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https://www.readbyqxmd.com/read/29351143/nutrition-in-the-icu-new-trends-versus-old-fashioned-standard-enteral-feeding
#1
Kristine W A C Koekkoek, Arthur R H van Zanten
PURPOSE OF REVIEW: The narrative review aims to summarize the relevant studies from the last 2 years and provide contextual information to understand findings. RECENT FINDINGS: Recent ICU studies have provided insight in the pathophysiology and time course of catabolism, anabolic resistance, and metabolic and endocrine derangements interacting with the provision of calories and proteins.Early provision of high protein intake and caloric overfeeding may confer harm...
January 18, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29340856/core-point-of-care-ultrasound-curriculum-what-does-every-anesthesiologist-need-to-know
#2
REVIEW
Massimiliano Meineri, Gregory L Bryson, Ramiro Arellano, Nikolaos Skubas
Point-of-care ultrasound (POCUS) is becoming an integral part of anesthesia practice throughout the world. Despite the growing interest in POCUS among trainees and faculty, POCUS training is variable among universities across Canada. This suggests a need for curriculum development and standardization. International guidelines for Emergency Medicine and Critical Care have common frameworks and may be used as a reference to model anesthesia-specific curricula. The Royal College of Anaesthetists of the United Kingdom currently offers the only nationally approved POCUS curriculum for anesthesia and critical care trainees...
January 16, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#3
Mary Beth Flynn Makic, Elizabeth Bridges
Recent updates emphasize early recognition and prompt intervention. ABSTRACT: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence...
January 11, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29327135/acquiring-and-maintaining-point-of-care-ultrasound-pocus-competence-for-anesthesiologists
#4
REVIEW
T Jared McCormick, Elizabeth Clarke Miller, Robert Chen, Viren N Naik
PURPOSE: Point-of-care ultrasound (POCUS) involves the bedside use of ultrasound to answer specific diagnostic questions and to assess real-time physiologic responses to treatment. Although POCUS has become a well-established resource for emergency and critical care physicians, anesthesiologists are still working to obtain POCUS skills and to incorporate them into routine practice. This review defines the benefits of POCUS to anesthesia practice, identifies challenges to establishing POCUS in routine anesthesia care, and offers solutions to help guide its incorporation going forward...
January 11, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29310974/sepsis-in-tropical-regions-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#5
Steven McGloughlin, Guy A Richards, Mohd Basri Mat Nor, Shirish Prayag, Tim Baker, Pravin Amin
Sepsis and septic shock in the tropics are caused by a wide array of organisms. These infections are encountered mainly in low and middle-income countries (LMIC) where a lack of infrastructure and medical facilities contribute to the high morbidity and mortality. Published sepsis guidelines are based on studies primarily performed in high income countries and as such recommendations may or may not be relevant to practice in the tropics. Failure to adhere to guidelines, particularly among non-intensive care specialists even in high-income countries, is an area of concern for sepsis management...
December 30, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29305954/clinical-use-of-the-polymyxins-the-tale-of-the-fox-and-the-cat
#6
Eric Wenzler, Kristen L Bunnell, Larry H Danziger
BACKGROUND: There is a need to identify practice patterns of polymyxin use, quantify gaps in knowledge, and recognize areas of persistent confusion. METHODS: A structured electronic survey was distributed to physicians, pharmacists, and microbiologists. Demographic information was obtained along with data regarding the availability, stewardship principles, therapeutic usage, dosing, microbiological testing, and knowledge, attitudes, and beliefs regarding the polymyxins...
January 3, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29304308/acute-kidney-injury-and-sepsis
#7
Steven J Skube, Stephen A Katz, Jeffrey G Chipman, Christopher J Tignanelli
BACKGROUND: Worldwide, both acute kidney injury (AKI) and sepsis are significant clinical complications, particularly in critical care patients. Sepsis is an important cause of AKI, and AKI is a common complication of sepsis. METHODS: We reviewed the literature, including current practice guidelines, on sepsis-associated AKI. RESULTS: We assessed causes of renal failure, potential mechanisms of sepsis-associated acute kidney injury, current practice guidelines, diagnostic criteria and methods, prevention strategies, treatment options, and outcomes...
January 5, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29295760/the-contents-of-a-patient-diary-and-its-significance-for-persons-cared-for-in-an-icu-a-qualitative-study
#8
Sandra Strandberg, Lisa Vesterlund, Åsa Engström
OBJECTIVES: The aim of this study was to describe the contents of a patient diary and its significance for persons cared for in an ICU. RESEARCH METHODOLOGY: An empirical study with a qualitative design. Eight telephone interviews and one face-to-face interview were conducted with nine persons previously been treated in an ICU and been given a patient diary. In addition, the person would have read his/her diary. The data have been analysed with qualitative content analysis...
December 30, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29284322/maximizing-nutrition-support-practice-and-measuring-adherence-to-nutrition-support-guidelines-in-a-canadian-tertiary-care-icu
#9
Michele E McCall, Alice Adamo, Katherine Latko, Ashley K Rieder, Nicole Durand, Tova Nathanson
OBJECTIVE: New comprehensive guidelines for nutrition support (NS) in the intensive care unit (ICU) can be used to improve quality of care and benchmark current practice. The objective of this study was to (a) compare NS practices in our medical/surgical ICU (MSICU) to 18 recommendations described in the Canadian Clinical Practice Guidelines and Society of Critical Care Medicine/American Society of Parenteral and Enteral Nutrition guidelines, (b) determine the percentage of goal calories and protein delivered, and (c) identify the barriers to successful NS delivery...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29279413/association-between-diastolic-blood-pressure-during-pediatric-in-hospital-cardiopulmonary-resuscitation-and-survival
#10
Robert A Berg, Robert M Sutton, Ron W Reeder, John T Berger, Christopher J Newth, Joseph A Carcillo, Patrick S McQuillen, Kathleen L Meert, Andrew R Yates, Rick E Harrison, Frank W Moler, Murray M Pollack, Todd C Carpenter, David L Wessel, Tammara L Jenkins, Daniel A Notterman, Richard Holubkov, Robert F Tamburro, J Michael Dean, Vinay M Nadkarni
Background -Based on laboratory cardiopulmonary resuscitation (CPR) investigations and limited adult data demonstrating that survival depends on attaining adequate arterial diastolic blood pressure (DBP) during CPR, American Heart Association recommends using BP to guide pediatric CPR. However, evidence-based BP targets during pediatric CPR remain an important knowledge gap for CPR guidelines. Methods -All children ≥37 weeks gestation and <19 years old in Collaborative Pediatric Critical Care Research Network intensive care units with chest compressions for ≥1 minute and invasive arterial blood pressure monitoring prior to and during CPR between July 1, 2013 and June 31, 2016 were included...
December 26, 2017: Circulation
https://www.readbyqxmd.com/read/29276852/organ-donor-management-part-1-toward-a-consensus-to-guide-anesthesia-services-during-donation-after-brain-death
#11
Michael J Souter, E Eidbo, James Y Findlay, Daniel J Lebovitz, Marina Moguilevitch, Nikole A Neidlinger, Gerhard Wagener, Anil S Paramesh, Claus U Niemann, Pamela R Roberts, Ernesto A Pretto
Worldwide 715 482 patients have received a lifesaving organ transplant since 1988. During this time, there have been advances in donor management and in the perioperative care of the organ transplant recipient, resulting in marked improvements in long-term survival. Although the number of organs recovered has increased year after year, a greater demand has produced a critical organ shortage. The majority of organs are from deceased donors; however, some are not suitable for transplantation. Some of this loss is due to management of the donor...
December 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29262441/imaging-in-neurocritical-care-practice
#12
Craig Williamson, Larry Morgan, Joshua P Klein
The use of neuroimaging in conjunction with serial neurological examinations is a core component of modern neurocritical care practice. Although there is a growing role for other neuromonitoring techniques, the ability to quickly and accurately interpret images in the context of a patient's clinical status arguably remains the indispensable skill for neurocritical care practitioners. Due to its rapid acquisition time and excellent ability to detect intracerebral hemorrhage (ICH), cerebral edema, and signs of elevated intracranial pressure, computed tomography (CT) remains the most useful neuroimaging technique for intensive care unit (ICU) patients...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29262437/ictal-interictal-continuum-when-to-worry-about-the-continuous-electroencephalography-pattern
#13
Justine Cormier, Carolina B Maciel, Emily J Gilmore
Continuous electroencephalography (cEEG) monitoring is an invaluable tool in the evaluation of encephalopathy and coma in critically ill patients. Marked increases in cEEG monitoring, coinciding with several societal guideline statements in the last decade, have allowed earlier detection and treatment of clearly harmful patterns, including nonconvulsive seizures (NCSz) and nonconvulsive status epilepticus (NCSE). However, it has also unmasked a range of EEG patterns of less clear clinical significance, with some more "malignant" than others given their potential association with increased neuronal stress and secondary brain injury...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29246795/acccn-workforce-standards-for-intensive-care-nursing-systematic-and-evidence-review-development-and-appraisal
#14
Diane Chamberlain, Wendy Pollock, Paul Fulbrook
BACKGROUND: The intensive care nursing workforce plays an essential role in the achievement of positive healthcare outcomes. A growing body of evidence indicates that inadequate nurse staffing and poor skill mix are associated with negative outcomes for patients, and potentially compromises nurses' ability to maintain the safety of those in their care. In Australia, the Australian College of Critical Care Nurses (ACCCN) has previously published a position statement on intensive care staffing...
December 12, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29244842/intensive-care-treatments-associated-with-favorable-discharge-outcomes-in-argentine-children-with-severe-traumatic-brain-injury-for-the-south-american-guideline-adherence-group
#15
Monica S Vavilala, Silvia B Lujan, Qian Qiu, Michael J Bell, Nicolás M Ballarini, Nahuel Guadagnoli, María Alejandra Depetris, Gabriela A Faguaga, Gloria M Baggio, Leonardo O Busso, Mirta E García, Osvaldo R González Carrillo, Paula L Medici, Silvia S Sáenz, Elida E Vanella, Carly K Farr, Gustavo J Petroni
OBJECTIVE: Little is known about the critical care management of children with traumatic brain injury (TBI) in low middle income countries. We aimed to identify indicators of intensive care unit (ICU) treatments associated with favorable outcomes in Argentine children with severe TBI. METHODS: We conducted a secondary analysis of data from patients previously enrolled in a prospective seven center study of children with severe TBI who were admitted to an ICU in one of the seven study centers...
2017: PloS One
https://www.readbyqxmd.com/read/29243536/variation-in-pediatric-organ-donor-management-practices-among-us-organ-procurement-organizations
#16
Robert S Ream, Eric S Armbrecht
INTRODUCTION: Reports of actual pediatric organ donor management practice among US organ procurement organizations are sparse, and the use of standardized management guidelines is unknown. A recent consensus statement from the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations offers guidelines for the management of the pediatric organ donor. RESEARCH QUESTION: To describe the use of guidelines and routine practices in the management of the pediatric organ donor with respect to hemodynamics, lung and ventilator management, fluid and electrolytes, hormonal replacement therapy, the use of blood products, thermoregulation, and prophylactic antibiotics...
January 1, 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29214518/outcome-of-older-persons-admitted-to-intensive-care-unit-mortality-prognosis-factors-dependency-scores-and-ability-trajectory-within-1%C3%A2-year-a-prospective-cohort-study
#17
Claude Level, Eric Tellier, Patrick Dezou, Karim Chaoui, Aissa Kherchache, Philippe Sejourné, Anne Marie Rullion-Pac Soo
BACKGROUND: The outcome and functional trajectory of older persons admitted to intensive care (ICU) unit remain a true question for critical care physicians and geriatricians, due to the heterogeneity of geriatric population, heterogeneity of practices and absence of guidelines. AIM: To describe the 1-year outcome, prognosis factors and functional trajectory for older people admitted to ICU. METHODS: In a prospective 1-year cohort study, all patients aged 75 years and over admitted to our ICU were included according to a global comprehensive geriatric assessment...
December 6, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29210769/direct-observation-of-medication-errors-in-critical-care-setting-a-systematic-review
#18
Margaret J Foster, Jodie C Gary, Sreedevi Moodahanglur Sooryanarayana
Medication errors continue to be an issue for the critically ill and are costly to both patients and health care facilities. This article reviews published research about these errors and reports results of observational studies. The types of errors, incidence, and root causes have been considered along with adverse consequences. The implications for bedside practice as a result of this review are fairly straightforward. Medication errors are happening at an alarming rate in the critical care environment, and these errors are preventable...
January 2018: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/29206731/enteral-feeding-practices-in-infants-with-congenital-heart-disease-across-european-picus-a-european-society-of-pediatric-and-neonatal-intensive-care-survey
#19
Lyvonne N Tume, Reinis Balmaks, Eduardo da Cruz, Lynne Latten, Sascha Verbruggen, Frédéric V Valla
OBJECTIVES: To describe enteral feeding practices in pre and postoperative infants with congenital heart disease in European PICUs. DESIGN: Cross-sectional electronic survey. SETTING: European PICUs that admit infants with congenital heart disease pre- and postoperatively. PARTICIPANTS: One senior PICU physician or designated person per unit. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Fifty-nine PICUs from 18 European countries responded to the survey...
December 4, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29206729/extracorporeal-cardiopulmonary-resuscitation-in-the-pediatric-cardiac-population-in-search-of-a-standard-of-care
#20
Javier J Lasa, Parag Jain, Tia T Raymond, Charles G Minard, Alexis Topjian, Vinay Nadkarni, Michael Gaies, Melania Bembea, Paul A Checchia, Lara S Shekerdemian, Ravi Thiagarajan
OBJECTIVES: Although clinical and pharmacologic guidelines exist for the practice of cardiopulmonary resuscitation in children (Pediatric Advanced Life Support), the practice of extracorporeal cardiopulmonary resuscitation in pediatric cardiac patients remains without universally accepted standards. We aim to explore variation in extracorporeal cardiopulmonary resuscitation procedures by surveying clinicians who care for this high-risk patient population. DESIGN: A 28-item cross-sectional survey was distributed via a web-based platform to clinicians focusing on cardiopulmonary resuscitation practices and extracorporeal membrane oxygenation team dynamics immediately prior to extracorporeal membrane oxygenation cannulation...
December 4, 2017: Pediatric Critical Care Medicine
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