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https://www.readbyqxmd.com/read/28937572/obstetric-care-consensus-no-6-periviable-birth
#1
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937567/obstetric-care-consensus-no-6-summary-periviable-birth
#2
(no author information available yet)
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28937547/management-of-emergency-electroconvulsive-therapy-in-the-intensive-care-unit-for-life-threatening-psychiatric-conditions-a-case-series
#3
Samuel Bulteau, Edouard-Jules Laforgue, Loïc Chimot, Romain Dumont, Olivier Loutrel, François Etcheverrigaray, Caroline Victorri-Vigneau, Alexandre Massri, Jean-Marie Vanelle, Anne Sauvaget
Catatonia can lead to severe complications and may be lethal but is often underdiagnosed. The clinical presentation can be similar to coma. In these situations, electroconvulsive therapy (ECT) can be used as first-line treatment to enable extubation, recovery of autonomy, and rapid discharge from intensive care. We report 4 cases of patients hospitalized in the intensive care unit with comatose clinical presentation and life-threatening condition caused by catatonia. All patients received ECT sessions, after which the catatonic symptoms partially or fully remitted...
September 20, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28937074/clinicoepidemiological-profile-of-peritonitis-complicating-acute-peritoneal-dialysis-a-single-center-experience
#4
Kunal Gandhi, Dharmendra Prasad, Vinay Malhotra, Dhananjai Agrawal, Pankaj Beniwal, Amith Vijay Leon Dsouza
A prospective observational study examining the incidence and microbiological aspects of peritonitis complicating acute intermittent peritoneal dialysis (IPD) was performed. A total of 145 acute IPD treatments were included involving 112 patients. The majority of patients suffered from acute kidney injury (72.3%) secondary to sepsis. Peritonitis occurred in 31 treatment sessions, giving a frequency of 21.4% of procedures performed. The mean interval between starting dialysis and the first sign of peritonitis was 2...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28937056/serum-cystatin-c-as-an-earlier-predictor-of-acute-kidney-injury-than-serum-creatinine-in-preterm-neonates-with-respiratory-distress-syndrome
#5
Noha Ahmed Abdelaal, Sherein Abdelhamid Shalaby, Abdelmoneim Kassem Khashana, Amina Mohamed Abdelwahab
In this study, we aimed to evaluate serum cystatin C (sCysC) as an early predictor of acute kidney injury (AKI) in preterm neonates with respiratory distress syndrome (RDS). Sixty preterm neonates diagnosed with RDS and 40 healthy controls (28-36 weeks) admitted to the neonatal Intensive Care Unit were investigated. AKI was defined on the 3rd day of life (DOL-3) as an increase in serum creatinine (sCr) of >0.3 mg/dL from baseline (the lowest previous sCr). sCysC levels were measured on DOL-1, -3 and -7. Of the 60 neonates with RDS, 24 (40%) developed AKI...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28936996/caregiver-perceptions-on-intensive-care-a-qualitative-study-from-southern-india
#6
Shuba Kumar, Jony Christina, Anna Revathi Jagadish, John Victor Peter, Kurien Thomas, Thambu David Sudarsanam
BACKGROUND: Admission of a patient to an intensive care unit (ICU) can result in tremendous stress to family caregivers not only because of the need to provide physical and emotional support to the sick relative, but also due to the burden of decision-making on behalf of the critically ill person. We enquired about family caregivers' perspectives on intensive care, the challenges they faced with decision-making and their perceptions on the nature of their interactions with healthcare providers...
May 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28936968/-progress-of-pain-assessment-and-analgesia-strategy-for-mechanical-ventilation-patients
#7
Qingdong Li, Xianyao Wan
Standardized pain assessment is a precondition of appropriate analgesia for mechanical ventilation patients. However, routine pain assessment rates remain very low in intensive care unit (ICU). Behavioral pain scale (BPS) and critical-care pain observation tool (CPOT) can be used to assess pain in mechanical ventilation patients who are unable to report pain by themselves. No matter what strategy we taken, analgesia-first sedation should be used in priority. Meanwhile, patient-centered and goal-directed sedation strategy should be adopted based on the individual condition...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936967/-effect-of-sedation-on-respiratory-function-of-patients-undergoing-mechanical-ventilation
#8
Jie Yang, Yan Kang
Sedation and analgesia for ventilated patients is an important treatment in intensive care unit (ICU). Patients receiving mechanical ventilation therapy comfortably and safely can improve patient-ventilator synchrony, reduce ventilation-related lung injury (VILI), improve compliance, decrease oxygen consumption and stress, prevent accidents, and reduce the incidence of complications and mortality in critical patients. Although sedation may protect lung function, it also has a greater impact on respiratory function...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936962/-evaluation-of-the-effect-of-a-new-fixation-tape-for-tracheal-catheter-in-intensive-care-patients
#9
Limin Chen, Ruihong Liu, Biyu Shen, Lingling Wang, Zhiming Cui, Guanhua Xu
OBJECTIVE: To evaluate the effect of a new type of fixation tape for tracheal catheter in intensive care patients. METHODS: A purposive sampling study was conducted. Ninety patients experienced oral tracheal intubation for mechanical ventilation, and admitted to respiratory intensive care unit (ICU) of the Second Affiliated Hospital of Nantong University from November 2015 to February 2017 were enrolled. All the patients were randomly (random number) divided into the control group and the observation group with 45 patients in each group...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936959/-correlation-between-apache-ii-scores-and-delirium-probability-of-senile-severe-pneumonia-patients-undergoing-invasive-mechanical-ventilation
#10
Xinghua Pei, Haiming Yu, Yanhong Wu, Xu Zhou
OBJECTIVE: To investigate the correlation between acute physiology and chronic health evaluation II (APACHE II) scores and delirium probability of senile severe pneumonia patients undergoing invasive mechanical ventilation (MV). METHODS: A retrospective study was conducted. Eighty-nine senile severe pneumonia patients undergoing invasive MV admitted to intensive care unit (ICU) of Hunan Provincial People's Hospital from January 2015 to March 2017 were enrolled. APACHE II scores were collected 24 hours before invasive MV...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936957/-pk-pd-of-vancomycin-in-patients-with-severe-acute-pancreatitis-combined-with-augmented-renal-clearance
#11
Juan He, Enqiang Mao, Feng Jing, Huiting Jiang, Wenyun Xu, Wanhua Yang, Erzhen Chen
OBJECTIVE: To evaluate the serum trough concentration and the pharmacokinetics/pharmacodynamics (PK/PD) of vancomycin in patients with severe acute pancreatitis (SAP), and analyze the effect of vancomycin continuous infusion for optimizing the characteristics of its PK/PD. METHODS: The inhospital patients with SAP received vancomycin treatment and admitted to emergency intensive care unit (EICU) of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2011 to December 2016 were enrolled...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936952/-application-of-injection-test-in-confirming-the-ideal-position-of-esophageal-balloon-catheter
#12
Han Chen, Ming Xu, Yanlin Yang, Xuan He, Jianxin Zhou
OBJECTIVE: To evaluate the safety and feasibility of injection test which is used to locate esophageal balloon catheter. METHODS: A prospective study was conducted. The patients undergoing invasive mechanical ventilation (MV) admitted to general intensive care unit (ICU) of Beijing Tiantan Hospital Affiliated to Capital Medical University from May 2015 and March 2017 were enrolled. The commercially available esophageal balloon catheter was modified to perform injection test...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936712/early-goal-directed-nutrition-versus-standard-of-care-in-adult-intensive-care-patients-the-single-centre-randomised-outcome-assessor-blinded-eat-icu-trial
#13
Matilde Jo Allingstrup, Jens Kondrup, Jørgen Wiis, Casper Claudius, Ulf Gøttrup Pedersen, Rikke Hein-Rasmussen, Mads Rye Bjerregaard, Morten Steensen, Tom Hartvig Jensen, Theis Lange, Martin Bruun Madsen, Morten Hylander Møller, Anders Perner
PURPOSE: We assessed the effects of early goal-directed nutrition (EGDN) vs. standard nutritional care in adult intensive care unit (ICU) patients. METHODS: We randomised acutely admitted, mechanically ventilated ICU patients expected to stay longer than 3 days in the ICU. In the EGDN group we estimated nutritional requirements by indirect calorimetry and 24-h urinary urea aiming at covering 100% of requirements from the first full trial day using enteral and parenteral nutrition...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28936675/reconnection-to-mechanical-ventilation-for-1%C3%A2-h-after-a-successful-spontaneous-breathing-trial-reduces-reintubation-in-critically-ill-patients-a-multicenter-randomized-controlled-trial
#14
M Mar Fernandez, Alejandro González-Castro, Monica Magret, M Teresa Bouza, Marcos Ibañez, Carolina García, Begoña Balerdi, Arantxa Mas, Vanesa Arauzo, José M Añón, Francisco Ruiz, José Ferreres, Roser Tomás, Marta Alabert, Ana Isabel Tizón, Susana Altaba, Noemi Llamas, Rafael Fernandez
BACKGROUND: Spontaneous breathing trials (SBT) can be exhausting, but the preventive role of rest has never been studied. This study aimed to evaluate whether reconnection to mechanical ventilation (MV) for 1 h after the effort of a successful SBT could reduce the need for reintubation in critically ill patients. METHODS: Randomized multicenter trial conducted in 17 Spanish medical-surgical intensive care units (Oct 2013-Jan 2015). Patients under MV for longer than 12 h who fulfilled criteria for planned extubation were randomly allocated after a successful SBT to direct extubation (control group) or reconnection to the ventilator for a 1-h rest before extubation (rest group)...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28936495/the-accuracy-of-nurses-predictions-for-clinical-outcomes-in-the-chronically-critically-ill
#15
Amy R Lipson, Sarah J Miano, Barbara J Daly, Sara L Douglas
BACKGROUND: Accurately predicting survivorship of patients in the intensive care unit is known to be difficult. Previous research has shown that nurses are more likely to recognize futile medical care than other disciplines. The purpose of this study was to describe the accuracy of nurse's predictions for survival of patients who are chronically critically ill (CCI). METHODS: Using a secondary data analysis from a longitudinal, descriptive study, we evaluated nurses' predictions for survival at admission and until ICU discharge or patient death...
September 2017: Research & Reviews: Journal of Nursing and Health Sciences
https://www.readbyqxmd.com/read/28935832/an-electronic-trigger-based-on-care-escalation-to-identify-preventable-adverse-events-in-hospitalised-patients
#16
Viraj Bhise, Dean F Sittig, Viralkumar Vaghani, Li Wei, Jessica Baldwin, Hardeep Singh
BACKGROUND: Methods to identify preventable adverse events typically have low yield and efficiency. We refined the methods of Institute of Healthcare Improvement's Global Trigger Tool (GTT) application and leveraged electronic health record (EHR) data to improve detection of preventable adverse events, including diagnostic errors. METHODS: We queried the EHR data repository of a large health system to identify an 'index hospitalization' associated with care escalation (defined as transfer to the intensive care unit (ICU) or initiation of rapid response team (RRT) within 15 days of admission) between March 2010 and August 2015...
September 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28935558/immediate-interruption-of-sedation-compared-with-usual-sedation-care-in-critically-ill-postoperative-patients-sos-ventilation-a-randomised-parallel-group-clinical-trial
#17
Gerald Chanques, Matthieu Conseil, Claire Roger, Jean-Michel Constantin, Albert Prades, Julie Carr, Laurent Muller, Boris Jung, Fouad Belafia, Moussa Cissé, Jean-Marc Delay, Audrey de Jong, Jean-Yves Lefrant, Emmanuel Futier, Grégoire Mercier, Nicolas Molinari, Samir Jaber
BACKGROUND: Avoidance of excessive sedation and subsequent prolonged mechanical ventilation in intensive care units (ICUs) is recommended, but no data are available for critically ill postoperative patients. We hypothesised that in such patients stopping sedation immediately after admission to the ICU could reduce unnecessary sedation and improve patient outcomes. METHODS: We did a randomised, parallel-group, clinical trial at three ICUs in France. Stratified randomisation with minimisation (1:1 via a restricted web platform) was used to assign eligible patients (aged ≥18 years, admitted to an ICU after abdominal surgery, and expected to require at least 12 h of mechanical ventilation because of a critical illness defined by a Sequential Organ Failure Assessment score >1 for any organ, but without severe acute respiratory distress syndrome or brain injury) to usual sedation care provided according to recommended practices (control group) or to immediate interruption of sedation (intervention group)...
September 18, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28935523/an-outbreak-of-burkholderia-cepacia-pseudobacteraemia-caused-by-intrinsically-contaminated-commercial-0-5-chlorhexidine-solution-in-neonatal-intensive-care-units
#18
Je Eun Song, Yee Gyung Kwak, Tae Hyun Um, Chong Rae Cho, Sollip Kim, In Sook Park, Jong Hee Hwang, Namhee Kim, Gang-Bok Oh
BACKGROUND: Burkholderia cepacia is intrinsically resistant to certain antiseptics. We experienced a sudden increase in the frequency of isolation of B. cepacia from blood cultures in a neonatal intensive care unit (NICU) of a university-affiliated hospital. AIM: An investigation was conducted to identify the source and to intervene in the ongoing infections. METHODS: The cases were defined as patients with positive blood cultures for B. cepacia in a NICU between November 2014 and January 2015...
September 18, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28935438/lipids-in-the-intensive-care-unit-recommendations-from-the-espen-expert-group
#19
REVIEW
Philip C Calder, Michael Adolph, Nicolaas E Deutz, Teodoro Grau, Jacqueline K Innes, Stanislaw Klek, Shaul Lev, Konstantin Mayer, Adina T Michael-Titus, Lorenzo Pradelli, Mark Puder, Hester Vlaardingerbroek, Pierre Singer
This article summarizes the presentations given at an ESPEN Workshop on "Lipids in the ICU" held in Tel Aviv, Israel in November 2014 and subsequent discussions and updates. Lipids are an important component of enteral and parenteral nutrition support and provide essential fatty acids, a concentrated source of calories and building blocks for cell membranes. Whilst linoleic acid-rich vegetable oil-based enteral and parenteral nutrition is still widely used, newer lipid components such as medium-chain triglycerides and olive oil are safe and well tolerated...
September 7, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28935428/predictive-factors-for-the-outcome-of-high-flow-nasal-cannula-therapy-in-a-pediatric-intensive-care-unit-is-the-spo2-fio2-ratio-useful
#20
Fulya Kamit Can, Ayşe Berna Anil, Murat Anil, Neslihan Zengin, Fatih Durak, Caner Alparslan, Zeynep Goc
OBJECTIVES: To determine the predictive factors for the outcome of high-flow nasal cannula (HFNC) therapy in a pediatric intensive care unit (PICU). MATERIALS AND METHODS: We prospectively included all patients with acute respiratory distress/failure aged 1month to 18years who were admitted to the PICU between January 2015 and May 2016 and treated with HFNC as a primary support and for postextubation according to our pre-established protocol. HFNC failure was defined as the need for escalation to non-invasive ventilation (NIV) or invasive mechanical ventilation (MV)...
September 6, 2017: Journal of Critical Care
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