Medical providers in the intensive care unit often deal with difficult situations with strong emotions, life-and-death decisions, and both interpersonal and interprofessional conflicts. The effect of mindfulness meditation training on healthcare providers during acute care tasks such as cardiopulmonary resuscitation remains unknown. Mindfulness meditation has the potential to improve provider well-being and reduce stress in individuals involved in resuscitation teams, which could then translate into better team communication and delivery of care under stress...
May 18, 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29773846/appetite-during-the-recovery-phase-of-critical-illness-a-cohort-study
#18
Judith L Merriweather, David M Griffith, Timothy S Walsh
BACKGROUND/OBJECTIVES: Reduced appetite is a recognised physiological symptom in survivors of critical illness. While reduced appetite has been reported by patients after intensive care unit (ICU) discharge, quantification using visual analogue scales (VAS) has not been previously performed, and follow-up duration has been limited. We aimed to describe appetite scores in ICU survivors during the first 3 months after ICU discharge and explore association with systemic inflammation. SUBJECTS/METHODS: Secondary analysis of data collected in a complex rehabilitation intervention trial (RECOVER)...
May 17, 2018: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29770452/the-effects-of-blood-transfusion-on-red-blood-cell-distribution-width-in-critically-ill-patients-a-pilot-study
#19
Savino Spadaro, Fabio Silvio Taccone, Alberto Fogagnolo, Federico Franchi, Sabino Scolletta, Riccardo Ragazzi, Alberto Fanni, Elisabetta Marangoni, Maurizio Govoni, Roberto Reverberi, Carlo Alberto Volta
BACKGROUND: Red blood cell distribution width (RDW) is a measure of anisocytosis, generally used in the differential diagnosis of anemia. Recently, RDW was associated with increased mortality in critically ill patients. Red blood cell (RBC) transfusions are potential confounders on RDW values interpretation. The aim of this study was to analyze the changes in RDW after RBC transfusion in intensive care unit (ICU) patients. STUDY DESIGN AND METHODS: This was a prospective, observational study including patients admitted to ICU requiring 1 RBC unit...
May 16, 2018: Transfusion
https://www.readbyqxmd.com/read/29770293/current-monitoring-and-innovative-predictive-modeling-to-improve-care-in-the-pediatric-cardiac-intensive-care-unit
#20
REVIEW
Mary K Olive, Gabe E Owens
The objectives of this review are (I) to describe the challenges associated with monitoring patients in the pediatric cardiac intensive care unit (PCICU) and (II) to discuss the use of innovative statistical and artificial intelligence (AI) software programs to attempt to predict significant clinical events. Patients cared for in the PCICU are clinically fragile and at risk for fatal decompensation. Current monitoring modalities are often ineffective, sometimes inaccurate, and fail to detect a deteriorating clinical status in a timely manner...
April 2018: Translational Pediatrics
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