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Functional status post icu

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https://www.readbyqxmd.com/read/29061618/critical-care-cycling-study-cyclist-trial-protocol-a-randomised-controlled-trial-of-usual-care-plus-additional-in-bed-cycling-sessions-versus-usual-care-in-the-critically-ill
#1
Marc R Nickels, Leanne M Aitken, James Walsham, Adrian G Barnett, Steven M McPhail
INTRODUCTION: In-bed cycling with patients with critical illness has been shown to be safe and feasible, and improves physical function outcomes at hospital discharge. The effects of early in-bed cycling on reducing the rate of skeletal muscle atrophy, and associations with physical and cognitive function are unknown. METHODS AND ANALYSIS: A single-centre randomised controlled trial in a mixed medical-surgical intensive care unit (ICU) will be conducted. Adult patients (n=68) who are expected to be mechanically ventilated for more than 48 hours and remain in ICU for a further 48 hours from recruitment will be randomly allocated into either (1) a usual care group or (2) a group that receives usual care and additional in-bed cycling sessions...
October 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29022204/the-relationship-between-single-and-two-dimensional-indices-of-left-ventricular-size-using-hemodynamic-transesophageal-echocardiography-in-trauma-and-burn-patients
#2
Duraid Younan, T Mark Beasley, David C Pigott, C Blayke Gibson, John P Gullett, Jeffrey Richey, Jean-Francois Pittet, Ahmed Zaky
BACKGROUND: Conventional echocardiographic technique for assessment of volume status and cardiac contractility utilizes left ventricular end-diastolic area (LVEDA) and fractional area of change (FAC), respectively. Our goal was to find a technically reliable yet faster technique to evaluate volume status and contractility by measuring left ventricular end-diastolic diameter (LVEDD) and fractional shortening (FS) in a cohort of mechanically ventilated trauma and burn patients using hemodynamic transesophageal echocardiographic (hTEE) monitoring...
October 11, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28841893/the-role-of-nutritional-support-in-the-physical-and-functional-recovery-of-critically-ill-patients-a-narrative-review
#3
REVIEW
Danielle E Bear, Liesl Wandrag, Judith L Merriweather, Bronwen Connolly, Nicholas Hart, Michael P W Grocott
The lack of benefit from randomised controlled trials has resulted in significant controversy regarding the role of nutrition during critical illness in terms of long-term recovery and outcome. Although methodological caveats with a failure to adequately appreciate biological mechanisms may explain these disappointing results, it must be acknowledged that nutritional support during early critical illness, when considered alone, may have limited long-term functional impact.This narrative review focuses specifically on recent clinical trials and evaluates the impact of nutrition during critical illness on long-term physical and functional recovery...
August 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28736089/long-term-cognitive-impairment-and-delirium-in-intensive-care-a-prospective-cohort-study
#4
Marion L Mitchell, David H K Shum, Gabor Mihala, Jenny E Murfield, Leanne M Aitken
BACKGROUND: Whilst there is a growing body of research exploring the effect of delirium in intensive care unit (ICU) patients, the relationship between patient delirium and long-term cognitive impairment has not been investigated in settings where low rates of delirium have been reported. OBJECTIVES: To assess the association between the incidence of delirium, duration of mechanical ventilation and long term cognitive impairment in general ICU patients. METHODS: Prospective cohort study conducted in a tertiary level ICU in Queensland, Australia...
July 20, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28713659/a-descriptive-report-of-early-mobilization-for-critically-ill-ventilated-patients-with-cancer
#5
Amanda Weeks, Claudine Campbell, Prabalini Rajendram, Weiji Shi, Louis Voigt
BACKGROUND: Early mobilization protocols have been successfully implemented to improve function in critically ill patients; however, no study has focused on the oncology population. OBJECTIVES: To investigate the feasibility of early mobilization and describe the rehabilitation interventions and discharge outcomes in a cohort of critically ill patients with cancer. DESIGN: Retrospective review. METHODS: A retrospective analysis of patients with cancer who participated in occupational and physical therapy while on mechanical ventilation utilizing an institutional early mobilization protocol from June 2010 - July 2011, was completed...
July 2017: Rehabilitation Oncology
https://www.readbyqxmd.com/read/28688653/ethnic-disparities-in-traumatic-brain-injury-care-referral-in-a-hispanic-majority-population
#6
Hailey C Budnick, Alan H Tyroch, Stacey A Milan
BACKGROUND: Functional outcomes after traumatic brain injury (TBI) can be significantly improved by discharge to posthospitalization care facilities. Many variables influence the discharge disposition of the TBI patient, including insurance status, patient condition, and patient prognosis. The literature has demonstrated an ethnic disparity in posthospitalization care referral, with Hispanics being discharged to rehabilitation and nursing facilities less often than non-Hispanics. However, this relationship has not been studied in a Hispanic-majority population, and thus, this study seeks to determine if differences in neurorehabilitation referrals exist among ethnic groups in a predominately Hispanic region...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28648809/improving-quality-in-measuring-time-to-initiation-of-cpr-during-in-hospital-resuscitation
#7
Ashley Siems, Elyse Tomaino, Anne Watson, Michael C Spaeder, Lillian Su
OBJECTIVE: Time from the onset of "low or no flow" indicators of cardiac failure to initiation of cardiopulmonary resuscitation is an important quality metric thought to improve the likelihood of survival and preservation of end organ function. We hypothesized that delays in initiation of chest compressions were under recognized during in-hospital resuscitation and aimed to develop a system which identifies the actual time of deterioration during cardiac events. METHODS: Retrospective review on prospectively identified resuscitation records and monitor data were compared...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28592080/-complete-revascularization-for-multi-vessel-coronary-diseases-through-lower-ministernotomy-on-beating-heart-off-pump-surgery
#8
Z B Xiao, Y Zhang, J Z Guo, Y Y Li, Y P Zhang
Objective: To discuss a novel method of complete revascularization for multi-vessel coronary diseases on beating heart off-pump surgery through lower ministernotomy. Methods: Clinical data of 79 patients underwent ministernotomy off-pump coronary artery bypass from January 2015 to May 2016 at Department of Cardiac Surgery, Heart Center, Beijing Friendship Hospital, Capital Medical University were analyzed retrospectively. There were 62 male and 17 female patients, with an average age of (65±9) years. All the patients were multi-vessel coronary diseases and planned to receive coronary artery bypass grafting...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28495240/risk-factors-for-pulmonary-complication-following-fixation-of-spine-fractures
#9
Douglas S Weinberg, Brian Z Hedges, Jonathan E Belding, Timothy A Moore, Heather A Vallier
BACKGROUND CONTEXT: Previous studies have suggested pulmonary complications are common among patients undergoing fixation for traumatic spine fractures. This leads to prolonged hospital stay, worse functional outcomes, and increased economic burden. However, only limited prognostic information exists regarding which patients are at greatest risk for pulmonary complications. PURPOSE: This study aimed to identify factors predictive of perioperative pulmonary complications in patients undergoing fixation of spine fractures...
May 8, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28463657/instrumental-activities-of-daily-living-after-critical-illness-a-systematic-review
#10
Ramona O Hopkins, Mary R Suchyta, Biren B Kamdar, Emily Darowski, James C Jackson, Dale M Needham
RATIONALE: Poor functional status is common after critical illness, and can adversely impact the abilities of intensive care unit (ICU) survivors to live independently. Instrumental activities of daily living (IADL), which encompass complex tasks necessary for independent living, are a particularly important component of post-ICU functional outcome. OBJECTIVES: To conduct a systematic review of studies evaluating IADLs in survivors of critical illness. METHODS: We searched PubMed, CINAHL, Cochrane Library, SCOPUS, and Web of Science for all relevant English-language studies published through December 31, 2016...
August 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28330483/predictors-of-hospital-and-one-year-mortality-in-intensive-care-patients-with-refractory-status-epilepticus-a-population-based-study
#11
Anne-Mari Kantanen, Reetta Kälviäinen, Ilkka Parviainen, Marika Ala-Peijari, Tom Bäcklund, Juha Koskenkari, Ruut Laitio, Matti Reinikainen
BACKGROUND: The aim was to determine predictors of hospital and 1-year mortality in patients with intensive care unit (ICU)-treated refractory status epilepticus (RSE) in a population-based study. METHODS: This was a retrospective study of the Finnish Intensive Care Consortium (FICC) database of adult patients (16 years of age or older) with ICU-treated RSE in Finland during a 3-year period (2010-2012). The database consists of admissions to all 20 Finnish hospitals treating RSE in the ICU...
March 23, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28325778/extracorporeal-life-support-as-a-bridge-to-lung-transplantation-a-single-center-experience-with-an-emphasis-on-health-related-quality-of-life
#12
Annemieke Oude Lansink-Hartgring, Wim van der Bij, Erik A Verschuuren, Michiel E Erasmus, Adrianus J de Vries, Karin M Vermeulen, Walter M van den Bergh
BACKGROUND: Extracorporeal life support (ECLS) as a bridge to lung transplantation is increasingly used, but information on long-term outcome is scarce. We aim to summarize our experience with an emphasis on health-related quality of life. Secondary outcomes include ICU and hospital stay and pre- and post-transplant mortality. METHODS: A retrospective cohort study of all adult subjects receiving ECLS as a bridge to lung transplantation from 2010 to 2014 was reviewed and compared with all adult subjects who underwent bilateral lung transplantation in the same period...
March 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28325699/spinal-correction-in-patients-with-fukuyama-congenital-muscular-dystrophy
#13
Wataru Saito, Takanori Namba, Gen Inoue, Takayuki Imura, Masayuki Miyagi, Toshiyuki Nakazawa, Eiki Shirasawa, Kentaro Uchida, Masashi Takaso
BACKGROUND: Fukuyama congenital muscular dystrophy (FCMD) is one of the most common congenital progressive muscular dystrophies in Japan. Some patients develop a severe spinal deformity that leads to an unstable sitting position or pain. Since 2008, we have treated FCMD using posterior spinal fusion. This study reports the short-term clinical and radiographic results of posterior spinal correction and fusion in FCMD. METHODS: We retrospectively reviewed 11 consecutive FCMD patients, average age 13 years old, treated with posterior spinal instrumentation and fusion between 2008 and 2015...
March 18, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28271450/patient-important-outcomes-in-randomized-controlled-trials-in-critically-ill-patients-a-systematic-review
#14
REVIEW
Stéphane Gaudry, Jonathan Messika, Jean-Damien Ricard, Sylvie Guillo, Blandine Pasquet, Emeline Dubief, Tanissia Boukertouta, Didier Dreyfuss, Florence Tubach
BACKGROUND: Intensivists' clinical decision making pursues two main goals for patients: to decrease mortality and to improve quality of life and functional status in survivors. Patient-important outcomes are gaining wide acceptance in most fields of clinical research. We sought to systematically review how well patient-important outcomes are reported in published randomized controlled trials (RCTs) in critically ill patients. METHODS: Literature search was conducted to identify eligible trials indexed from January to December 2013...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28057565/development-and-validation-of-a-continuously-age-adjusted-measure-of-patient-condition-for-hospitalized-children-using-the-electronic-medical-record
#15
Michael J Rothman, Joseph J Tepas, Andrew J Nowalk, James E Levin, Joan M Rimar, Albert Marchetti, Allen L Hsiao
Awareness of a patient's clinical status during hospitalization is a primary responsibility for hospital providers. One tool to assess status is the Rothman Index (RI), a validated measure of patient condition for adults, based on empirically derived relationships between 1-year post-discharge mortality and each of 26 clinical measurements available in the electronic medical record. However, such an approach cannot be used for pediatrics, where the relationships between risk and clinical variables are distinct functions of patient age, and sufficient 1-year mortality data for each age group simply does not exist...
January 2, 2017: Journal of Biomedical Informatics
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
#16
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/27916062/-perioperational-management-of-gynecological-cancer-patients-with-severe-internal-medical-complications-a-serial-of-37-clinical-cases
#17
J Hu, W Q Lyu, Y L Guo, H W Wen, H Qiao, Y Qu
Objective: To evaluate the effectiveness and safety of perioperational management of gynecological cancer patients with severe internal medical complications. Methods: We collected 37 cases of gynecological cancer patients with severe internal medical complications who were hospitalized in Peking University First Hospital from Jan. 2010 to Nov. 2014. All of the cases were planned to move to ICU right after operation based on the preoperational assessment of anesthetist and physician. The median age was 69.4 years, and 25 cases (68%,25/37) of them were over 70 years old...
November 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27881152/fitness-and-mobility-training-in-patients-with-intensive-care-unit-acquired-muscle-weakness-fitonicu-study-protocol-for-a-randomised-controlled-trial
#18
Jan Mehrholz, Simone Thomas, Jane H Burridge, André Schmidt, Bettina Scheffler, Ralph Schellin, Stefan Rückriem, Daniel Meißner, Katja Mehrholz, Wolfgang Sauter, Ulf Bodechtel, Bernhard Elsner
BACKGROUND: Critical illness myopathy (CIM) and polyneuropathy (CIP) are a common complication of critical illness. Both cause intensive-care-unit-acquired (ICU-acquired) muscle weakness (ICUAW) which increases morbidity and delays rehabilitation and recovery of activities of daily living such as walking ability. Focused physical rehabilitation of people with ICUAW is, therefore, of great importance at both an individual and a societal level. A recent systematic Cochrane review found no randomised controlled trials (RCT), and thus no supporting evidence, for physical rehabilitation interventions for people with defined CIP and CIM to improve activities of daily living...
November 24, 2016: Trials
https://www.readbyqxmd.com/read/27822310/anaphylactic-shock-during-cement-implantation-of-a-total-hip-arthroplasty-in-a-patient-with-underlying-mastocytosis-case-report-of-a-rare-intraoperative-complication
#19
Anita Ten Hagen, Pieter Doldersum, Tom van Raaij
BACKGROUND: Cemented total hip arthroplasty (THA) is a safe and common procedure. In rare cases life threatening bone cement implantation syndrome (BCIS) may occur, which is commonly caused by pulmonary embolism (PE). CASE PRESENTATION: We describe the rare case of a 70-year old patient who underwent an elective total hip replacement. Before surgery he was diagnosed with underlying systemic indolent mastocytosis, a rare pathological disorder that may result in anaphylaxis after massive systemic mast cell activation...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27703584/the-role-of-levosimendan-in-patients-with-decreased-left-ventricular-function-undergoing-cardiac-surgery
#20
REVIEW
Marija Bozhinovska, Gordana Taleska, Andrej Fabian, Maja Šoštarič
The postoperative low cardiac output is one of the most important complications following cardiac surgery and is associated with increased morbidity and mortality. The condition requires inotropic support to achieve adequate hemodynamic status and tissue perfusion. While catecholamines are utilised as a standard therapy in cardiac surgery, their use is limited due to increased oxygen consumption. Levosimendan is calcium sensitising inodilatator expressing positive inotropic effect by binding with cardiac troponin C without increasing oxygen demand...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
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