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https://www.readbyqxmd.com/read/28914279/blood-products-provided-to-patients-receiving-futile-critical-care
#1
Thanh H Neville, Alyssa Ziman, Neil S Wenger
The number of hospitalized patients receiving treatment perceived to be futile is not insignificant. Blood products are valuable resources that are donated to help others in need. We aimed to quantify the amount of blood transfused into patients who were receiving treatment that the critical care physician treating them perceived to be futile. During a 3-month period, critical care physicians in 5 adult intensive care units completed a daily questionnaire to identify patients perceived as receiving futile treatment...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28913745/management-of-type-1-diabetes-in-the-hospital-setting
#2
REVIEW
Carlos E Mendez, Guillermo E Umpierrez
PURPOSE OF REVIEW: The purpose of this article was to review recent guideline recommendations on glycemic target, glucose monitoring, and therapeutic strategies, while providing practical recommendations for the management of medical and surgical patients with type 1 diabetes (T1D) admitted to critical and non-critical care settings. RECENT FINDINGS: Studies evaluating safety and efficacy of insulin pump therapy, continuous glucose monitoring, electronic glucose management systems, and closed loop systems for the inpatient management of hyperglycemia are described...
September 14, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28864072/improvements-in-the-quality-of-advanced-life-support-and-patient-outcome-after-implementation-of-a-standardized-real-life-post-resuscitation-feedback-system
#3
Pia Hubner, Elisabeth Lobmeyr, Christian Wallmüller, Michael Poppe, Philip Datler, Markus Keferböck, Sebastian Zeiner, Alexander Nürnberger, Andreas Zajicek, Anton Laggner, Fritz Sterz, Patrick Sulzgruber
BACKGROUND: Educational aspects in the training of advanced life support (ALS) represent a key role in critical care management of patients with out-of-hospital cardiac arrest (OHCA) and received special attention in guidelines of various international societies. While a positive association of feedback on ALS performance in training conditions is well established, data on the impact of a real-life post-resuscitation feedback on both ALS quality and outcome remain scarce and inconclusive...
August 31, 2017: Resuscitation
https://www.readbyqxmd.com/read/28863029/requirements-for-trial-registration-and-adherence-to-reporting-guidelines-in-critical-care-journals-a-meta-epidemiological-study-of-journals-instructions-for-authors
#4
Matthew T Sims, Jake X Checketts, Cole Wayant, Matt Vassar
BACKGROUND: The purpose of this study was to investigate the policies of critical care journals with regard to guideline adoption and clinical trial registration to understand the extent to which journals use these mechanisms to improve reporting practices. METHODS: The current study's sample comprised 37 critical care journals cataloged in the Expanded Science Citation Index of the 2015 Journal Citation Reports and Google Scholar Metrics h5-index critical care subcategory...
August 31, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28831819/private-rooms-in-low-acuity-settings-a-systematic-review-of-the-literature
#5
Jeffrey Voigt, Michael Mosier, Rabih Darouiche
OBJECTIVES: Determine if the peer-reviewed evidence supports single-patient ward bedrooms in low-acuity care settings within a hospital. BACKGROUND: New evidence exists since the 2006 Facility Guideline Institute guideline recommended single-bedded rooms (SBRs) in low-acuity care settings. Additionally, prior studies evaluated high-acuity care settings (e.g., critical care) in their recommendations on SBRs. There is a need to reevaluate the evidence. METHODS: A systematic review of the literature was completed including electronic and hand searches of references...
January 1, 2017: HERD
https://www.readbyqxmd.com/read/28820650/critical-care-nutrition-support-best-practices-key-differences-between-canadian-and-american-guidelines
#6
Jayshil J Patel, Margot Lemieux, Stephen A McClave, Robert G Martindale, Ryan T Hurt, Daren K Heyland
Since 2015, Society of Critical Care Medicine/American Society for Parenteral and Enteral Nutrition and Canadian critical care nutrition support guidelines have both been updated. Despite a similar evidentiary basis, there remain key differences between guideline recommendations. These differences in recommendations may pose confusion for the clinician and may encumber widespread applicability. The aim of this review was to enhance practitioner confidence in applying critical care nutrition support guidelines to patient care in their settings by outlining the similarities and differences between the American and Canadian methods for guideline development and describing the key differences and reasons behind the differences...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28817507/comparison-of-consent-models-in-a-randomized-trial-of-corticosteroids-in-pediatric-septic-shock
#7
Kusum Menon, Katharine O'Hearn, James Dayre McNally, Anand Acharya, Hector R Wong, Margaret Lawson, Tim Ramsay, Lauralyn McIntyre, Elaine Gilfoyle, Marisa Tucci, David Wensley, Ronald Gottesman, Gavin Morrison, Karen Choong
OBJECTIVES: To describe the use of deferred and prior informed consent models in the context of a low additional risk to standard of care, placebo-controlled randomized controlled trial of corticosteroids in pediatric septic shock. DESIGN: An observational substudy of consent processes in a randomized controlled trial of hydrocortisone versus placebo. SETTING: Seven tertiary level PICUs in Canada. PATIENTS: Children newborn to 17 years inclusive admitted to PICU with suspected septic shock between July 2014 and March 2016...
August 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28797851/palliative-care-development-in-georgia
#8
Nina Kiknadze, Pati Dzotsenidze
Georgia has established the foundational measures for a national palliative care program-policy, education, drug availability, and implementation. Amendments to legislation needed to develop palliative care have been approved. Palliative care has been recognized as a subspecialty in oncology, critical care, internal medicine and surgery. The National Plan for Palliative Care for 2011-2016 was approved. Opioids, especially oral morphine, are available on a limited basis for patients at home but oral morphine is not available for patients in the hospital...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28763355/regulatory-considerations-for-physiological-closed-loop-controlled-medical-devices-used-for-automated-critical-care-food-and-drug-administration-workshop-discussion-topics
#9
Bahram Parvinian, Christopher Scully, Hanniebey Wiyor, Allison Kumar, Sandy Weininger
Part of the mission of the Center for Devices and Radiological Health (CDRH) at the US Food and Drug Administration is to facilitate medical device innovation. Therefore, CDRH plays an important role in helping its stakeholders such as manufacturers, health care professionals, patients, patient advocates, academia, and other government agencies navigate the regulatory landscape for medical devices. This is particularly important for innovative physiological closed-loop controlled (PCLC) devices used in critical care environments, such as intensive care units, emergency settings, and battlefield environments...
July 28, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28760636/changing-the-paradigm-messages-for-hand-hygiene-education-and-audit-from-cluster-analysis
#10
D J Gould, D Navaïe, E Purssell, N S Drey, S Creedon
BACKGROUND: Hand hygiene is considered the foremost infection prevention measure. How health workers accept and make sense of the hand hygiene message is likely to contribute to success and sustainability of initiatives to improve performance, which is still often poor. METHODS: Survey of nurses in critical care units in three National Health Service trusts in England to explore opinions about hand hygiene, use of alcohol handrubs, audit with performance feedback and other key hand hygiene-related issues...
July 28, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28751970/service-evaluation-of-the-implementation-of-a-digitally-enabled-care-pathway-for-the-recognition-and-management-of-acute-kidney-injury
#11
Alistair Connell, Hugh Montgomery, Stephen Morris, Claire Nightingale, Sarah Stanley, Mary Emerson, Gareth Jones, Omid Sadeghi-Alavijeh, Charles Merrick, Dominic King, Alan Karthikesalingam, Cian Hughes, Joseph Ledsam, Trevor Back, Geraint Rees, Rosalind Raine, Christopher Laing
Acute Kidney Injury (AKI), an abrupt deterioration in kidney function, is defined by changes in urine output or serum creatinine. AKI is common (affecting up to 20% of acute hospital admissions in the United Kingdom), associated with significant morbidity and mortality, and expensive (excess costs to the National Health Service in England alone may exceed £1 billion per year). NHS England has mandated the implementation of an automated algorithm to detect AKI based on changes in serum creatinine, and to alert clinicians...
2017: F1000Research
https://www.readbyqxmd.com/read/28749392/evaluation-of-evidence-for-pharmacokinetics-pharmacodynamics-based-dose-optimization-of-antimicrobials-for-treating-gram-negative-infections-in-neonates
#12
REVIEW
Nusrat Shafiq, Samir Malhotra, Vikas Gautam, Harpreet Kaur, Pravin Kumar, Sourabh Dutta, Pallab Ray, Nilima A Kshirsagar
BACKGROUND & OBJECTIVES: Neonates present a special subgroup of population in whom optimization of antimicrobial dosing can be particularly challenging. Gram-negative infections are common in neonates, and inpatient treatment along with critical care is needed for the management of these infections. Dosing recommendations are often extrapolated from evidence generated in older patient populations. This systematic review was done to identify the knowledge gaps in the pharmacokinetics-pharmacodynamics (PK-PD)-based optimized dosing schedule for parenteral antimicrobials for Gram-negative neonatal infections...
March 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28742548/association-between-survival-and-time-of-day-for-rapid-response-team-calls-in-a-national-registry
#13
Matthew Michael Churpek, Dana P Edelson, Ji Yeon Lee, Kyle Carey, Ashley Snyder
OBJECTIVES: Decreased staffing at nighttime is associated with worse outcomes in hospitalized patients. Rapid response teams were developed to decrease preventable harm by providing additional critical care resources to patients with clinical deterioration. We sought to determine whether rapid response team call frequency suffers from decreased utilization at night and how this is associated with patient outcomes. DESIGN: Retrospective analysis of a prospectively collected registry database...
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28733841/analgosedation-of-adult-patients-with-elevated-intracranial-pressure-survey-of-current-clinical-practice-in-austria
#14
Guenther Herzer, Claudia Mirth, Udo M Illievich, Wolfgang G Voelckel, Helmut Trimmel
BACKGROUND: Analgesia and sedation are key items in intensive care. Recently published S3 guidelines specifically address treatment of patients with elevated intracranial pressure. METHODS: The Austrian Society of Anesthesiology, Resuscitation and Intensive Care Medicine carried out an online survey of neurointensive care units in Austria in order to evaluate the current state of practice in the areas of analgosedation and delirium management in this high-risk patient group...
July 21, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28731387/a-comparative-analysis-of-pulmonary-and-critical-care-medicine-guideline-development-methodologies
#15
COMPARATIVE STUDY
Noah C Schoenberg, Alan F Barker, John Bernardo, Robin R Deterding, Jerrold J Ellner, Dean R Hess, Neil R MacIntyre, Fernando J Martinez, Kevin C Wilson
RATIONALE: The Institute of Medicine (IOM) standards for guideline development have had unintended negative consequences. A more efficient approach is desirable. OBJECTIVES: To determine whether a modified Delphi process early during guideline development discriminates recommendations that should be informed by a systematic review from those that can be based upon expert consensus. METHODS: The same questions addressed by IOM-compliant pulmonary or critical care guidelines were addressed by expert panels using a modified Delphi process, termed the Convergence of Opinion on Recommendations and Evidence (CORE) process...
September 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28726037/can-a-collaborative-subspecialty-antimicrobial-stewardship-intervention-have-lasting-effects
#16
Kaushal B Shah, Ramzy H Rimawi, Mark A Mazer, Paul P Cook
OBJECTIVE: We previously demonstrated the benefit of direct, daily collaboration between infectious disease (ID) and critical care practitioners (CCP) on guideline adherence and antibiotic use in the medical intensive care unit (MICU). In this post-intervention review, we sought to establish whether the effect on antibiotic use and guideline adherence was sustainable. DESIGN: A retrospective review of 87 patients, admitted to the 24-bed MICU, was done 3 (n = 45) and 6 months (n = 42) after the intervention...
July 19, 2017: Infection
https://www.readbyqxmd.com/read/28723883/the-american-college-of-critical-care-medicine-clinical-practice-parameters-for-hemodynamic-support-of-pediatric-and-neonatal-septic-shock-executive-summary
#17
Alan L Davis, Joseph A Carcillo, Rajesh K Aneja, Andreas J Deymann, John C Lin, Trung C Nguyen, Regina S Okhuysen-Cawley, Monica S Relvas, Ranna A Rozenfeld, Peter W Skippen, Bonnie J Stojadinovic, Eric A Williams, Tim S Yeh, Fran Balamuth, Joe Brierley, Allan R de Caen, Ira M Cheifetz, Karen Choong, Edward Conway, Timothy Cornell, Allan Doctor, Marc-Andre Dugas, Jonathan D Feldman, Julie C Fitzgerald, Heidi R Flori, James D Fortenberry, Ana Lia Graciano, Bruce M Greenwald, Mark W Hall, Yong Yun Han, Lynn J Hernan, Jose E Irazuzta, Elizabeth Iselin, Elise W van der Jagt, Howard E Jeffries, Saraswati Kache, Chhavi Katyal, Niranjan Kissoon, Alexander A Kon, Martha C Kutko, Graeme MacLaren, Timothy Maul, Renuka Mehta, Fola Odetola, Kristine Parbuoni, Raina Paul, Mark J Peters, Suchitra Ranjit, Karin E Reuter-Rice, Eduardo J Schnitzler, Halden F Scott, Adalberto Torres, Jacki Weingarten-Abrams, Scott L Weiss, Jerry J Zimmerman, Aaron L Zuckerberg
No abstract text is available yet for this article.
September 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28711861/healthcare-infrastructure-capacity-to-respond-to-severe-acute-respiratory-infection-sari-and-sepsis-in-vietnam-a-low-middle-income-country
#18
Vu Quoc Dat, Nguyen Thanh Long, Kim Bao Giang, Pham Bich Diep, Ta Hoang Giang, Janet V Diaz
PURPOSE: This study investigated the availability of relevant structural and human resources needed for the clinical management of patients with severe acute respiratory infections and sepsis in critical care units in Vietnam. MATERIAL AND METHODS: A questionnaire survey was conducted by purposive sampling of 128 hospitals (36% of total hospitals in surveyed provinces), including 25 provincial and 103 district level hospitals, from 20 provinces in Vietnam. Data on availability of hospital characteristics, structural resources and health care workers was then analyzed...
July 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28697503/update-of-sepsis-in-the-intensive-care-unit
#19
Kelly Roveran Genga, James A Russell
Sepsis, the most common cause of admission to an intensive care unit (ICU), has had an increased incidence and prevalence over the last years with a simultaneous decrease in its short-term mortality. Sepsis survivors are more frequently discharged from hospital and often experience long-term outcomes such as late mortality, immune dysfunction, secondary infections, impaired quality of life, and unplanned readmissions. Early recognition and management of sepsis have challenged emergency care and critical care physicians and nurses...
July 12, 2017: Journal of Innate Immunity
https://www.readbyqxmd.com/read/28691958/guidelines-for-the-provision-and-assessment-of-nutrition-support-therapy-in-the-pediatric-critically-ill-patient-society-of-critical-care-medicine-and-american-society-for-parenteral-and-enteral-nutrition
#20
Nilesh M Mehta, Heather E Skillman, Sharon Y Irving, Jorge A Coss-Bu, Sarah Vermilyea, Elizabeth Anne Farrington, Liam McKeever, Amber M Hall, Praveen S Goday, Carol Braunschweig
This document represents the first collaboration between two organizations, American Society of Parenteral and Enteral Nutrition and the Society of Critical Care Medicine, to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric (> 1 mo and < 18 yr) critically ill patient expected to require a length of stay greater than 2 or 3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2,032 citations were scanned for relevance...
July 2017: Pediatric Critical Care Medicine
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