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https://www.readbyqxmd.com/read/28105617/-establishment-of-prediction-model-of-acute-gastrointestinal-injury-classification-of-critically-ill-patients-based-on-digital-gastrointestinal-sounds-monitoring
#1
Yan Wang, Jianrong Wang, Weiwei Liu, Guangliang Zhang
OBJECTIVE: To develop the prediction model of acute gastrointestinal injury (AGI) classification of critically ill patients. METHODS: The binary channel gastrointestinal sounds (GIS) monitor system was used to gather and analyze the GIS of 60 consecutive critically ill patients who were admitted in Critical Care Medicine of PLA General Hospital from April 2015 to November 2015 (patients with chronic gastrointestinal disease or history of gastrointestinal surgery were excluded)...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28104546/dying-in-intensive-care-units-of-india-commentaries-on-policies-and-position-papers-on-palliative-and-end-of-life-care
#2
REVIEW
Jaydeep Sengupta, Suhita Chopra Chatterjee
PURPOSE: This study critically examines the available policy guidelines on integration of palliative and end-of-life care in Indian intensive care units to appraise their congruence with Indian reality. MATERIALS AND METHODS: Six position statements and guidelines issued by the Indian Society for Critical Care Medicine and the Indian Association of Palliative Care from 2005 till 2015 were examined. The present study reflects upon the recommendations suggested by these texts...
December 24, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28103536/evidence-based-guidelines-for-the-use-of-tracheostomy-in-critically-ill-patients
#3
Néstor Raimondi, Macarena R Vial, José Calleja, Agamenón Quintero, Albán Cortés, Edgar Celis, Clara Pacheco, Sebastián Ugarte, José M Añón, Gonzalo Hernández, Erick Vidal, Guillermo Chiappero, Fernando Ríos, Fernando Castilleja, Alfredo Matos, Enith Rodriguez, Paulo Antoniazzi, José Mario Teles, Carmelo Dueñas, Jorge Sinclair, Lorenzo Martínez, Ingrid von der Osten, José Vergara, Edgar Jiménez, Max Arroyo, Camilo Rodríguez, Javier Torres, Sebastián Fernandez-Bussy, Joseph L Nates
OBJECTIVES: To provide evidence-based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. METHODS: A taskforce composed of representatives of 10 member countries of the Pan-American and Iberic Federation of Societies of Critical and Intensive Therapy Medicine and of the Latin American Critical Care Trial Investigators Network developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation system...
October 20, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28098628/the-abcdef-bundle-science-and-philosophy-of-how-icu-liberation-serves-patients-and-families
#4
E Wesley Ely
Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the postintensive care syndrome." Patients with postintensive care syndrome are robbed of their normal cognitive, emotional, and physical capacity and cannot resume their previous life. The ICU Liberation Collaborative is a real-world quality improvement initiative being implemented across 76 ICUs designed to engage strategically the ABCDEF bundle through team- and evidence-based care...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28063084/methodological-issues-surrounding-the-use-of-baseline-health-related-quality-of-life-data-to-inform-trial-based-economic-evaluations-of-interventions-within-emergency-and-critical-care-settings-a-systematic-literature-review
#5
REVIEW
Melina Dritsaki, Felix Achana, James Mason, Stavros Petrou
BACKGROUND: Trial-based cost-utility analyses require health-related quality of life data that generate utility values in order to express health outcomes in terms of quality-adjusted life years (QALYs). Assessments of baseline health-related quality of life are problematic where trial participants are incapacitated or critically ill at the time of randomisation. This review aims to identify and critique methods for handling non-availability of baseline health-related quality of life data in trial-based cost-utility analyses within emergency and critical illness settings...
January 6, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28024548/canadian-cardiovascular-society-canadian-cardiovascular-critical-care-society-canadian-association-of-interventional-cardiology-position-statement-on-the-optimal-care-of-the-postarrest-patient
#6
Graham C Wong, Sean van Diepen, Craig Ainsworth, Rakesh C Arora, Jean G Diodati, Mark Liszkowski, Michael Love, Chris Overgaard, Greg Schnell, Jean-Francois Tanguay, George Wells, Michel Le May
Out of hospital cardiac arrest (OHCA) is associated with a low rate of survival to hospital discharge and high rates of neurological morbidity among survivors. Programmatic efforts to institute and integrate OHCA best care practices from the bystander response through to the in-hospital phase have been associated with improved patient outcomes. This Canadian Cardiovascular Society position statement was developed to provide comprehensive yet practical recommendations to guide the in-hospital care of OHCA patients...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28004327/nutritional-and-bioenergetic-considerations-in-critically-ill-patients-with-acute-neurological-injury
#7
Peter A Abdelmalik, Susan Dempsey, Wendy Ziai
The brain, due to intensive cellular processes and maintenance of electrochemical gradients, is heavily dependent on a constant supply of energy. Brain injury, and critical illness in general, induces a state of increased metabolism and catabolism, which has been proven to lead to poor outcomes. Of all the biochemical interventions undertaken in the ICU, providing nutritional support is perhaps one of the most undervalued, but potentially among the safest, and most effective interventions. Adequate provisions of calories and protein have been shown to improve patient outcomes, and guidelines for the nutritional support of the critically ill patient are reviewed...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27998322/international-federation-for-emergency-medicine-consensus-statement-sonography-in-hypotension-and-cardiac-arrest-shoc-an-international-consensus-on-the-use-of-point-of-care-ultrasound-for-undifferentiated-hypotension-and-during-cardiac-arrest
#8
Paul Atkinson, Justin Bowra, James Milne, David Lewis, Mike Lambert, Bob Jarman, Vicki E Noble, Hein Lamprecht, Tim Harris, Jim Connolly
: Introduction The International Federation for Emergency Medicine (IFEM) Ultrasound Special Interest Group (USIG) was tasked with development of a hierarchical consensus approach to the use of point of care ultrasound (PoCUS) in patients with hypotension and cardiac arrest. METHODS: The IFEM USIG invited 24 recognized international leaders in PoCUS from emergency medicine and critical care to form an expert panel to develop the sonography in hypotension and cardiac arrest (SHoC) protocol...
December 21, 2016: CJEM
https://www.readbyqxmd.com/read/27993546/post-resuscitation-management-of-cardiac-arrest-patients-in-the-critical-care-environment-a-retrospective-audit-of-compliance-with-evidence-based-guidelines
#9
REVIEW
A Milonas, A Hutchinson, D Charlesworth, A Doric, J Green, J Considine
BACKGROUND: There is a clear relationship between evidence-based post resuscitation care and survival and functional status at hospital discharge. The Australian Resuscitation Council (ARC) recommends protocol driven care to enhance chance of survival following cardiac arrest. Healthcare providers have an obligation to ensure protocol driven post resuscitation care is timely and evidence based. OBJECTIVES: The aim of this study was to examine adherence to best practice guidelines for post resuscitation care in the first 24h from Return of Spontaneous Circulation for patients admitted to the intensive care unit from the emergency department having suffered out of hospital or emergency department cardiac arrest and survived initial resuscitation...
December 16, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27927658/aneurysmal-subarachnoid-hemorrhage-red-blood-cell-transfusion-and-outcome-sahara-a-pilot-randomised-controlled-trial-protocol
#10
Shane W English, D Fergusson, M Chassé, A F Turgeon, F Lauzier, D Griesdale, A Algird, A Kramer, A Tinmouth, C Lum, J Sinclair, S Marshall, D Dowlatshahi, A Boutin, G Pagliarello, L A McIntyre
INTRODUCTION: Anaemia is common in aneurysmal subarachnoid haemorrhage (aSAH) and is a potential critical modifiable factor affecting secondary injury. Despite physiological evidence and management guidelines that support maintaining a higher haemoglobin level in patients with aSAH, current practice is one of a more restrictive approach to transfusion. The goal of this multicentre pilot trial is to determine the feasibility of successfully conducting a red blood cell (RBC) transfusion trial in adult patients with acute aSAH and anaemia (Hb ≤100 g/L), comparing a liberal transfusion strategy (Hb ≤100 g/L) with a restrictive strategy (Hb ≤80 g/L) on the combined rate of death and severe disability at 12 months...
December 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27907961/critical-care-management-of-the-patient-with-traumatic-brain-injury
#11
G Duemani Reddy, Shankar Gopinath, Claudia Robertson
The critical care management of patients with traumatic brain injury is complex. The primary goal is to minimize the effects of secondary injury that would otherwise serve to further worsen neurologic function. This requires an understanding of the abnormal brain physiology that is found in these patients. In this article the authors discuss this physiology and describe suggested treatment strategies for these patients based on evidence-based guidelines.
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27890495/critical-care-guidelines-more-science-less-art
#12
EDITORIAL
The Lancet Respiratory Medicine
No abstract text is available yet for this article.
December 2016: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/27876084/a-trial-to-determine-whether-septic-shock-reversal-is-quicker-in-pediatric-patients-randomized-to-an-early-goal-directed-fluid-sparing-strategy-versus-usual-care-squeeze-study-protocol-for-a-pilot-randomized-controlled-trial
#13
Melissa J Parker, Lehana Thabane, Alison Fox-Robichaud, Patricia Liaw, Karen Choong
BACKGROUND: Current pediatric septic shock resuscitation guidelines from the American College of Critical Care Medicine focus on the early and goal-directed administration of intravascular fluid followed by vasoactive medication infusions for persistent and fluid-refractory shock. However, accumulating adult and pediatric data suggest that excessive fluid administration is associated with worse patient outcomes and even increased risk of death. The optimal amount of intravascular fluid required in early pediatric septic shock resuscitation prior to the initiation of vasoactive support remains unanswered...
November 22, 2016: Trials
https://www.readbyqxmd.com/read/27868189/an-evaluation-of-inpatient-morbidity-and-critical-care-provision-in-zambia
#14
P J Dart, J Kinnear, M D Bould, S L Mwansa, Z Rakhda, D Snell
The aim of this study was to objectively measure demand for critical care services in a southern African tertiary referral centre. We carried out a point prevalence study of medical and surgical admissions over a 48-h period at the University Teaching Hospital, Lusaka, recording the following: age; sex; diagnosis; Human Immunodeficiency Virus (HIV) status and National Early Warning Score. One-hundred and twenty medical and surgical admissions were studied. Fifty-four patients (45%) had objective evidence of a requirement for critical care review and potential or probable admission to an intensive care unit, according to the Royal College of Physicians (UK) guidelines...
November 21, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27858808/guideline-for-reversal-of-antithrombotics-in-intracranial-hemorrhage-executive-summary-a-statement-for-healthcare-professionals-from-the-neurocritical-care-society-and-the-society-of-critical-care-medicine
#15
Jennifer A Frontera, John J Lewin, Alejandro A Rabinstein, Imo P Aisiku, Anne W Alexandrov, Aaron M Cook, Gregory J Del Zoppo, Monisha Kumar, Ellinor I B Peerschke, Michael F Stiefel, Jeanne S Teitelbaum, Katja E Wartenberg, Cindy L Zerfoss
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27855228/the-devil-is-in-the-details-incomplete-reporting-in-preclinical-animal-research
#16
Marc T Avey, David Moher, Katrina J Sullivan, Dean Fergusson, Gilly Griffin, Jeremy M Grimshaw, Brian Hutton, Manoj M Lalu, Malcolm Macleod, John Marshall, Shirley H J Mei, Michael Rudnicki, Duncan J Stewart, Alexis F Turgeon, Lauralyn McIntyre
Incomplete reporting of study methods and results has become a focal point for failures in the reproducibility and translation of findings from preclinical research. Here we demonstrate that incomplete reporting of preclinical research is not limited to a few elements of research design, but rather is a broader problem that extends to the reporting of the methods and results. We evaluated 47 preclinical research studies from a systematic review of acute lung injury that use mesenchymal stem cells (MSCs) as a treatment...
2016: PloS One
https://www.readbyqxmd.com/read/27852357/a-multifaceted-approach-to-reduction-of-catheter-associated-urinary-tract-infections-in-the-intensive-care-unit-with-an-emphasis-on-stewardship-of-culturing
#17
Katherine M Mullin, Christopher S Kovacs, Cynthia Fatica, Colette Einloth, Elizabeth A Neuner, Jorge A Guzman, Eric Kaiser, Venu Menon, Leticia Castillo, Marc J Popovich, Edward M Manno, Steven M Gordon, Thomas G Fraser
BACKGROUND Catheter-associated urinary tract infections (CAUTIs) are among the most common hospital-acquired infections (HAIs). Reducing CAUTI rates has become a major focus of attention due to increasing public health concerns and reimbursement implications. OBJECTIVE To implement and describe a multifaceted intervention to decrease CAUTIs in our ICUs with an emphasis on indications for obtaining a urine culture. METHODS A project team composed of all critical care disciplines was assembled to address an institutional goal of decreasing CAUTIs...
February 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27849676/platelet-transfusion-in-critical-care-and-surgery-evidence-based-review-of-contemporary-practice-and-future-directions
#18
Eric W Etchill, Sara P Myers, Jay S Raval, Adnan Hassoune, Anirban SenGupta, Matthew D Neal
Thrombocytopenia is prevalent in critical care, surgical, and trauma settings. Despite the fact that a significant proportion of these patients receive platelet transfusion during their hospital course, much work remains to be done with regard to development of platelet transfusion guidelines. Given the wide variety of platelet transfusion practices and the frequency with which patients present with thrombocytopenia, it is paramount to understand standards of care and to identify deficiencies that may exist...
November 15, 2016: Shock
https://www.readbyqxmd.com/read/27829710/early-norepinephrine-decreases-fluid-and-ventilatory-requirements-in-pediatric-vasodilatory-septic-shock
#19
Suchitra Ranjit, Rajeswari Natraj, Sathish Kumar Kandath, Niranjan Kissoon, Balasubramaniam Ramakrishnan, Paul E Marik
AIMS: We previously reported that vasodilatation was common in pediatric septic shock, regardless of whether they were warm or cold, providing a rationale for early norepinephrine (NE) to increase venous return (VR) and arterial tone. Our primary aim was to evaluate the effect of smaller fluid bolus plus early-NE versus the American College of Critical Care Medicine (ACCM) approach to more liberal fluid boluses and vasoactive-inotropic agents on fluid balance, shock resolution, ventilator support and mortality in children with septic shock...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27818334/neuromuscular-blockade-in-the-21-st-century-management-of-the-critically-ill-patient
#20
REVIEW
Julian deBacker, Nicholas Hart, Eddy Fan
Neuromuscular blockings agents (NMBAs) have a controversial role in the ventilatory and medical management of critical illness. The clinical concern surrounding NMBA-induced complications stems from evidence presented in the 2002 clinical practice guidelines, but new evidence from subsequent randomized trials and studies provides a more optimistic outlook about the application of NMBAs in the intensive care unit (ICU). Furthermore, changes in the delivery of critical care such as protocolized care pathways, minimizing or interrupting sedation, increased monitoring techniques, and overall improvements in reducing immobility have created a modern, 21st century ICU environment whereby NMBAs may be administered safely...
November 3, 2016: Chest
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